Breast Augmentation 101

1. A Best Friend’s Guide Breast Augmentation to WWW.NAIDUPLASTICSURGERY.COM

2. What you need to know prior to having a breast augmentation: The decision to undergo breast augmentation is an important one. Have you always thought about increasing the size of your breasts, but haven’t known who or what to ask? We’ve got you covered. Within this guide, we’ll introduce you to everything you need to know about breast augmentation: How To Choose a Plastic Surgeon, Breast Implant Sizes and Types, Breast Incision Placement, Risks, Recovery and more. We’re here to guide you through this journey. WWW.NAIDUPLASTICSURGERY.COM

3. Who are we? Dr. Naidu is a board-certified plastic surgeon in New York who takes great pride in providing her patients with the safest and most effective techniques to enhance their natural beauty. She is committed to providing highly personalized and compassionate care at all stages of treatment, including at the initial consultation, during surgery, and throughout the recovery process. While patient safety is the top priority, every attempt is also made to make the experience as comfortable and simple as possible. Dr. Naidu is Board Certified by the American Board of Plastic Surgery and is a Clinical Assistant Professor of Surgery at Weill Cornell Medical College. Her practice focuses on aesthetic and reconstructive surgery of the face, breast, and body, with a special emphasis on breast augmentation surgeries. We want to ensure the best education and support for all women interested in plastic surgery, whether you become a patient of ours or not. WWW.NAIDUPLASTICSURGERY.COM

4. The Basics: Breast augmentation is performed to enhance the size of the breasts. A woman’s breasts may be congenitally small or asymmetric, or they may have changed following pregnancy or weight loss. Breast augmentation can produce a more feminine size and shape to the breasts while maintaining a natural look and feel. Most women report an improved self-image following breast augmentation surgery. Breast augmentation surgery requires research, careful consideration ,and a basic understanding of what will be involved – even before your first consultation. Being prepared is the best way to ensure a successful procedure and a happier you. Now that you have some background, it’s time to move forward and dive deeper into what you need to consider prior to having a breast augmentation. Keep in mind throughout your research that expectations must be realistic in order to avoid disappointment, and should be carefully discussed with your surgeon. This leads us to the first and most important part of your journey – Choosing the Right Surgeon. Well.. we’ve got you covered. We’re here to guide you through this journey. WWW.NAIDUPLASTICSURGERY.COM

5. Choosing your plastic surgeon: • The single most important factor in achieving the results you desire is selecting the best plastic surgeon for your breast augmentation. Choosing the right surgeonfor you is one of the most important decisions. Don’t let yourself be pressured into making uneducated, quick decisions. Instead, do your own research and check your surgeon’s training and experience prior to your first consultation. Diligent research on your part will give you peace of mind during the entire process and your procedure. • You’ll want to research and verify your surgeon’s: • Plastic surgery specialty • Plastic surgery board-certification • Years of experience and training • Hospital privileges • Surgical facility/office, and accreditation by a national or state agency WWW.NAIDUPLASTICSURGERY.COM

6. Plastic Surgery Certification: There are many ways to find a qualified physician. Referrals from friends or family members who’ve had a breast augmentation is always a great place to start. Researching plastic surgeons in your area and reading testimonials from previous patients is another option for finding a plastic surgeon. In addition you may also contact a number of respected professional organizations, such as: • The American Society of Plastic Surgeons (ASPS) • American College of Surgeons • International Society of Aesthetic Plastic Surgeons WWW.NAIDUPLASTICSURGERY.COM

7. Questions for Your Plastic Surgeon: • In addition to learning about your plastic surgeon’s certification and experience, the following questions will help to address more specific questions you may have. They will also give you a feel of your surgeon’s bedside manner and whether or not you feel comfortable with him or her. • What are the risks and complications associated with having breast implants? • How many operations should I anticipate over a lifetime after having a breast augmentation? • How will my breasts look if I eventually choose to have the implants removed without replacement? • What shape, size, surface texturing, incision site and placement site are recommended for me? • How will my ability to breastfeed be affected? • How can I expect my breasts to look over time? • How can I expect my breasts to look after pregnancy or after breastfeeding? • What are my options if I’m dissatisfied with the cosmetic outcome of my breast augmentation? • What alternate procedures or products are available if I choose not to have breast implants? • Do you have before and after photos I can look at for each procedure, and which results are realistic for me? These questions and your initial consultation will help you to assess your plastic surgeon and ensure that you feel comfortable with him or her. You’ll want to make sure that your surgeon takes time to answer your questions and that he or she speaks to you in a patient, respectful manner. WWW.NAIDUPLASTICSURGERY.COM

8. The Breast Augmentation Procedure From start to finish, we’ll discuss exactly what happens during your breast augmentation procedure. It is important to understand the process and have realistic expectations of how long the procedure takes, what is involved during surgery, recovery, and potential risks. Though it is always important to continue to ask your plastic surgeon questions about your procedure, understanding the process beforehand will help to guide you. WWW.NAIDUPLASTICSURGERY.COM

