BREAST AUGMENTATION
For Size Enhancement and Minimal Lift

 Background
 Patient Groups
 Patient Concerns and Planning
 Preparing for Surgery
 The Operation
 Recovery
 At Home
 Office Visits and Follow-up
 Outcome and Complications
 Case Histories (Before and After)

OUTCOME AND COMPLICATIONS
The breasts will continue to settle, expand slightly, and rearrange themselves in the first six weeks following surgery. Subtle flaws in shape and symmetry may be noticed. These may reflect the minor differences in the preoperative natural shape and take-off position to each breast from the chest wall. By six weeks following surgery, the patient and surgeon should have a good idea of the near final shape and cup enhancement. Softening will be rapid in this period. Patients with large implants, or tight inelastic muscular chests, may sense that the implants are firm, but this should resolve further in time. Some occasional twinges of soreness, feelings of fullness in the chest, and heaviness may still be present at this time.

The complication rate for breast augmentation surgery is very low. The chance of bleeding, blood collections called seromas or hematomas are very rare. Infection is quite uncommon but can occur no matter whether good technique, use of preoperative and postoperative antibiotics were used, and whether the postoperative recovery was normal.Up to 26% of younger patients may say they could have gone to a larger size, but as the they accommodate to the chests in volume and distribution of breast mass, 90 per cent of these patients are perfectly happy with the size selected. Many older patients are adamantly against large augmentations, and thus seek satisfaction much earlier after surgery.

The incidence of capsular fibrosis or scar hardening around saline implants is exceedingly low. Since 1992, in this Practice, the incidence of firm breasts with textured tear-drop and anatomic saline implants has been about 10%, while for the smooth-shell saline implants it has remained under 1%. The small series of textured silicone implants placed in the past few years have remained quite soft but were placed at the time newer pocket method s were employed and when drains were used at surgery. The incidence of scar formation with silicone gel implants having a smooth shell in the past was around 20% over a 5 year period.

Implant deflation may begin to occur at 4 to 7 years with textured implants and with some anatomic, tear-drop, and postoperatively adjustable implants. A number of these patients may experience only one-sided deflation and then present at 9 to 12 years with a deflation on the opposite side. Implant deflation with smooth-shell round implants has been seen well after 8 to 10 years in this Practice. There have been only 5 cases of early saline implant deflation under one year after placement in 15 years of experience with saline implants.