Augmentation of the breast can be achieved with either autogenous tissue or implants. Most patients prefer augmentation with implants, either filled with saline or liquid silicone. Implants have vastly improved since their introduction in the 1960’s, but they remain a foreign material inside the body, and they still entail risks, including surgical hemorrhage, infection, scar formation, displacement, spontaneous rupture, diminished breast sensation and lactation, ptosis of the breast and repeat operation. Recent studies have revealed that implants with textured surfaces may cause a lymphoma (ALCL) and are no longer recommended.
The patient seeking breast augmentation should consider carefully their goals for a lifetime, not just the immediate gratification of a new body image. Future childbirth(s) will invariably change the breast anatomy, as will weight gain , weight loss, menopause and normal aging. Breast disease such as cancer deserves great deliberation regarding reconstruction with the oncologist, general surgeon and plastic surgeon. For women with a congenital breast asymmetry, breast implants can often be part of the solution.
The best results of a breast augmentation include: giving the patient natural looking and feeling breasts; breasts that are symmetrical; preservation of normal nipple sensation; normal movement of the breast; and inconspicuous surgical scars.
I encourage prospective patients to bring a spouse, dear friend or close adult family member during the consultation. Breast augmentation is not an urgent procedure and should not be hurried. Additional opinions/consultations and time for consideration are worthwhile. It is valuable to let patients “try on” a breast implant inside their bra of different sizes. Finally, breast augmentation is a serious surgery, even though a quite safe one in a modern surgical center and with an experienced surgeon.
