More than 300,000 breast augmentation procedures are performed annually, and this number is growing. This makes the procedure the most popular cosmetic surgery procedure in the United States. Women have different reasons for choosing to have breast augmentation. Many women choose breast augmentation to increase breast size, while others may want to change their breasts’ shape, create breast symmetry, correct deformities they were born, or restore volume that was lost with weight changes, aging, or pregnancy. Still others may choose breast augmentation to restore their body’s shape affected by breast cancer or other illnesses.
Understanding Breast Augmentation in New York City
Breast augmentation, or augmentation mammoplasty, involves surgically increasing breast size by placing implants in the breast.
During a breast augmentation, implants are placed either under existing breast tissue or under the chest muscle. The result is fuller, rounder, and often a more symmetric appearance. There are several types of implants that may be used, and vary by the type of material inside the implant, the type of shell, and the overall shape. Implants can be saline versus silicone filled, smooth versus textured shell, and round versus tear-drop shape. The specific implant will be determined during your consultation and will depend on your body type and your desired appearance.
Below are descriptions of the different types of breast implants available to you:
- Saline: Filled with sterile saltwater. The implants come unfilled, so they can be filled to whatever volume you want. These implants tend to feel firmer than silicone and can show more rippling in thin women.
- Structured saline: Filled with sterile saltwater and containing an internal structure. These are designed to appear softer and with less rippling than the traditional saline implant.
- Silicone: Filled with silicone gel. These implants have less tendency to show rippling and appear and feel more natural than saline. These implants come pre-filled, so the size needs to be determined before placing them.
- Round: round shape to the implant. These tend to show more upper pole fullness than the tear-drop shape. Both saline and silicone implants can be round and is the most common shape used.
- Anatomic: These are tear-drop shaped implants that give less upper pole fullness and a more natural breast shape. Tear-drop implants have a risk of rotating, and this can be a cause for revision surgery.
- Textured: rough surface to the implant that promotes tissue in-growth and prevent rotation. All tear-drop shaped implants are textured to prevent rotation. Round implants can be either smooth or textured.
- Smooth: smooth surface of the implant that allows rotation and movement of the implant. These are the most common shells used in the United States.
While cosmetic surgery in general is growing in popularity, breast augmentation continues to be the most popular surgical procedure, but no two breast augmentation procedures are exactly alike. This is because everyone’s breast are different shapes and sizes.
Because the breast continues to grow and develop through the teenage years and into young adulthood, breast augmentation is appropriate only after a woman is done growing. Ideal candidates are also healthy women who are not smokers. If you are in the process of losing weight, Dr. Schulman recommends waiting until your weight loss has stopped for 6 months. If you were recently pregnant, Dr. Schulman advises that you wait about 9 months after giving birth before having breast augmentation, or any cosmetic surgery. This is to allow time for your body to change after pregnancy. Also, if you breastfed a baby you should wait at least 3 months after completing breastfeeding so that your breasts can return to normal size.
If you are planning to breastfeed future children, make sure to let Dr. Schulman know, so he can discuss this with you during your consultation. There are specific choices regarding breast implant placement and incision location that can minimize the risk of your surgery affecting your ability to breastfeed in the future.
It’s also important to have an open conversation with Dr. Schulman about what you’re hoping to get out of surgery. Depending on your needs, Dr. Schulman may recommend a different procedure altogether. For instance, women who have saggy or droopy breasts should understand the limitations of breast augmentation. Unlike a breast lift, which moves the location of the breast and nipple to a higher point on the chest, breast augmentation simply enlarges the breast in its current position. This may give the impression of a small lift, but it really will not lift your breasts. It is not uncommon for women to come for a breast augmentation consultation, but they really need a breast lift. If is possible to combine a breast lift and a breast augmentation if you need your breast to be lifted but also want them to be larger.
