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 the surgical placement of breast implants to increase fullness and projection of the breasts to improve symmetry of the breasts. Clinically referred to as augmentation mammaplasty, the procedure is used cosmetically to:

• 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 women 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

Where Do I Begin?

A consultation with Dr. Paula Legere is the first step to learn how breast augmentation can enhance your breasts’ appearance and improve your body image. A consultation is designed to fully educate you about breast augmentation in a non-pressured environment and will include:

• A discussion of your goals and en 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 Dr. Legere

Dr. Legere will answer any question you may have regarding breast augmentation surgery.

Evaluation

Overall health and personal outlook can greatly impact the outcome of breast augmentation surgery. These will be carefully evaluated 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 Dr. Legere’s instructions

Safety

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

Dr. Paula Legere is certified by The American Board of Plastic Surgery. This certification designates surgeons who are specifically trained in plastic surgery of the face and entire body.

My Breast Augmentation

Dr. Legere performs breast augmentation using medical grade, biocompatible, textured, or smooth Natrelle ® saline or gel filled implants. You may visit their website to view the differences between saline and gel at: http://www.natrelle.com/breast_augmentation.aspx#4.

Implant placement, type and size will be determined based on your breast anatomy, body type and desired increase in size, as well as your plastic surgeon’s judgement.

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 (IOM) has found no proven link between breast implants and auto-immune or other systematic 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.

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. Legere will carefully explain your breast augmentation procedure. Prior to 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 will asked to sign consent forms to assure Dr. Legere that you fully understand the procedure you will undergo and any potential risks or complications.

Possible risks of breast augmentation 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 and additional risks will be discussed prior to your consent.

It is important to have all of your questions answered and it is natural to feel some anxiety about surgery. Discuss these feelings with Dr. Legere.

What happens during breast augmentation surgery?

Step 1 – Anesthesia

Medications are administered for your comfort during breast augmentation surgery. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

Incisions are made in inconspicuous areas to minimize visible scarring. You and your plastic surgeon will discuss which incision options are appropriate for your desired outcome. Incision options include:

Inframammary incision

Periareolar incision

Incisions vary based on the type of implant, degree of enlargement desired, your particular anatomy, and patient-surgeon preference.

Step 3 – Implant choice: Silicone breast implants or saline breast implants?

Breast size and shape are important, so be honest and open about your expectations when talking with your surgeon.

Implant type and size will be determined not just on your desired increase in size but more importantly on your breast anatomy, skin elasticity and body type.

Options for Breast Implants

Saline breast implants are filled with sterile salt water. They can be filled with varying amounts of saline which can affect the shape, firmness and feel of the breast. Should the implant shell leak, a saline breast implant will collapse and the saline will be absorbed and naturally expelled by the body.

Silicone breast implants are filled with an elastic gel. The gel feels and moves much like natural breast tissue. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket.

A leaking implant filled with silicone gel may not collapse. If you choose these implants, you may need to visit your plastic surgeon regularly to make sure the implants are functioning properly. An ultrasound or MRI screening can assess the condition of breast implants.

Currently Saline breast implants are FDA-approved for augmentation in women 18 years of age and older.

Currently Silicone breast implants are FDA-approved for augmentation in women 22 years of age and older.

Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.

See for current information.

Step 4 – Inserting and placing the breast implant

After the incision is made, a breast implant is inserted into a pocket either:

• Under the pectoral muscle (a submuscular placement), or
• Directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement)

The method for inserting and positioning implants depends on the type of implant, degree of enlargement desired, your body type, and your surgeon’s recommendations.

Step 5 – Closing the incisions

Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin. Over time the incision lines will fade.

Step 6 – See the results

The results of breast augmentation surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for fuller breasts.

Following Surgery

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

• How to care for the breasts following surgery
• Medications to apply or take orally to aid healing and reduce the risk of infection
• Specific changes at the surgical site or in overall health
• When to follow-up with Dr. Legere

Progress And Healing

Initial healing may include swelling and discomfort at the incision sites and in 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 cleanse the incision sites and apply any ointment as directed. Follow all instructions carefully; this is essential to the success of your outcome. A return to light, normal activity is possible as soon as you feel ready, usually within a day or two of surgery.

Initial wound healing may take 5 to 10 days, at which time any sutures will be removed. 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. Intimate contact with breasts may resume when healing is more fully completed, usually within 4 to 6 weeks.

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. Legere’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 will continue to fade over the next year.

Over time, your breasts can 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.