A Board Certified Plastic Surgeon Resource
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Robert Applebaum, M.D.
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Milind K. Ambe, M.D.
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Ocean Plastic Surgery Center
Breast augmentation procedure
Home « Breast Augmentation « Breast augmentation procedure
Before you decide to go through with a breast augmentation procedure, you should know your options and variations of the procedure.
Inpatient or Outpatient
After choosing your physician and the method of surgery, your breast augmentation procedure can be performed as an inpatient procedure, requiring an overnight hospital stay, or as an outpatient procedure, being released the same day. In most cases the breast augmentation procedure is performed on an outpatient basis. The procedurecan beperformed in a hospital operating room, surgery center, or a surgical suite in asurgeon's office. The average operating time can range from 1 - 2.5 hours. The proper type of anesthesia for the breast augmentation procedure will be decided by your surgeon. General anesthesia is commonly used and local anesthesia is an option as well.
Incision and Placement
During the breast augmentation procedure, your surgeon will make an incision and create a "pocket," or space, within your breast tissues. The breast implant will be placed in the pocket, filled with saline and properly positioned. The incision is then closed with stitches, and possibly taped.
The two major decisions of the breast augmentation procedure are the incision site and the breast implant placement.
Choosing an Incision Site
The smallest possible incision is desired when performing the breast augmentation procedure. This requires the implant being inserted first and then filled with saline afterit's already in place. There arefour possible incision sites used in the breast augmentation procedure
- Transaxillary is performed in the armpit
- Periareolar is made around the nipple
- Inframammary is made under the breast fold
- Transumbilical (TUBA) is made in the belly button area
If the incision is made under the arm, the surgeon may use a probe fitted with a miniature camera, along with minimally invasive instruments, to create a "pocket" for the breast implant. This periareolar incision is the most concealed, but is associated with a higher likelihood of inability to successfully breast feed. The inframammary incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast-feeding. The axillary incision may be less concealed than the periareolar, but is associated with less breast-feeding difficulties than the periareolar incision site. Transumbilical incisions require less anesthesia time and typically have a faster recovery period then other incisions.
Implant Placement
Placement of the breast implant during the breast augmentation procedure can take place either sub-glandular, which is between the chest muscle and the breast tissue, or sub-muscular, which is below the chest muscle. Sub-glandular placement will usually make your surgery and recovery time shorter. If re-operation is necessary, it may be less painful and may make the implant easier to access. Sub-glandular placement also makes it easier to see and feel your implants through your skin post-op. Unfortunately, capsular contracture is more likely with sub-glandular placement and mammography images may be more difficult to read.
The sub-muscular breast augmentation procedure is a more painstaking surgery. This breast augmentation procedure may make surgery last longer, may make recovery longer, may be more painful, and may make it more difficult to have some re-operation procedures, as opposed to the sub-glandular placement. Benefits of this placement can be less palpable implants, less capsular contracture, and easier imaging of the breast with mammography.
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