IF YOUʼRE CONSIDERING BREAST AUGMENTATION
Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons:

• To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
• To correct a reduction in breast volume after pregnancy.
• To balance a difference in breast size.
• As a reconstructive technique following breast surgery.
• By inserting an implant behind each breast, surgeons are able to increase a woman's bust line by one or more bra cup sizes. If you're considering breast augmentation, this will give you a basic understanding of the procedure when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on your individual circumstances. Please ask your surgeon if there is anything you don't understand about the procedure.

THE BEST CANDIDATES FOR BREAST AUGMENTATION
Breast augmentation can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently.  Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you're physically healthy and realistic in your expectations,  you may be a good candidate.

TYPES OF IMPLANTS
Breast implants are medical devices with a solid silicone, outer shell. The implant shell may be filled with either saline solution (sterile salt water) or elastic silicone gel. Both saline and silicone gel breast implants are approved by the U.S. Food and Drug Administration (FDA). Approval means that an
implant has been rigorously researched and tested, and reviewed by an independent panel of physicians for safety.

• Adult women of any age can benefit greatly from the enhancement breast implants provide. It is usually recommended, however, that a womenʼs breasts are fully developed prior to placement of breast implants.
• Saline implants are FDA approved for augmentation in women 18 years of age and older.
• Silicone implants are FDA approved for augmentation in women age 22 and older.
• Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.

ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure.

The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant.

As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.

A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.

Some women report that their nipples become oversensitive, under sensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear within time, but may be permanent in some patients.

There is no evidence that breast implants will affect fertility, pregnancy, or your ability to breast feed. If, however, you have breast fed a baby within the year before augmentation, you may produce milk for a few days after surgery. This may cause some discomfort, but can be treated with medication prescribed by your doctor.

Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the man-made shell to leak.

• If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be harmlessly absorbed by the body.
• If a silicone-gel filled implant leaks or breaks, the elastic silicone gel may remain within the implant shell, or may escape into the breast implant pocket (a capsule of tissue that surrounds the implant). A leaking implant filled with silicone gel may not deflate and may not be noticeable except through imaging techniques such as an MRI. For this reason, a women with silicone breast implants is advised to visit her plastic surgeon annually to assess that her implants are functioning well.  The FDA recommends that women with these implants receive MRI breast screening three years after implantation and every two years thereafter.

A few women with breast implants have reported symptoms similar to diseases of the immune system, such as scleroderma and other arthritis-like conditions. These symptoms may include joint pain or swelling, fever, fatigue, or breast pain. Research has found no clear link between silicone breast implants and the symptoms of what doctors refer to as "connective-tissue disorders," but the FDA has requested further study.

While there is no evidence that breast implants cause breast cancer, they may change the way mammography is done to detect cancer. When you request a routine mammogram, be sure to go to a radiology center where technicians are experienced in the special techniques required to get a reliable x-ray of a breast with an implant. Additional views will be required. Ultrasound examinations may be of benefit in some women with implants to detect breast lumps or to evaluate the implant.

While the majority of women do not experience these complications, you should discuss each of them with your physician to make sure you understand the risks and consequences of breast augmentation.

PREPARING FOR YOUR SURGERY
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.  If you smoke, it's especially important to stop at least a week or two before and after surgery; smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas.

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