Breast augmentation: Be confident. Be free of worries!

Types of breast implants

For many years, saline implants were the only option for women seeking breast augmentation surgery. Saline implants are made from a silicone shell that is filled with sterile salt water. They are inserted into the breast empty and filled once they are in place, requiring a smaller incision than pre-filled silicone implants. Saline implants have a number of advantages over silicone implants; they yield a smaller scar because they are filled after insertion, and they make it easy to spot a rupture, which can lead to faster treatment. If a saline implant ruptures, the implant will deflate and the body will absorb the saline. The major disadvantage of saline implants is the way they feel and the way they look. Many say that saline implants feel harder and less natural than silicone implants. Silicone implants are pre-filled with a gel that mimics the feel of human fat. They have often been said to look and feel more natural than saline implants. Silicone implants are gaining more popularity as the FDA has lifted its ban on them, so long as women understand the risk of silent rupture. Gummy bear implants are a new form of highly cohesive silicone implants that have begun to be available for clinical use in the United States. They are called « gummy bear » implants because they retain their shape when cut in half and have a similar feel to the candy. Like regular silicone implants, they look and feel very natural, but one of the big advantages is that they do not leak. This means there is less of a chance of developing scar tissue around the implant or needing a removal or replacement surgery. Polyurethane implants are form-stable implants developed in the 70s that are rarely, if ever, used today. They differ from other implants in that they have a foam covering, which reduces the chances of developing scar tissue, rotation, or a « tuberous » look, but they do not feel and look natural. Textured shell implants were created to try and reduce the chances of an implant slipping out of place in the pocket and to reduce the likelihood of capsular contraction; however, they have been shown to increase the risk of late development seroma or possible lymphoma. All these types of implants can vary in size, diameter, and projection, depending on the body size of the patient and the desired look. The width or diameter of the implant should not go beyond the natural breast width of the patient.

Silicone gel implants

Silicone gel-filled implants have a silicone outer shell filled with a viscous (thick) silicone gel. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket. A leaking implant filled with silicone gel will not collapse. If you choose these implants, you may need to visit your plastic surgeon regularly to make sure the implants are functioning properly. An ultrasound or MRI screening can assess the condition of breast implants. Silicone gel-filled implants are approved for breast augmentation in women age 22 or older and for reconstruction in women of any age.

Selection of appropriate silicone implants

A careful selection of the silicone implant is the most critical part for augmentation mammaplasty because of the wide range of sizes and implant types. High or mid-profile implants are suitable for most women, but those with broad chests should consider dual-plane or sub-glandular placement using moderate-profile implants to achieve the best aesthetic result. Taller women or those with narrow chests may be suitable for high-profile implants to project their breasts proportionate to their body. Ptotic patients should consider staged auto-augmentation with Wise pattern mastopexy, using a moderate or high-profile implant in the sub-glandular plane followed in a second procedure by an implant change to sub-pectoral and the release of the lower pole to allow the implant to sit in a more favorable position. Anatomic implants may be suitable for some patients; however, they have a higher risk of re-operation because of their shape and may cause visibility or palpability of the implant if there is any rotation from the intended position. Size estimation is best achieved using a sizer system intraoperatively, and any woman unhappy with her breast size also requires a good psychological assessment and justification before proceeding with surgery.

Breast augmentation surgery

After surgery, it is very common to feel a bit of pain, swelling, and discomfort, but this is usually short-lived.
The operation will be done under general anesthesia and usually takes between one to two hours. You will be required to stay a night in the hospital. You will be given postoperative instructions to follow, which may include how to take care of the area of surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow up with your plastic surgeon. Each year, you will visit your surgeon for a check-up and to assess the condition of your implants. There are several different ways to do a breast augmentation. The two main ways are to use saline implants or silicone implants. Both types of implants have their advantages and disadvantages.

