When did they start this procedure?
In 1890, Austrian doctor Robert Gersuny started off by injecting paraffin into women’s chests. The results looked fine for awhile, but over time grew hard and lumpy. Worse yet, infection rates were alarmingly high, by the 1920s the procedure had been totally abandoned. Breast augmentation was first attempted in the 19th century, when in 1895, Czerny transplanted a patient’s lipoma to her breast to fill out a defect caused by the removal of an adenoma. Later on surgeons experimented with the transplantation of fatty tissue from the abdomen and buttocks to the breasts, but the fat was often reabsorbed by the body, leaving the subject with asymmetrical breasts and unsightly scars where the fat had been harvested.
While the painful failures scared women away from the surgical methods for some time, in the 1940s and 1950s, many women turned to “falsies” and bra-stuffing to keep up. During World War II, Japanese prostitutes reportedly injected themselves with silicone to better attract the patronage of American GIs, a technique that became so popular that silicone became a precious commodity. Topless dancers in the U.S. also got hip to silicone shots, but it wasn’t long before complications like discoloration and infection put a damper on the silicone fever. It didn’t take long, however, for surgeons to get out their scalpels and needles again, and in the 1950s women began to have various types of synthetic and polyvinyl sponges implanted. This may have been the worst approach yet: the sponges began to shrink and harden a few months after surgery, and infections, inflammations and a cancer scare.
Then, in 1961, a corporation called Dow Corning collaborated with two Houston cosmetic surgeons to create the first silicone breast prosthetic, made from a rubber sac filled with viscous silicone gel. The first augmentation mammoplasty was performed in 1962. The basic design remained unchanged for 30 years, though it was modified slightly for safety reasons in 1982. Ten years later, after nearly 100,000 women had the modified version implanted, the FDA announced that the polyurethane in the implants could break down into the body and form a carcinogen. As a result, many U.S. surgeons turned to the safer, but less natural feeling, saline implants designed in France back in the 1960s. In 1962, Cronin and Gerow developed the silicone gel prosthesis where the silicon gel is contained in a synthetic shell. Various coatings of the surrounding shell, saline-filled implants, and combinations of saline and silicone-filled implants have been developed over the years.
Who needs this procedure?
It’s rare for insurance to cover breast surgery for purely cosmetic reasons. Surgery will sometimes be covered when correcting severe asymmetry due to developmental deformity or reconstruction after mastectomy or lumpectomy. For breast reductions, insurance will sometimes pay if the breasts are so large they create symptoms of back pain, neck pain, or rashes under the breast or if surgery is otherwise medically necessary.
There is no “typical” breast augmentation patient, and women choose to have the procedure for many different reasons—having larger breasts is just one of them. Breast augmentation is one of the most effective procedures to correct noticeable breast asymmetry, and breast implants can be used to help correct tuberous breast deformities. Other common goals of breast augmentation: Restoring breast fullness lost after pregnancy & breastfeeding, Feeling more confident in a swimsuit, Adding balance to better complement curvy hips, and Enhancing self-image.
What is the advantage of this procedure?
The main advantage of breast augmentation is fuller, firmer, and shapely breasts. However, there are many more benefits related to breast augmentation beyond your appearance. One benefit that cannot be understated is the boost to your self-confidence. Feeling great and confident in your own skin will have a positive impact on every aspect of your life.
For Underdeveloped Breasts
If your breasts are underdeveloped, your doctor will work with you to find the ideal implant size that will give you the well-proportioned figure you desire. Symmetry can also be addressed, so you can look and feel fabulous in and out of your clothes.
For ‘Deflated’ Breasts
Breastfeeding, age, or weight loss can cause breasts to sag and look deflated. Augmentation can restore your breasts and fill them back up for fuller, perkier breasts. A breast lift may be needed in conjunction, so be sure to talk to your doctor about any additional procedures that would ensure the results you desire.
Added Volume and Curves
Some women are born with breasts that are naturally small and flat and don’t provide their desired curves to their physique. Because breast implants especially add volume to the top of the breasts, a breast augmentation is a perfect way to add volume and curves to your silhouette, making you feel more voluptuous and feminine. Whether your goal is to go up to a certain cup size, fill out a bikini top, or just have curves in your everyday clothing, a breast augmentation can give you that new look you desire.
Even Out Naturally Asymmetrical Breasts
All women have some degree of breast asymmetry. But for some women, the differences in their breast sizes are so noticeable that it makes shopping for bras and bathing suits difficult. A breast augmentation is a great way to balance out naturally uneven breasts for women. Because you can choose a different breast implant size, shape and profile per breast, a breast augmentation can allow you to finally have evenly matched breasts that fit well into bras, bathing suits, and clothing.
