How is Breast Augmentation surgery performed?
There are basically two methods of performing breast enhancement or breast augmentation.
Autologous transfer of fat tissue
Fat from the abdomen and or thighs is removed by liposuction. This fat is then purified and injected into the breast tissues.
Advantages
Disadvantages
Silicone implants
High grade medical quality silicone implants are placed beneath the existing breast tissue through a small surgical incision in the breast crease. Your surgeon may choose to place the implant either above or below the chest wall muscle depending on your body type.
Advantages
Disadvantages
How do I prepare for my breast augmentation consultation and surgery?
At least two consultations are advised before surgery. When you come in for your first consultation, your surgeon will ask you to describe your ideal size. You may bring photos of the type of breast you want. Though it may not be possible to meet all your expectations with the surgery, we will do our best to give you a well shaped big and beautiful breast.
Though patients always want the biggest size of implant, we encourage patients to go for a more natural look. It is more important that your breasts look naturally large and beautiful instead of obviously surgically enlarged. Depending on your body type and your personal preference plus your surgeon’s experience, you and your surgeon can decide which implant is best suited for you. At your second consultation we will typically take measurements of your body to finalise the size and shape of your breast implant. The selected implant will be ordered and you will be given a date for surgery. Your surgeon will also check the results of any blood tests or other investigations advised on your first visit.
What to expect after breast augmentation surgery?
Recovery after breast augmentation surgery takes upto 3 weeks. You will be discharged home after 2-3 days in hospital. Your breasts will be bruised swollen and sore for a few days and appropriate painkillers will be prescribed.
Initially strong tapes or elastic bandages will be applied to your chest. These will be replaced by a support bra after a weeks. The stitches, if any are taken on the skin, will be removed after 10-14 days. After discharge you will need to rest at home for a week and not perform any strenuous activities. You should have someone who can look after you during this period.
After 2-3 weeks you can start exercising your lower body, walking. However upper body workouts, running, swimming can only be resumed after a month. Your breasts and nipple might feel numb for the first few months. The sensation will return over the course of the year but may be permanent in some patients. Breast lift surgery does leave permanent scar, but they are usually covered within the bra.
What are the Risks/Complications of Breast augmentation Surgery?
Types of Breast Implants - in depth look
Breast implants come in a variety of shapes, sizes and projections. Projection refers to how far forward the breast rises from the chest wall. This is the distance between the chest wall to the nipple. There are several options available so we can choose how far forward your breast will project.
Types of implants
Saline Breast implants
Saline is a sterile solution of salt in water. It is similar to saline used for intravenous or IV fluid drips. The contents of this implant are the same as found in your body fluids. Saline implants are empty,ie, deflated when they are put inside the body. They are inflated,ie, filled with saline.
The advantage is that they can be inserted through the tiniest of incisions and so will give a much smaller scar. In case of a leak or rupture the fluid is naturally absorbed by the body.
The disadvantage is that they are more likely to have capsular contracture over time. Sometimes a rippling effect can be visible on the surface of the breast. This is more obvious in thin patients. Hence these implants should always be placed below the muscle of the chest wall.
Silicone breast implants
Cohesive silicone gel implants are the latest generation of silicone implants. They have significant advantages over the earlier implants as the contents are in solid form. The silicone therefore does not leak into the body even if the outer shell ruptures. The shape achieved is stable over a longer period of time, and the feel is soft and natural. Rippling is rarely seen with this type of implant.
However since these implants are pre-filled to the actual size, a larger incision is required. Currently most plastic surgeons worldwide use silicone breast implants as the first and only choice for breast augmentation.
Shapes of Breast Implants
Round Breast Implants
A round implant implies just that... it looks like half of a sphere. This is the shape most commonly used by surgeons as it has lower complication rates.
Anatomical
This is a pear shaped implant which closely resembles how the breast hangs from the chest wall.However studies have shown that the results obtained by both round and anatomical implants are identical in terms of the final shape.
Smooth vs Textured implants
This refers to the outer silicone shell which contains either the saline or silicone gel.
Smooth Breast implants
The outer surface is smooth so the implant doesn’t attach to body tissues. They are moveable within the capsule that forms around them. Most breast implants used today are of this type.
Textured Breast implants
The outer surface is rough like sandpaper so the implant attaches to the tissue capsule around it. This prevents it from moving. They are used in specific circumstances such as after capsular contracture surgery or if anatomical shaped implants are required.
There is a 1 in 30,000 risk of developing a rare tumor called Anaplastic Large Cell Lymphodema ( ALCL) associated with this type of implant shell. This is a late complication occurring more than 5 years after implant placement and can be treated by removal of implant alongwith the tumor.
Implant leak/rupture
The risk of implant deflation increases by one percentage point for every year. So at the end of 10 years only 10% of women are at risk for developing a leak. Many women go their entire life without ever needing to change their implants. Some women of course may choose to do so for a bigger size.