This type of surgery is also known as « boob job » to increase the size of your breasts. It involves placing silicone or saline implants under the chest muscle or breast tissue. It is popular in the US as well as in the UK. In the US, it is the most commonly performed cosmetic surgery and in the UK, it is one of the top three. Although it is very popular, you should always remember that a « boob job » is still major surgery and you should not decide upon it very lightly. You should consider all the pros and cons and take time over your decision.

Location to place implants

There are three choices for the location of the surgical incision for breast implants. Your surgeon can make an incision under your arm, under your breast, or around your nipple. The implant is then placed either under the muscle or on top of the muscle. Each of these options has its pros and cons. The incision around the nipple has a greater chance of reducing nipple sensation and may reduce the ability to breastfeed. The incision under the arm may leave undesirable scars. The incision under the breast is usually the best option. Placing the implant under the muscle has a greater chance of reducing the risk of capsular contracture and interfering less with breast examination and mammograms. However, this option is more painful and has a longer recovery time. After considering these options, the decision should be made by the surgeon and patient together based on the patient’s physical condition, the type of implant to be used, and the desired outcome.

Self-preparation before breast implants

Preparing a support system is key in self-preparation before breast implants. Having someone to come to the pre-operative visit with you to ask questions that you may not have thought of is very helpful. Asking a friend to assist in planning a schedule to help you prepare for surgery is also useful. Maybe there are household tasks that you want to be sure are finished before surgery and you may need some assistance.When discussing breast augmentation with children, it is best to explain that you are having an operation to look and feel better in and about your body. It is very important to not elicit fear into your child. Explain the recuperation time as a period in which you may need a little more help from others and that you will not be able to lift anything heavy.

Before you invest in new bras, it is best to wait until your pre-operative visit with the doctor. Your surgeon may ask you to purchase a surgical bra. This can be done by calling the surgeon’s office and inquiring about exactly what kind of bra would be suitable for your procedure. A surgical bra is sometimes difficult to find. It would be helpful to call the doctor’s office a week in advance so that you will have ample time to locate the right garments.

Steps of breast augmentation surgery

Marking the new breast crease – Once the patient has been anesthetized and is asleep, the first part of the breast augmentation operation is commenced. Through the use of a sterile marking pen, the surgeon will usually mark the infra-mammary fold. This is the point at which the new breast crease will be made. Most breast implants are placed through an incision at this point. The best way to decide where the new crease should be is to consider where the nipple is in relation to the chest. The implant should be placed so that it is centered behind the nipple. So a patient with borderline ptosis or droopiness of the breasts would require the crease to be raised in order to ensure that the implants do not end up too low.

Creating the pocket in which the breast implant will sit – After marking the new crease, the patient is prepared for the operation. This involves sterilizing the chest with an antibacterial solution. Then the patient is ‘draped’ with sterile drapes. The next step is for the surgeon to make the incision. There are several types of incision that can be utilized, but the most standard is the infra-mammary incision. An infra-mammary incision is a cut made under the breast, in the crease where the breast meets the chest. Having made the incision, the surgeon then creates the pocket. This is space within the breast, which is designed to accommodate the breast implant. There are two main types of pocket which can be created. The first is called a sub-glandular pocket. This is a pocket, which is made above the pectoral muscle, beneath the actual breast. The second is called a sub-muscular pocket. This is a pocket made below the pectoral muscle.

Post-operative complications after breast augmentation surgery

Long-term complications that may occur many years post-implantation exist. The expected lifespan of breast implants is not guaranteed; a significant number of patients will undergo implant removal and/or exchange at some point in their lives. This may be prompted by a cosmetic change or malposition of the implant, ptosis, pain, or an adverse effect on mammographic surveillance. Changes in the breast following implantation can be commonly attributed to age and breastfeeding, but certain changes may occur more frequently and/or earlier than in the absence of implants. As for the rare adverse health effects claimed to be linked to silicone or saline breast implants, evidence has been insufficient to confirm a causative relationship, but many symptoms have felt to be due to an immune response to a foreign substance. Any claims made by patients of a chronic disease like syndrome occurring post-implantation should be taken seriously.

