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Before your surgery, your anesthesiologist will discuss with you
the available options for accomplishing your surgery safely and
comfortably. Monitored anesthesia care with local anesthetic and
sedation or a general anesthetic are most often used. An anesthesiologist
will be available to ensure your comfort and safety.
Breast implants are placed beneath a woman's breast to increase
projection and fullness of the breast cup size. These implants can
be placed either above or below the pectoralis major muscle. Surgical
approaches to place the implant include an incision beneath the
breast in the natural crease, at the edge of the pigmented skin
(areola) around the nipple, through an incision in the apex of the
armpit (axilla), or through the umbilicus (navel). The preference
of one's surgeon and the individual body, breast shape, size and
an individual's breast enlargement desire will dictate incision
selection.
Implants placed above the muscle are chosen by many surgeons and
patients because of decreased discomfort following surgery, ease
of dissection and enhanced ability to fill or lift a drooping breast.
Many physicians and patients also opt to select breast implant placement
below the pectoralis muscle for a number of reasons. These reasons
may include a decreased chance of sensation loss of the skin or
nipple, decreased chance of seeing or feeling rippling of saline
implants, decreased incidence of postoperative breast implant hardening,
and lessened interference with mammograms. Some surgeons believe
these potential benefits are theoretical and the exact placement
of the implant is really dependent upon the patient's individual
characteristics and patient and surgeon preferences.
The surgical procedure is frequently performed in an outpatient
ambulatory surgical center or in a hospital setting.
Wrinkling and rippling is a problem that appears to be mainly associated
with some saline breast implants. Some of the textured gel implants
have been known to give the rippling effect as well. This can be
apparent in very lean and thin patients when the implant is placed
above the muscle. By placing the implant below the muscle, more
tissue exists between the skin and the implant thus, the chance
of seeing or feeling rippling can be decreased.
At the completion of the operation, drainage tubes are frequently
placed beneath the skin to minimize swelling. These tubes are connected
to a bulb. It is necessary to empty the drainage fluid a few times
at home. The nurse will give the patient's caregiver at the time
of discharge. The patient may choose to go home on the day of surgery
or spend the night with an office consultant or nurse from the surgery
center. The drains will be removed within approximately seven days
after surgery.
Your surgeon and the manufacturer of your breast implants expect
the implants to last indefinitely. The life span of all types of
implants, however, can be shortened by trauma or mechanical failures.
Such a rupture may be clinically undetectable to you or your surgeon
if you have silicone gel filled implants, but could be picked up
during mammography or other specialized tests.
Rupture or leakage could lend to gel migration or formation of
lumps within your breast, necessitating future breast biopsies and
implant replacement. However, rupture of a saline filled implant
will generally be obvious because the breast will suddenly resume
its previous size. Both major implant manufacturers in the United
States have strong warranties regarding ruptures should they occur.
It is strongly suggested that you return to see your surgeon at
least once a year for a breast examination. These examinations are
provided without cost to you.
A brassiere, circumferential Ace wrap, or both may be fitted at
the completion of your operation.
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