Breast Augmentation

What is breast augmentation?
Breast Augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast:

• 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 bustline by one or more bra cup sizes. Breast augmentation surgery is one of the most in demand aesthetic procedures preformed in the United States. Because a woman's breasts -- natural or surgically modified -- are an integral part of her physical and emotional identity, it's important to point out what breast augmentation can and cannot do. Some women approach this surgery unrealistically, thinking that a bigger, more shapely bustline will change their lives in extraordinary ways. The procedure can give you greater self-confidence, which in turn may change the way that people respond to you.

Tell me more about breast augmentation surgery.
In your initial consultation, Dr. Broadway will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. Be sure to discuss your expectations frankly with Dr. Broadway and he will describe your alternatives and the risks and limitations of each. Dr. Broadway's staff will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.

The surgery will be performed at one of our surgery centers. An overnight stay is recommended and you will be able to rest comfortably with the assistance of the nursing staff. The anesthesia will be selected based on your health and past surgical experience. The surgery itself takes approximately 1-1/2 hours and stitches are used to close the incisions and may also be taped for greater support. A bandage may be applied over your breasts to help with keeping the implants settled. You're likely to feel tired and sore for a few days following your surgery, but you'll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication. You will be given detailed instructions in caring for your incisions and when to remove your bandages. As you begin to heal, you will experience different sensations as your nerves heal. Everyone heals differently and some patients do not experience any of these symptoms at all. Remember that you will have surgery on two breasts and each one will heal differently than the other.

Most patients are able to return to work in a week, depending on the level of activity required for your job. You may begin driving once you are off your pain medication for 24 hours. Follow Dr. Broadway's advice on when to begin exercises and normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually three to four weeks after surgery. Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely. Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the mammographic technician will use a special technique to assure that you get a reliable reading.

What are the risks of breast augmentation surgery?
As with any operation, there are risks associated with this procedure. Fortunately complications are very unusual. Capsular contracture occurs if the scar or capsule around the implant becomes thickened and tightens around the implant. This can cause the implant to feel hard or to become misshapen. This can be treated by removal or scoring of the scar tissue. This occurs in less than 5% of cosmetic breast augmentation patients. As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding occurs, another operation may be needed to control the bleeding and remove the accumulated blood. This is a very rare complication. Postoperative infection is uncommon, but possible. We reduce this to a minimum by giving intravenous antibiotics during surgery and oral antibiotics after surgery. Most infections are mild and resolve without incident. If a serious infection develops, the implant will probably need to be removed. The implant can then be replaced with a new implant several weeks later. Nerves that supply skin or nipple sensation may be cut or damaged while the pocket or space for the implant is being created. If sensory loss occurs, the nerves slowly recover over a period of 1-2 years in about 85% of cases. If for any reason the valve or implant covering fails, the saline will leak and be excreted by your body. This causes no medical harm, as the saline fluid in the implant is the same fluid used in intravenous injections. The implant will need to be replaced in a secondary procedure. The implant manufacturer guarantees the implants.

What are the costs associated with breast augmentation surgery?
Breast augmentation surgery fees start at $6,000. This fee includes everything with the exception of a mammogram (if required by Dr. Broadway), an overnight stay and prescriptions. If you choose a silicone gel implant, the cost is slightly higher.

Why do you recommend an over-night stay following breast augmentation surgery?
An over-night stay for breast augmentation surgery patients is recommended. The advantages to staying over-night are:

• You do not have to be transported to your home immediately following surgery.
• Your post-operative pain can be better controlled with shots than oral medication.
• If you develop post-operative nausea, the nurses with IV medication can better treat it.
• Your family is reassured that you are receiving the best care and they do not feel responsible for providing the care that you will want and need.
• Patients that are from out of town will be required to stay in a near-by hotel or the overnight stay facility.
• Your first post-operative check is done the following morning after your surgery, thereby eliminating the need to drive to my office the next morning. During that appointment your drains and pain pump will be removed.

What type of implants do you use for breast augmentation?
Dr. Broadway currently offers both saline and silicone gel implants. There are different styles and shapes available and during your consultation we will show you the different types available. A recommendation of the type, style and size range will be made to you based on your measurements, body type and your goal of what you are seeking. We will work with you to achieve your goals.

High Cohesive Silicone Gel implants are pre-filled, feel more natural, have fewer wrinkles and are lighter in weight. They are semi-solid and will keep their shape should the shell rupture. During your consultation, pros and cons will be reviewed with you.  Dr. Broadway implants Mentor High Cohesive Silicone Gel breast implants and remains a participant in the Sientra High Cohesive Silicone Gel breast implant study.

Dr. Broadway was one of the first six plastic surgeons nationally chosen in 2002 to participate in the breast implant study with Sientra.  He now has over 300 patients in this study, and is one of the most experienced plastic surgeons in Denver to implant the silicone gel breast implants because of his participation.  The study has been very successful and we have been very pleased with the results. Sientra is offering a reimbursement of up to $650 over a ten year period to study participants.

What happens during a breast augmentation consultation?
The consultation is a vital part in making your decision on whether you should have breast augmentation surgery. Plan on spending approximately 1-1/2 hours meeting with Dr. Broadway and his staff. During the consultation, you will:

• Be asked to fill out a detailed medical history form. This will give Dr. Broadway an opportunity to assess if you are a good candidate for surgery. He will also discuss your past surgical experience and current medical status.
• Dr. Broadway will meet with you and discuss the surgery itself and the risks involved. He will review the different implants available and you will be able to see and touch them. This is a good opportunity to ask any questions or concerns you may have about the surgery.
• Dr. Broadway and a Patient Coordinator will examine you and thoroughly measure you. Based on this examination, a recommendation of implant styles & sizes will be made to help you get the cup size you desire. You will also have an opportunity to try on the implants.
• After the examination, the Patient Coordinator will show you before & after pictures and will go over a final quote of your surgery fees and explain what is needed to schedule your surgery. You can schedule your surgery then or can call us after you have had time to consider your options. We will do everything we can to make you feel comfortable in your decision and share with you any other information you require.

Is there another option for a breast augmentation consultation?
If you have been thinking about breast augmentation cosmetic surgery for the last couple of years, you know it is a very difficult decision to make. There are many questions you have about the surgery, the implants and recovery. A consultation with a board certified plastic surgeon is your first step to learn more about this surgery and learn more about the physician. However, you are ready to see the doctor NOW, and you do not want to wait 4-8 weeks for a consultation. Unfortunately, there are times it can take that long for your appointment. As a convenience to our patients, you can now meet with our Patient Advocate for your first consultation. This complimentary consultation is very informative and you will learn so much about the complete process. This is truly a one-on-one educational experience from someone who has been through the process herself. She can share her personal experience as well as give good concise information.