Pain and changes in nipple and breast sensation are also short-term complications, although for some patients, it may be a long-term side effect. They are usually attributed to a compromised periareolar nerve at the time of the surgery and are either temporary (resolving in a couple of days) or, if the nerve is more seriously damaged, permanent. Changes in nipple sensation can also be attributed to the location of the incision. Numbness is not uncommon around the areolar region, but it is usually temporary. Any loss of sensation occurring in the nipple and areola areas could affect sexual function and lactation, so you should make your surgeon aware of this outcome as it may affect future pregnancy decisions.

Subsequent infections with implants have an increased likelihood in the development of capsular contracture and/or implant extrusion.Capsular contracture is the hardening of the breast around the implant. It can be treated in various ways, such as massage to break the capsule or an open operation (with an incision) to remove the capsule. These are short-term complications. Complications following breast implant surgery: A significant percentage of patients who undergo breast implant surgery experience some short-term complications.

Recovery after breast augmentation surgery

When going home after surgery, you can be generally sore, tired, and have some mild pain. It is normal to feel this way for several days, and if it persists, contact your surgeon. You will need assistance from a friend or relative for the first 3 days, so arrange for someone to help you around the house and to help care for the children (if applicable). The assistance from another adult is advised to last about a week. Remember that metabolism slows in the evening hours, and rest is most important, so create a few comfortable areas around the house to sleep, read, and watch TV. Also, remember that you will not be allowed to cook food for yourself or others for the first day, so make sure to have meals lined up. Lastly, do not lift heavy objects. This can stretch out the pocket where the implant was placed or even cause it to bleed.

After your breast augmentation, it is important to remember that your body will need time to heal, which can vary person to person. Though you may not feel exactly like yourself for several weeks and/or months,  Remember that every body heals differently, and the amount of time it takes to go back to normal activities can vary greatly. « Recovery » is a relative term when speaking about major surgery such as breast augmentation.

Breast augmentation revision

When a woman undergoes breast implantation, she may assume that the next operation involving her breasts would be for breast implant replacement. Nevertheless, this is not the case. An inordinate amount of women (reported as high as 40%) never need additional surgery after breast implantation. For various reasons, those that do need breast implant revision surgery fall into two groups. The first group involves women who experience a complication, a subset of this group is women with capsular contracture of the breast implying hardening, deformation and possible painfulness of the implanted breast. This happens to 15% of women after breast augmentation. Implant rupture is a common cause of second surgery. In these cases, it is recommended that the implant and the scar tissue that has formed around it be removed. This is referred to as a total capsulectomy when the entire Internally, the breast is composed of skin, gland, connective tissue, and fat which can all be affected differently by aging and various factors. The breast can begin to droop through the effects of gravity, pregnancy, breastfeeding, and weight change. Because the breast implant is placed under the breast gland or under the breast gland and chest wall muscle, the implant does not prevent the effects of age-related glandular descent. In the long run, these effects may change the appearance of the breast causing a woman to consider simultaneous or second surgery involving lifting of the breast and or exchange of the implant to restore a more natural youthful look.

Age range and breast augmentation

Breast augmentation is visually pleasing for the increasing cohort of younger women. Implants themselves are designed with long-term durability, and this is a significant consideration for younger women. The idea is that breast augmentation at a young age will not require replacement of the implants at various intervals in their future and will be maintenance-free during their childbearing years and possibly rearing. Also, the psychological benefit of improved self-esteem and confidence for a young person is a potent factor. It will affect their social and intimate relations throughout their personal and occupational life. Many younger breast augmentation patients have not yet had children, so breast feeding is often discussed. Although there are no reported detrimental effects of breast feeding with implants, it is recommended to perform the breast augmentation after childbearing years. Older patients are often quite private on the topic of cosmetic breast enhancement as they feel embarrassed about their age and believe it is vanity to have the procedure done. They are often the most appreciative of the subtle changes that breast augmentation can make on their physique and psychological outlook.