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Updated 03/31/06
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Breast
Augmentation
Breast
augmentation is a surgery
designed to enlarge the
breasts. This surgery is
frequently sought by women who
are unhappy with the small
size of their breasts,
sometimes after pregnancy or
weight loss.
If you are considering breast
augmentation, the following
information will provide you
with a good introduction to
the procedure. For more
detailed information about how
this procedure may help you,
we recommend that you schedule
a consultation with Dr. Kremer / Dr. Zettl.
What
are some of the most common benefits
of breast augmentation?
Breast augmentation is usually quite
successful at making the breasts
larger and fuller. The results may
not look exactly like “natural”
larger breasts; implanted breasts
tend to be a bit more round and less
saggy than natural breasts of the
same size. Most women find these
differences to be an improvement.
During the consultation, you and
Dr. Kremer / Dr. Zettl will discuss the changes that you
would like to make in your
appearance. Because this is a highly
personal decision, you’ll want to
take time to discuss all of your
concerns and desires, including how
large you want your breasts to be.
Show Dr. Kremer / Dr. Zettl pictures of breast
sizes you like. He will be able to
determine which size implants will
achieve your preferred size. He will
also explain the different options
available to you, including incision
type, location of the implant, type
of implant, and whether a breast
lift might also be beneficial.
Dr. Kremer / Dr. Zettl will also explain the
anesthesia he will be using during
your procedure. You should tell him
about any medications you currently
are taking, and any health
conditions you have. Be sure to ask
all the questions you have about the
surgery. Learning everything you can
about your options, risks and
benefits is the key to making an
informed decision.
Breast augmentation consists of
making an incision, lifting the
breast tissue, creating a pocket in
the chest/breast area, and placing a
breast implant into this pocket.
An incision may be made in any one
of the following places: the crease
below the breast, around the areola,
under the armpit, or, very rarely,
through the navel.
The implants can be placed either
under the chest muscle or directly
under the breasts. Placement
considerations include the anatomy
of your breasts, the type of implant
as well as other individual factors.
Although several implants are
available at the present time, the
implant being used for nearly all
breast augmentation surgeries is
made of a silicone rubber sack
filled with a saline solution. Under
certain conditions, such as
reconstructive surgery, silicone gel
implants can be used instead.
Silicone gel filled implants are
only offered on a limited basis,
under approved studies, due to
questions about silicone implants
correlated to autoimmune diseases. Dr. Kremer / Dr. Zettl
will
discuss the choice of implant, and
review with you the size changes
that are possible with the
operation.
Most likely, the anesthesia you
receive will be general, although a
local anesthetic along with a
sedative can be used.
Breast augmentation surgery usually
takes about one to two hours to
complete. The length of the
procedure varies according to the
technique used and the placement of the
implants.
Probably not. Most breast
augmentation surgery is performed in
a surgicenter as an outpatient
procedure; you’ll be able to
return home within a few hours of
the surgery or may spend the night
if you decide to do so.
What
can I expect after surgery?
How
much pain is there?
Dr. Kremer / Dr. Zettl
use an operative technique,
which he studied during his clinical
training in Dallas, TX, developed by
Dr. John B. Tebbetts. Full
normal activity in 3 days or less is
routine in 90% of his breast
augmentation patients.
Breast augmentation stretches the
tissues, and can be painful. This is
especially true when the implants
are placed under the muscle and in
young women who have never had
children. The pain is greatest
within the first 24 hours, but
improves with each day and is
somewhat relieved by pain
medications.. In spite of the
initial discomfort, most women
report that they are very satisfied
with the results of the surgery.
When you wake up you will feel
tired, sore, and stiff. Your breasts will be wrapped with
gauze bandage as well as a tighter
bandage for protection and support. It is
important to take the medication
prescribed to you by Dr. Kremer / Dr. Zettl.
Someone will need to drive you home,
and you may need assistance at home
over the next couple of days.
Dr. Kremer / Dr. Zettl will prescribe an
antibiotic medication to be taken
after the surgery. It is a good idea
to have these prescriptions filled
beforehand.
Your
scars will be pink for several
weeks. After several months they
will begin to fade. It is critical
that you review post-procedure care
with Dr. Kremer / Dr. Zettl. Following his
instructions carefully will help
ensure you have a speedy, healthy
recovery. Also keep in mind that:
Rest
is important to the healing
process, so do it as much as
possible following your
procedure. Drink plenty of
fluids, and be sure to take Dr. Kremer / Dr. Zettl's prescribed medications.
