Breast Augmentation

Breast augmentation is a procedure to increase breast size, improve shape, and restore volume.

Overview

Breast augmentation (augmentation mammoplasty) is a procedure that uses implants or fat transfer to increase the size and improve the contour of the breasts.

The procedure is usually done in the cases of:  

• aesthetic enhancement,

• post-partum restoration, and

• correction of asymmetry.

American Society of Plastic Surgeons (ASPS) states that breast augmentation ranks as one of the most frequently performed cosmetic procedures globally, with over 300,000 procedures performed annually.

What You Can Expect

Implant Placement

Your surgeon decides where the implant will be placed: either over the chest muscle or under the chest muscle. This choice is made based on your body type and what they believe will give you the best, most natural result.

• Submuscular Placement: This procedure is preferred as the muscular coverage can provide clearer visualization of breast tissue during future mammograms, a key long-term health consideration.

• Gummy Bear Implants: The use of form-stable, highly cohesive silicone gel implants offers improved shape retention and reduced risk of gel migration in the event of rupture compared to older silicone types.

During the Procedure

The surgery takes about one to two hours and is done under general anesthesia (you are asleep) or local anesthesia with sedation.

1. Incision: The surgeon makes a small cut (incision) in the natural fold under the breast. Other places could also include around the nipple or in the armpit.

2. Implant Placement: The implant is then placed into a space created either above the chest muscle or under the chest muscle. Placement is decided beforehand by your surgeon based on your body and goals.

3. Closure: The surgeon closes the cut with stitches.

Risks

Breast augmentation has risks:

• Hardening of the Breast: The natural scar tissue that forms around the implant gets too tight and hard. This makes the breast feel firm, look misshapen, and sometimes causes pain.

• Implants Breaking:

  • Silicone: If a silicone implant breaks, the gel usually stays put, so you might not notice right away.

  • Saline (Saltwater): If a saline implant breaks, the breast will quickly flatten as the saltwater is safely absorbed by your body.

  • In either case, the broken implant must be removed and replaced.

• Infection: Bacteria can cause an infection soon after surgery.

• Numbness or Change in Feeling: The feeling in your nipples or breast skin might change. They could become extra sensitive, numb, or lose feeling entirely.

• Uneven Look (Asymmetry): Your breasts might not end up being the exact same size or shape.

• Very Rare Cancer Risk (BIA-ALCL): There is a very low risk of a specific type of cancer linked mainly to implants with rough surfaces. To keep this risk low, surgeons usually recommend implants with smooth surfaces.

• Need for More Surgery Later: Implants don't last forever. You will likely need another surgery in 10 to 15 years to replace or remove the implants because of rupture, hardening, or simply because your body has changed.

Medical Tourism Consideration

The primary driver for breast augmentation abroad is the cost, providing savings of 50% to 70% compared to average costs in the United States or Western Europe.

Popular medical tourism destinations known for high-quality, internationally accredited facilities for breast augmentation include Turkey, Mexico, Thailand, and South Korea.

How You Prepare for Medical Tourism

1. Surgeon and Facility Verification: Confirm the plastic surgeon's board certification (equivalent to ASPS in the U.S.) and the facility's international accreditation (e.g., JCI - Joint Commission International).

Selecting the right surgeon is the single most important step in medical tourism. Make sure you verify the surgeon's training and experience.

• Board Certification: Confirm the surgeon is certified by their country's national plastic surgery board, or an internationally recognized body like the International Society of Aesthetic Plastic Surgery (ISAPS). A general surgeon or gynecologist should not perform cosmetic plastic surgery.

• Experience: Ask directly: "How many breast augmentation surgeries do you perform each year?" An experienced surgeon will have high procedure volume and be able to show you a wide range of before-and-after photos from patients with similar body types and goals.

• Facility Accreditation: Ensure the hospital or surgical center is accredited by a recognized international organization, such as the Joint Commission International (JCI).

• Communication: Verify that you can easily communicate with your surgeon and their immediate medical staff. Misunderstandings about your goals or post-operative care can lead to poor results or dangerous complications.

2. All-Inclusive Packages: Carefully review the contents of any all-inclusive medical tourism package. The packages should clearly cover the cost of the implants, anesthesia, facility fees, and the essential post-operative stay.

3. Medication and Mobility: Consult your surgeon about any prescribed post-operative medications. Plan to secure an aisle seat and move regularly during long flights (after the approved waiting period) to aid circulation and mitigate DVT risk.

4. Aftercare and Revision: Clarify the protocols for complications with your healthcare provider. If a revision surgery is needed later, you may incur additional travel and lodging costs to return to the original surgeon.

5. Insurance Coverage: Standard insurance policies (including health and travel) do not cover complications from elective cosmetic surgery. Having a specific medical complications insurance for medical travel is strongly advised.

Key Takeaways

• Procedure Goal: Breast augmentation increases breast volume using silicone or saline implants, or autologous fat transfer.

• Implant Risk: Breast augmentation risks include common issues such as breast hardening, implant rupture, infection, permanent changes in sensation, and the very rare risk of BIA-ALCL (a type of cancer linked to textured implants).

• Cost Factor: Medical tourism offers substantial financial savings, but a comprehensive review of all-inclusive packages and contingency plans is important.

• Travel Safety: The combination of recent surgery and air travel could increase the risk of complications, particularly Deep Vein Thrombosis (DVT). Adherence to post-operative travel wait times recommended by your surgeon is important.

• Implant Longevity: Breast implants are not lifetime devices and will likely require revision or replacement surgery within 10 to 15 years.

Frequently Asked Questions about Breast Augmentation

What is the typical recovery period?

Most patients return to light work within 7 to 10 days, full physical recovery (including avoiding heavy lifting or chest strain) could take around 6 weeks. The implants will "settle" into their final position (drop and fluff) over 3 to 6 months.

Will breast augmentation affect my ability to breastfeed?

For most procedures using the common inframammary fold incision, the ability to breastfeed is preserved. Consult with your surgeon on this specific concern.

Do implants interfere with mammograms?

Yes. Implants placed over the muscle can obscure breast tissue. Patients must inform the technician, who will use special techniques to visualize the tissue behind the implant.

Can implants rupture from airplane cabin pressure?

No. Modern silicone and saline implants are designed to withstand significant pressure changes and are not affected by the pressurized environment of a commercial aircraft cabin. The concern with flying too soon is the increased risk of blood clots (DVT).

What should I do if a complication happens after returning home?

You should first contact the surgeon who performed the operation, as they are most familiar with the procedure. However, for any severe complications (e.g., excessive pain, infection, or signs of DVT/Pulmonary Embolism), seek immediate emergency medical care in your home country and notify your operating surgeon afterward.

Is separate insurance necessary for medical tourism?

Yes. Standard travel insurance excludes coverage for complications arising from elective cosmetic surgery. You can obtain a medical complications insurance policy for your trip to cover unexpected expenses for revision or emergency care.