Breast Augmentation Surgery: A Step-by-Step Walkthrough

Going through any change in a person’s life can be stressful, especially one that involves a medical procedure. Breast augmentation surgery is no different. That’s why we have developed a step-by-step guide to walk you through every step of the process.

What is Breast Augmentation Surgery?

Breast augmentation (or “augmentation mammoplasty”, sometimes called a “boob job”) is a common type of cosmetic surgery. It results in the increase of a person’s breast size and shape. There are two main ways to do this: breast implants and fat transfer. There are also two types of implants: they can be filled with either silicone or saline. The method that you choose depends on the desired look and feel of your breasts.

For more information about breast augmentation surgery, please refer to What is Breast Augmentation Surgery?

A Step-by-Step Process for Breast Augmentation Surgery

Below is a step-by-step guide for the process that you will have to go through for breast augmentation surgery. This guide focuses on cosmetic breast augmentation surgery.

Consultation for Breast Augmentation Surgery

Before actually having the surgery, you will first attend a consultation with your doctor. This will give you the opportunity to discuss the operation with your doctor, ask questions, and thoroughly discuss what you want to change about your breasts. Your doctor will also make sure you’re in good health mentally and physically, and ask you questions about your medical history. These questions may include asking about:

• The medications you are taking
• Any allergies you may have
• Your smoking history
• Your use of herbal supplements, alcohol, and recreational drugs
• Prior surgeries
• Any previous issues you’ve had with your breasts, including lumps, previous mammograms and any family history of breast issues

Your surgeon will also give you a medical exam to ensure that you are a good candidate for breast augmentation surgery. This evaluation will include:

• Evaluating your general health, taking into account pre-existing health conditions or risk factors
• Measuring and examining your breasts (size, shape, etc.)
• Taking photographs

Questions to Ask Your Doctor

These consultations are also a good opportunity to ask your doctor for some information. Do not be afraid to ask tough or important questions because the more you know, the more comfortable you will be with your operation. Here is a list of questions about breast augmentation surgery that you might want to write down to ask your doctor during the consultation:

Questions about your doctor’s qualifications and experience

First, be sure to ask about the doctor’s qualifications and his or her experience, to ensure that you will get the best service available:

• Are you certified by the American Board of Plastic Surgery? If not, why?
• How long have you been performing breast augmentation surgery?
• Were you trained specifically in the field of plastic surgery?
• How many breast augmentation surgeries do you usually perform in a month?
• How many revisions of your own work, on average, do you perform?
• Have you been involved in any medical malpractice suits?

Questions about the surgeon’s past work

Then, it is recommended that you ask for examples of their past work to make sure that the results they produce are in line with your personal desires:

• Can I see some before and after photos of your clients?
• Can I speak with some of your previous clients?
• If I don’t like the results of my breast augmentation surgery, what can I do?

Questions about breast implants

• Third, if you decide to get breast implants as opposed to fat transfer breast augmentation, then you should ask these questions about implants:

• Are silicone breast implants or saline implants better for me, and why?
• What breast size do you suggest for my body type?
• Will I lose any sensation in my nipples or breasts?
• Do implants affect breastfeeding?
• Will the implants make mammograms less accurate in detecting breast cancer?
• What is the warranty for this breast implant, and what fees do I have to pay if it ruptures?

Questions about the risks and complications of breast implants

Fourth, be sure to ask about the possible risks and complications of breast augmentation surgery so that you have a detailed explanation about everything that might happen as a result of getting the surgery.

• What are the possible risks of breast augmentation surgery?
• Is it possible to prevent breast implants from rupturing, rippling, or wrinkling?
• If I have any breast implant complications, what is your policy? Do you cover expenses? Do you recommend a cosmetic surgery complication insurance policy?

Questions about how to prepare for the surgery

Then, ask the doctor about the things you have to do to prepare for your surgery. This includes the medications you should or should not take and the things you may need to temporarily cut out of your life.

• What diet and lifestyle changes will I need to make before breast implant surgery?
• What do you recommend to treat swelling, bruising, and pain?
• Will my regular pills (birth control pills, antidepressants, diet pills) affect the anesthesia?

Questions about the surgery

After that, ask about the surgery itself so that you know exactly what the process you will go through will be.

• Where will my breast augmentation surgery be performed, and is the surgery center accredited?
• Is the center set up to handle a life-threatening emergency?
• What hospital would I be taken to if there were a problem?

Questions about the recovery process

Afterward, you should ask about the recovery process to ensure that you have all the information that you need to prepare for a smooth recovery. This information will be reiterated after your surgery, as well.

• If I have an emergency after going home, how can I reach you?
• How long will healing take?
• Will I have to have other implant-related surgeries in the future?
• How will my breasts look if I choose to have the implants removed in the future without replacement?

Questions about financial issues

Finally, you should ask about any financial transactions that you will have to make for the surgery.

