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Q. Who can benefit from this procedure?
Adult women, of any age, who seek to improve their appearance and breast volume, can benefit from breast augmentation. If this sounds like you, and you're in reasonably good health, and you're realistic in regard to your expectations, you may be a perfect candidate.

First, though, you should know that:

• Due to safety concerns of the Food & Drug Administration, silicon gel-filled implants-whether new or replacements-are currently available only to women participating in approved studies.
• Saline-filled implants are still available, on an unrestricted basis, to breast augmentation patients.
• For safety, appearance, and other reasons, approved implants should be surgically implanted only by qualified and experienced surgeons.

Q. What are the risks?
There are risks associated with any surgery, and there are specific complications that may occur with breast augmentation. For example:

• Capsular contracture-the formation of scar tissue around an implant- is the most common problem. It can occur if the scar or capsule around the implant begins to tighten. This squeezing can cause the breast to feel hard. Treatment of this condition may require the removal or "scoring" of the scar tissue, or the removal or replacement of the implant.
• Excessive bleeding following the operation might occur (as it might with any other surgical procedure) and cause swelling and pain. Should this continue, a second operation may be needed to stop the bleeding and remove the pool of blood.
• In relatively rare cases, an infection may develop around an implant, usually within a week after surgery (but sometimes later on). Should this occur, it may be necessary to remove the implant for several months, until the infection clears. Then a new implant may be inserted.
• In some cases, the nipple may become oversensitive, under sensitive, or numb. Numbness may also occur near the incisions made to insert the implants. Usually, these symptoms eventually disappear, but may prove permanent in a few patients.
• Breast implants occasionally break or leak, usually as a result of some injury to the breast or from the normal compression and movement of the breast and implant that causes the man-made shell to leak. If a saline- filled implant leaks, that salt water will be harmlessly absorbed by the body, and the implant will deflate in a few days. However, if a gel-filled implant leaks, a second operation may be needed to remove as much of the gel as possible and to replace the implant.

In general, though, most implants have proven to be safe, with no serious consequences.

If you're considering breast augmentation, it's important to schedule a consultation with Dr. Kapoor in advance, at his medical center, so that you and he can discuss the benefits, limitations, potential risks, type and size of implant, pre- and post-surgical procedures, and other relevant topics. Insurance does not usually cover breast implants.

Q. Where and how is the procedure performed?
Dr. Kapoor most often performs breast augmentations in a Beverly Hills surgical center or in one of the hospitals he's affiliated with in Los Angeles, on an outpatient basis, with general anesthesia administered to the patient.

An incision can be made in the crease where the breast meets the chest, or around the areola of the breast, or in the armpit. The resulting scars will be as inconspicuous as possible. After working through the incision, Dr. Kapoor will lift the skin and breast tissue and create a pocket-usually beneath the pectoral (chest wall) muscle. An implant is then inserted in each pocket and centered beneath the nipples. Stitches are sewn in to close the incisions, and tape may be used for additional support.

The entire procedure usually takes about an hour, and recovery is usually fast. After a week or so, the stitches will be removed, and you should allow from three to five weeks for the swelling in your breasts to disappear before you engage in normal activities. The scars will be visible for at least six weeks, and then they'll begin to fade, although they'll never disappear completely.

Countless women throughout the world have had breast augmentations for one or sometimes two of the reasons given earlier. Please contact Dr Kapoor to discuss your options.