Before Breast Augmentation in New York City
During your private consultation with Dr. Schulman, you’ll have a chance to learn about every facet of the breast enlargement procedure and ask any questions you may have. In that consultation, Dr. Schulman also will discuss with you all of your options, including the type of implants, size of implants, placement of implants (whether above or below the chest muscles), anesthesia options, surgical facility, and recovery process. The consultation will also give Dr. Schulman a chance to fully examine your body and your individual anatomy. This allows him to develop a plan specifically for you that will give you the best chance of achieving your ideal cosmetic outcome. It is important to understand that proper breast augmentation combines your what you want with what your body can accept. If you choose implant sizes that are too large for your body, you will place yourself at increases risk for future complications and needing additional surgeries.
Many of our patients choose to have breast augmentation done at the same time as other body-contouring procedures, including tummy tuck, liposuction, or a Brazilian butt lift. This allows them to dramatically enhance their entire body in a single operation called a mommy makeover.
Once you and Dr. Schulman have developed your individualized surgical plan, it’s important to prepare your body for the procedure. Our staff will provide you with specific instructions, but a few simple steps can help your surgery go well.
- Wear comfortable, warm clothing that will be easy to take on and off. Shirts that zip in the front are recommended, as you may feel pain when lifting your arms over your head. Slip on shoes or slippers will also help.
- Avoid medications such as fish oil, aspirin and ibuprofen for at least 10 days ahead of time, as these can increase your bleeding risk.
- Arrange for someone to drive home from the surgical facility and to stay with you for at least one night.
- Continue exercising regularly and eating healthy up until the day of the surgery.
- Prepare your home for recovery to make it easier for you. This includes making sure that you have food and drinks so you do not have to go shopping after the surgery.
- Arrange for childcare and/or pet care.
- Make appropriate arrangements for time off from work or school. Dr. Schulman will be able to tell you how much time off is appropriate for your specific surgery.
During Your Procedure
Dr. Schulman uses a variety of advanced techniques to ensure the most beautiful, natural-looking outcomes and a faster and less painful recovery. This includes the short-scar breast augmentation featuring the Keller Funnel and Botox-assisted breast augmentation. The specific techniques used in your surgery will depend on the size and type of your implants, as well as your body and your cosmetic goals.
After being brought to the operating room, you will be given anesthesia and you will drift off to sleep. Dr. Schulman will make a small incision in the location you discussed. This may be in the breast fold, around the areola, or within the armpit. The specific incision placement will depend on many factors that you will discuss during your consultation.
Once the incision is made, Dr. Schulman will create a space for the breast implant. This breast pocket may above or below the chest muscle. The implant will be placed in this pocket and centered behind your nipple. For those who are receiving saline implants, Dr. Schulman will then fill the implant with sterile saltwater to the desired volume. Silicone implants are pre-filled, so they do not require filling once they are in your breast.
With the implants in their desired locations, the Dr. Schulman will carefully close your incision with absorbable stitches. You will then be placed in a soft surgical bra. Within an hour, you will be in our recovery room, where you will remain until you feel comfortable enough to go home.
After Breast Augmentation in New York City
Dr. Schulman and our staff will provide you with specific, detailed instructions for recovery. You should follow these closely, as they will give you the best chances of seeing the results you imagined and reduce the risk for any complications..
Most patients find their chest is sore for a few days to a few weeks after the surgery. You may also feel some slight pressure from the breast implants. You will remain in a special surgical bra for a few weeks.
Your breast shape may seem a bit unnatural over the first several weeks or months. This is because your skin needs to stretch and the implants will settle into a more natural position. The overall size may seem a little large than your desired at first, because your will have some normal postoperative swelling.
While you should not smoke for your overall health, it’s especially important to avoid smoking while recovering from any surgery, including breast augmentation. In addition to having a negative effect on many aspects of your health, nicotine exposure causes blood vessels to constrict. This can slow healing and put you at risk for infection or necrosis (tissue death). You need to avoid nicotine exposure, either by smoking or vaping, for at least four weeks prior to surgery and eight weeks after surgery.
