For years now, breast enhancement with implants has built itself a solid track record in accomplishing satisfying results for women. For those who wish to enhance or restore the size, shape, proportion, and overall appearance of their breasts, implants have become a popular choice.
Recent numbers by the American Society of Plastic Surgeons (in which Dr. Larry Fan is a proud member) reveal that breast augmentation remains on top of the most frequently performed surgical cosmetic procedures, closely followed by nose reshaping surgery and liposuction.
At our San Francisco practice, Dr. Fan and the rest of his expert team are often asked about what happens during a breast augmentation procedure. The truth is that no two surgeries are the same. Each procedure is unique and dependent on individual factors such as implant type, implant positioning, incision, and most importantly, your body.
However, certain elements are universal to breast implant surgeries. In this article, we'll show the process of the most common breast implant procedures, so you can have a better idea of what to expect on the day of your surgery.
Breast Augmentation: Making the Decision
Once the decision is made to get breast implants, careful and thorough planning should be in order.
Dr. Fan is not a proponent of rushing women into surgery as quickly as possible. You should know exactly why you want to have the procedure done in the first place. Then, you should understand, and be totally confident in the decisions of size, type, and placement of your breast implants.
In a nutshell, breast augmentation is more than just enhancing the size of your breasts; it helps you accomplish a more defined sense of femininity, image, and self-confidence.
Planning for Your Breast Augmentation
After a thorough discussion of your goals and preferences, Dr. Fan will meticulously assess and evaluate the existing shape, size, dimension, and symmetry of your breasts in proportion to your existing body contours.
Dr. Fan employs a consistent and highly effective method to assess your measurements. This is crucial in helping you find the most suitable implant type and size. Dr. Fan will walk you through the process of choosing the best size, shape, texture, implant location, and incision placement to deliver you the very best results.
All of these decisions can be overwhelming at first. However, Dr. Fan's vast experience in breast enhancement surgery makes a huge difference in helping you make the best decisions for you.
Getting Ready for Surgery
Our warm and helpful patient coordinators will provide you with a comprehensive list of dos and do not's in the weeks before your scheduled surgery.
There are some adjustments you may have to make, such as quitting smoking, that would adversely affect the healing process. You will also need to avoid certain medications, such as blood thinners, which can increase your risk of bleeding during and after surgery. Basic blood tests and lab work will be performed to ensure you are physically ready for your operation.
During the weeks leading up to your appointment, it is the best time to take stock of your post-surgery supplies, file for leave from work, and schedule someone to help you home after the surgery.
You should consider fully stocking your pantry and running any errands before your operation. If possible, you may also want to consider hiring help throughout your recovery process, such as someone who can cook or clean, or a nanny to help care for your children.
Read More: How to Get Ready for Breast Augmentation Surgery
The Breast Implant Procedure
Step 1: Administering Anesthesia
Following pre-surgery marking, anesthesia will be administered for your comfort. Your options include general anesthesia and intravenous sedation. Dr. Fan will recommend the best choice for you, based on your health, and personal preference.
Step 2: Making the Incision
Incisions are made to gain access to the breast so that a precise pocket can be created for each implant.
The incision can be made in one of four places:
- Inframammary crease - Underneath your breasts, within the crease.
- Transaxillary - Within the armpit, where the arm meets the chest area.
- Periareolar - Around the lower edge of the areola (the dark area surrounding the nipple).
- Transumbilical - In the navel.
The incision will largely depend on breast implant type, the degree of enlargement, your particular anatomy, and your preference.
Many patients would like to choose the incision location purely on where and how noticeable the scar will appear. At our practice, we consider this a bad idea since the risks and complications of each approach are different, and these issues are far more important than only scar appearance.
Your safety and comfort are our utmost priorities.
Upon review, the inframammary incision is the most popular. It is recognized as the best approach for a number of reasons, including safety and versatility. The armpit incision is another popular choice that can be good for some, but not all patients.
By and large, there is no single incision that is considered the best for all patients. Dr. Fan is skilled with all four approaches and he will help you decide which incision options are appropriate for the best outcome.
Step 3: Placing the Implants
Once the incision is made, the implant is put into place. Breast implant positioning depends on the type of implant, degree of enlargement, and your body type.
Placement can be one of three options:
- Dual Plane Placement ("Under The Muscle") - The implant is placed partly under the pectoral muscle (upper half) and partly behind the breast tissue (lower half)
- Subpectoral Placement ("Under The Muscle") - Under the pectoral muscle
- Subglandular Placement ("Over The Muscle") - Over the pectoral muscle and behind the breast tissue
Dr. Fan most commonly recommends implant placement under the muscle in the dual plane. Dual plane placement allows the implant to be protected by the muscle, which reduces the risk of implant rippling, implant visibility, and capsular contracture, while also allowing the implant to sit in a pleasing, natural position. Dual placement also facilitates mammogram examinations.
Dr. Fan will advise you on the best implant placement possible in lieu of your needs and body type.
Step 4: Closing the Incision
Incisions are carefully closed with layered sutures. Once healed, the incision lines from breast augmentation are typically concealed and inconspicuous.
While it is technically possible to perform the surgery in as little as 20 minutes, we believe that performing a careful, precise dissection with full control of bleeding and meticulous pocket control leads to safer and better results. Breast augmentation usually takes one-to-two hours to perform.
Having a Comfortable and Safe Recovery
After the surgery is complete, you will be discharged, but you will need a family member, friend, or caretaker to drive you home and accompany you for at least the first night after surgery.
Expect mild-to-moderate discomfort, swelling, and possible bruising. Discomfort can be reduced with pain medications.
The implants will often start "high and tight" and settle down over the course of 2 to 4 months as your body adjusts. Your relationship with Dr. Fan and our team will continue during this time of recovery.
You can get in touch with us at any time, and we encourage patients to communicate concerns or issues with us at all times. Dr. Fan will see you for regular follow-up examinations and show you how to maintain your beautiful results.
Enjoying Your Beautiful, Proportional, and Natural-Looking Results
The plastic surgeon of your choice will have a huge impact on your breast augmentation results.
Choose a surgeon who is an expert on breast implants, has a detailed understanding of breast anatomy, and has a genuine concern for your desired aesthetics, comfort, and safety.
We strongly recommend evaluating plastic surgeons on more than cost alone. All surgeons are not created equal; you choose a surgeon that is board certified, and has an established history in performing breast augmentation. Beyond their credentials, the best way to gauge a plastic surgeon's expertise, skills, and passion for achieving stunning results, is to schedule an in-person consultation.
Pay attention to how confident they make you feel, and how caring they are for your desires, concerns, and health. Once you find a doctor you know is looking out for your best interest, and has the experience to deliver the results you want, you can rest assured that your surgery will go smoothly.
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