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Breast Augmentation
Chapter 3

The actual insertion surgery is not overly lengthy - only an hour or two - but a general anesthesia is required. As you will be quite sore for a few days, your doctor should give you painkillers for the first while. Usually a drainage tube is inserted within the breast for a day or two, necessitating hospitalization during this period. Most people are up and about a few days later, and many are able to return to work within a week after surgery depending on level of physical activity your job demands. You should generally hold off on a lot of exercise for a few weeks, depending on your doctor's specific recommendations. The breasts are often wrapped in gauze for a number of days, after which you will be given a surgical bra to wear for a few weeks. You may experience burning nipples during this period, but the discomfort usually subsides as the bruises fade. Stitches are removed about 7-10 days after surgery, but your breasts will remain swollen for another 5-7 weeks. Your incision scars will be quite pink and noticeable for approximately six weeks, after which they should begin to fade gradually.

There are several varieties of complications which may arise as a result of breast augmentation surgery; the most severe being implant rupture and leakage. As a result of injury, accident or sometimes for no apparent reason, your implant may rupture. If it is a saline implant, it will be rather like the deflation of a balloon; it will be noticeable immediately. Although it would be a terrible thing to have happen, the saline doesn't pose any immediate health risks and is simply absorbed by your body, eventually being expelled via your urine. If, on the other hand, it is a silicone gel implant, you are at risk of gel leakage which may be localized to the region, or worse, may migrate into other body tissues. With silicone implants, ruptures are often detected only during mammograms and must be removed or replaced immediately. The long term effect of silicone gel floating around in your tissues (especially in your lymph nodes) is thought to be dangerous, but the specifics are still largely unknown.

A similar, but harder to detect phenomenon is a gel bleed. This process involves tiny, microscopic particles of silicone gel moving through the implant's outer shell and into your body's tissues. Macrophages are cells in your immune system that try to destroy foreign material. When they can't destroy the invader, which is the case with silicone, it is once again transferred over to the lymph nodes. For the most part, the capsule surrounding your implant will absorb most of the silicone gel, but the rest will move through out your body, again being potentially harmful. Unfortunately, it is impossible to tell using a mammogram or ultra sound if this is occurring, as the particles are too small to be picked up. The only means to detect runaway silicone is to utilize MRI, magnetic resonance imaging, which is very expensive and has a very long waiting list.

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