Breast Augmentation Procedure

What is Breast Augmentation Surgery?

Also known as augmentation mammaplasty, breast augmentation surgery uses breast implants to make your breasts fuller (breast enlargement) or to restore breast volume lost after weight reduction or pregnancy (known as breast enhancement).

If you are dissatisfied with your breast size, you can consider breast augmentation surgery (either breast enlargement or breast enhancement). Breast augmentation can:

• Increase fullness of your breasts
• Bring balance to your figure
• Improve your self-image and self-confidence

Implants also may be used to reconstruct a breast after mastectomy or injury.

You may find it helpful to review our before and after photos and view my breast augmentation consultation video.

Dr. Bruce Van Natta’s "Rapid Recovery" Breast Enlargement

Interested in natural-looking breast augmentation, but worried about the down time? Whether you’re a busy mom and/or a career professional, you probably don’t have the option to take a lot of time off for surgery. I am performing breast enlargement with no down time and no narcotics!

Typically with most surgeons, recovery after breast augmentation involves several days of downtime.  This includes time off work (which can mean lost income), the inability to drive for 7-14 days, taking prescription narcotics and time away from caring for your family.

My advanced surgery technique, along with my unique post-operative program allows patients to undergo a Rapid Recovery after breast enlargement. You will wash your hair, go shopping and out to eat the day/evening of surgery and take only Motrin for mild discomfort. You’ll also go back to work and resume your normal activities the next day.

I employ a stretching regimen designed to prevent the chest muscles from tightening and stiffening. Post-operative discomfort is therefore minimized and easily treated with ibuprofen. There is no longer a need for prescription medication utilized in the past – which can have negative effects and takes time to get out of your system. Typically, most plastic surgeons bind their patients and tell them not to use their arms. We are 180 degrees in the other direction, and our patients are thrilled with their results. This is truly a breakthrough for women who want to have breast enlargement. If you lead a busy lifestyle, this may be a great option for you!

View my Rapid Recovery video to learn more about our exciting breast augmentation program.

What Breast Augmentation Won't Do

Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with a breast augmentation. I am often able to do limited lifting procedures in conjunction with breast augmentation. We call this a mini-mastopexy, and you can view before and after examples of this technique.

Is Breast augmentation Right For Me?

Breast augmentation is a highly individualized procedure, and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image. It may be a good option if:

• You are physically healthy
• You have realistic expectations
• Your breasts are fully developed
• You feel your breasts are too small
• You’re dissatisfied with your breasts losing shape and volume after pregnancy, weight loss, or with aging
• Your breasts vary in size or shape
• One or both breasts failed to develop normally

What You Should Know Before Breast Augmentation Surgery

A safe and successful breast augmentation procedure depends very much on your being completely candid during your consultation. Be sure to address any problems, concerns and questions with Dr. Van Natta. He will ask you a number of questions about your health, desires and lifestyle.

Be Prepared to Discuss:

• Why you want breast augmentation surgery, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries
• Family history of breast cancer and results of any mammograms or previous biopsies

Dr. Van Natta May Also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine your breasts, take detailed measurements of their size and shape, evaluate skin quality as well as placement of your nipples
• Take photographs for your medical record
• Discuss likely outcomes of breast augmentation surgery and any risks or potential complications
• Discuss the use of anesthesia during your breast augmentation procedure

Preparing For Breast Augmentation Surgery

After researching the basics about breast enhancement or breast enlargement, many patients want to know what to expect before surgery.

Prior to breast surgery, Dr. Van Natta may ask you to:

• Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
• Stop smoking well in advance of your breast augmentation surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements, as they can increase bleeding

Special Instructions You Receive Will Cover:

• What to do the day of surgery
• Post-operative care and follow-up
• Breast implant registry documents (when necessary)

Your breast augmentation surgery will be performed at Meridian Plastic Surgery Center, an AAAHC accredited facility utilizing seasoned anesthesiologists from St. Vincent Hospital in Indianapolis, Indiana.

You'll Need Help

Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery. This caregiver will also assist you with our Rapid Recovery.

Breast Augmentation Procedure Steps

What happens during breast augmentation surgery?

Step 1 - Anesthesia

Medications are administered for your comfort during breast augmentation surgery. You will have a light general anesthetic given by a board certified anesthesiologist.

Step 2 - The incision

Dr. Van Natta uses the “inframammary” incision almost exclusively – primarily because it has the lowest complication rate. This incision is in or just below the existing breast fold in most cases.

