Deciding to undergo breast augmentation or any plastic surgery procedure is a huge decision. You’re probably (and hopefully!) super excited but also feeling a bit anxious, which is completely normal. When selecting your surgeon, you’ve likely been diligent about searching for someone who is qualified in their area of expertise. You’ve analyzed before and after photos, checked the doctor’s credentials, assessed their bedside manner during your consultation – all of these are incredibly important steps to take when choosing a surgeon to perform your breast augmentation.
In addition to looking for a qualified, informed doctor, being a well-informed, prepared patient can also impact your surgical outcome. Let’s talk about five things every patient should ask their plastic surgeon when considering breast augmentation.
1. Where will the incision be, and how big will it be?
There are three types of incisions used during breast augmentation surgery – under the nipple, in the armpit, and underneath the breast. Your surgeon should discuss with you which of these incisions makes sense for you and the type of implant that you’re going to get. There are pros and cons to each of the different incisions.
The periareolar incision, which is made right along the lower edge of the areola, is very well hidden. However, because the incision is small, there is a greater risk that the implant will rupture when being placed. Although many surgeons will show you tiny incisions on social media, the truth is that if the incision is too small, the implant is more likely to break on its way in.
The armpit (or transaxillary) incision also yields a smaller, hidden incision; however, it holds a greater risk of complications and can only be used with saline implants.
An inframammary incision is one made underneath the breast, right along the inframammary fold. The incision is slightly larger, but it also provides the surgeon with greater access. I promise it’s worth it to have a slightly longer incision, so your implant gets safely in there.
2. What type of implant does your surgeon recommend?
When we talk about types of breast implants, we’re referring to silicone, saline, and the profile (low, moderate, or high). You want to make sure your plastic surgeon doesn’t have a “one-size-fits-all” philosophy when it comes to breast augmentation. The type of implant you decide on will depend on your personal aesthetic, the shape of your breasts, your body type, and your desired outcome—understanding why they’re recommending a specific implant and how it will benefit you is critical.
3. Will the implant be placed over or under the muscle?
Both over- and under-the-muscle breast augmentations can produce gorgeous, long-lasting results with low risk of complications. Deciding which implant placement is best for you is extremely important. Over-the-muscle has increased in popularity and is the technique I primarily use. Bear in mind, each option has advantages and disadvantages, so talk with your surgeon about what they suggest to fit your body and your needs.
4. What does your surgeon do in the operating room to minimize the risk of implant complications?
This is such an important question, and many patients don’t remember or don’t think to ask. Breast implant complications can be devastating and expensive. Potential complications could include infection, breast implant illness, incisions healing poorly, and capsular contracture. All of these issues can be terrible for patients to endure. With that, there are things that we can do in the operating room as surgeons to reduce risk of complications during breast implant surgery. Some of these are very simple; some are a bit more complicated.
For instance, just covering the nipple with a Tegaderm or a clear plastic dressing can reduce your infection and contracture rate. Surgeons should use a Keller funnel or a sterile funnel to place implants. This minimizes the chance of bacteria contaminating the implant as it’s placed into the body. Some of these measures may cost you a little more money, but they’re crucial for preventing problems.
5. How do I maintain these implants long-term?
Breast implants are not lifetime devices. They’re not going to be in there forever, and you need to know as a patient what the maintenance will be. Your surgeon should be upfront about whether you need imaging, when you need it, and how you can get on a schedule. You should have an idea of what these types of imaging studies cost and where you need to go to get them. Your surgeon should also discuss with you whether or not they recommend that your particular type of implant should be replaced at a certain point to prevent rupture-related complications.
Every time you go into surgery, you need to know not only the beautiful results you can expect to have but what this looks like long-term to prevent complications and keep that result looking good for the rest of your life.