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Breast Augmentation Surgery FAQ

This section answers frequently asked questions (FAQ) about breast augmentation surgery. If you have a suggestion for any additional questions, please let us know.

Read the entire Anesthesia Section to learn more about the subject.

What type of anesthesia is best for my breast implant surgery? Do I have a choice?
Can I have my breast implant surgery under local anesthesia only?
What does having an intravenous (IV) line feel like?
What does anesthesia feel like?
Do I have to have a urinary catheter put in for my breast implant surgery?
I am having my surgery performed in a surgery center. What accreditations do I look for?
Can I have other plastic surgery procedures performed at the same time as my breast augmentation surgery?
How long does breast implant surgery take?
What if I wake up during surgery? What if I don't wake up at all?
Will doctors other than my plastic surgeon perform any part of the operation? Will students be present to watch?
What will it feel like when I wake up? Will I be groggy? Will know what's going on? Will I be scared?
How long do I have to stay there before I am able to go home?
Will I get sick on the way home?

1. What type of anesthesia is best for my breast implant surgery? Do I have a choice?

There is no one best type of anesthesia. There is only the best choice for your and your surgeon. The choice of anesthesia is dictated more by your health, the type of cosmetic surgery procedure you are having, where you are having it, and your surgeon’s preferences, so you will more than likely find out that you don't have a choice.

Discuss the choice of anesthesia with your plastic surgeon. Also ask about who will administer anesthesia for you. An anesthesiologist, who is a physician trained in anesthesia and pain management, or a nurse-anesthetist, who is a nurse-practitioner certified in anesthesia administration, can administer anesthesia.

2. Can I have my breast implant surgery under local anesthesia only?

It can be done. Subglandular (under) breast implant placement can be done under local anesthesia only with lidocaine. Lidocaine is an injectable local anesthetic and the injections will be placed within the breasts and breast area. You will usually also be given an oral sedative that will make you relaxed and sleepy, possibly to the point of dosing off. Not all surgeons recommend local anesthesia for breast augmentation surgery and it may not be right for you.

3. What does having an intravenous line (IV) feel like?

You will most likely have an intravenous (IV) line started before your breast implant surgery. This will give you surgeon a means of administering drugs if needed. The line will usually be hooked up to a bag of saline (sterile salt water), which will keep you hydrated. Having an IV line started is very much like having blood drawn. It stings for a few seconds and usually does not hurt after that. After the needle is in the vein, it is withdrawn and a thin plastic tube called a catheter is left in the vein. The catheter is then taped down to your arm so that it can’t be knocked out accidentally.

The most common site to insert an IV line is the inside of your elbow. Occasionally, the line is inserted into a vein in the back of your hand. Where the line is inserted depends on where you have the best veins.

You may have a bruise at the site of the IV. Usually, the site does not hurt while you have the IV in. If you feel a lot of pain, tell the surgeon or staff.

4. What does anesthesia feel like?

If you have been given an oral sedative ahead of time, you might not notice the onset of anesthesia. If you have the anesthetic administered by IV, you will feel the effect soon after it is started, just a few seconds in fact. For some people, then it feels like a warm feeling spreading up your arm. You might have an odd metallic taste in your mouth and then you are out.

If you are having gas anesthesia, you will just breathe in through a mask. After you are out, the anesthetist may insert a tube down your windpipe to administer the gas. You may wake up with a sore or raw throat. You may be asked to count backwards from 100. Most people don’t make it past 95 before they are blissfully asleep!

5. Do I have to have a urinary catheter put in for my breast implant surgery?

This is dependent upon how long your breast implant surgery will be and if your surgeon makes a habit of it for shorter surgeries. This also depends on factors such as whether you have a weak bladder. Usually, inserting a urinary catheter is done after you are anesthetized. Removing it feels a bit weird or uncomfortable, but it is over quickly.

6. I am having my surgery performed in a surgery center.What accreditations do I look for?

If your breast augmentation surgery is to be performed in a surgical suite at your surgeon’s office or in a free-standing surgery center, make sure the site are accredited. The American Association for Accreditation For Ambulatory Surgery Facilities and the Accreditation Association of Ambulatory Health Care, among other groups, inspect and accredit surgical units that are not in a hospital. They ensure that the site where you will have your surgery is well equipped and staffed, sterile, competent, and safe. The surgical unit must also have life-saving equipment, autoclaves, back up generators, sterility, air filters, proper fire exits, and easy access to emergency vehicles in case of an emergency. Ask to see a certificate of accreditation and make sure it is current.

