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During surgery to enlarge the breasts (augmentation mammoplasty), an implant is placed under the breast tissue or under the chest muscle beneath the breast. An implant is a soft silicone shell filled with silicone gel or a saline (saltwater) solution.
To position the implant, an incision is made in the bottom crease of the breast, the armpit, or along the lower edge of the areola (the coloured area surrounding the nipple). The implant is inserted through the incision and may be placed under either the breast tissue or the chest muscle beneath the breast. Some doctors believe that putting the implant beneath the chest muscle lowers the risk for a condition called capsular contracture (hardening of tissue surrounding the implant) and interferes less with mammography than when the implant is under the breast tissue but in front of the muscle. After the implant has been carefully adjusted to the correct shape and position, the incision is closed with stitches.
A breast lift (mastopexy) may be done at the same time as the breast enlargement. A breast lift can raise sagging or drooping breasts and elevate the nipple and areola. To lift the breasts, excess skin from the bottom of the breast and the area around the areola is removed. The remaining skin is then brought together, which tightens and raises the breast. A breast lift requires larger incisions than a breast enlargement alone. Incisions may extend from the areola down to the crease where the bottom of the breast meets the chest.
What To Expect After Surgery
Immediately after the surgery, gauze is taped over the stitched incisions, and the breasts are wrapped in an elastic bandage or supported by a special bra. The stitches may be removed in 7 to 10 days.
Most women have some swelling, bruising, and soreness in their breasts for several days after the procedure. Medicine can help relieve the pain. Swelling and bruising may last for several weeks. Some women also have a burning sensation in their nipples right after surgery. Wearing a supportive bra 24 hours a day can help reduce swelling and support the breasts while they heal.
Most women can resume their normal work and social activities within a few days, unless those activities involve heavy lifting or strenuous exercise. Your doctor will tell you when you can return to more vigorous exercise and activities.
You will have scars after breast enlargement surgery. But these are usually in well-concealed areas (such as the crease under the breast, the armpit, or the border of the areola). These procedures are designed to minimize scarring so that incisions are not easily seen. Scars usually fade after several months. Having a breast lift in addition to an enlargement leaves larger, more visible scars.