Breast Augmentation 101

There are many reasons that lead women into desiring a breast augmentation; thus making this procedure one of the top procedures done in the plastic surgery field. Some of the major reasons why women desire a breast augmentation are as follows:


1. It provides a boost of self-confidence

Women with abnormally small breasts (micromastia) are often embarrassed about their appearance, especially when in swim wear or naked. This can sometimes make them feel less feminine and or desirable. Also, after having children, women’s breasts lose volume or become smaller which can make moms have low self-esteem and wishing their breasts can return to how they were pre-baby. Breast implants can provide a boost in self-confidence by restoring volume to their breasts and can also make them larger if desired.


2. It can fix asymmetrical breasts

Uneven estrogen levels, puberty, or medical reasons can leave women with asymmetrical breasts which can cause low self-esteem. Breast implants can be used to correct this problem and provide a more even bust.


3. They have had a mastectomy.

Women who have had a mastectomy due to breast cancer or other severe medical condition often desire breast implants to restore their femininity and feel “normal” again. Breast reconstruction that include breast implants are a great option and can achieve this goal.


And the list can go on and on. Most importantly, the more one is informed and confident in the plastic surgeon that they choose, breast augmentation is easily one of the most satisfying surgical procedure there is. Which brings us to the next topic:


How to choose the correct plastic surgeon?

Choosing the right surgeon for you is critical. It is usually best to make several consultations to allow you to pick the best fitting surgeon for you. Your surgeon should make you feel comfortable and never pressure you into making a fast decision. Take as much time as you need to do your research and look into each surgeon’s training and experience. The following respected professional organizations include board-certified plastic surgeons:

-The American Society of Plastic Surgeons (ASPS)

-The American Society for Aesthetic Plastic Surgery (ASAPS)

-The American Academy of Cosmetic Surgeons (AACS)


What to expect at your consultation?

As part of your consultation, you will get a chance to meet your surgeon and privately discuss your goals and desired outcome. Your surgeon will discuss with you all the different types of implants and provide helpful information to allow you to make your own, fully-informed choice. Your doctor can also show you samples of the different kinds of implants so you can see what they feel like.

Your doctor will ask about your general health status and determine any pre-existing health conditions that impact your candidacy for a breast augmentation. He/she will also discuss and clarify any risks or potential complications that may arise during or after the procedure.

Here at Mountcastle Plastic surgery, we provide a unique experience for our patients with the use of Crisalix 3D simulation virtual reality system. We understand that it can be overwhelming not knowing what you will look like after breast augmentation surgery, so we believe utilizing this tool really helps and gives patients a chance to actually see what they will look like. By seeing a three-dimensional image of your body, you will able to see how the various implants and shapes will look on your body type, thus allowing you to make an informed decision in regards to the type of implants and size you want.

Another important discussion to have is to decide whether to have your implants placed over or underneath your pectoral muscles. Most surgeons, including Dr.Mountcastle, favors under the muscle placement which tends to provide a more natural look and links to fewer complications.


What are your options? Saline vs Silicone Implants

Both saline and silicone implants are approved by the Food and Drug Administration (FDA) for breast augmentation. Saline is recommended for ages 18 and up and silicone is recommended for ages 22 and up.

Saline implants are made out of a silicone exterior with saline solution filling. They are inserted into the breasts while empty and are then filled with salt water once they’re in the right position. They have the advantage of requiring only a small incision since they are placed into the breast empty during surgery. Saline implants can also be easily adjusted during surgery to correct asymmetry; one implant can be filled with more saline solution than the other as needed.

Silicone implants are made out of silicone exterior with silicone gel filling. Rather than being filled once inserted into the breasts, silicone implants are pre-filled and are inserted as ready-made units. Many women prefer silicone breast implants because they look and feel more natural than saline implants. Silicone implants come in a variety of sizes, shapes, projections and provide a very natural-looking result.


Your breast implant procedure

Prior to surgery, you may be asked to undergo several lab tests, potentially a mammogram, and to avoid certain medications in the weeks leading to your surgery. You will also be scheduled for a pre-op appointment in where you will have the opportunity to finalize your breast implant size/shape and get all your questions answered in regards to post-operative care. A set of written instructions will also be provided. You’ll be given prescriptions for medications to get filled prior to surgery. They typically include a pain and anti-nausea medication.

If you are a smoker, your surgeon will advise you to stop smoking in the weeks before breast augmentation. This is important because smoking reduces blood oxygenation, which can slow down healing and raise risk of complications.

On the day of your procedure, you’ll meet with your surgeon again to review the process and discuss any questions. Breast augmentations are performed under general anesthesia and is typically out patient which means you do not spend the night at the hospital. Once it’s complete, your breasts are bandaged and then covered with an ace wrap and/or surgical support bra. Finally, you’ll be moved to a recovery room while you awaken from the anesthesia. Once you are awake and vitals are stable, you will be able to go home.


What to expect after your implant procedure

Most people experience only minimal discomfort afterward, and while you may need some pain medication for the first day or two, you’ll likely be back to normal after a few days. When it comes to exercise and physical activity, you’ll need to avoid anything strenuous for ~2 weeks. Typically your post op appointment is scheduled at 1 week following surgery for a wound check and to ensure proper healing and possible suture removal.

Swelling and bruising are also part of the normal healing process and will fade as the weeks pass. Arnica gel and silicone based scar creams are recommended to apply.

A surgical bra is typically provided either by the hospital or your surgeon and recommended to wear for at least two weeks, 24 hours. Non-wire bras are recommended for at least 6 weeks minimum to allow your incision to heal.


Risks and complications:

Every surgical procedure has risks, including breast augmentation. These include pain, hardening, infection, or the need for additional surgery.

Some of the risks associated with breast augmentation are:

  • Fluid accumulation

  • Permanent loss of breast/nipple sensation

  • Blood clots

  • Implant rupture or leakage

  • Asymmetry

  • Capsular contracture - this is a unique complication directly related to breast implants. Capsular contracture is when there is hardening of the breasts due to the formation of scar tissue around the implant. This can distort the shape of the implant and it can be painful.

Although capsular contracture is a unique and unpredictable risk associated with breast augmentation, there are several things a surgeon can do to help decrease the chance of this happening.

Fortunately, with a skilled surgeon such as Dr. Mountcastle, the chances of capsular contracture are very low. Here are the steps we take here at Mountcastle Plastic surgery to help prevent this from happening:


One week before surgery, we ask patients to wash their breasts with an antibacterial soap. During surgery, a triple antibiotic mixture is used to irrigate the breast pocket prior to placing the implant. Another way to decrease the risk of a contracture is to make the incision in the inframammary fold. During placement of implant, it is important not to insert and remove an implant multiple times into the implant pocket to adjust the pocket dimensions. This can cause unnecessary trauma to the tissue and can introduce bacteria. To avoid this, Dr. Mountcastle uses specialized plastic funnels during surgery to perform a “no-touch” insertion technique, minimizing contact directly with the implant.


Breast massage is also an important post operative technique that patients must be able to commit to doing, usually for the whole life span of the implants. This is a good preventative measure to avoid capsular contracture.

We truly hope patients find the above information useful and we encourage everyone who has been thinking about getting a breast augmentation to contact our office and meet with our professionally trained staff.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.