What is breast enlargement?

In breast enlargement surgery, the doctor makes the breasts larger by putting an implant under the breast tissue and often under the chest muscle. An implant is a soft silicone shell filled with a saltwater solution or a gel.

Your doctor will make a cut, called an incision. It will be in the bottom crease of the breast, the armpit, or along the lower edge of the nipple and the dark area around the nipple. The doctor will make a pocket under the muscle or breast tissue. Then the doctor will put in the implant and adjust it to the correct shape, size, and position. The incision is closed with stitches.

You may have a breast lift at the same time as the breast enlargement. A breast lift is also called mastopexy. It can raise sagging or drooping breasts. It can also pull up the nipple and the area around it. To lift the breasts, the doctor removes excess skin from the bottom of the breast or from around the nipple. The remaining skin is sewn together. This tightens and lifts the breast. A longer incision is needed for a breast lift than for a breast enlargement alone.

You will probably be asleep during surgery. You may be able to go home the same day. Depending on the type of work you do, you should be able to go back to work or your normal routine in 1 to 2 weeks. The incisions leave scars. But the scars will fade with time. Your doctor will try to make the incisions in line with the curve of your breast as much as possible.

Your new breasts may feel firmer and look rounder. It is very important to understand that your breasts will look and feel different after surgery. You will have scars where the doctor made the incisions in your skin. The skin on your breasts may be numb. This usually gets better with time. But you may always have some loss of feeling in the nipple area. Most breast implants don't last a lifetime. Over time, you may need surgery to remove or replace your implants. This could cost a lot.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
• If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
• Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
• If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

• Bring a picture ID.
• Your doctor will use a marker to draw lines on your breasts. He or she will use the lines during surgery to reshape your breasts.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The surgery will take about 1 to 2 hours.

Going home

• Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
• You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare for your surgery.
• You become ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the surgery.