Breast Augmentation

If you often wish that your breasts were larger and fuller, breast augmentation surgery may be the right choice for you. Breast augmentation (augmentation mammaplasty) is a cosmetic procedure that uses breast implant surgery or fat (Autologous fat transfer) to enlarge and shape the breasts. Your new look will give you greater freedom with fashion and may give your self-image a boost as well. You are a good candidate for breast augmentation if:

Before

After

• You feel that your breasts are too small.
• Weight loss has changed the size and shape of your breasts.
• Post pregnancy your breasts have become smaller and lost their firmness.
• One of your breasts is noticeably smaller than the other.
• You feel conscious wearing a swimsuit or a form-fitting top.

Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation.

Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Your plastic surgeon will assist you in making this decision.

Silicone breast implants are filled with silicone gel. The gel feels a lot like natural breast tissue. The cohesive silicone gel implants which are now currently used have an added benefit that if the implant leaks, the gel may remain within the implant shell and not leak into the surrounding tissue. A leaking implant filled with silicone gel will not collapse.

If you choose a breast implant surgery, you may need to visit your plastic surgeon regularly to make sure the implants are functioning properly. An ultrasound or MRI screening can assess the condition of breast implants.

Types (Depending on shape) –

• Round –These implants have a tendency to make breasts appear fuller than form-stable implants. Higher profile options can achieve even more projection. Because round implants are the same shape all over, there is less concern about them rotating out of place.
• Anatomical (form-stable or gummy-bear) – These implants are pear-shaped rather than round. They have more projection at the bottom and are tapered towards the top. If a shaped implant rotates, it may lead to an unusual appearance of the breast. Placement of gummy bear implants requires a longer incision in the skin.

How is breast augmentation surgery performed?

The procedure is performed in an operation theatre under general anaesthesia. Your surgeon will mark the areas and identify the planned incisions for you pre-operatively in the upright position.

Incisions are made in inconspicuous areas to minimize visible scarring. You and your aesthetic surgeon will discuss which incision options are appropriate for your desired outcome. Incision options include: axillary, peri-areolar and infra-mammary. We at Make a Change prefer the infra-mammary incision as it provides easy and optimum access, does not go through a potentially contaminated area like the axilla, lead to natural looking results and results in a barely noticeable scar.

After the incision is made, a breast implant is inserted into a pocket either under the pectoral muscle (a submuscular placement) (Fig C) or directly behind the breast tissue, over the pectoral muscle (a submammary / subglandular placement) (Fig B). This decision is largely based on the available soft tissue and skin padding on the breast area. We at Make a Change prefer to place the implant in the sub-fascial plane (Fig A), which is a modified plane over the pectoral muscle but under the breast tissue as well as under the pectoral fascia (distinct tissue layer covering the muscle).

The incisions are then closed in layers with the skin being closed by buried self-dissolving sutures. A protective dressing is applied over the incision area and you will be advised to wear a supportive sports bra.

The procedure may be performed as a day care procedure or you may be advised to stay for one night in the hospital

Recovery

You are likely to feel sore for a day or two but you can be up and about after 24 hours. The discomfort is controlled by oral medications. You will be advised to use a sports bra regularly for at least 4 weeks. You must avoid sudden excessive movements at your shoulder.
Stitches will be removed by 10th day. You will be advised to massage the breast after 2 weeks. Your surgeon will explain the details of the massage during your follow-up visit.
The scars will be firm and pink for at least 6 weeks after which they generally begin to fade.
Breast augmentation DOES NOT

• cause breast cancer
• affect fertility, pregnancy or breast feeding

Possible Risks

Breast augmentation is a surgical procedure and has some potential problems associated with it. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

Possible breast augmentation surgery risks include:

• Anesthesia risks
• Bleeding
• Infection
• Changes in nipple or breast sensation
• Poor scarring of skin
• Wrong or faulty position of the implant
• Implant leakage or rupture
• The formation of tight scar tissue around the implant (capsular contracture)
• Fluid accumulation (seroma)
• Wrinkling of the skin over the implant
• Possibility ofrevision surgery

Consultation

During consultation be prepared to discuss:

• Your surgical goals
• If you prefer a breast implant surgery
• Medical conditions, drug allergies, and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
• Previous surgeries

Your aesthetic surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine and measure your breasts, including detailed measurements of their size and shape, skin quality, and placement of your nipples and are olas.
• Take clinical photographs
• Discuss your surgery options. The implant size will be decided as per your goals as well as your body characteristics. At Make a Change we help you decide your implant size in an objective manner by use of “sizers” in the clinic during consultation.
• Recommend a course of treatment
• Discuss likely outcomes of and any risks or potential complications

It’s very important to understand all aspects of your procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your cosmetic surgeon.

Preparing for Breast augmentation

In preparing for surgery, you may be instructed as follows:

• Get lab testing or a medical evaluation. You will be asked to get a mammogram done to assess the existing breast tissue for any pathological lesion.
• Take certain medications or adjust your current medications
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

Be sure to arrange for someone to stay with you for at least the first night following surgery.

Breast Augmentation using your own fat

Fat can be transferred to the breast for breast augmentation. This procedure uses liposuction to take fat from other parts of your body and inject it into your breasts.

This is an option for women who are looking for a relatively small increase in breast size and have sufficient fat in other regions of their body. The details of fat transfer will be discussed in the Autologous Fat Transfer section.

There is sufficient evidence in literature to support the claim that Water-jet assisted liposuction is the best modality available for harvest of fat for this procedure.