Breast Augmentation

Augmentation Mammoplasty, Breast Enlargement, Breast Implant Surgery

Breast Augmentation surgery takes about 2 - 3 hours. The time varies on the anesthetic used and whether it is a local or general anesthetic.

The benefits of the breast augmentation surgery are both physical and psychological. They includes:

• Increasing breast size
• Enhancing overall body shape, balance and proportions
• Achieving an enhanced appearance and size, following pregnancy and/or weight loss
• Restoring appearance through reconstruction following mastectomy (breast amputation)

The surgery is addressed to certain categories of patients among which are:
• patients with small breasts, disproportionate compared to body shape
• patients who desire a pronounced enlargement of  breast volume
• Women who experience unilateral or bilateral breast hypoplasia (an incomplete development of the breasts that remain small)
• Women who experience unilateral or bilateral breast agenesis (the involution of the breast)
• Women who want to regain or enhance their figure after having children
• Women who want to regain breast size after weight loss
• Women want to enhance their appearance 
• Women who want to boost self confidence
• Women who want to correct uneven or deformed breasts, or a congenital absence of breasts
 Note:• a woman must be at least 18 years of age for breast augmentation
(* listed in next section)

The breast augmentation procedure can not be applied on:
• Women with existing malignant or pre-malignant cancer of the breast without adequate treatment
• Women with an active infection anywhere in her body
• Women who are currently pregnant or nursing

The average recovery time is about 1 to 2 weeks. It takes a few months for the breasts to settle after breast implant surgery. In the beginning, you will feel tired for the first few days. You might experience temporary swelling, hardness and discomfort with some bruising, twinges and pains for the first few weeks. These can be overcome by prescribed medications by your surgeon.
 
In case of excessive swelling, deflated breasts, offensive wound discharge or excessive pain or heat in the breast, the patient should approach their doctor immediately.

Before choosing to undergo  breast augmentation surgery, a woman should think about it carefully as it may not be a one time surgery. She may need additional surgery and surgeon visits for the remainder of her life: however, it can really satisfy  expectations. The following are the points to consider:
• Breast implants are not considered lifetime devices. You will likely undergo implant removal with or without replacement over the course of your life.
• Many of the changes to your breast following implantation are irreversible (cannot be undone). If you later choose to have your implant(s) removed, you may experience unacceptable dimpling, puckering, wrinkling or other cosmetic changes of the breast.
• Breast implants may affect your ability to produce milk for breast feeding. Also, breast implants will not prevent your breast from sagging after pregnancy.
• With breast implants, routine screening mammography will be more difficult, and you will need to have additional views, which means more time and radiation.
• For patients who have undergone breast implantation either as a cosmetic or a reconstructive procedure, health insurance premiums may increase, coverage may be dropped and/or future coverage may be denied.

Before you undergo the surgery, make sure to discuss all the possible requirements, outcomes and expectations taking into account your age, skin texture and the existing shape and position of your breast tissue and nipples with your surgeon. During the discussion, make sure to ask  the following questions:
1. Where is the breast augmentation procedure going to be performed (i.e., hospital vs. office surgical suite)
2. What are the risks and complications associated with having breast implants?
3. Is my body's physical condition ready for the surgery?
4. How many additional operations on my implanted breast(s) can I expect over my lifetime?
5. How will my breasts look if I decide to have the implants removed without replacement?
6. What shape, size, surface texturing, incision site and placement site are recommended for me?
7. Who qualifies for this kind of surgery?
8. What kind of anesthesia will the surgeon use during the breast augmentation surgery, and what are the side effects associated with this anesthesia?
9. What are the outcomes?
10. How much sensation will be left in my nipples after surgery?
11. How long will it take for the swelling to go down after surgery?
12. How long do I have to wear a special bra after breast augmentation?
13. Will I experience any pain?
14. How long will it be before I can start normal activities?
15. How much will the entire procedure cost?
16. What are the implant made of?
17. What holds the implants in place?
18. Will I have scars or will they be visible?
19. What kind of incisions will be used, and how will the scars look?
20. How can I expect my implanted breasts to look over time?
21. Will the surgery affect breast feeding?
22. How can I expect my implanted breasts to look after pregnancy? After breast feeding?
23. What are my options if I am dissatisfied with the cosmetic outcome of my implanted breasts?
24. What alternate procedures or products are available if I choose not to have breast implants?
25. Do you have before and after photos I can look at for each procedure?

Usually general anesthesia is preferred as it is the combination of conscious sedation and local tumescent anesthetic. A surgeon may choose to use local anesthesia, depending on the necessary requirements.

Risks and complications are obvious in most of the cosmetic surgeries. Regarding the breast implants, the associated risks are:
 
Infection: Infection occurs usually within days or weeks of surgery. Although infection is rare but in some cases when it occurs for long then the implant may have to be removed until the infection subsides. The implant may then be inserted later.

Bottoming Out: Bottoming out is a complication when the implant rides too low in the breast tissue and may cause the nipple to point upwards. Surgeon can help overcome this complication by re-entering the breast and re-creating the pocket.

