Breast Augmentation

Why breast augmentation?

Breast augmentation is done to: 

• Enhance your appearance if you think your breasts are too small or that one is smaller than the other 
• Adjust for a reduction in the size of your breasts after pregnancy 
• Correct uneven breasts after breast surgery for other conditions 
• Improve your self-confidence 

It is important to have a realistic goal regarding breast augmentation and for that you should have  a frank discussion with your plastic surgeon as to what a breast augmentation can do for you.

Risks

Just like any other surgery, breast augmentation poses various risks, including: • Scar tissue that distorts the shape of the breast implant (capsular contracture) • Breast pain 

• Infection 
• Changes in nipple and breast sensation 

• Implant leakage or rupture.

Preparing for breast augmentation

You will consult with your plastic surgeon about your preferences for size, feel and appearance  of your breasts. On hearing your requirements, the surgeon will describe specific types of  implants — smooth or textured, round or shaped like a teardrop, saline or silicone — as well as  options for surgical techniques. 

It is the duty of the patient to carefully read the written information, such as information  provided by the manufacturer of the implant that you are getting and keep copies for further  reference. Before taking a plunge into the surgery, consider the following points.

Breast implants won’t prevent your breasts from sagging:

To correct sagging breasts, you  might need a breast lift in addition to breast augmentation.

No lifetime guarantees on breast implants: 

The average life span of an implant is 10 years.  There is possibility of an implant rupture. Also, your breasts will continue to age. If you put on  or shed weight, it may reflect on the way your breasts look.

Mammograms might be more complicated:

If you have breast implants, in addition to routine  mammograms, you will require additional, specialized views.

Breast implants and breast-feeding:

Some women are able to successfully breast-feed after  breast augmentation. For others, however, breast-feeding is a challenge.

Insurance does not cover breast implants:

Unless it is medically necessary (after a  mastectomy) breast augmentation is not covered by insurance. Be prepared to handle the  expenses, including related surgeries or future imaging tests.

You might need additional surgery after breast implant removal:

If you decide to have your  implants removed, you might need a breast lift or other corrective surgery to help restore your  breasts’ appearance.

Before surgery, you are required to have a baseline mammogram. Your surgeon might tweak  your medication list before the surgery. For instance, it is important to avoid aspirin or other  medications that can increase bleeding. Make arrangements for someone to drive you home after  the surgery and to be with you for at least the first night. 

Breast augmentation is generally done in a surgical centre as a normal day case procedure.  Sometimes, breast augmentation is done under local anesthesia where you are awake and your  breast area is numbed. But most of the breast augmentation is done under general anesthesia, in  which you are asleep during the surgery.

During the procedure

In order to insert the implant, your surgeon will make a single cut (incision) in one of three areas: • In the crease under your breast (inframammary) 

• Under your arm (axillary).
• Around your nipple (periareolar)

After making an incision, the surgeon will separate your breast tissue from the muscles and  connective tissue of your chest. This creates a pocket either behind or in front of the outermost  muscle of the chest wall (pectoral muscle). The surgeon will insert the implant into this pocket  and center it behind your nipple. 

Saline implants are inserted empty and then filled with sterile salt water once they are in place.  Silicone implants are pre-filled with silicone gel. 

When the implant is in place, the surgeon will close the incision — typically with stitches  (sutures) — and bandage it with skin adhesive and surgical tape.

Breast augmentation with fat grafting

Fat transfer for breast enhancement provides a very natural feel compared to silicone, saline, or  gummy bear implants. Furthermore, using your own fat to enhance your breast eliminates most  of the potential complications that accompany breast implants. Fat transfer for breast  enhancement is generally appropriate for women who want to enhance their appearance in quite  a subtle way and do not want to add very significant volume to their breasts.

After the procedure

After the surgery, soreness and swelling are likely to be there for a couple of weeks. Bruising  can also be present. Scars will fade over time, but not disappear completely. During the  recuperative phase, it might help to wear a compression bandage or sports bra for extra support  and positioning of the breast implants. Your surgeon might prescribe painkillers as well. With  regard to returning to regular activities, you must follow your surgeon’s instructions. You  should not do anything that could raise your pulse or blood pressure for at least two weeks. It  should be kept in mind that until fully healed your breasts will be sensitive to physical contact or  jarring movements. 

If your surgeon used sutures that don’t absorb on their own or placed drainage tubes near your  breasts, you require follow-up appointment for removal. If you feel warmth and redness in your  breast area or you run a fever, you should contact your surgeon.