Restore Breasts after Pregnancy and Aging
Pregnancy can take a toll on a mother’s body, especially her breasts. Mothers often end up with breasts that are sagging and have decreased volume, particularly if they breastfed their babies. And even women who do not have children notice similar changes in their breasts as gravity takes over as they age. A breast augmentation is a fantastic way to restore lost volume to breasts and make them appear more youthful and perkier.
Rebuild Breasts after a Mastectomy
Breast cancer is an extremely physically and emotionally difficult disease to deal with, and a mastectomy, though it can be life-saving, can leave a woman feeling like a shell of her former self. A post-mastectomy breast augmentation/reconstruction, which can be performed either using a woman’s own body tissue or a silicone or saline breast implant, can restore breasts and help cancer patients and survivors feel like themselves again.
For women who are unhappy with the natural appearance of their breasts, their current look can make them feel inferior and lack confidence. A breast augmentation can be a confidence booster, making women feel more comfortable in their bodies and confident enough to step out in beach attire.
What is this procedure?
Breast augmentation, or augmentation mammoplasty, is a surgical procedure that aims to increase the size, shape, or fullness of the breast. It involves placing breast implants under breast tissue or chest muscles. The surgeon places silicone, saline, or alternative composite breast implants under the chest muscles or breast tissue. Implants last from 7 to 12 years on average.
Breast augmentation involves using breast implants or fat transfer to increase the size of your breasts. This procedure can also restore breast volume lost after weight reduction or pregnancy, achieve a more rounded breast shape or improve natural breast size asymmetry.
Are there non-surgical treatments?
There’s a new alternative to implants that uses your own fat cells to enhance breast tissue. It’s called fat grafting, and while it is an involved process of multiple injection procedures, the end result does not involve any surgery or scarring.
Many patients are good candidates for fat grafting, but it won’t work for everyone. Also, the number of operations needed for the process varies by individual. On average, a full mastectomy reconstruction requires up to five surgeries with between 300 and 400 ml of fat injected per session.
Step 1: Tissue expansion
First, depending on a patient’s anatomy and whether her doctor recommends it, a woman may wear a tissue-expansion device to prepare for successful fat grafting in the breasts. There is a large, suctioning device called Brava® fits over the breasts like a bra. It’s battery-powered and gently puts tension on the breasts, stretching the tissue and preparing it for upcoming procedures.
Step 2: Fat grafting
Once the tissue is prepared to make a fat transfer more viable, a plastic surgeon harvests a patient’s fat via liposuction or contouring. Next, oil and blood are removed from the fat. The surgeon then injects small amounts in tissues throughout the breast area. Future mammograms do not seem to be a problem. Radiologists can tell the difference on the images between the repositioned fat cells and any potential calcifications that might be cancerous.
Autologous Augmentation by Fat Transfer and Stem Cell Breast Augmentation
This procedure has also been referred to as “stem cell breast augmentation.” This label is a misnomer. Fat removed by liposuction contains stem cells. A stem cell is a cell that can develop into different types of tissue, based on where it is placed in the body. Stem cells alone cannot be injected into the breast and expected to increase breast size. The stem cells must be combined with fat. Hence, the term “stem cell breast augmentation” is not entirely accurate.
Advantages: No implant used, Small incisions, Uses woman’s own excess fat, Relatively low complication rate, Breast look and feel natural, Good safety record, Patients and doctors are satisfied with the results.
What is the surgical treatment like local or sedation?
Sometimes, breast augmentation is done during local anesthesia — you’re awake and your breast area is numbed. Often, though, breast augmentation is done during general anesthesia, in which you’re asleep for the surgery. It is possible to do a breast augmentation under local anesthesia or local with sedation, especially if the implant is placed under the breast tissue and above the muscle. You need to be tolerant to the injections initially, and be a good candidate for the surgery and type of anesthesia.
Yes, local anesthesia is one way of doing breast augmentation. Unless you are very stoic, however, you will also need sedation. This requires the same precautions and a certified operating room that general anesthesia requires in order to provide a safe environment. Because of this, and the extra time that local takes, the costs are about the same. I would personally prefer a quick general anesthesia, as the effects wear off very quickly.
Local anesthesia + Sedation (oral or intravenous) – Local anesthesia is given as above, but also sedation is given to relax you. If sedation is given, you should be monitored by an anesthesiologist or nurse anesthetist as over sedation can cause you to stop breathing on your own. Proper monitoring would prevent this or at least allow immediate intervention should this be required. Sometimes if local + sedation is not working well (difficulty keeping the level of sedation at the right level), then the patient can be converted to general anesthesia.
“Awake breast augmentation” is a breast augmentation procedure performed using local anesthetic while you are awake. Some surgeons will also give you some sedation to relax you, some will not. This procedure requires injecting your breasts with a solution of local anesthetic (“numbing medicine”). The proponents of this procedure claim that you are “involved in the size selection” of your implants during surgery and that you will recover faster.
