After any surgery, there will a period of time when there is increased swelling followed by recovery and resolution of the swelling. Typically, the swelling increases for the first 4-5 days and peaks out about day 5. Then there is a relatively rapid decrease in swelling for about 6 weeks. At this time usually about 80% of the swelling has resolved. The remaining 20% may take several more months to resolve entirely.

Immediately after breast augmentation there is also some tightness about the implant as these tissues are draped over the implants. As time goes on the tissues will slowly stretch and accommodate to the implant. This entire process may take up to 4-6 months. During this time there is continued softening of the breasts and relaxation of the implant within its pocket.

About a month after surgery, although the entire healing process is not yet complete, the breasts begin to have a very pretty appearance since enough of the swelling has resolved and some softening has developed. Nevertheless, the final result will not be apparent until about 6 months.

Finally, after having done breast augmentations for more than a decade, my experience is that, with rare exception, most women after about 6 months wish they had chosen an implant somewhat larger than what they actually did choose. My recommendation to you is that you be patient for the time being, allow things to heal and settle down before you make a decision about changing size. In the big scheme of things you are still relatively early in the healing period.

1. Size matters.
Obviously any woman desiring a breast augmentation wants to be fuller and larger and this can be readily accomplished with a large variety of implant sizes and/or types. Women who have had previous pregnancies often have some breast skin laxity. In order to get an optimal result, it may be advantageous to choose an implant large enough to fill out the breast and restore the projection and “perkiness” of the breast. This will also fill out clothing and add to the feminine figure. Nevertheless, the initial enthusiasm for choosing a large implant should be weighed against the potential long term disadvantages of supporting the weight of these implants. Large heavy implants can over time lead to stretch of the skin and excessive dropping of the implant. It is difficult to predict exactly what size will lead to this situation and the recommendation of the surgeon should be carefully considered.

2. Incision doesn’t matter.
The three most common locations for the incision are in the skin crease at the bottom of the breast, around the edge of the nipple and in the armpit. An excellent cosmetic result can be achieved with any of these incisions. The recovery, scarring and risks are all essentially the same. Some surgeons (including myself) may have a personal preference but the final result should be independent of which incision is used.

3. Implants are different.
Breast implants are filled with either saline (a salt water solution such as IV fluid) or silicone. Both are good implants and excellent results can be achieved with either type of implant. Nevertheless, there are some differences. The silicone implants feel softer and more realistic. Further, after augmentation the tissues of the breast tend to drape over the silicone implants a in a more natural fashion and give a prettier appearance. After years of study, the FDA has determined that there are no health hazards associated with silicone filled implants as compared to saline filled breast implants. They are available to any woman 22 years old or older.

4. Placement can be either above or below the chest wall muscle.
The pectoralis major muscle can be used to add additional padding or coverage over the implant during breast augmentation. This is especially advantageous when using saline filled implants, which have a tendency to ripple. The rippling can cause the appearance of waves on the surface of the breast especially in the upper portion and especially if there is relatively little breast tissue covering the implant. Placing the implant under the muscle minimizes this risk.

5. Surgeon choice matters.
Surgeons certified by the American Board of Plastic Surgery (ABPS) have undergone extensive training and testing under the guidelines of the ABPS specifically related to plastic surgery including cosmetic surgery. Plastic surgeons who are members of the American Society for Aesthetic Plastic Surgery (ASAPS) have also demonstrated particular interest in cosmetic surgery and are required to maintain levels of continuing education. In addition to credentials, you must feel comfortable with your choice of surgeon and also realize that this is your operation. Your surgeon should give you information and advice about the procedure, but in the end the decision should be yours. You should be able to choose your own implant size, style, location of incision and so forth.

For more information about breast augmentation and other plastic surgery procedures, call us at 615-327-0201 or visit our website at http://www.DrNein.com