Breast Augmentation FAQ

Choosing to have a breast augmentation is a major decision, and with any big choice comes loads of questions. You'll not only have inquiries before the procedure, but after as well. Here are some top questions and answers covering the pre-op and recovery period.

Pre-Breast Augmentation

Can silicone gel move outside the pocket or scar capsule?

Yes, according to the FDA, it’s possible for silicone to migrate away from the breast. The free silicone may cause granulomas to form in areas in and around the breast, as well as other areas of the body that the silicone has migrated to, such as the abdomen, arm, armpit, and chest wall. Usually, the free silicone stays within the scar capsule and does not migrate to other areas.

How long are the incisions used for breast augmentation?

If you get an inflatable saline implant, the incision will probably be around an inch long, but may be shorter depending on the skill of the surgeon. If you get a prefilled implant, such as silicone, the incision will be a little longer. A lot depends on the skill of your surgeon, as well as the type and size of implant you choose. Because textured implants are a little firmer than smooth implants, they require longer incisions (for textured, prefilled implants). Textured implants have been equated to trying to squeeze a ball of sandpaper through a small incision, though this is certainly not the opinion of all plastic surgeons. Some incisions will need to be longer than others.

Will my areolas stretch out after I get implants?

This varies from woman to woman. If you get large implants, then you may notice a difference in nipple/areola size.

What is the minimum age to have a breast augmentation?

As of May 2000, federal regulation prohibits breast augmentation for purely aesthetic surgery in women under the age of 18.

Will my insurance pay for my breast augmentation?

No, your insurance will not pay for any surgery that is for cosmetic purposes only. However, your insurance will likely cover some of the cost if you have a physical deformity such as one breast larger than the other, if you had trauma to the chest requiring repair, or if you are a mastectomy patient. Insurance may also cover a breast reduction if your breasts are large and have caused quality of life issues like severe back, neck, and shoulder pain.

Will I get stretch marks when I have my breast augmentation? Can I prevent them?

It’s literally impossible to determine whether you will get stretch marks after your breast augmentation. Many doctors believe that your skin elasticity is a large factor. However, you can always take preventative measures. Many women have moisturized heavily prior to their surgery by using Palmer's Cocoa Butter, shea butter lotion, and vitamin E. It certainly will not hurt to try it.

If your breasts have pre-existing stretch marks due to pregnancy, breastfeeding, weight gain, etc., the implants will most likely help to fill them out and make them less noticeable. Regardless of where they are located, stretch marks can be treated with laser surgery. However, you will likely not get stretch marks due to breast augmentation surgery.

Breast Augmentation Recovery

How do I know if there’s a problem with my incision?

If your incision is healing slowly or is red, feverish, or painful; appears to be opening up, or has pus oozing from it, you need to contact your doctor immediately. These symptoms could be a sign of infection.

What can I do about itchy incisions?

Itching occurs when the incision starts healing. It's perfectly normal and nothing to worry about. Applying something warm or cool (not too hot, not too cold) on or around the site can sometimes alleviate the itchy feeling for a while. Though it's not fully understood, many women claim that the change in temperature helps. You may also try scratching around the incision. Many times, this helps as well. Do not apply anti-itch creams (Cortizone, etc.) to your incision, or anything else until the wound has completely closed. Once it has completely closed, you probably won't experience anymore itching.

What can I do about itchy breasts?

If your breasts are itching, it's most likely due to the skin stretching. You can apply a moisturizing lotion on them, but make sure you do not get any on your incisions (assuming they're in the crease or around the areola).

Will I have to massage my implants after my augmentation?

All surgeons have different opinions regarding massaging smooth breast implants. Some doctors ask all their patients to do it, and others say that it is not necessary or beneficial. The doctors who suggest it believe that it helps to keep the pocket open, thus helping to deter capsule contracture. Whether or not your doctor asks you to massage them has nothing to do with how the surgery is performed; it's simply a matter of whether or not your surgeon prefers and recommends massage.

Most surgeons will advise against massaging textured breast implants. The purpose of the textured shell is for it to adhere to your tissue. Moving the implant around will only inhibit tissue adherence.

Do exactly as your doctor asks you. This is important, because if you do not follow their instructions and you encounter a complication, you can easily be held responsible for it. However, do not be afraid to ask your doctor questions in regards to their instructions. The only stupid question is the one that isn't asked.

Will smoking affect my recovery?

Most doctors will recommend that you stop smoking prior to your surgery, especially if you are having a breast lift. Smoking decreases the amount of oxygen in the blood, which can slow healing by constricting the capillaries.

Capillaries are a system of microscopic vessels that link the arteries and the veins. Through their walls, which can be so small that only one red blood cell at a time can pass through, blood and tissue cells exchange various substances. The blood gives oxygen and nutrients to the cells and collects wastes from the cells. While blood flows rapidly through the arteries and veins, the flow through the capillaries is much slower. This allows time for the exchange of oxygen, nutrients, and wastes between tissue fluids and surrounding cells. If the capillary is constricted, the exchange of the nutrients is compromised.

Breast lift patients have even more reason to stop smoking. Lack of oxygen to the tissues can cause necrosis (death of healthy tissue). Due to the amount of incisions that are used during a breast lift (depending upon what type of lift you get), you will most certainly not want to compromise the level of oxygen that is supplied to those tissues. In severe cases, the necrosis can lead to extrusion of the implant, not to mention putting you at a much higher risk of infection, as well as ugly scarring.

Will I have swelling?

You will likely have some degree of post-op swelling, and it’s not uncommon for it to migrate down to your abdominal or even groin area. This is nothing to be alarmed about, as the swelling will dissipate within a few days to a few weeks. Sleep in a reclining position to help the fluid move away from the breast. Less fluid means less tension on the breast, which means less pain.

Will I have bruising?

You may or may not have bruising. Like the swelling, bruising may also migrate downward to your ribs, abdomen, groin, and even as far as your upper thighs, though this isn’t as common. A bruise that looks really bad and feels firm should be reported to your plastic surgeon. This could be a hematoma, which is a collection of blood outside a blood vessel.

Will it be comfortable to sleep on my stomach after my surgery?

Yes, but it may take a little time before it’s comfortable. It depends on how you recover. Some women can sleep on their stomach as early as two weeks post-op, while it takes others a little longer.

How long will it take my implants to settle into place?

This depends on the individual. You’ll likely see them settle around 2 to 3 months post-op. However, slight settling may still occur after this, and may continue for up to a year.

Updated July 2016

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