General anesthesia – drugs are given intravenously to make you relaxed, all anxieties you may have will disappear, and you will slowly drift off to sleep. Once asleep, a breathing tube is gently placed through your windpipe through which oxygen and some anesthetic drugs in gas form are given to you. Your vital signs, oxygen and carbon dioxide levels are continually monitored for your safety. General anesthesia affords you the following: no perception of pain, no recollection of the period of time between when you go to sleep and when you wake up, muscle relaxation and a peaceful sleep. Your airway is protected via the breathing tube and the muscle relaxation is important to reduce post operative discomfort and facilitate the surgery.
What is the recovery like?
Your breasts will be covered with gauze an elastic bandage or support bra will minimize swelling and support the breasts as they heal. You may have drainage tubes, which will be removed in a few days. You may need to wear a surgical bra as you heal. You’ll need to take it easy for a few days after your breast augmentation surgery. For instance, you shouldn’t do any heavy lifting for up to six weeks after getting your implants.
Over-the-counter pain relievers such as acetaminophen may help relieve discomfort. Your doctor may also prescribe pain medication for you. You will probably have some swelling in the area where the surgery was done. Over time, the swelling should ease and the scars will fade.
Wear your support garment (a bra or elastic band, called a bandeau) around the clock as instructed by your plastic surgeon. Some surgeons may ask patients cleanse the incision sites and apply ointment, while others will ask their patients to keep tape or a bandage on.
How long will full recovery take?
It’s important to note that, since every woman’s body is unique, there is no exact timeline for recovery. However, most surgeons agree that a full recovery can take on average six weeks or so, and women may notice that they feel perfectly fine after about a week.
Postoperative recovery stages
The first five to seven days
Typically, the first three to five days are the most uncomfortable. Your doctor will likely prescribe pain medication, and your surgeon may even recommend receiving a pain injection or pain pump to ease discomfort for those first 72 hours.
After the first few days, most women can manage postoperative discomfort with over-the-counter painkillers. In addition, a majority of women are able to return to desk jobs about a week following surgery.
The next few weeks
After the first week, patients are encouraged to slowly ease back into light exercise and a normal daily routine. The discomfort should be minimal by this point, but doctors advise women to refrain from strenuous or jarring activity like running, horseback riding or rigorous workouts. Heavy lifting is also discouraged until they are fully recovered. Patients with labor-intensive jobs are recommended to remain out of work for at least three weeks.
During your follow-up appointment, your doctor will be able to assess how far along your healing has progressed. Generally speaking, after two months, most patients are fully cleared to resume all normal activities.
How long does it take?
Breast augmentation is usually an outpatient procedure, though some can elect to stay overnight. The surgery will last between one and two hours, and you will likely receive general anesthesia. During the procedure, the surgeon will make cuts under the breast, under the arms, or around the nipples.
How long has it been around?
The modern prosthetic breast was invented in 1961 by the American plastic surgeons Thomas Cronin and Frank Gerow, and manufactured by the Dow Corning Corporation; in due course, the first augmentation mammoplasty was performed in 1962.
While there were almost certainly earlier attempts to surgically enhance the breasts, the first recorded surgical examples were from 1889. A surgeon, Dr. Robert Gersuny was using paraffin wax as breast implants. Sadly, they were not successful, and the end result was that the breasts became hard and lumpy.
The early part of the 20th century saw the advent of any number of rather dubious materials being used as implants for breast augmentations. These ranged from ivory, glass or steel balls, to ground rubber, animal cartilage, or foam sponges. As you may well expect, these all proved to be about as successful as the paraffin wax from the 19th century.
Between the 1940s and the mid-1960s, approximately 50,000 women received liquid silicone injections directly into their breasts, despite the FDA’s strict disapproval of such a procedure. This practice started among prostitutes in the Pacific Theater during World War II, in an effort to appeal more to American GIs. Many of these women ended up with hardened breasts, which often led to the need for a mastectomy.
The early 1960s saw the beginning of the first implant technologies that were the direct precursors to the ones that are still in use today. The first successful augmentation procedure with this implant was performed a year later. Two years later, the first saline breast implant was developed by the French manufacturers.
What are the complications?
Common complications include infection and other surgical risks, chronic breast pain, breast or nipple numbness, capsular contracture, breakage and leakage, necrosis (skin death), the need for additional surgery, and cosmetic problems — such as dissatisfaction with how the breast looks with the implant.
In addition, surgical risks include infection and hematoma (blood collecting around an implant), both of which can range from mild to severe.