Step 3 - Implant choice: Silicone breast implants or saline breast implants?

Breast size and shape are important, so be honest and open about your expectations when talking to Dr. Van Natta. Implant type and size will be determined not just by your desired increase in size, but more importantly on your breast anatomy, skin elasticity and body type.

Options for Breast Implants

Saline breast implants are filled with sterile salt water. They can be filled with varying amounts of saline which can affect the shape, firmness and feel of the breast. Should the implant shell leak, a saline breast implant will collapse and the saline will be absorbed and naturally expelled by the body. 

Silicone breast implants are filled with an elastic gel. The gel feels and moves much like natural breast tissue. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket.

A leaking implant filled with silicone gel may not collapse. If you choose these implants, you may need to visit your plastic surgeon regularly to make sure the implants are functioning properly. An ultrasound or MRI screening can assess the condition of breast implants.
Implant manufacturers occasionally introduce new styles and types of implants, so there may be additional options available.

• Currently, Saline breast implants are FDA-approved for augmentation in women 18 years of age and older.
• Currently, Silicone breast implants are FDA-approved for augmentation in women 22 years of age and older.
• Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.

See http://www.breastimplantsafety.org/ for current information.

Step 4 - Inserting and placing the breast implant

• After the incision is made, a breast implant is inserted into a pocket
• Under the pectoral muscle (a submuscular placement). The method for inserting and positioning implants depends on the type of implant, degree of enlargement desired, your body type and your surgeon’s recommendations.

Step 5 - Closing the incisions

Incisions are closed with layered sutures in the breast tissue and with sutures. Sutures, skin adhesive or surgical tape is used to close the skin. Over time, the incision lines will fade.

Step 6 - See the results

The results of breast augmentation surgery are immediately visible. Over time, post-surgical swelling will resolve, and incision lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for fuller breasts.

(Illustrations courtesy of the American Society of Plastic Surgeons)

Important Facts About Breast Augmentation Risks and Complications

The decision to have breast augmentation surgery is extremely personal. You’ll have to decide if the benefits will achieve your goals and if the risks of breast implant safety and potential complications are acceptable to your personal situation.

Dr.Van Natta and/or his staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The Risks of Breast Implants and Complications After Breast Augmentation May Include:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Poor healing of incisions
• Changes in nipple or breast sensation (temporary or permanent)
• Capsular contracture, which is the formation of firm scar tissue around the implant
• Implant leakage or rupture
• Wrinkling of the skin over the implant
• Anesthesia risks
• Fluid accumulation
• Blood clots
• Pain, which may persist (Rare)
• Deep vein thrombosis, cardiac and pulmonary complications (Extremely rare)
• Possibility of revision surgery—23.5% at 4 years nationally, 6-7% at 4 years for Dr. Bruce Van Natta (he has one of the lowest re-operation rates in the country).

Although there potentially may be complications with breast implants, they do not impair breast health. Careful review of scientific research conducted by independent groups such as the Institute of Medicine has found no proven link between breast implants and autoimmune or other systemic diseases.

Other Important Considerations:

• Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants.
• Pregnancy, weight loss and menopause may influence the appearance of augmented breasts over the course of your lifetime.

Breast Augmentation Recovery Time

One of the most exciting things about Bruce Dr.Van Natta’s approach to breast augmentation is the Rapid Recovery program. This approach allows our patients to go home after surgery and after a brief rest period, shower, get dressed, go shopping and out to eat, only taking ibuprofen – no narcotics! Please review the details of our Rapid Recovery program and watch the video journal of an actual patient as she goes through the early recovery of breast augmentation.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure, and another surgery may be necessary.

Breast Augmentation Results

The results of your breast augmentation surgery will be long-lasting. You will find it easier to wear certain styles of clothing and swimwear. Like many women who have had breast augmentation, you may also experience a boost in self confidence.

Implants May Need to Be Replaced Or Revised

It's important to know that after receiving breast implants, results are long-lasting, but they are not permanent and may require replacement during your lifetime. You should expect to have future visits with your plastic surgeon to discuss changes in your breasts.

Over time, your breasts can change due to aging, weight fluctuations, hormonal factors and gravity. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast lift or implant exchange to restore a more youthful contour.

Be sure to continue to follow your plastic surgeon's instructions to ensure the best results for breast enlargement or breast enhancement, and attend follow-up visits as scheduled.

