Choosing a breast augmentation plastic surgeon

Choosing a breast augmentation plastic surgeon

Choosing a doctor:

It is critical to select a physician who is adequately trained and experienced in breast augmentation procedures. See our Plastic surgeon feature to find a surgeon in your area, including detailed profile information for many of the listed doctors. Also read How to Select a Plastic Surgeon for a more detailed discussion on choosing the right doctor.

Questions to ask your doctor:

How long has the surgeon been doing breast surgery?
What is the total number of procedures that the doctor has performed?
Has the plastic surgeon ever had his/her malpractice insurance coverage denied, revoked, suspended? (No)
Does the FDA approve the implant the doctor will be using? (Yes)
What procedure is the doctor recommending and why? (Discuss different incision types, location of the implant, type of implant, and whether the doctor recommends a lift in addition to enhancement.)
Please explain the risks associated with the procedure, including: capsular contracture, infection, nipple sensitivity, rippling, rupture, symptoms of immune system disorders (see Risks section for detailed explanations.)
Percent of patients who experienced any of the aforementioned risks?
In the event that a second procedure is needed, does the original cost cover the additional expense?
Is there a warranty on the implants?
Where will the procedure be performed?
Who will be assisting the doctor during the surgery? What are their qualifications? Does the plastic surgeon perform the entire surgery?
What type of anesthesia will be used, and who will administer it?
Will the doctor provide references of patients who have had the same procedure? (The doctor should have a list of references available.)
Will the doctor provide before/after photographs of breast augmentations he/she has performed?
What are the guidelines and recommendations for selecting the implant size?
Can you observe the exact procedure you are having before you decide to have the surgery? (Yes, either on videotape or ask to view one in real life.)
What should you expect post-operatively, in terms of soreness, what to watch for, medication, bathing, and level of activity?
Who will be assisting the doctor during the surgery? What are their qualifications? Does the plastic surgeon perform the entire surgery?
How will the implants affect the way your routine mammograms are performed?
Do you offer patient financing?

Additional notes on breast augmentation

Tell your doctor about any allergies you have (to foods, drugs, environmental elements)
Tell your doctor about all medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription)
Carefully follow any instructions your surgeon gives you regarding eating and drinking, smoking, and vitamins.
Avoid aspirin and aspirin-containing medicines for two weeks prior to surgery.
Arrange for someone to drive you home after surgery.
Try to schedule surgery at a time other than your menstrual period.

To check if you are an ideal candidate for breast augmentation click here

The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. The best method of determining your options is to consult qualified surgeons who are able to answer specific questions related to your situation.

Breast augmentation cost and financing options

Costs for breast augmentation vary, depending on the doctor, the location, technique used and the difficulty of the specific case. The national average of 1999 surgeon fees for breast augmentation was $3,142 (Source: The American Society of Aesthetic Plastic Surgery).These fees do not include anesthesia, operating room facility, hospital stay and other related expenses. In most cases, health insurance policies do not cover the cost of this plastic surgery procedure.

Breast augmentation risks and complications

Breast augmentation risks & complications

Possible breast augmentation complications:

Your breasts will be wrapped with gauze bandage as well as a tighter bandage for protection and support. You also may have drainage tubes coming out of the incision for several days, to help drain some excess fluid.

It is important to take the medication prescribed to you by your doctor. Someone will need to drive you home You may need assistance at home over the next couple of days.

Breast augmentation risks:

There are several concerns regarding Breast augmentation: surgery itself, implants, breast cancer, and risk of anesthesia. Risks involved with breast augmentation have received a lot of attention, but neither cancer nor arthritis has been shown to be caused by breast implants. All operations carry some risk and possibility of complications can include (but are not limited to) infection, unsatisfactory results, excessive bleeding, adverse reaction to anesthesia, need for second or sometimes third procedures.

We recommend you read the specific complications outlined in the Food and Drug Administration Information for Women Considering Saline-Filled Breast Implants (courtesy of McGhan Medical Corporation and FDA). To obtain this information, read this online bulletin or contact the McGhan Medical Corporation, F.D.A. Consumer Information Line at (800) 532-4440 or your surgeon. There is no known association of breast implants with breast cancer in human beings; in fact several large studies have shown a lower incidence of breast cancer in women with breast implants. (Breast implant type devices have been shown to cause a rare form of cancer in rats that are prone to cancer, but this cancer has not been reported in humans with breast implants.)

Other side effects specific to breast augmentation include:
Capsular contracture: occurs when the scar or area around the implant begins to tighten, causing the breast to feel hard.
Nipple sensitivity or loss in sensitivity: usually disappears after several weeks, but for some this is permanent.
Rippling: indentations, often caused when the implant moves.
Rupture: when the breast implants tear and/or leak. This may require a second operation to replace the implant.
Symptoms of immune system disorders: some women have reported having symptoms such as joint pain swelling, fever, fatigue, or pain. Although research has not found conclusive evidence correlating breast implants with these symptoms, further studies have been requested by the FDA.
Many times patients will not be aware of complications until days or months after the procedure has been performed.