Common local complications include loss of nipple sensitivity or painfully sensitive nipples. Some women are dissatisfied with the cosmetic results of breast implants, because their breasts look or feel unnatural or asymmetrical, or they can hear a “sloshing sound” from saline-filled implants. Problems like these can interfere with sexual intimacy.
Scar tissue that forms around any implant or foreign body can become hard or tight around the implant. This common problem is called capsular contracture. The scar tissue is inside the body, but it can cause the breasts to become very hard and misshaped, and it leads to discomfort that ranges from mild to severely painful. Correcting these complications might require more surgery, either to remove or replace the implants.
What can you do to speed up recovery?
Healing after breast augmentation takes time, but there are steps you can take in advance of surgery to speed up the recovery process.
Give Up Smoking – This step isn’t optional. If you’re considering breast augmentation, you must be willing to give up tobacco at least two weeks in advance of surgery and for another two weeks after surgery. Because smoking inhibits blood flow to the skin, it can delay wound healing and increase your risk of post-surgical scarring.
Eat Low-Sodium – A high-sodium diet is one of the main causes of excess fluid retention, which can extend swelling during your recovery. If you currently consume a high-sodium diet, cutting out sodium in advance of surgery (1500 mg a day or less) will improve your recovery by diminishing swelling.
Discontinue Certain Medications – Prior to surgery, it’s essential that you are honest and up front about the supplements, over-the-counter medications and prescriptions that you are currently taking or plan to take in the near future. Certain medications like aspirin can increase your risk or bruising and bleeding during recovery.
Post-Surgery: Supplements and Natural Healing Remedies
There are a variety of natural supplements and remedies that can be used to speed up the healing process, and minimize some of the negative side effects often associated with recovery.
Arnica Montana– The root and flowers have been used for hundreds of years to diminish swelling, bruising and discomfort.
Bromelain–is made from protein-digesting enzymes found in pineapple extract and works as a natural anti-inflammatory to alleviate post-surgical swelling.
Selenium–is a mineral that works as an anti-inflammatory to speed up wound healing and recovery.
Vitamin C–or ascorbic acid, acts an antioxidant to support the immune system and speed up recovery.
Vitamin A–is composed of fat soluble compounds that can help stave off infection and speed up the recovery process.
Do you need to rest up afterwards and for how many days?
You may have drainage tubes, which will be removed in a few days. You may need to wear a surgical bra as you heal. You’ll need to take it easy for a few days after your breast augmentation surgery. For instance, you shouldn’t do any heavy lifting for up to six weeks after getting your implants.
Breast Augmentation Recovery: Immediately After Surgery (Day One)
Breast augmentation surgery generally takes from 2 to 3 hours and is performed as an outpatient procedure at an accredited surgery center. After surgery, you are placed in a recovery room, supervised by medical staff as you awake from general anesthesia. You will feel fatigued and want to sleep.
Sleep in an inclined position: Sleep on your back (at about a 30-degree angle) after surgery, while significant swelling remains. Purchase a specially designed wedge pillow, prop yourself up with a few bed pillows or sleep in a recliner chair.
Breast Augmentation: Recovery: Day Two
You will be wearing a medical compression bra to support your breasts over the bandages covering your breast augmentation incisions. The garment will help to minimize swelling and avoid placing stress on your stitches by limiting breast movement. Small, thin tubes will be in place under your skin to drain excess body fluids or blood for the first day up to 48 hours. Your chest may feel tight due to swelling, which is normal and will gradually improve.
Pain medicine: Following your breast augmentation surgery, you will have some discomfort and you may take prescription pain medication the first week after your surgery. Bandages and drains will be removed on your first follow-up visit.
Taking a shower: Once your sutures are removed (and your surgeon gives permission) you can shower. This is usually after a day or two.
Breast Augmentation Recovery: The First Week
You will continue wearing a compression bra, 24 hours a day during your breast augmentation recovery period. Be sure to carefully avoid any impact to your chest throughout the healing and recovery process. Your breasts may feel hard and you’ll experience occasional painful twinges, which may persist for a few weeks.
Driving: Don’t drive until after you have stopped taking prescription pain medication. Postpone driving for as long you can to avoid putting a strain on your incisions.
Communication: Call your surgeon if you develop a fever, experience excess swelling or pain or if you have any concerns. Do not hesitate to call anytime during recovery and your surgeon will be available to you.
Working: Most women are able to return to work in a week in an office environment after breast augmentation.
Breast Augmentation Recovery: Weeks Two through Six
Removal of stitches: Your stitches will be removed in 2 to 3 weeks or may be absorbable.
Exercising: You may perform light exercise after about three weeks.
Strenuous exercise: Do not lift anything over your head and avoid serious workouts for six weeks. Wear a stretchy but supportive sports bra during exercise.
First menstrual period: The first period after breast implant surgery may cause pain and swelling in the breasts.