Your Breast Augmentation Surgery

Depending on your physician and the method of surgery that has been chosen, your breast augmentation procedure can be performed as an inpatient (requiring an overnight stay in the hospital) or as an outpatient (no overnight stay required). In general, breast augmentation is performed on an outpatient basis in a hospital operating room, surgery center or surgical suite in a surgeon's office. On average, the surgery lasts one to two hours.

General anesthesia is commonly used and local anesthesia also is an option. Your surgeon can discuss with you the most appropriate choice of anesthesia for your procedure.

Your surgeon will make an incision and create a "pocket," or space, within your breast tissues for the breast implant. The breast implant will be placed in the pocket, filled and positioned. Then, the incision will be closed, usually with stitches, and possibly taped.

Breast Augmentation Surgery Incision Sites

To permit the smallest possible incision, the breast implant is typically inserted empty and then filled with saline. You should discuss with your surgeon the pros and cons for the specific incision site recommended for you.

There are three common incision sites: under the arm (axillary), around the nipple (periareolar), or within the breast fold (inframammary). If the incision is made under the arm, the surgeon may use a probe fitted with a miniature camera, along with minimally invasive (very small) instruments, to create a "pocket" for the breast implant.

Periareolar – This incision is the most concealed, but is associated with a higher likelihood of inability to successfully breast feed, as compared to the other incision sites.

Inframammary – This incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast-feeding.

Axillary – This incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast feeding.

Umbilical/endoscopic – This incision site has not been studied and is not recommended.

Breast Implant Placement

Breast implants may be placed subglandular, which is between the chest muscle and the breast tissue; or submuscular, which is below the chest muscle.

Subglandular Breast Implant Placement

Subglandular placement may make your surgery and recovery time shorter. It may be less painful and it may make the implant easier to access if reoperation is necessary. This placement also may make it easier to see and feel your implants through your skin after your surgery. Capsular contracture is more likely with subglandular placement and imaging of the breast with mammography may be more difficult.

Submuscular Breast Implant Placement

The submuscular placement may make surgery last longer, may make recovery longer, may be more painful, and may make it more difficult to have some reoperation procedures than the subglandular placement. The possible benefits of this placement are that it may result in less palpable implants, less capsular contracture, and easier imaging of the breast with mammography.

No one incision or placement choice is right for every woman. By knowing your options and discussing them with your physician, both of you can decide upon an incision/placement combination that is best for you.