9. Step 1: Anesthesia Breast augmentation surgery is performed on an outpatient basis, either in the hospital or in an ambulatory surgery center. The surgery lasts 1 – 1 ½ hours, and is performed under general anesthesia. Prior to surgery you will be required to obtain medical photographs, routine bloodwork, and in some cases preoperative clearance from your primary medical doctor. The evening prior to surgery, you should not eat or drink anything after midnight. This ensures that you will have an empty stomach prior to surgery, which is very important for your safety. You will need to have a responsible adult available to escort you home after surgery. Breast Augmentation Surgery *Image provided by ASPS Step 2: Incisions There are three commonly used incision locations for placement of breast implants: within the breast fold (inframammary), around the nipple (peri-areolar), or under the arm (transaxillary). The inframammary incision is well-concealed and allows the best visualization of your tissues. There is a lower risk of difficulty breast-feeding with this incision. The peri-areolar incision is also well-concealed, but it is difficult to place some types of silicone implants through this incision and has a higher risk of difficulty with breast-feeding. While the transaxillary incision is off the breast, it may be visible in some types of clothing, and runs a risk of injury to important nerves and vessels in the arm. Large silicone implants cannot be placed through this incision. WWW.NAIDUPLASTICSURGERY.COM

10. Breast Augmentation Surgery Step 3: Inserting and Placing the Breast Implant Breast implants can be placed either partially under the pectoralis muscle (submuscular) or over the muscle and under the breast tissue (subglandular). The goal is to provide optimal long-term coverage of your implants and to avoid creating deformities which cannot be corrected, including visible implant edges and rippling. • SUBGLANDULAR • not recommended for thin tissues • more visible and palpable implants • higher risk of capsular contracture • more difficult mammograms • SUBMUSCULAR • appropriate for thin tissues • less visible and palpable implants • lower risk of capsular contracture • easier mammograms Step 4: After Surgery Immediately following surgery small pieces of tape are placed over the incisions. Drains, pumps, and support bras are not used. A soft bra without an underwire may be worn the following day if desired. Most swelling will resolve within one month, and the breasts will achieve their final shape and size within six months. You should expect to remain out of work for 3-4 days. Light activity including walking is permitted and encouraged immediately following surgery. Heavy exercise, lifting, and sexual activity should be avoided for two weeks following surgery. You may return to chest exercises six weeks after surgery. WWW.NAIDUPLASTICSURGERY.COM

11. Breast Augmentation Recovery It is vitally important that you follow all patient care instructions provided by your plastic surgeon. This will include information about wearing compression garments, care of your drains, taking an antibiotic if prescribed and the level and type of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. Following breast augmentation surgery, you will awaken in the recovery area. Once you are fully alert, you will be transported to the step-down area where you will be given something to eat prior to discharge. You will need to be seen in the office 3-5 days following surgery. You may return to most normal activities the day after surgery, but aerobic and sexual activity should be limited for 2 weeks. Most patients take 3-4 days off of work. You will be given detailed written recovery instructions regarding activity. You may notice some temporary swelling, tightness and numbness. If you notice sudden swelling of one of breasts, severe pain, redness, drainage, or a fever, contact the office immediately. View our Recovery Timeline next. WWW.NAIDUPLASTICSURGERY.COM

12. Recovery Timeline • The First Week: • You will be permitted to shower the day after surgery. • Light activity including walking is permitted and encouraged immediately following surgery. • You may be able to return to work 3-4 days after surgery, depending on the nature of your job. • You should refrain from lifting, pulling or pushing anything that causes pain and limit strenuous activity for 2 weeks. • You will need to set up an appointment with your surgeon to ensure your recovery process is on track. • Two – Three Weeks: • You should minimize excessive physical or sexual activity for at least two weeks after surgery. • Most swelling will resolve within one month. • Long-term: • For safety, as well as the most healthy outcome, it’s important to return to your plastic surgeon's office for follow-up evaluation at the prescribed times and if you notice any changes in your breasts. Do not hesitate to contact your plastic surgeon if you have any questions or concerns. WWW.NAIDUPLASTICSURGERY.COM

13. Potential Risks • All surgery carries specific risks and benefits. The specific risks of breast augmentation surgery include but are not limited to the following: • Rupture: Abreast implant may rupture at any time after surgery, and this is more likely when implants have been in place for ten years or longer. MRI screening is recommended by the FDA for silicone implants at 3 years after your initial surgery, and every two years thereafter, to assess for silent rupture. If a rupture is found, removal with or without replacement is recommended. • Capsular contracture: Capsular contracture is a tightening of the scar tissue surrounding an implant. This may result in firmness of hardness of the breast, or pain. Additional surgery may be required if pain and firmness are severe. • Infection: Although most infections occur within several days after surgery, this complication is possible at any time. Infection may necessitate implant removal for at least three months prior to replacement. • Hematoma/seroma: Hematoma refers to a collection of blood in the space surrounding the implant. A seroma is a pocket of clear fluid that sometimes develops in the body after surgery. Both collections can result in an eventual infection or capsular contracture. While small collections may resolve spontaneously, larger amounts of fluid or blood will require additional surgery and possibly additional scars. • Mammography: Breast implants make mammography more difficult. Although techniques have been developed to move your implants during the study, complete visualization of the breast tissue is not possible You should alert your mammography center that you have breast implants, and you should continue to perform monthly self-examination of your breasts. WWW.NAIDUPLASTICSURGERY.COM