Breast Augmentation
OBJECTIVE
To enhance the size of the breasts using either silicone gel or saline implants.
WHO CAN WANT IT
Women who feel that their breasts are too small. This can be due to the fact that, the breasts have not developed properly, or evenly, leaving one breast smaller than the other or that the original shape and volume may have been lost due to weight loss, childbirth or aging.
PROCEDURE
There are several choices either an incision of one to two inches underneath the breast along the fold, a half moon following the lower edge of the areola, or an incision within the armpit. Whether the implant will be placed on top of or underneath the chest muscle will depend on each case and on the type of implant chosen. After the incision a pocket is made into which the implant will be inserted, either behind the breast or under the pectoral muscle. If the breasts are flaccid a breast lift may be recommended in conjunction with the augmentation.
OPERATING TIME
1 to 1 and half hours
ANESTHESIA
Local anesthesia with sedation is preferred, general anesthesia can also be used.
IN/OUT PATIENT
Usually performed on an outpatient basis
There will be temporary soreness and sensitivity, swelling, a change in nipple sensation and possibly bruising for two to three weeks.
A return to work, if not physically strenuous, is possible in a few days. The scar will fade after several months but can be up to a year or more in some cases. Dressings will be changed over several days immediately post operatively. Showering is permitted between three and seven days following surgery, and stitches are removed after 7 days. A support bra is worn for a month, driving is permitted after two weeks and exercise after two to three weeks.
Nipple or breast sensation may change, usually temporarily. Surgical removal and replacement of the implants may be required to treat capsular contracture, which can provoke breast hardness.
A computer consultation helps tremendously when choosing the appropriate new breast size and shape. The patients’ image can be seen with various breast sizes and the location of the incision is chosen.
Results are variable but usually long-lasting, however implants may require removal or replacement. Mammograms are routinely prescribed annually after the age of 40. Significant weight loss can affect the result. Pregnancy and breast-feeding can alter breast size in an unpredictable way, although breast implants do not affect pregnancy or the ability to breast-feed. If, with aging, the appearance of the breasts change, it is possible to undergo a breast lift to improve contour.
