Breast Augmentation

Ideal candidates are those having small breasts, having asymmetry in their breast size, with sagging breasts due to breast feeding and pregnancy and undergoing reconstruction after the surgery to treat breast cancer

What are the types of surgeries?

Breasts can be made larger by placing an implant either under the breast tissue or behind the muscle on which the breast lies. Implants are usually inserted through incisions in the fold under the breast (i.e. inframammary fold). Alternatively, the incisions may be made around the areola or in the armpit. There are four possible types location where the incision is made. You must be clear about what you want and specify the surgeon about your goals. This helps the surgeon to check which procedure works on you and best suits you as it is different and specific to every individual.

  • Trans-axillary – In this surgical procedure, a slit is made in the armpit and the implant is inserted with the help of a video camera, called the "endoscope."
  • Inframammary fold or Sub-pectoral – In this procedure, the incision is made under the breast on the chest. (Most commonly used)
  • Peri-areolar - The surgery involves making an incision around the nipple.
  • Trans Umbilical Breast Augmentation (TUBA) – In this procedure, the incision is made in the belly button.
  • What happens during augmentation mammoplasty?

    This surgery is performed on a day care basis in the hospital. It takes about 1-2 hours to complete the surgery.

    You will be taken to the surgical ward and will be given general anesthesia. The surgeon will make appropriate incisions at the breast tissue. The type of the incision will depend on the type of the implant used. It can be areolar, inframammary or trans-axillary incision. Your surgeon will place the implant either beneath the breast tissue or the muscle tissue. Finally, suturing is done to close the incisions. These sutures will be removed after about a week or two.

    What is the aftercare of surgery?

    Your surgeon will suggest few tips which you should follow carefully after the surgery.

    You may have to avoid sleeping on your stomach for about 6 weeks. Do not lift heavy weights at least for 2 weeks after the surgery. This is because the pain and discomfort get completely relieved only after 6 weeks of the surgery. You may return to work after a week depending on your pain status, but make sure you are not involved in strenuous work. You may have to avoid taking a bath for 2 weeks, after which you can take a shower and dry your sutures.

    What are the post-surgical considerations?

    Side effects are uncommon with this surgical procedure, bleeding and infection being the major risks. Apart from these, you may also have a scar. Stay away from the sunlight to prevent tanning of your scars, which if occurs may have to be removed using a secondary surgery. The sensitivity of the nipple may be lost for a few weeks, which may be restored in about 6 months or a year. The skin over the implant may become wrinkled, or there can be a leakage or rupture of the implant. There can also be a persistent pain occasionally which needs doctor’s consultation.

    Capsular contracture
    When any foreign material is inserted in the body, it makes a protective coating around it, which in most women forms a thin membrane that remains undetectable externally. In a few women, however the reaction to the implant is greater and this is referred to as a capsule as the membrane becomes much thicker. The capsule around the implant can become thickened and contracted. The newer designs of implants have features to reduce the likelihood of this happening. This problem occurs to some extent in around 5 or 6% of patients and usually starts at about a year after surgery although it may take many years to become noticeable when looking at the chest. This can lead to pain, and/or an abnormally hard feel of the implant in the breast. Treatment may be needed and occasionally removal of the implant.

    Breastfeeding
    Breast augmentation does not usually interfere in breast-feeding, and there is no evidence that any silicone is found in breast milk

    Mammography
    The presence of breast implants may interfere in mammography, which is an X-ray screening method for breast cancer. Special X-ray views can be taken to minimize this interference and studies have shown that the sensitivity of detecting a breast cancer in patients who have had implants is not reduced compared to normal women who do not have implants

    Safety of silicone
    Whatever the filling of the implant, the outer layer is made of silicone, which is a firm type of material referred to as silicone elastomer. Silicon is a naturally occurring element, which becomes silicone when it is combined with carbon hydrogen and oxygen. Silicone is manufactured into many items including cosmetics, foods, and medical implants. Many studies have been conducted to establish whether silicone breast implants cause certain diseases. Because of these studies, we can say that at present there is no evidence to suggest that silicone breast implants are associated with an increased incidence of breast cancer. There is also no evidence to suggest that these implants cause autoimmune diseases such as rheumatoid arthritis.

    What is Breast augmentation?

    Many females are self-concerned about their breasts and are conscious about their appearance. Females love to have breasts with fullness and perfect contouring to boosts their self-image and confidence.

    The size of breasts is genetically determined. Once developed, the breasts may fluctuate in size in response to changes in weight, pregnancy and breast feeding.

    The aging process causes the shape of the breast to change so that they gradually droop (called ptosis). This effect is greater following pregnancy, breast feeding and in particular after a large weight loss.

    Most women have breasts of slightly different sizes, but occasionally a very marked difference may develop.

    However, if you are unhappy about your breasts, which are loose and lack the fullness, then breast augmentation, also called as augmentation mammoplasty can be a right solution for you.

    Breast augmentation is a cosmetic surgery to reshape your breasts giving them a full and perfectly contoured look. It involves the use of either fat or implants to increase the volume of your breasts.

    Who would be eligible for the surgery?

    Go for the surgery only on your will, not by other’s urge. Ideal candidates for the breast augmentation are those:
  • having small breasts
  • having asymmetry in their breast size
  • with sagging breasts due to breast feeding and pregnancy
  • undergoing reconstruction after the surgery to treat breast cancer
  • Candidates who have had either one or both the breasts removed due to cancer are not suitable for the augmentation surgery. (They are suitable for breast reconstruction surgery) Also, the candidates in whom the previous failed augmentation surgery was not successful are not ideal for the surgery.

    How should I prepare for surgery?

    Breast augmentation is one of the most common cosmetic procedures in India which is testimony to its safety and ability to achieve a satisfying outcome in most patients.

    Before the surgery, you need to have some pre-operative preparation. You need to select a plastic surgeon who is well-experienced. It is advisable to go with a plastic surgeon who has a minimum of 5 years of experience in the breast augmentation surgery, as this can help to overcome the complications after the surgery.

    You may have to take 2-3 pre-surgery consultations, and provide your complete health and medical history stating your fitness to the surgeon. You must also clearly understand the advantages and disadvantages of the surgery and make clear guidelines and then go for a specific procedure. Be prepared mentally for the complications that may occur after the surgery. Before the surgery, you must stop smoking or alcohol consumption. You should also stop taking aspirin-like medications which may increase your chances of post-surgical bleeding.

    What are the types of breast implants?

    The augmentation procedure is performed by using breast implants which are of various types depending upon your need.

    Silicone breast implants - These are the silicone gel-filled breast implants that give a feeling of a natural breast tissue. They are approved by FDA for breast augmentation in females aged 22 years and above.
    Saline breast implants - These are sterile salt water-filled implants that give a firm and uniform shape and feel. They are approved by the FDA and are for use in women aged 18 years and above.
    Fat transfer augmentation – here the patient’s own fat is harvested from the abdomen and then transferred to the breast for augmentation – you can get upto one cup improvement by this method. This method is gaining popularity as it gives less visible scarring.

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