Symmastia: Symmastia produces the appearance of breasts being too close to each other. To correct symmastia, a surgical procedure may be required. Larger implants may be exchanged for smaller implants. After corrective surgery, a special support bra and other supportive bandages may be needed to provide the necessary cleavage support while the tissues heal.

Capsular Contraction: It occurs when the scar tissue that naturally forms around the breast implant begins to shrink causing the implant to harden and sometimes deform. The body's natural healing process creates a capsule around the breast implant. In some cases, however, the capsule closes or contracts around the implant. This closure is called capsular contraction. Capsular contraction compresses the implant, causing the implant to look distorted.

In the most advanced cases, the implant can feel hard and misshapen. The implant has not changed or hardened, but the capsule squeezing the implant has caused it to feel hard. Capsular contraction is measured by a grading system referred to as the Baker grading system.

The Baker grading system has four grades:
• Grade I - The breast is normally soft and looks natural
• Grade II - The breast feels a little firm but looks normal
• Grade III - The breast feels firm and may appear distorted
• Grade IV - The breast feels hard, possibly painful, and may appear distorted
A surgery may be required to remove or replace the implant in order to avoid capsular contractions.

The silicone controversy: The silicon implant has been the subject of much controversy after women claimed to have Connective Tissue Disorders (CTDs) and other illnesses from the silicone gel. These related mainly to silicone gel leakage and possible migration to other parts of the body. The symptoms included muscle spasm and pain, swollen and painful joints, rashes, changed eye and saliva fluid and hair loss.

However, the incidence of CTDs is not higher in women with silicon implants than with those without implants, and the Independent Review Group's (IRG) report in 1998 found no scientific relationship between silicone gel implants and immune reactions, no relationship between silicone gel implants and long-term systemic illness (affecting the whole body), nor with specific connective tissue disease or non-specific systemic illness.

The side effects of the breast implant surgery are:

Breast Feeding: Many breast implant patients may successfully breastfeed. However, breast implants may interfere with breast feeding. Thus, consult with your doctor about your plans of breastfeeding.

Loss of Sensation: After breast surgery, some patients experience loss of sensation in the nipple and breast area. This occurs due to the damage to nerve endings in the breast and nipple. It is often temporary, but some cases can be permanent. Your surgeon can determine the most appropriate implant and surgical technique to minimize loss of sensation.

Mammography: Sometimes, you may need mammography later in your life as there is a risk that breast implants may cause small amounts of calcium to form around the implant, which may be confused as tumors on a mammography. Mammography then compresses the breasts, which causes rupture.

Rupture: No implant lasts forever. Implants can break or rupture, causing deflation. Many ruptures result from the natural aging of the implant, excessive compression to the breast or trauma to the breast. The most noticeable effect is that the size and shape of the breast change. Depending on the size of the rupture, changes in breast appearance can occur over a few days or over a very long period of time. 

The obvious risk from ruptured implants is that the contents of the implant will escape from the shell into the breast and cause siliconomas (small lumps), which, in turn, can  cause tenderness or pain in the breast. In such cases, the surgeon or patient may decide to remove the deflated breast implant and replace it with another one. Those who do not replace the implants, dimpling or puckering of the breast may appear after removal.

Bleeding and Haematoma Formation: Patients may lose blood after a breast augmentation, and the drains may not drain all of the blood. The blood can accumulate in the pocket created for the implant. As a result, the breast may swell and become increasingly painful. If this occurs the patient has to undergo another operation in order to have the haematoma removed to stop the bleeding.

Breast Cancer: According to  past evidence, it has been observed that women who have breast implants have no increased risk of developing breast cancer. In fact, it is thought that the risk may actually be less. Instead, if those who have breast implants develops breast cancer, scientific studies have consistently shown that the risk of cancer recurring is no greater than in women without implants.

Rippling or unevenness in breast texture: This usually happens when the breast implant moves.

Symptoms of immune diseases: Rare, it has been reported by some women more commonly by those women who have used silicone implants.

It takes a few months for the breasts to settle after breast implant surgery. Patients might experience temporary swelling, hardness and discomfort with some bruising, twinges and pains for the first few weeks. These can be overcome by prescribed medications by your surgeon.

In case of excessive swelling, deflated breasts, offensive wound discharge or excessive pain or heat in the breast, the patient should approach their doctor immediately. You may feel less sensation in your nipples temporarily; this should become normal as your breasts start healing.

The gauze dressing will be removed 2-3 days after sugery, and you will have to wear a surgical bra or a sports bra 24 hours a day for one full month. You will have a light dressing in place which will need to be kept dry for 2 weeks. After 2 weeks, your dressing will be removed and the wound inspected and lightly cleaned.

The bra will help drain down the fluid and reduce the swelling and bruising. You should avoid strenuous activities for about six weeks. However, you can resume your daily routine in about three months after the surgery.

After the surgery, you may experience some pain, swelling, bruising, and tenderness which can be overcome by the medicine prescribed by your doctor. You may be advised to wear a post-operative bra, compression bandage or jog bra to support your breasts as they heal.

USD 2,300-4,000