Dr. Schulman will let you know when it’s safe to return to all of your normal activities, but you may need to avoid heavy lifting (anything over 10 pounds) for a few weeks after your surgery so that you do not strain your chest muscles. Your chest area will be quite sensitive for a few weeks, so avoid jarring movements or contact to your breast region.
All surgical procedures involve some risk. Your consultation with Dr. Schulman and the post-operative instructions you receive are both aimed at reducing the risks associated with breast augmentation, but several complications could be possible, including:
- Scar tissue around the implant, known as capsular contracture
- Poor skin scarring
- Breast pain
- Changes in sensation of the nipples
- Leaking of the implant
- Shifting of the implant
For most patients, the risk of a leak or rupture to their implant is their greatest concern. With leaking or ruptured saline implants, the saline will be absorbed safely by the body since it’s only sterile saltwater. With silicone implants, the material could stay within the implant shell or leak out, depending on the type of silicone. Also, rupture of saline implants is obvious, as the implant will lose its volume and the breast will appear to deflate. With silicone gel, a rupture is not always obvious, which is one reason why routine follow-ups are necessary for women who have silicone breast implants.
Remember that while the results should last for many years, breast augmentation may not last the rest of your life. Even if there is never a problem with your implants, your body and breasts will continue to change over time. It is likely that at some point in the future, you will desire another surgery to either change the size of the implants, exchange them for a newer (and maybe better) implant, or have a breast lift.
Questions and answers about breast augmentation surgery
Q:How long does the surgery take?
A: The procedure takes about an hour.
Q:Can I go home the same day?
A: Yes, after a stay in our recovery room, you are able to go home when you feel up to it.
Q:What kind of anesthesia is used?
A: You will be given intravenous medications to sedate you and you will fall asleep. This is the safest and most comfortable form of anesthesia for your breast augmentation.
Q:Where is the scar?
A: The scar will depend on exactly where the incision is placed. Most common locations are within the fold under the breast, around the areola, and within the underarm area. Dr. Schulman will review with you which location is best for your procedure. Over time the scars will fade and you can help the appearance by using scar gels that your surgeon recommends.
Q:Will I know what size implants I am getting?
A: Of course! Dr. Schulman will meet with you several weeks prior to your surgery to review implant options and allow you to select your size. During this “sizing visit”, you will be able to try on implants to see exactly what you will look like after your surgery.
Q:How will I know if my implants are leaking?
A: Implant rupture is not common. Detecting a rupture will depend on what type of implant you have. If a saline implant ruptures, the salt water leaks out and is absorbed by the body. The implant will deflate over time. Sometimes this happens quickly (over a few days) and sometimes it may take months if it is a very small leak. Silicone implant ruptures are not so obvious since the gel is like a gummy bear. You may notice a very subtle change in shape or you may not notice any change at all. To detect a silicone gel implant rupture, you would need an MRI. Following up regularly with your surgeon will help you detect a rupture or other issues with your implants.
Q:Can I breastfeed with implants?
A: Yes. The implants are unlikely to interfere with the breastfeeding mechanism of your breasts. Keep in mind that not every woman is able to breastfeed and this may be the case, whether or not you have breast implants.
Q:Will implants interfere with my mammograms?
A: No. There are millions of women with breast implants, so mammographers are very experienced in examining breasts with implants. You will need to tell them before your mammogram that you have implants, so that they can make special adjustments to how the mammogram is performed.
Q:Do I need to change my breast implants every 10 years?
A: No. There is no standard time period where you have to change your implants. If you are happy with your implants and the size, and there is no evidence of leaking or rupture, you can keep your implants in forever. Keep in mind, that the risk of implant leaking will increase as the implants get older, so some women prefer to change them after about 10 years just to be safe. Also, the technology changes over time, so the implants that are available in 10 years may be better than the implants you get now, and you may want to change them. If you get breast implants, you should at least be aware that you will likely want to have another breast surgery in your lifetime.
Schedule a Consultation
To learn more about breast augmentation or to schedule a consultation with Dr. Schulman at our New York City practice, fill out the contact form. You can check out before-and-after photos of some of our breast augmentation procedures here.