Plastic Surgery and Cosmetic Procedures: Augmentation and Reconstruction Procedures

Abstract

In 2018, breast augmentation was the most common cosmetic surgical procedure performed in the United States. It was the most commonly performed cosmetic surgical procedure in women ages 18 to 34 years. Silicone gel-filled implants are the most commonly used in the United States, followed by saline-filled implants. The most common approach to placement of implants is through an incision in the inframammary fold. The majority of implants are placed subglandularly, under the breast tissue but on top of the pectoralis muscle. Postoperative complications include lumps, asymmetry, leakage or deflation, capsular contracture, changes or loss of nipple and areolar sensation, seroma, hematoma, changes in breast shape, and infection. Long-term complications include infection, implant rupture, capsular contracture, and breast implant-associated anaplastic large cell lymphoma. Any patient who has undergone breast augmentation who presents with a breast lump or mass should be referred to a breast unit for evaluation. Lumps can indicate implant rupture, capsular contracture, seroma, hematoma, breast cancer, or infection. Studies have shown no association between silicone-filled breast implants and connective tissue disorders. Breast reconstruction after mastectomy frequently involves placement of implants. Autologous reconstruction remains another option. Various implants are approved by the Food and Drug Administration for buttock and calf augmentation.