Making aAn Informed Decision About Breast Augmentation or Enlargement

Your cosmetic surgeon will of course give you information on these subjects, and make recommendations after he has examined you. The decisions are best made by both you and your cosmetic surgeon together.

Am I a good candidate?

Do you want breast augmentation to please and satisfy yourself? If you want it to please somebody else, it would be best to hold off until you work through the issues around wanting to please that person. Having larger breasts does not change you as a person (although it can give you more physical confidence). Nor does it make you better liked or give you a more active social life.

However, if you?re sure that larger breasts will increase your own self-esteem, regardless of anyone else?s opinions, that is a good reason for doing it. If you have lost breast tissue after pregnancy, or if you?ve been disappointed with your natural development through the teen years, or if you?d like to have more equally sized breasts, you?ll be one of a large group of women who enjoy the benefits of this procedure.

Choosing an implant size

It?s nice to have a breast size that makes it easy to find clothes that fit well, and that complements the rest of your body shape. To achieve that, a large implant is probably not necessary. If you allow photos of movie stars and models to push you into choosing too large an implant size, know that there could be some disadvantages:

? You may be uncomfortable sleeping on your stomach

? You may need extra support, especially for physical activity

? You?ll be carrying extra weight and your muscles may need to adjust

? You may be uncomfortable about attention from unappealing men

? You may encounter envy from some other women

?Choosing the implant size is best done as a joint decision,? explains cosmetic surgeon Dr. Adrian Lo in Philadelphia, PA. ?You tell me what you?d like, and I?ll make some measurements, give you suggestions, and together we can come to the best decision.?

The size of a breast implant represents the difference between the size you start out with, and the size you end up with. Implants come in volume sizes, (ounces of fill, or cubic centimeters), not in the familiar alphabetical sizes of bras. If you are currently a 34A size and would like to be 34C, you?ll need a larger size implant than would a woman who starts off at 34B.

Implant types

Since November, 2006, when the FDA approved the use of silicone gel implants, there is now a choice which was not available before. The other type of implant is saline (filled with sterile salt water). The two types have a different feel, as silicone gel more closely resembles breast tissue. Also, the silicone gel in these newly-approved implants is cohesive, meaning that it sticks to itself and doesn?t leak. If a saline implant leaks, it isn?t a health problem, as the salt water is easily absorbed by the body.

A saline implant is inserted empty and filled afterwards, so a smaller incision is possible. Implants can have smooth or textured shells, a round or teardrop shape, varying diameters, and a low, medium, or high projection. All these options can be discussed with your cosmetic surgeon.

Implant locations

Implants can be positioned in two ways: beneath the breast tissue but above the pectoral muscle, or beneath both. When they?re above the muscle, depending on how much breast tissue you already have, sometimes the edge of the implant becomes visible. When the implant is beneath the muscle, actually only the top part of it is beneath, and the lower part is beneath the breast tissue only.

Incision locations

If you choose saline implants, there are three possibilities: ? Areolar incision (the incision is actually below the nipple at the lower edge of the areolar, although sometimes referred to as the ?nipple? incision)

? Crease incision or below the breast in the crease

? Transaxillary or in the armpit

Because the silicone gel implants come prefilled, you only have the choice between the crease incision and the areolar incision.

All surgery brings risk and side effects. Breast implant surgery is fairly straightforward, but there will still be some bruising and bleeding during the healing period. Any time the skin is incised there will be a scar, although the implant incision sites are chosen to leave you with the least visible scar possible.

Some of the risks of breast implant surgery are:

? Capsular contracture ? where the scar formation around the implant contracts too much, squeezing the implant and causing the breast to feel hard

? Possible infection ? much less likely if you do a good job of following your after- surgery instructions

? Increased or decreased sensitivity in the nipples ? which often disappears but sometimes becomes permanent

? Rupture of the implant ? and then it must be replaced

There are procedures to deal with all these possible complications. In general, breast implant surgeries are very successful.

?The decision to enhance your appearance with cosmetic surgery is an important one,? says Dr. Lo. ?Choose a cosmetic surgeon who will listen to you and work with you to arrive at the best possible outcome. This way when you wake up after your surgery there will be no unpleasant surprises.?

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