Breast Augmentation

Full, shapely breasts can make any woman feel more feminine, beautiful, and secure. We believe that every woman deserves to love her body; that's why we have mastered the art of breast augmentation at our offices in Oklahoma City. Breast augmentation is a cosmetic procedure designed to increase and enhance the size and shape of a woman's breast. The end result is a more curvaceous, sexy bust line and a natural, sculpted look.

The operation consists of creating a pocket behind the breast tissue. An implant is placed in this area between the breast and the chest wall or beneath the muscle behind the breast. The implant thrusts the breast forward, but it is not actually within the breast tissue. The most common way to gain access to the area behind the breast in our office is through an incision approximately two inches long in the axilla (armpit). 

The size of the implant to be used is determined by the amount of the existing breast tissue that you have and by your height, weight and general body stature. There is probably no greater tendency to develop cysts or lumps in breasts with implants than without. Implants are not known to cause cancer at the present time, although, the use of implants have been known to cause cancer in certain animals. For unknown reasons, the incidence of breast cancer, according to most studies, is less after one has had breast implants.

This operation is performed in our surgical suite as an outpatient surgical procedure. You will be given local anesthetic with heavy sedation, and you will have no pain whatsoever during the procedure. Generally speaking, there is little risk in the use of local anesthesia with sedation, as it is a bit safer than general anesthesia. However, in rare cases, there can be a reaction. You will be sent home (or to your hotel, if from out of town) shortly after the operation, once you are in stable condition and your caretaker has been given post-operative instructions. Please note that it is REQUIRED to return the morning after surgery for your follow-up appointment.

As with any surgery, you will have a scar. Fresh scars are usually firm and red for period of approximately six months and then they gradually improve over the first year. The underarm incision is preferred since this area scars less and it leaves no scar visible on the breast. No guarantee can be made concerning the appearance of your scar(s), since each person heals differently and neither the physician nor the patient can completely control the patient's healing.

As with any operation, an infection may develop, although this is rare. Infection, if present, is generally limited to a very small area and simply means healing might be delayed a few days. The most serious infection would result in removal of the implant. After a satisfactory period of healing (three to six months), the implant would then be replaced.

Following surgery, you can expect some bruising near the incision and on the breast itself. A larger amount of bleeding could occur but is unusual. Treatment for this would require opening the incision, draining the blood and removing blood clots, controlling the bleeding, re-insertion of the implant and closing the incision. While this can be irritating, it is generally not serious. BECAUSE OF BLEEDING, NO ASPIRIN, ADVIL, IBUPROFEN PRODUCTS OR VITAMIN E CAN BE TAKEN FOR AT LEAST 10 DAYS BEFORE SURGERY AND IF IT IS KNOWN BY THE DOCTOR, THE SURGERY WILL BE CANCELLED.

Numbness, tenderness or burning of the nipples or skin around the incision may be present after surgery, but is generally only temporary. A change in sensation of the nipples that may be permanent is rare.

In approximately 5-10% of the cases, breast become firmer following implant surgery. The implant itself does not become firm, but the firmness is due to the formation of scar tissue around the implant. If this contracts excessively, it can result in undesirable firmness. While some firmness is beneficial to some patients, excessive firmness is ordinarily not desirable. If excessive firmness develops, a second operation may also be required. It is also the opinion of this office that there are a small percentage of women who cannot tolerate breast implants without having permanently firm breasts.

On the day of the operation, you should not have had anything to eat or drink for 6-8 hours before your scheduled surgery. Please arrive at the scheduled arrival time given to you in your pre-op instructions. If you have anything to eat or drink during the time before your surgery, it is imperative that you tell Parkway staff so Dr. Metcalf can decide if surgery needs to be rescheduled. Additionally, if you have taken any aspirin in the last 10 days, your surgery will be rescheduled.

It is important to take a deep breath and try to be as relaxed as possible the morning of your procedure. Take solace in the fact that there will be no pain during your surgery, and you will have adequate pain management for recovery. Parkway Medical understands you might be nervous, so we provide medication to help ease those pre-op "jitters".

Following surgery, you will be observed for a period of time before leaving for home or your hotel room. Additional post-operative instructions will be given to your caretaker, who is required to be with you at least the first 48 hours after surgery.  

For the first few days you must rest and relax. You will be wearing a jog bra without under wiring, which will be provided for you at my office. You may sit or lie on your back or either side. You may be up to the bathroom and for meals. There should be no housework at all for the first two full days. It is important to be cool and calm. Avoid overheating and excitement of any kind during this period of time to eliminate the possibility of accidental injury or bruising. You may raise the arms above the shoulders as needed after the first day. A shower can be taken after the first full day. Passive sexual activity may be resumed on the second day but no vigorous activity for at least one week. You should wear the recommended bra most of the time in the first week. Sutures will be removed in 7-10 days. The time for your next return appointments will be the first day after surgery, then approximately one week later and then on an as needed basis. I will determine the time of the appointments after the first two weeks and you must understand that these appointments must be kept. You will receive follow-up evaluation and instructions at no charge.

Most of the discomfort will be over after the first two or three days; however, you may have some tenderness and soreness, which could last for a few weeks. After the first two days, you may drive a car if not taking pain medication and do light housework such as washing dishes. You should avoid hot baths and vigorous activity for at least two weeks unless instructed otherwise and should not participate in any sports such as jogging, swimming, bowling, tennis, etc. until after surgery is approximately three to four weeks old.

Silicone implants are generally recommended, although saline and gummy implants are available as well. At Parkway, we prefer silicone implants since saline implants generally need to be replaced every 10 years due to rippling, rupture, or other complications and gummy implants are firmer and can feel a little less natural. New patients need to be at least 22 years of age to get silicone implants, otherwise it voids the warranty by the company that manufactures the implant.