The Augmentation Procedure 101

What is a basic description of the procedure?

Your plastic surgeon will make an incision and create a "pocket," or space within your breast tissues, for the breast implant. The breast implant will be placed in the pocket and positioned. Then the incision will be closed, usually with stitches, and possibly taped.

Where is the surgery performed?

Breast augmentation is most frequently performed on an outpatient basis in a hospital operating room, surgery center or surgical suite in a surgeon's office. You and your plastic surgeon may have decided on an approach to your surgery that may require an overnight stay at the hospital

How long does the procedure take?

On average, the surgery lasts one to two hours.

What anesthesia will be used?

General anesthesia is commonly used, but local anesthesia also is an option. Your doctor can discuss with you the most appropriate choice of anesthesia for you.

What are the differences between incision site options?

With incision sites, the goal is always to choose the option that will result in the least obvious scar. There are three common incision sites used for breast augmentation: under the arm (transaxillary), around the nipple (periareolar), or within the breast fold (inframammary). If the incision is made under the arm, the surgeon may use a probe fitted with a miniature camera, along with minimally invasive (very small) instruments, to create a pocket for the breast implant.

Incision options:

Periareolar
This incision is the most concealed, but is associated with a higher likelihood of inability to successfully breast feed, as compared to the other incision sites.

Inframammary
This incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast-feeding.

Transaxillary
This incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast feeding.

Umbilical/endoscopic
This incision site has not been studied and is not recommended.

Where are implants placed in the breasts?

Here again, you have options. Breast implants may be placed sub-glandular, which is between the chest muscle and the breast tissue, or sub-muscular, which is below the chest muscle.

Sub-glandular Breast Implant Placement

Sub-glandular placement may make your surgery and recovery time shorter. It may be less painful and it may make the implant easier to access if re-operation is necessary. This placement also may make it easier to see and feel your implants through your skin after your surgery. Capsular contracture is more likely with sub-glandular placement, and imaging of the breast with mammography may be more difficult.

Sub-muscular Breast Implant Placement

The sub-muscular placement may make surgery last longer, may make recovery longer, may be more painful, and may make it more difficult to have some re-operation procedures than the sub-glandular placement. The possible benefits of this placement are that it may result in less palpable implants, less capsular contracture, and easier imaging of the breast with mammography.