Breast Augmentation Costs

As an elective surgery, the cost of breast augmentation is a consideration for many patients. A surgeon's cost for breast augmentation may vary based on any additional procedures being done at the same time and the type and cost of breast implants used.

Our practice offers patient financing plans, so be sure to ask us about this option.

Cost May Include:

• Surgeon’s fee
• Hospital or surgical facility costs
• Anesthesia fees
• Breast implant cost
• Prescriptions for medication
• Post-surgery garments
• Medical tests

Typically, health insurance will not cover the cost of breast augmentation or breast enhancement (unless due to breast cancer reconstruction). Most health insurance plans will not cover related complications or another surgery to revise the appearance of your breasts. Some carriers even exclude breast diseases in patients who have breast implants. You must carefully review your health insurance policy.

Your Satisfaction Involves More Than a Fee

When choosing a plastic surgeon for breast enlargement or breast enhancement, remember that the surgeon’s experience with breast implants, their personal reoperation rate and your comfort with him or her are just as important as the final cost of the surgery. As with most things in life, you get what you pay for.

Breast Augmentation Glossary

• Areola: Pigmented skin surrounding the nipple.
• Augmentation mammaplasty: Breast enlargement or breast enhancement by surgery.
• Breast Augmentation: Also known as augmentation mammaplasty; breast enlargement or breast enhancement by surgery.
• Breast Implants: Medical devices placed in your body to enhance an existing breast size or to reconstruct your breast. Breast implants fall into two categories: saline breast implants and silicone breast implants.
• Capsular contracture: A complication of breast implant surgery which occurs when scar tissue that normally forms around the implant tightens and squeezes the implant and becomes firm.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Hematoma: Blood pooling beneath the skin.
• Inframammary incision: An incision made in the fold under the breast.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Local anesthesia: A drug injected directly into the site of an incision during an operation to relieve pain.
• Mammogram: An x-ray image of the breast.
• Mastectomy: The removal of breast tissue, typically to rid the body of breast cancer.
• MRI: Magnetic Resonance Imaging; a painless test to view tissue (similar to an x-ray).
• Saline implants: Breast implants filled with salt water.
• Silicone implants: Breast implants filled with an elastic gel.
• Submuscular or subpectoral placement: Breast implants placed under the pectoral muscle, which is located between the breast tissue and chest wall.
• Sutures: Stitches used by surgeons to hold skin and tissue together.

Questions to ask your Breast Augmentation Surgeon

It is important to be an active participant in the process, so we've developed the following list of questions to ask during your breast augmentation consultation.

• Are you certified by the American Board of Plastic Surgery?
• Were you specifically trained in the field of plastic surgery?
• How many years of plastic surgery training have you had?  
• Is the office-based surgical facility where you perform surgery accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
• Am I a good candidate for this procedure?
• What will be expected of me in order to get the best results?
• Where and how will you perform my procedure?
• Is there a specific surgical technique recommended for me?
• How long of a recovery period can I expect, and what kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• How are complications handled?
• How can I expect my breasts to look over time?
• What are my options if I am dissatisfied with the cosmetic outcome of my breast augmentation?
• Do you have before and after photos I can look at for this procedure, and what results are reasonable for me?

Use This Checklist As a Guide During Your Consultation

The following points are important regarding Dr. Van Natta:

• He is certified by the American Board of Plastic Surgery.
• He was trained specifically in the field of plastic surgery and had 5 years of general surgery training as well as 2 ½  years of plastic surgery training.
• He has been in practice more than 20 years.
• His surgical facility, Meridian Plastic Surgery Center, is accredited by a nationally recognized accrediting agency, and it is state-licensed and Medicare-certified.
• He also has hospital privileges to perform this procedure at St. Vincent Hospital.
• He performs more than 200 breast augmentation surgeries each year.
• He is known both locally and nationally as an expert in breast surgery.

How are complications handled? If you experience a rare complication requiring reoperation, Dr. Van Natta often won’t charge for his services, but you may well have additional expenses for the operating room as well as anesthesia.

