Breast Augmentation (Breast Implants)

Breast Augmentation is a surgery designed to enlarge the breasts. This surgery is frequently sought by women who are unhappy with the small size of their breasts, sometimes after pregnancy or weight loss.

If you are considering breast augmentation, the following information will provide you with a good introduction to the procedure. For more detailed information about how this procedure may help you, we recommend that you schedule a consultation with Dr. Kremer.

What are some of the most common benefits of breast augmentation

Breast augmentation is usually quite successful at making the breasts larger and fuller. The results may not look exactly like “natural” larger breasts; implanted breasts tend to be a bit more round and less saggy than natural breasts of the same size. Most women find these differences to be an improvement.

What will happen at the initial consultation?

During the consultation, you and Dr. Kremer will discuss the changes that you would like to make in your appearance. Because this is a highly personal decision, you’ll want to take time to discuss all of your concerns and desires, including how large you want your breasts to be.

Show Dr. Kremer pictures of breast sizes you like. He will be able to determine which size implants will achieve your preferred size. He will also explain the different options available to you, including incision type, location of the implant, type of implant, and whether a breast lift might also be beneficial.

Dr. Kremer will also explain the anesthesia he will be using during your procedure. You should tell him about any medications you currently are taking, and any health conditions you have. Be sure to ask all the questions you have about the surgery. Learning everything you can about your options, risks and benefits is the key to making an informed decision.

How is breast augmentation done?

Breast augmentation consists of making an incision, lifting the breast tissue, creating a pocket in the chest/breast area, and placing a breast implant into this pocket.

An incision may be made in any one of the following places: the crease below the breast, around the areola, under the armpit, or, very rarely, through the navel.

The implants can be placed either under the chest muscle or directly under the breasts. Placement considerations include the anatomy of your breasts, the type of implant as well as other individual factors.

Although several implants are available at the present time, the implant being used for nearly all breast augmentation surgeries is made of a silicone rubber sack filled with a saline solution. Under certain conditions, such as reconstructive surgery, silicone gel implants can be used instead. Silicone gel filled implants are only offered on a limited basis, under approved studies, due to questions about silicone implants correlated to autoimmune diseases. Dr. Kremer will discuss the choice of implant, and review with you the size changes that are possible with the operation.

Most likely, the anesthesia you receive will be general, although a local anesthetic along with a sedative can be used.

How long does the surgery take?

Breast augmentation surgery usually takes about one to two hours to complete. The length of the procedure varies according to the technique used and  the placement of the implants.

Do I have to stay in the hospital?

Probably not. Most breast augmentation surgery is performed in a surgicenter as an outpatient procedure; you’ll be able to return home within a few hours of the surgery or may spend the night if you decide to do so.

What can I expect after surgery? How much pain is there?

Dr. Kremer uses an operative technique, which he studied during his clinical training in Dallas, TX, developed by Dr. John B. Tebbetts. Full normal activity in 3 days or less is routine in 90% of his breast augmentation patients.

Breast augmentation stretches the tissues, and can be painful. This is especially true when the implants are placed under the muscle and in young women who have never had children. The pain is greatest within the first 24 hours, but improves with each day and is somewhat relieved by pain medications.. In spite of the initial discomfort, most women report that they are very satisfied with the results of the surgery.

When you wake up you will feel tired, sore, and stiff. Your breasts will be wrapped with gauze bandage as well as a tighter bandage for protection and support. It is important to take the medication prescribed to you by Dr. Kremer. Someone will need to drive you home, and you may need assistance at home over the next couple of days.

Dr. Kremer will prescribe an antibiotic medication to be taken after the surgery. It is a good idea to have these prescriptions filled beforehand.

What is the recovery period like?

