Breast Augmentation: Surgery FAQ

How should I prepare for surgery?

  1. Do not take aspirin, aspirin containing products, or ibuprofen (Excedrin, Bufferin, Anacin, Advil) 2 weeks before surgery. These drugs can change how blood clots. By asking your doctor, another drug can be used in its place.
  2. No food or of drink should be taken after midnight the night before the surgery.
  3. Do not drink any alcohol within 24 hours of having lab work done or before the surgery.
  4. Make sure you have someone to take you to and from surgery and to take care of you for 48-72 hours after the surgery.
  5. For 3 days before the surgery, wash your breasts thoroughly each day with antibiotic soaps such as Safeguard, or Dial.
  6. Do not wear deodorant, perfume, or powders the day of the surgery.
  7. Wear comfortable, loose fitting clothes that button in front, the day of the surgery. Also wear low heeled, slip-on shoes.
  8. Bring a contact lenses container.
  9. Fill all prescriptions given by your plastic surgeon before the surgery.
  10. Do not start taking your antibiotics until after the surgery, or as directed by your doctor.
  11. Remove nail polish and trim the nail of your left index finger, since this is where an oxygen monitor will be attached.
  12. In the car for the ride home have a bucket with a lid in case of nausea from the anesthesia. Also bring your pain medications, and two pillows.
  13. Arrange care for children and/or pets.
  14. Lay out all bathroom items so no excess reaching is necessary.
  15. Take care of all the little things like bills, gas for the car, and emptying the garbage before surgery.
  16. Have easy to eat foods like Jell-O and soup as well as easy to fix foods in places that are easy to reach!
  17. Though reaching and lifting objects greater than 5 pounds is not allowed after surgery, patients are encouraged to walk as much as possible. Problems with blood clots in the legs can occur after surgery and walking can help prevent this.
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What will I be instructed to do following the surgery?

Visit our postoperative instructions page.
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Where should I have the surgery?

Several options exist for where breast augmentations are done. For the most part, patients undergo breast augmentation as an outpatients, "a day surgery" without an overnight hospital stay. Outpatient surgery can be done at a hospital, or even at a private plastic surgery practice that has an operating room. After surgery, when the affects of the general anesthesia have worn off and the patient feels capable of walking (1-2 hours), they are then allowed to go home. Wherever you decide to have the surgery, the office or hospital should be accredited. JCAHO is a one example of an accrediting organization. This means that the medical center has been inspected and has passed tests for quality.
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What kind of anesthesia will I have?

General anesthesia is most often used for this surgery. This means that patients are "asleep" and will not have any memories of the surgery.
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How long will the surgery take?

Depending on the type of breast augmentation chosen (where the incision in made) the surgery usually last 1-2 hours.
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What type of implant will be used?

Implant Surface - Two implant surface types exist: smooth and textured. The textured surface means the outside of the implant has lots of tiny microscopic bumps. This was developed to decrease a complication called contracture after surgery (discussed in risk section below.) Some studies show a decrease in this complication when using textured implants. In reality, however, many surgeons have excellent results with the smooth implants. Smooth implants also have a softer more natural feel. Since options exist on what type of implant is used, it is important to ask your plastic surgeon.

Implant Filler - Although several implant filler types exist, the saline implant is the only one being used in the United States. The FDA banned silicone gel implants in 1992 because of concerns over their safety. They have recently been reintroduced under close FDA surveillance for use in breast reconstruction and in patients with previous silicone implants. In the past 10 years, saline implants have been used with excellent results.

Implant Shape - Two options exist for shape as well. There are anatomical or "tear dropped" shaped implants as well as round implants. Generally, round implants work the best. Most women have excellent results since these round implants conform to the natural shape of the breast. Contoured implants are often used if large parts of the breast have already been removed in a previous operation, for instance in mastectomy reconstruction.
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What kind of scars will I have?

This will depend on which of the four possible surgeries are performed. The incision site determines where the scar will be. (A complete description of the pros and cons is located at the link below. It is strongly encouraged that you review these.)

  1. Trans-axillary - The incision in made in the armpit. The implant is inserted with the help of a small video camera, or "endoscope."
  2. Inframammary fold or Sub-pectoral - The incision is made under the breast on the chest.
  3. Peri-areiolar - The incision is made around the nipple.
  4. Trans Umbilical Breast Augmentation or TUBA - The incision is made in the belly button.
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How long will I be in the hospital/outpatient surgery center?

For outpatient surgery, (surgery without an overnight stay in the hospital), patients are allowed to go home after the anesthesia has worn off which is usually about 2 hours. Before leaving the medical center, patients will be able to walk, drink water, go the bathroom, and have their pain controlled by pain pills.
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Will my breasts look "natural"?

Patient satisfaction for breast augmentation surgery is high. Even women who experience complications after surgery are often satisfied with the way they look. How "natural" post-implanted breasts look will depend on the size of the implant AND the patient. For example, women who have small breasts before surgery and are receiving large implants are less likely to have "natural" appearing breasts, compared with women receiving smaller implants (i.e. more modest enlargement.)

Not all patients are happy with this surgery. 3% of patients report that they are dissatisfied with their implants. Understanding the potential risks for this surgery and working with a plastic surgeon you are comfortable with will help ensure a good result.

Strom SS. Et al. Cosmetic saline breast implants: A survey of satisfaction, breast-feeding experience, cancer screening, and health. Plastic & Reconstructive Surgery. 100(6):1553-7, 1997 Nov.
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Will my nipple sensation or feeling change?

Most women will have loss of some feeling or sensation following breast augmentation surgery. For most of them, this lasts 6-12 months before returning to normal. 15% of women, however, have permanent alterations in nipple sensation.
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