Breast augmentation candidates

Ideal breast augmentation candidate:

In general, a best candidate for Breast augmentation is:
18 years of age or older
Not currently pregnant or nursing
In good physical health
Psychologically stable
Wanting to improve their appearance
Realistic in their expectations
Having this surgery for the first time
The above is only a partial list of criteria that your plastic surgeon will consider in determining whether or not this plastic surgery procedure is appropriate for you. Be sure to ask your surgeon if he / she consider you an ideal candidate for Breast augmentation.

While many women seeking breast augmentation are young women who have been unhappy with their figures all their lives, others are women who feel that their breasts are no longer attractive following changes in weight, changes associated with aging, or changes due to childbearing. That means we see a relatively wide range of ages of women seeking this procedure.

The best candidate is one with little or no sagging, and a reasonable amount of breast tissue with which to cover the lower part of the implant. Women who are less than ideal candidates can still get excellent results, though, as we are usually able to perform additional procedures or modify the procedure in ways to overcome the problematic features. Dr Smith has had over 20 years of experience performing breast augmentations, and is well recognized for his expertise in his ability to treat a wide variety of complications from breast augmentation including the management of hundreds of women with problems related to leaking, or otherwise problematic, gel implants.

The breast augmentation procedure
The procedure is performed through a small incision with the patient completely asleep under general anesthesia. We typically perform breast augmentation in the office surgery facility and discharge the patient to the care of a responsible adult afterward. However, if you prefer, arrangements can be made to admit you to a nearby hospital.

After breast augmentation procedure
Like most procedures the first day and night is the most uncomfortable. The patient usually progresses quite rapidly to performing most normal activities in just a few days. We recommend wearing a soft brassiere with no under wire and to avoid any extremely strenuous activities for six weeks after the surgery after which time there are no further limitations on your activities. The procedure is performed through a small incision and any skin sutures are removed in only a couple of days. Dr Smith routinely follows his augmentation patients for at least one year and recommends annual visits with Dr. Smith for a breast exam by him indefinitely.

After breast augmentation surgery

What can I expect after surgery?

Your breasts will be wrapped with gauze bandage as well as a tighter bandage for protection and support. You also may have drainage tubes coming out of the incision for several days, to help drain some excess fluid.

It is important to take the medication prescribed to you by your doctor. Someone will need to drive you home You may need assistance at home over the next couple of days.

What is the recovery period like?

Your scars will be pink for several weeks. After several months they will begin to fade. It is critical that you review post-procedure care with your doctor. Following his/her instructions carefully will help ensure you have a speedy, healthy recovery. Also keep in mind that:
Rest is important to healing process, so do it as much as possible following your procedure. Drink plenty of fluids. Be sure to take your doctor’s prescribed medications.
For at least 3-5 days, you should try to keep arm extension to a minimal. Elbows should not be raised higher than armpit. Tissues will heal more quickly if you avoid stretching and separating muscle/tissue surrounding the breast implants.
Most likely, you will be able to resume calm, quiet work within a few days of your surgery. You should still avoid physical exertion for several weeks, depending on advice of your plastic surgeon.
After several days, your gauze dressing will be removed. You may be required to wear a support bra to help your breasts form and maintain a pleasing, balanced shape. You may or may not be able to shower, depending on where your stitches are.
Stitches will come out within a week to ten days, but swelling may continue, gradually subsiding over several weeks. With swelling, your breasts may seem hard ie. unnatural, but eventually they should soften to a more natural feel.
You will probably be able to resume exercise and normal physical activities within a month or two, when soreness has subsided. Recovery varies from patient to patient and depends upon technique, type of implant, site of placement that the doctor uses, as well as the level of activities in your daily routine. Ask your doctor for more specific information.

What is long-term outcome like for most people?

Breast augmentation reliably increases size as well as possibly balancing body proportions. Clothes may fit better, and you may also experience an increase in confidence and self-esteem.

How long do the results last?

Breast augmentation makes breasts larger. Remember, also that larger breasts sag faster than smaller breasts - augmented breasts do this as well. It is possible that you may require plastic surgery in later years to correct sagging if you choose to have large implants. Gravity, unfortunately has no exceptions. A study by Scott Spear, M.D. gives some information about how long breast implants last. This study can be found at www.plastic.org/info/HowLongDoSalineImplantsLast.html

How much pain is there?

Breast augmentation stretches tissues, and can be painful. This is especially true when the implants are placed under muscle. Pain is greatest within the first 48 hours, but improves with each day and is somewhat relieved by pain medications. In spite of the initial discomfort, most women report that they are very satisfied with their results of the plastic surgery.

When you wake up you will feel tired, sore - stiff. It is important to take medication prescribed to you by your doctor. Someone will need to drive you home, and you may need assistance at home over the next couple of days.

Your plastic surgeon may prescribe an antibiotic and an anti-inflammatory medication to be taken after surgery. It is a good idea to have these prescriptions filled beforehand.

Do I have to stay in the hospital?

Probably not. Most Breast augmentation is performed in a surgical suite as an outpatient procedure; you’ll be able to return home within a few hours of the plastic surgery.