Throughout the ages, physical beauty has been determined by the values of each society. In our western culture during the late 1890's, for example, the large breasted woman with the small waist was the ideal. In the "flapper" era of the 1920's, women wanted slim bodies and very small breasts. Because an individual's body build is determined for the most part by genetic influences, women may not be able to achieve the look they want through diet and exercise alone. Today,through modern technology, many women are able to alter the shapes of their bodies. Breast Enhancement, or Breast Augmentation, is a safe, effective surgical procedure designed to improve the contour of a woman's body by implanting ;specially designed materials beneath the breast or chest wall muscles.

BEFORE SURGERY~ A complete medical history is taken in order to evaluate the general health of the patient. An examination of the breasts is also made to determined the most effective surgical approach. Pictures may be taken for medical documentation and before and after evaluation. The doctor describes the surgery and the risks are explained, and the results which can realistically beexpected. A mammogram may be required. Preoperative instructions often include the elimination of certain drugs, such as aspirin, in order to minimize the possiblity of excess bleeding. Stopping smoking for two weeks before and two weeks after surgery is required to promote healing. Birth control and other estrogen containing hormones may also be discontinued temporarily for the same reason. Antibiotics designed to prevent infection may be prescribed for a few days prior to surgeryand for a week following surgery.

THE PROCEDURE~ A breast augmentation is commonly performed in an outpatient surgery center under general anesthesia with the patient asleep. A local anesthesia in which the pateint remains awake and the area is numbed may also be used. The physician may choose from a variety of surgical procedures, depending upon what changes are desired. Prior to surgery, premedication to relax the patient is administered and the breasts are marked carefully to indicate where incisions are to be made. One of the techniques most frequently used is an incision made around the lowerportion of the areola ( the dark pink area surrounding the nipple). Anothertechnique is an incision made in the lower portion of the breast near the chest wall, or a location less frequently used is in the armpit.

Breast tissue is raised to form a pocket either under the breast tissue or beneaththe chest wall muscle. An implant containing either saline or silicone, is inserted into the pocket. Different sizes of implants may be used to correct breast asymmetry, or in the case of saline implants, one implant may be filled with additional saline to result in a more equal breast size. After the implant is securely;in place, small sutures are used to close the incision. A breast augmentation can take two hours or more, depending on the procedure and extent of the surgery.

FOLLOWING SURGERY~ The patient may wear a breast band to hold the implants more securely in the chest pocket and bandages and sterile skin tape, which is replaced with a special sports bra worn for up to two weeks after surgery.;Pain connected with the procedure is minimal to moderate and is controlled with oral medication. Antibiotics will be prescribed to prevent infection. Instructions for the day of surgery include bed rest and limited activities. The doctor will determine when normal activities can be resumed. However,strenuous exercises and overhead lifting, or picking up any weight greater than ten pounds must be avoided for several weeks. Sutures are removed in about five toseven days at which time the physician will recommend massage to keep the breast supple and prevent capsule scar contracture. Numbness around the treated area;may occur but this condition isusually temporary. Swelling and discoloration disappear in a few days and scars from the incisions although permanent fade significantly with time and are usually not noticible. Complications such as infection and slow healing are uncommon, however there are certain inherent risks connected with every surgical procedure which should be thoroughly discussed with the doctor. Patients can minimize complications by carefully following directions given by the doctor. In some cases in which the breast becomes too firm due to the formation of capsular scar tissue, a second procedure may be necessary. If you are interested in learning more about breast augmentation, please contact our office and we will be happy to answer your questions.