Your scars will be pink for several weeks. After several months they will begin to fade. It is critical that you review post-procedure care with Dr. Kremer. Following his instructions carefully will help ensure you have a speedy, healthy recovery. Also keep in mind that:

• Rest is important to the healing process, so do it as much as possible following your procedure. Drink plenty of fluids, and be sure to take Dr. Kremer's prescribed medications.
• For at least 3-5 days, you should try to keep arm extension to a minimal. Elbows should not be raised higher than the armpit. The tissues will heal more quickly if you avoid stretching and separating muscle/tissue surrounding the breast implants.
• Most likely, you will be able to resume calm, quiet work within a few days of your surgery. You should still avoid physical exertion for several weeks, depending on the advice of Dr. Kremer.
• After several days, the gauze dressing will be removed. You will be required to wear a support bra for a couple of weeks to help your breasts form and maintain a pleasing, balanced shape.
• The stitches will come out within a week to ten days, but swelling may continue, gradually subsiding over several weeks. With the swelling, your breasts may seem hard and unnatural, but eventually they should soften to a more natural feel.
• You will probably be able to resume exercise and normal physical activities within a month or two, when the soreness has subsided. Recovery varies from patient to patient and depends upon the technique, type of implant, and site of placement that was used, as well as the level of activities in your daily routine.

How long do the results last?

Breast augmentation makes the breasts larger for the life of the implant. This can be more than 10 years and cannot be predicted by anyone to date. All manufacturers in the European Union market at this point (2007) grant an unlimited durability of their implants, a life-long guarantee as far as material is concerned. Remember also that larger breasts sag faster than smaller breasts, and augmented breasts do this as well. It is possible that you may require surgery in later years to correct sagging if you choose to have large implants. Gravity, unfortunately, has no exceptions. If new implants are necessary in several years or if an additional breast lift is advisable can be decided at that point in time.

Ideal candidate:

In general, the best candidates for breast augmentation are:

• 18 years of age or older
• Not currently pregnant or nursing
• In good physical health
• Psychologically stable
• Wanting to improve their appearance
• Realistic in their expectations
• Having this surgery for the first time

The above is only a partial list of the criteria that Dr. Kremer will consider in determining whether or not this procedure is appropriate for you.

Possible complications:

Some of the more common possible complications include postoperative infection, bleeding with hematoma formation, implant rupture, deflation or leakage, capsular contracture, changes in nipple or breast sensation as well as shifting of the implant.

Risks:

There are several concerns regarding breast augmentation. The risks involved with breast augmentation have received a lot of attention, but neither breast cancer nor arthritis have been shown to be caused by breast implants. All operations carry some risk and the possibility of complications can include (but are not limited to) infection, excessive bleeding, adverse reaction to anesthesia, and the need for second or sometimes third procedures.

There is no known association of breast implants with breast cancer in human beings, and in fact several large studies have shown a lower incidence of breast cancer in women with breast implants. Breast implant type devices have been shown to cause a rare form of cancer in rats that are prone to cancer, but this cancer has not been reported in humans with breast implants.

Read more about breast implants and health on the Food and Drug Administration (FDA) website.

Other side effects specific to breast augmentation include:

• capsular contracture: occurs when the scar or area around the implant begins to tighten, causing the breast to feel hard. This occurs more frequently in silicone-gel filled implants than in saline-filled ones.
• nipple sensitivity or loss in sensitivity: usually disappears after several weeks, but for some this is permanent.
• rippling: dependent on thickness of skin, type and size of implant. Indentations on the breast, often caused when the implant moves.
• rupture: when the breast implants tear and/or leak. This may require a second operation to replace the implant.

Be sure to:

• Tell Dr. Kremer about any allergies you have (to foods, drugs, environmental elements)
• Tell Dr. Kremer if you have a history of bad scarring, such as keloids.
• Tell Dr. Kremer about all medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription)
• Carefully follow any instructions Dr. Kremer gives you regarding eating and drinking and smoking.
• Avoid aspirin and aspirin-containing medicines for two weeks prior to surgery.
• Arrange for someone to drive you home after surgery or after discharge from the day surgery center or the hospital.
• Please inform Dr. Kremer immediately in case you should experience fever or symptoms of an infection after surgery.
• Try to schedule surgery at a time other than your menstrual period.  

The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. 

The best method of determining your personal options is to schedule a personal consultation with Dr. Kremer. He will be able to answer specific questions related to your situation.

Find more general information on breast augmentation at the

Breast Augmentation Directory - A one stop resource for all your breast augmentation needs.