Breast size is important to many women. Some individuals feel that small breasts not only limit their fashion choices, but can also cause dissatisfaction with body image. Breast augmentation to increase fullness and projection of the breasts improves the balance in a woman's figure and can enhance her self-image and self-confidence.

Breast augmentation enlarges a woman's breasts through the surgical placement of breast implants. In general, it is a cosmetic procedure strictly performed to fulfill your personal desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy. Implants may also be used for reconstructive purposes to restore a breast that is lost due to mastectomy, injury or for other reasons. In any case, breast implants allow women the choice of fuller, natural appearing breasts and a more balanced figure.

What is a breast augmentation?

Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery.

• Enlarge a naturally small breast, most commonly the result of heredity
• Restore breast volume lost following pregnancy, as a result of breast-feeding or due to weight loss
• Achieve better symmetry when breasts are moderately disproportionate in size and shape

Breast augmentation does not however correct sagging breasts. In cases where a woman desires to enhance breast fullness and at the same time improve the position and shape of sagging breasts, a breast lift may be performed in conjunction with breast augmentation.

Breast augmentation is a highly individualized procedure - one that you should choose to undergo to fulfill your own desire for enhanced breast size, not the desire of others. Permanent breast enhancement can only be achieved surgically. There is currently no medical treatment of any kind for breast enhancement with the proven results and satisfaction of breast augmentation.

Adult woman of any age can benefit from breast augmentation to enhance small breast size or restore fullness. However it is recommended that breasts be fully developed prior to breast augmentation. You should also be aware that breast augmentation does not generally interfere with a woman's ability to breastfeed.

A woman who is motivated by her own personal desire to enhance breast contour is most likely to be satisfied with the results of breast augmentation surgery. Good candidates are defined as:

• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Non-smokers
• Individuals with a positive outlook and specific goals in mind for improving their body image

For additional detailed information regarding the safety of breast implants, please visit www.breastimplantsafety.org

Where do I begin?

• A discussion of your goals and an evaluation of your individual case
• The options available in breast augmentation surgery
• The likely outcomes of breast augmentation and any risks or potential complications
• The course of treatment recommended by your plastic surgeon

Dr. Prevel will also answer your questions.

Evaluation

Overall health and personal outlook can greatly impact the outcome of breast augmentation surgery. These will be carefully evaluated in consultation with your plastic surgeon. The success of your procedure, safety and overall satisfaction require that you:

• Honestly share your expectations
• Fully disclose health history, current medications, the use of vitamins, herbal supplements, alcohol, tobacco and drugs . Be candid about any history of breast cancer in your family and your personal breast health
• Commit to precisely following all of your plastic surgeon's instructions

By making the decision to consult with your plastic surgeon and following all the instructions given, you are taking
an important step in helping to assure your safety.

Your plastic surgeon is certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada®. This certification designates surgeons who are specifically trained in plastic surgery of the face and entire body.

My breast augmentation

Incisions are made to keep scars as inconspicuous as possible, in the breast crease, around the nipple, or in the armpit. Breast tissue and skin is lifted to create a pocket for each implant.

Breast implants have not been shown to impair breast health. Careful review of scientific research by independent groups such as the National Academy of Sciences Institute of Medicine (lOM) has found no proven link between breast implants and auto-immune or other systemic diseases in women. Implants can, however, create subtle or more noticeable changes in the look and feel of your breasts. Capsular contracture, a condition that causes the naturally-forming scar tissue around a breast implant to contract, occurs in a variable percentage of patients and can make the breast feel firmer than normal. While this condition can be addressed surgically, correction is not always permanent.

You should be aware that breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants. Pregnancy, weight loss and menopause may influence the appearance of augmented breasts over the course of a woman's lifetime. Breast augmentation requires maintenance over time, including regular examinations for breast health and to evaluate the condition of your implants.

The breast implant may be inserted directly under the breast tissue or beneath the chest wall muscle.

A mammogram may be recommended prior to your procedure to ensure breast health and serve as a baseline for future comparison. Following the procedure, mammography is technically more difficult. Obtaining the best possible results requires specialized techniques and additional views. You must be candid about your implants when undergoing any diagnostic breast exam.

Preparing for surgery

Dr. Prevel will carefully explain your breast augmentation procedure. Prior to your surgery, you will be given specific instructions that may include:

• Pre-surgical considerations, diagnostic testing and medications
• Day of surgery instructions and medications
• Specific information related to the use of anesthesia
• Postoperative care and follow-up

In addition, you'll be asking to sign consent forms to assure Dr. Prevel you fully understand the procedure you will undergo and any risks and potential complications.

Risks associated with breast augementation include bleeding, infection, or poor healing of incisions and changes in nipple or breast sensation. Capsular contracture, implant leakage or rupture, or wrinkling of the skin over the implant is also possible and may require a second procedure. All surgery carries risks associated with anesthesia. These risks and others will be fully discussed prior to your consent.

It is important that you address all your questions directly with Dr. Prevel. It is natural to feel some anxiety, whether from excitement for the anticipated outcomes or preoperative stress. Discuss these feelings with Dr. Prevel.

What to expect

Breast augmentation may be performed in your plastic surgeon's accredited office-based surgical facility, an ambulatory surgical facility or a hospital. The decision for anesthesia will be based on the requirements of your specific procedure and considerations of patient and surgeon preference. Dr. Prevel and the assisting staff will fully attend to your comfort and safety.

Following surgery

Once your procedure is completed, dressing or bandages will be applied to your incisions, and an elastic bandage or support bra will minimize swelling and support the breasts as they heal. Before you are released following surgery, you and an accompanying responsible familhy member, friend or caregiver will be given specific instructions that may include:

• How to care for the surgical site
• Medications to apply or take orally to aid healing and reduce the potential for infection
• Specific concerns to look for at the surgical site or in overall health
• When to follow up with Dr. Prevel

After surgery, breasts appear fuller and more natural in tone and contour. Scars will fade with time.

Progress and healing

Initial healing may include swelling and discomfort at the incision sites and breast tissue overall. Discomfort is common and can be controlled with medication. A support bra may be recommended around the clock for the first week or two. It is important to cleans the incision sites and apply any ointment as directed. Follow all instructions carefully; this is essential to the success of your outcome. You will be ready to return to work and light, normal activity within a few days.

Initial wound healing may take 5 to 10 days, after which time sutures will be removed if necessary. You will be ready to return to work and normal activity at this time, if you feel comfortable, so long as you do not engage in any heavy lifting or vigorous exercise. Initmate contact with breasts may resume when healing is fully completed, usually within 4 to 6 weeks.

Additional healing will continue for several weeks as swelling resolves, implant position settles and incision lines continue to refine. Incision lines are permanent, although inconspicuously located. Continue to follow Dr. Prevel's instructions and attend follow-up visits as scheduled.

Results and outlook

The results of breast augmentation are immediately visible. Final results appear gradually over the next few weeks as swelling resolves and breast size and shape settles. Incision lines typically continue to fade over the next year.

Over time, your breasts change due to aging, weight fluctuations, hormonal factors and gravity. However, your new enhanced breast contour and the freedom to wear the clothes you enjoy without the need for padded bras should bring you added self-confidence whether at the beach or in the boardroom.