Planning your surgery

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In your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor may also recommend a breast lift.

Be sure to discuss your expectations frankly with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each. You may want to ask your surgeon for a copy of the manufacturer’s insert that comes with the implant he or she will use — just so you are fully informed about it. And, be sure to tell your surgeon if you smoke, and if you’re taking any medications, vitamins, or other drugs.

Your surgeon should also explain the type of anesthesia to be used, the type of facility where the surgery will be performed, and the costs involved. Because most insurance companies do not consider breast augmentation to be medically necessary, carriers generally do not cover the cost of this procedure.

Preparing for your surgery

Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.

While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.

Where your surgery will be performed

Your surgeon may prefer to perform the operation in an office facility, a freestanding surgery center, or a hospital outpatient facility. Occasionally, the surgery may be done as an inpatient in a hospital, in which case you can plan on staying for a day or two.

Types of anesthesia

Breast augmentation can be performed with a general anesthesia, so you’ll sleep through the entire operation. Some surgeons may use a local anesthesia, combined with a sedative to make you drowsy, so you’ll be relaxed but awake, and may feel some discomfort.

The surgery

The method of inserting and positioning your implant will depend on your anatomy and your surgeon’s recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.

Working through the incision, the surgeon will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath your chest wall muscle (the pectoral muscle). The implants are then centered beneath your nipples.

Some surgeons believe that putting the implants behind your chest muscle may reduce the potential for capsular contracture. Drainage tubes may be used for several days following the surgery. This placement may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue. Placement behind the muscle however, may be more painful for a few days after surgery than placement directly under the breast tissue..

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