7. Can I have other plastic surgery procedures performed at the same time as my breast augmentation?

Yes. It is not uncommon to have liposuction on your abdomen or thighs or a face lift at the same time as your breast augmentation surgery. Discuss this with your surgeon. Combining procedures cuts down on costs and combines two recovery periods into one. Some surgeons are willing to perform several procedures, and still send you home afterward, but there are limits.

8. How long does breast implant surgery take?

This depends upon the technique, TUBA can take as little as 35 minutes, while a breast augmentation with full lift may take 2 to 3 hours. It also depends on your surgeon. If you choose to have additional cosmetic plastic surgery procedures, your surgery will take longer.

9. What if I wake up during surgery? What if I don't wake up at all?

If you wake up during surgery, they usually increase your anesthetic by a little back and you promptly go back to sleep. Although we think of anesthesia as the medication that makes us sleep through the surgery, you actually get two or more drugs, some of which make you sleep and some that numb the pain. You possibly will wake up, but you are unlikely to feel anything. I know I have woken up during surgery and found that I was totally pain-free and just very sleepy.

On the subject of not waking up at all: This is a sensitive subject and there really is no right answer. To completely ignore the possibility of something terrible happening would be ignorant and naive. But to address it bluntly could scare someone out of having surgery that is very, very safe.

The chances of something going very wrong during your breast implant surgery are very slim. Although complications are possible they are very rare. Try to put it out of your mind. Dwelling on the risk of something bad happening is unhealthy and can cause you unneeded anxiety. If you really cannot stop thinking about it, make sure your affairs are in order, so that you are not as worried about financial matters and loved ones. To be blunt, if you don't wake up, you won't know about it. Try to think happy thoughts, like about how good you will look!

10. Will doctors other than my plastic surgeon perform any part of the operation? Will students be present to watch?

This is to be determined before your breast implant surgery. If you are going to a university or teaching hospital, expect to have medical students present at your surgery as observers. If your plastic surgeon has a surgical resident (a graduate of a medical school who is still training), the resident may assist at your surgery, but your surgeon will be in charge and doing the bulk of the work. If you are having surgery at a smaller hospital or in a surgery center, it will probably be just your surgeon working on you, but the rest of the operating room staff will be there, too.

Ask at your consultation if anyone other than he or she will be performing any part of the breast implant surgery. If you are having several cosmetic surgery procedures done at the same time, it is not uncommon to be dealing with two different surgeons, such as one who specializes in breast augmentation and a second who performed face lifts.

11. What will it feel like when I wake up after breast augmentation surgery? Will I be groggy? Will know what's going on? Will I be scared?

As you begin to regain consciousness you may feel very disoriented. You may feel a bit dizzy and confused. Everything may look white or blanched and you may experience tunnel vision. As you come awake, you may feel very emotional and even start to cry, which is common as you come out of medium to deeper sedation. As the anesthesia wears off, the sluggish feeling in your limbs will subside. Many patients wake up thinking that they didn't have their surgery yet. This is because you have no sense of time while you are under and due to the amnesiac properties of the anesthesia.

Some patients begin shivering and may become nauseated so alert your recovery nurse if this happens to you. You can have a warm blanket and a few sips of cool water to help feel better. If you think you are going to vomit, ask for a bowl.

12. How long do I have to stay there before I am able to go home?

This depends on what type of anesthesia you had, for the most part. If you had general anesthesia you will need to wait a few hours. If you had light anesthesia, you can go home sooner, but still may have to sit tight for at least an hour or two. You need to stay where you can be observed until you are fully out of anesthesia. If any complications arise, they usually occur as you are recovering from anesthesia.

You will need to have someone drive you or accompany you home from the breast implant surgery. You will not be in any physical shape to drive and you may still be groggy.

13. Will I get sick on the way home?

You may feel nauseous on the way home. This happens fairly frequently and usually to those who have had general anesthesia or who are very sensitive to pain medications such as Vicodin or codeine. Bring some cool water to sip or a few packs of crackers to help with nausea. Some surgeons may prescribe an anti-nausea medication for you.

You might want to have a small bucket or plastic container with a lid in the car for if you get sick. If you do get sick, don't worry, it is usually not enough to cause any damage (suture popping, bleeding, etc.) Just grab your bucket, throw up, and cover it all with the lid. Sip some cool water and hope it doesn't happen again before you get home.