Breast Augmentation Caregiver Instructions and Post-Op/Recovery

Day of Surgery

• After arriving home from surgery, you need to take a 2-hour nap. If you have a long car ride home, be sure to count that time in the nap. You should not sleep more than 2 hours. You need to wake up and move around. It’s okay to sit down and rest, but no more sleeping until bedtime. 
• You need to eat something substantial; crackers are simply not enough. And, you need to stay hydrated. If you normally drink Diet Coke, drink a regular Coke or something with sugar. This will jump-start your system. 
• Nausea can occur within the first 3-4 hours after surgery. If you feel nauseous, it may be due to taking the medication on an empty stomach or not drinking enough fluids and becoming dehydrated. This is why it is important to eat something substantial and drink plenty of fluids. 
• As soon as you have eaten, please take 800mg of Ibuprofen, and wait 30 minutes. After 30 minutes, we want your arms above your head in a slow “jumping jack” type motion. Keep the arms straight out all the way up and touch the back of the hands to each other. Your bicep muscles should touch your ears. You need to do a set of 5 every hour, on the hour until at least 10 pm or later if the surgery ended later in the morning.
• Once you feel comfortable moving, take a shower. The shower is magic to loosen things up and help wipe away the fog from anesthesia. After showering, go out to shop and walk around the mall – go out to dinner at your favorite restaurant. A change of scenery is a wonderful thing. We do expect you to close your own car door and put on your own seat belt. You can even carry a couple of shopping bags.
• Feel free to do normal activities around the house: unload the dishwasher, make dinner, and read to the kids. By moving around, you will feel better faster and reduce your risk of capsular contracture and another operation. 

You cannot hurt yourself through normal movement. Remember, we have NO incentive to tell you to do something that would send you back to the operating room. It is important to stay active and keep moving.

The Night of Surgery

• Once you are home and ready for bed, you must lie on your breasts for 15 minutes. You are to lie directly down on the breasts until you put your full weight on them. Do NOT try a push-up to get up. Instead, roll to the side and sit up. Please do not cheat! It is important to put pressure on the breasts immediately. Most patients tell us it feels good to have weight on the breasts – it is just the getting up part that is difficult until they get used to it. Many patients find it is easier to do this by kneeling, bending at the waist, or laying on a bench or ottoman. We expect you to do this tonight and every night until it is simply not an issue anymore – for at least 4 to 6 weeks.
• Around 10 pm, make sure you take another 800mg Ibuprofen with food and either Ambien or Benadryl to help you sleep. During the night, you will wake up when you roll onto your side.  With the help of Ambien or Benadryl, you will go right back to sleep. 
• You can do anything to make yourself comfortable. That may mean more showers, more arm movements, more lying on your breasts, or wearing a bra without underwire for more support. A bra is totally optional. Some patients are more comfortable wearing a bra, and some are more comfortable without. We will leave that up to you. 

The Day Following Surgery

• Get up to eat breakfast, and take 800mg Ibuprofen. Wait 30 minutes and take a nice warm shower. In the warm shower, we want you to do another set of 5 arm stretches. It is hard to just pop out of bed and do the stretches. Follow the post-operative instructions, and you will do great. 
• Use the momentum you have built to get out and do something – run daily errands, drive a car, etc. We do not expect you to stop in the mall and start doing your arm stretches, but we do expect you to close your own car door, put on your own seat belt, and carry a couple of shopping bags. Normal movement is essential. 
• You can expect to run out of energy mid-day. Plan your time so that you can stop and rest for a while. After a short nap, get up and moving again! You will find the more you move, the better you feel. Treat this like a pulled muscle. Yes, you feel it, but it only gets better with movement.
• Expect to feel tighter and more swollen by the end of the day. This is normal and temporary.  You may also begin to complain of soreness of the ribs and lower back around the end of day one or day two. This is simply fluid moving through the tissue. You will urinate all of it out and lose the bloated feeling within 5 to 7 days.
• If you complain of soreness or discomfort in your upper back, it is because you are tensing your shoulders into an unnatural position. Remember to stretch your shoulders forward and backwards … and relax!

Medication Schedule

• We expect you to take one 800mg Ibuprofen at breakfast, again around lunch, and at bedtime.  If you need additional relief around dinner, you can take two 200mg Advil.
• You can take Ambien or Benadryl before bedtime for the first 5 days only. This is not mandatory. Ambien is non-habit forming and really helps you get the rest you need. 
• You need to take all the Ibuprofen prescribed to you. You may choose the number per day, but we would like for you to take them all.

If you are in Indiana, please visit our breast augmentation in Indianapolis page.

Please call the office sometime during the day and let us know how you are doing. You can call (317)575-0336 ext 168 and leave a message for the nurses, or call toll-free at (800)345-1962.