• What is included in the surgical fee? What is not covered?
• If I am not satisfied and need a revision surgery, is that included in the initial fee?
• Is implant removal included in the initial fee?
• If there are complications with the results of my breast augmentation surgery, is that included in the initial fee?
• Will my deposit be refunded if I change my mind?

Preparation for Breast Augmentation Surgery

Before you have surgery, your doctor will ask you to do a few things to prepare:

• Take a blood test
• Take certain medications
• Possibly adjust certain medications you are already taking
• Avoid taking aspirin and certain anti-inflammatory drugs (they can increase bleeding after the surgery)
• Avoid certain foods or drinks
• Stop the use of recreational drugs

You should also make a few arrangements for after breast augmentation surgery. On the day of, you should arrange for someone to drive you home. You should also have someone stay with you for at least the first night after surgery. At least three days off of work will be needed for immediate recovery after the surgery. This time frame increases to three weeks if you have a labor-intensive job.

It is also recommended that you have a special recovery area in your home set up. This area could include:

• Pain medication prescribed by your surgeon (if you have been prescribed any)
• Clean gauze to cover the incisions
• Loose, comfortable, button-down shirts

Breast Augmentation Surgery

Then, it is time for the actual surgery. Breast augmentation can be done as an outpatient procedure (allowing you go to home right after the surgery) or you might be required to stay at the hospital overnight. The surgery itself takes about an hour to two hours. It will be done in four stages:

Anesthesia

Breast augmentation surgery will be done during local anesthesia or general anesthesia. Local anesthesia is when you are awake during surgery, with only your breast area being numbed. More often, though, you will be under general anesthesia. This is when you are asleep during the surgery.

Incision

You will decide where the incisions are going to be made with your doctor before breast augmentation surgery. This ensures that the placement will best suit your needs. The areas vary based on the type of implant, how much you want to increase your breast size, your body’s anatomy, and patient-surgeon preference. The incisions will be either:

• Along the crease under your breast (known as the inframammary fold)
• Along the edge of your areola (known as the periareolar incision)
• Via your armpit (known as a transaxillary approach)

Implant Insertion

Implants can be inserted in two ways:

• Under the pectoral muscle (a submuscular placement)
• Over the pectoral muscle, directly behind the breast tissue (a submammary/ subglandular placement)

The placement of the implant depends on the type of implant, the desired degree of enlargement, your body type, and your surgeon’s recommendations.

Closing the Insertion and Going Home

After inserting the implants, your surgeon will close the insertion site using stitches. They might also use drainage tubes. After you come out of breast augmentation surgery, you will be taken to an observation room. Your breasts will be covered using a gauze bandage and you may also be sent home wearing a surgical bra. Your surgeon might also give you prescription medication to help with any pain you may feel. If not, over-the-counter pain relievers, like acetaminophen, may also help. If your surgeon used drainage tubes, you will also be instructed on when to get those, as well as your bandages, removed. Be sure to follow your surgeon’s instructions for taking care of the incision site after going home.

After Breast Augmentation Surgery and Recovery

After breast augmentation surgery, your stitches will probably be ready to be removed in about a week’s time. Be sure to take it easy after the surgery to give your body time to recover. For about the first four weeks, do not do any heavy lifting. Furthermore, if you are active in sports, you may need to refrain from doing so for about six weeks. Usually, a full recovery will take about six to eight weeks.

Be sure to wear your support garment (a bra or elastic band) as instructed by your surgeon. Some patients will be asked to clean the incision site and regularly apply ointment, while others will be instructed to keep the bandages on at all times. This depends on your surgeon’s recommendations.

Swelling around the area in which the breast augmentation surgery was done is normal and expected. This swelling will go down over time. However, the incisions may take a little longer to fade completely. It may take a few months, but it could even be a few years, depending on the patient. Furthermore, it is possible to bleed into the pockets around the implants for the first few days.

Contacting your doctor or surgeon is recommended if:

• You have a fever
• You see abnormal discharge, like pus, coming from your incision site
• Your stitches open or tear
• You see that one of your breasts is larger or firmer than the other and you experience pain and pressure in that area

Moreover, the results of breast augmentation surgery are usually visible immediately. However, sometimes the final results take a longer time to show. This is because the swelling experienced after surgery usually takes a while to go down, and the skin around the breast area takes some time to stretch.

Maintenance

One major thing about breast augmentation surgery is that the implants are not meant to last forever. Over time, just like natural breasts, the size and shape of the breast will change. This can be because of aging, gaining or losing weight, or hormonal factors. Therefore, if you experience this change, or if you experience complications, you might need to have your implants replaced. Some patients also choose to have breast lifts instead of an implant exchange.

Furthermore, you will need to visit your cosmetic surgeon once a year to have a checkup. This is so your surgeon can check the health of your breasts and make sure the implants are in good shape. If you chose to have silicone gel-filled implants, three years after your surgery you will be required to get an MRI scan, which will be repeated every two years afterward. This is to check your implant for silent rupture (when the implant breaks inside your breasts but there are no outward signs). If your implants rupture, you will have to replace or remove the implant.