Breast augmentation is also known as mammoplasty, breast enlargement or breast enhancement. A saline-filled prosthesis is used, typically after mastectomy as a part of the breast reconstruction process or used cosmetically to augment small breasts. Recent advancements in technology have provided different shapes (anatomic, teardrop, or round) and textures (smooth or fuzzy). These allow the doctor to customize your surgery and satisfy individual tastes in appearance. Saline implants are used almost exclusively and have been for at least the past twenty years. Saline is not new or experimental in any way and has more than stood the test of time. New implant fillers such as soybean are still experimental, and have not been approved by the FDA. The ideal candidate for breast augmentation typically has complaints of breasts that are too small or uneven, out of proportion to the rest of her body, or appear to be sagging or deflated. She may also have a desire for clothing to fit better or to feel sexier and have a better body image. The breast augmentation procedure usually takes about two hours and is done under general anesthesia. The patient will need to take 5-7 days away from work or strenuous obligations. Using the now widely practiced TUBA (Trans Umbilical Breast Augmentation) technique, an incision is made around the upper edge of the belly button. Through the incision, a slender instrument passes under the skin to a location behind the breast tissue. Temporary breast implant sizers are inserted in the space and inflated to create the space and adjustments are made, then an empty saline implant is placed in the pocket and filled with sterile saline. The space is made exactly in the right place and position to correspond to the exact type of implant. The incision is closed with a few absorbable stitches. The nipples and areolas usually enlarge in proportion to the increased breast size. The advantages of TUBA include faster recovery, very little tissue trauma, less risk of injury to the sensory nerves of the nipple and breast, shorter operative time, and a single scar away for the breast. The only dressing necessary is a surgical bra. No drains are required and this surgery can be combined with other procedures. Following the surgery, you will feel very groggy for the first two days and weak for about ten days. However, you can go home after several hours and can shower on the second day after surgery. Moderate pain is typical for the first two days but is mostly gone by the third day and easily controlled by medications. Bruising is unusual and swelling will be moderate for the first week but rapidly disappear. For the first three weeks, breasts will sit high on the chest. They will gradually settle into a natural position and contour. Many everyday activities can be resumed within the first week, and most by at least three weeks. The result of TUBA is very natural, enlarged, full, balanced breasts that improve with time. They will appear with a softness and natural bounce that persists.
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