For
at least 3-5 days, you should
try to keep arm extension to a
minimal. Elbows should not be
raised higher than the armpit.
The tissues will heal more
quickly if you avoid stretching
and separating muscle/tissue
surrounding the breast implants.
Most
likely, you will be able to
resume calm, quiet work within a
few days of your surgery. You
should still avoid physical
exertion for several weeks,
depending on the advice of Dr. Kremer / Dr. Zettl.
After
several days, the gauze dressing
will be removed. You will be
required to wear a support bra
for a couple of weeks to help your breasts form and
maintain a pleasing, balanced
shape.
The
stitches will come out within a
week to ten days, but swelling
may continue, gradually
subsiding over several weeks.
With the swelling, your breasts
may seem hard and unnatural, but
eventually they should soften to
a more natural feel.
You
will probably be able to resume
exercise and normal physical
activities within a month or
two, when the soreness has
subsided. Recovery varies from
patient to patient and depends
upon the technique, type of
implant, and site of placement
that was used, as well as
the level of activities in your
daily routine.
Breast augmentation makes the
breasts larger for the life of the
implant. This can be more than 10
years and cannot be predicted by
anyone to date. Remember also that larger
breasts sag faster than smaller
breasts, and augmented breasts do
this as well. It is possible that
you may require surgery in later
years to correct sagging if you
choose to have large implants.
Gravity, unfortunately, has no
exceptions.
In
general, the best candidates for
breast augmentation are:
18
years of age or older
Not
currently pregnant or nursing
In
good physical health
Psychologically
stable
Wanting
to improve their appearance
Realistic
in their expectations
Having
this surgery for the first time
The
above is only a partial list of the
criteria that Dr. Kremer / Dr. Zettl
will
consider in determining whether or
not this procedure is appropriate
for you.
Some of the more common possible
complications include postoperative
infection, bleeding with hematoma
formation,
implant rupture, deflation or
leakage, capsular contracture, changes in nipple
or breast sensation as well as shifting of
the implant.
There
are several concerns regarding
breast augmentation. The
risks involved with breast
augmentation have received a lot of
attention, but neither breast cancer
nor arthritis have been shown to be
caused by breast implants. All
operations carry some risk and the
possibility of complications can
include (but are not limited to)
infection, excessive bleeding, adverse reaction
to anesthesia, and the need for
second or sometimes third
procedures.
There is no known association of
breast implants with breast cancer
in human beings, and in fact several
large studies have shown a lower
incidence of breast cancer in women
with breast implants. Breast
implant type devices have been shown
to cause a rare form of cancer in
rats that are prone to cancer, but
this cancer has not been reported in
humans with breast implants.
Other side effects specific to
breast augmentation include:
capsular
contracture: occurs when the
scar or area around the implant
begins to tighten, causing the
breast to feel hard. This occurs
more frequently in silicone-gel
filled implants than in
saline-filled ones.
nipple
sensitivity or loss in
sensitivity: usually disappears
after several weeks, but for
some this is permanent.
rippling:
dependent on thickness of skin,
type and size of implant. Indentations on the breast,
often caused when the implant
moves.
rupture:
when the breast implants tear
and/or leak. This may require a
second operation to replace the
implant.
Tell
Dr. Kremer / Dr. Zettl about any allergies
you have (to foods, drugs,
environmental elements)
Tell
Dr. Kremer / Dr. Zettl if you have a history of
bad scarring, such as keloids.
Tell
Dr. Kremer / Dr. Zettl about all
medications, herbal supplements
or natural supplements you are
taking (both prescription and
non-prescription)
Carefully
follow any instructions Dr. Kremer / Dr. Zettl
gives you regarding eating and
drinking and smoking.
Avoid
aspirin and aspirin-containing
medicines for
two weeks prior to surgery.
Arrange
for someone to drive you home
after surgery or after discharge
from the day surgery center or
the hospital.
Please
inform Dr. Kremer / Dr. Zettl immediately in
case you should experience fever
or symptoms of an infection
after surgery.
Try
to schedule surgery at a time
other than your menstrual
period.
The
information on this web site is only
intended as an introduction to this
procedure and should not be used to
determine whether you will have the
procedure performed nor as a
guarantee of the result.
The
best method of determining your
personal options is to schedule a
personal consultation with Dr. Kremer / Dr. Zettl. He will be able to answer
specific questions related to your
situation.
