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Breast Augmentation
Breast augmentation is one of the most popular and satisfying cosmetic surgery procedures today. It is used to enhance the size and shape of a woman's breast for a number of reasons:
| Reasons for Breast Augmentation |
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To increase the size of the breasts for a woman who feels her breasts are too small or to create symmetry between the two breasts
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To restore breast volume lost due to weight loss or pregnancy |
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In combination with a breast lift, to improve the volume of sagging breasts |
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To improve breast appearance in a situation where the breast is disfigured due to trauma, congenital abnormalities or surgery
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Good surgical results may help a woman gain or regain confidence in her body. Breast enhancement surgery may elevate a woman’s (or man’s) level of sexual enjoyment and change the way she dresses. Our view at Reflections is that the results of breast enhancement should look completely natural.
The rapport you have with the plastic surgeon is essential as this is a very personal decision and you want to work with a physician who will understand your goals and help you to make great decisions regarding surgery. The surgeon should give you alternatives for types of implants and methods of surgery and be open to your feedback.
Though the procedure is aesthetic in nature, we want patients to really understand and scrutinize the decision before moving forward.
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Breast Augmentation Consultation
In your initial consultation, it's important to discuss your expectations frankly with your surgeon, and to listen to his or her opinion. Every patient--and every physician, as well--has a different view of what is a desirable size and shape for breasts.
The surgeon will examine your breasts and measure them while you're sitting or standing. He or she will discuss the variables that may affect the procedure--such as your age, the size and shape of your breasts, and the condition of your skin--and whether a breast lift is advisable. You should also ask if the nipple and aerola position will change.
Don't hesitate to ask the surgeon any questions you may have, especially those regarding your expectations and concerns about the results.
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Types of Implants
There are many choices with respect to type of implant, size, shape and other features. The decisions will be made on the basis of your anatomy, body size, age and personal preference.
Breast implants contain a solid silicone, rubber shell. The shell may be filled with either saline solution (sterile salt water) or silicone gel. Both saline and silicone gel breast implants are approved by the U.S. Food and Drug Administration (FDA).
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Options under development include cohesive silicone gel implants — also called "gummy bear" implants - and saline implants that allow implant volume to be adjusted after surgery. Cohesive implants are currently under FDA review. They are claimed to hold their shape better than saline or older silicone gel implants and look and feel more natural. The gummy consistency decreases the likelihood of rippling and should provide greater safety because, being more solid, the silicone will tend not to escape from the shell if it were to rupture.
| The following qualities describe the breast implants: |
| Volume |
measured in cubic centimeters
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| Texture |
The implant shell may be smooth or textured |
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The implant may have a round profile or one that is anatomic (teardrop or tapered shape) |
| Profile |
The implant may have a low, medium or high projection (the depth of the implant from the base to the highest point of the implant curve)
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| Diameter |
The width of the implant measured across it's base (the side of the implant that will be positioned over the chest wall)
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Silicone Implants
Some women feel that silicone implants are smoother and softer than saline-filled implants. These implants feel like a semisolid gel. Because of their smooth surface, silicone implants are often preferable for women who have little breast tissue, particularly for women undergoing breast reconstruction.
The U.S. Food and Drug Administration (FDA) removed silicone implants from the general consumer market in 1992 as a precautionary measure over conflicting reports of possible complications. However, they were reapproved in 2005. (Read more about implants and the FDA.)
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What are the concerns regarding breast augmentation?
Please be aware that breast implants may not last a lifetime and future surgery may be required to replace one or both implants. Regular examinations for breast health and screening exams to evaluate the condition of your implants are important.
Breast augmentation is a wonderful and safe surgery. But as with any operation, there are associated risks and specific complications that you should be aware of.
The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant.
Some women report that their nipples become oversensitive, undersensitive, or even numb. These symptoms usually disappear within time.
Breast implants do not generally interfere with a woman's ability to breast feed, or present a health hazard during pregnancy to a woman or her baby. However, pregnancy and the associated changes to a woman's body may alter the results of breast augmentation. Diagostic imaging with mammography may be more difficult with implants and other procedures like MRI or ultrasound may be necessary.
Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the shell to leak.
· If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be absorbed and naturally expelled by the body.
· If a silicone-gel filled implant were to leak or break, the silicone gel may remain within the implant shell or may escape into the breast implant pocket that surrounds the implant. An MRI may be the only way to detect a leak. Routine examinations with the plastic surgeon, including MRI evaluation every few years is recommended.
While the majority of women do not experience these complications, you should discuss each of them with your physician to make sure you understand the risks and consequences of breast augmentation.
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The Surgery
Breast augmentation is usually performed under general anesthesia. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. In addition, a saline implant may be placed through an incision at the navel. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible. The location of the incision will be discussed at consultation.
The breast implants can be placed either directly behind your breast tissue (subglandular placement) or direct on top of the chest wall, under the pectoral muscle (submuscular placement). The advantages of each of these approaches will be discussed at consultation. The surgery usually takes one to two hours to complete.
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What about after the surgery?
You're be up and around in 24 to 48 hours after the surgery. Some bruising is normal and swelling may last several weeks. Your breasts will likely be sensitive to touch for a few weeks as well. Direct contact is avoided for three to four weeks.
You should be able to return to work within a few days, depending on the level of activity required for your job.
Your scars will be firm and pink for several weeks and after several months they will fade. Women who want to reduce the appearance of surgical scars can be treated with a Pulsed Dye laser (Vbeam) or Fraxel starting at time of suture removal.
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Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery.
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Incisions are made to keep scars as inconspicuous as possible, in the breast crease, around the nipple, or in the armpit. Breast tissue and skin is lifted to create a pocket for each implant.
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The breast implant may be inserted directly under the breast tissue or beneath the chest wall muscle.
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After surgery, breasts appear fuller and more natural in tone and contour. Scars will fade with time.
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