Breast Augmentation Frequently Asked Questions: From Scars to Sensation

Getting breast implants is a major decision. With any big choice comes loads of inquiries. Here are some common questions women want to know before breast augmentation surgery.

The breast augmentation questions women ask before surgery

Women spend up to a year or more researching and consulting with board-certified plastic surgeons before taking the leap into breast augmentation surgery. Over that period, they often have these questions about cost, breast implant sizes, and aesthetics.

1. Does every patient have breast augmentation scars?

Breast augmentation scars are an inevitable part of the breast augmentation process. Whether the incision is made around the areola, under the arm, under the breast or along the navel, you will have them. But fret not, breast augmentation scars tend to heal extremely well over time, and there are ways to minimize scarring.

2. How long are breast implant incisions?

This depends a lot on your surgeon's skill, as well as the breast implant sizes and types you choose. If you get an inflatable saline implant, the incision will be approximately an inch long but may be shorter. If you get a pre-filled implant, such as textured silicone, the incision will be longer.

Textured implants are a little firmer than smooth implants, so they require longer incisions. Some surgeons say placing this implant type is like trying to squeeze a ball of sandpaper through a small incision. In short, some incisions will need to be longer than others.

3. What is the minimum age to have breast augmentation surgery?

As of May 2000, federal law prohibits breast augmentation for purely aesthetic purposes in females under the age of 18.

4. Will insurance cover breast implants?

Generally speaking, your insurance will not pay for any surgery that is purely cosmetic. Insurance companies are more apt to cover some of the cost if you have a physical deformity, such as one breast larger than the other, 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 cause quality-of-life issues like severe back, neck and shoulder pain.

5. How long do breast implants last?

Breast implants are not lifetime devices and most likely will need to be replaced at some point. However, many patients have breast implant lifespans that last more than 10 years. The 10-year figure most people hear about is actually referring to breast implant warranties, which often expire after a decade. But just because the warranty expires, doesn't mean your breast implants will.

6. Do implants look smaller than breast implant sizers once placed under the muscle?

Breast implant sizers only give an approximation and are not an accurate method of predicting breast size after breast augmentation surgery. If your implants are placed under the muscle, the final look will appear about 10 percent smaller than what you see when using sizers.

The reason for this is that the muscle compresses the implant, so while the implant does not change, the projection of the implant outward from your chest wall is less. To the contrary, implants over the muscle tend to look fuller since they lay on top of the muscle.

7. How much does a breast augmentation cost?

The cost of your breast augmentation depends on a variety of factors, including your location, the type of implant you choose (saline vs silicone, for example) and whether the procedure is coupled with another breast surgery like a breast lift. That said, the U.S. national average for a breast augmentation runs a little more than $6,000.

8. When it comes to implant rippling, are saline implants more likely to ripple than silicone implants?

Saline implants tend to ripple more than silicone implants due to being filled with a fluid (saline water) rather than a gel, which is more solid. If you choose large breast implants and have little breast tissue to cover them, the chances of rippling increase. Placing saline implants under the muscle can reduce rippling but will not necessarily rid all rippling.

9. How long does it take for breast implants to drop and fluff?

The amount of time it will take for your implants to settle in shape and position depends on your tissues, pockets, and implants. But in general, it takes 3-6 months for breast implants to drop and settle. What this really means is that the tissues have relaxed and the skin has stretched to allow the volume of the implant to occupy the pocket.

While the position of the implants will change and lower over the 3-6 month period, at approximately six weeks the overall volume of the breasts will be what they are going to be. Expect for your breasts to soften over the first year.

10. Will I have large areola after breast augmentation?

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

11. Will I get breast stretch marks after my breast augmentation? Can I prevent them?

It’s impossible to determine whether you will get stretch marks after your breast augmentation, but doctors believe that skin elasticity plays a major factor. Many women take preventative measures by heavily applying moisturizers like Palmer's Cocoa Butter, shea butter lotion, and vitamin E prior to their surgery.

12. What are the signs of infection after breast augmentation?

If your breast implant incision appears to be opening up, is healing slowly, is red and painful, or if pus is oozing out, these are signs of infection. You may also experience fever. If any of these symptoms present, you should contact your plastic surgeon immediately to receive treatment.

13. What should I do about itchy incisions and breasts after augmentation?

Itchy incisions and breasts are perfectly normal after breast augmentation. The itchiness occurs when the incision starts healing and due to the stretching of the skin.

Try applying a warm or cool (not too hot, not too cold) compress on or around the site. Many women claim the change in temperature helps to alleviate the itchy feeling. You may also try scratching around the incision. Only when the incisions have completely closed and healed can you apply anti-itch creams (e.g., Cortisone) and moisturizers.

14. I've heard of massaging breast implants. Will I need to massage after breast augmentation?

Surgeons have different opinions about massaging breast implants. Some doctors ask their patients to do it, while others say it is neither necessary nor beneficial. Those who do recommend massaging believe it helps keep the pocket open, thus reducing the risk of capsule contracture.

The recommendation to massage may also be based on whether you have smooth or textured implants. Most surgeons advise against massaging textured breast implants. The purpose of the textured shell is for it to adhere to your tissue. If you move the implant, you interfere with this process. To help in this debate, do exactly as your doctor asks.

15. How will smoking after breast augmentation with mastopexy affect my recovery?

Most doctors recommend that you stop smoking prior to surgery and for some time after, especially if you are having a breast augmentation with mastopexy (breast lift). A breast lift requires many more incisions than a breast augmentation alone. Smoking decreases the amount of oxygen in the blood and slows healing by constricting the capillaries. Lack of oxygen to the tissues can lead to necrosis (death of healthy tissue) and, in severe cases, necrosis can lead to extrusion of the implant. It also puts you at a much higher risk of infection, as well as ugly scarring.

16. Will I have swelling after breast augmentation?

It is normal to have some degree of post-op swelling in your breasts after breast augmentation. Within a few days to a few weeks, this swelling will dissipate. Sleeping in a reclining position will help the fluid move away from the breasts. Remaining hydrated and doing light movements assist as well.

17. Is it common to have breast augmentation bruising?

You may or may not have bruising. Like swelling, bruising may also occur in other areas like your ribs, abdomen, groin, and even as far as your upper thighs, though this isn’t as common. Tell your surgeon about any bruises that look really bad and feel firm. This could be a hematoma, a collection of blood outside of a blood vessel.

18. Will I be uncomfortable sleeping on my stomach after breast augmentation?

It will take a little time before you are able to sleep on your stomach after breast augmentation. Surgeons typically recommend patients sleep on their back in an elevated position for anywhere from two to six weeks after surgery. This is advised to help move fluid buildup and reduce swelling and pain. It also helps to avoid the risk of breast implant shifting before the breasts have had time to heal.

19. Will I have loss of nipple sensation after breast augmentation?

Some women experience tingling or numbness after breast augmentation, while others experience hypersensitivity. This too is normal. Changes in nipple sensation usually return to normal within a few months after the procedure.

Still have questions? Here's where to turn.

These are just some questions women have about breast augmentation surgery. Many more will arise, and when they do, ask a board-certified surgeon and join a breast augmentation forum. Women going through the initial and recovery stages of breast augmentation have found it helpful to consult with one another in these areas. There, they share invaluable stories and tips that help them get through the process.

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