cosmetic surgery - augmentation
breast enlargementAugmentation mammoplasty is a surgical procedure that involves the placement of an implant behind the breasts to enhance their size and shape.Breast augmentation is indicated for the following reasons:
Is Breast Enlargement the right thing for me? A consultation with one of our breast surgeons will help you to decide whether breast enlargement is right for you. You should talk about why you want the procedure and what you hope to achieve from it. Your surgeon will explain how the procedure is done and what you can realistically expect as a result. What happens at a breast enlargement consultation? In your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor may also recommend a breast lift, (For more information on this procedure, ask your surgeon for the brochure on breast lift, also known as mastopexy). Be sure to discuss your expectations frankly with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each. Be sure to tell your surgeon if you smoke, and if you're taking any medications or other drugs. Your surgeon should also explain the type of anaesthesia to be used, the type of facility where the surgeon will be performed, and the costs involved. Because insurance companies do not consider breast augmentation to be medically necessary, they do not cover the cost of this procedure. How is breast enlargement performed? There are several techniques used for breast enlargement- they all involve the insertion of an implant either behind the breast tissue or behind the pectoral muscle. The method of inserting and positioning your implant will depend on your anatomy and your surgeon's recommendations. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple) or in the armpit. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible. Some surgeons believe that putting the implants behind your chest muscle may reduce the potential for capsular contracture. This placement may also interfere less with mammography than if the implant is placed directly behind the breast tissue. Placement behind the muscle, however, may be more painful for several days after surgery than placement directly under the breast tissue. Please bear in mind that breast implants are not guaranteed to last your lifetime. It is important for you to understand that you may require at least one operation in later life to remove or replace your implants. Type of Implants Breast implants are available in an extensive range of sizes, shapes and types of fill. All implants have an outer silicon rubber layer and are filled with either silicone gel or saline (salt water). There are round implants or anatomically (tear-drop) shaped implants. Your surgeon will give you more information so you can decide which implant best suits you. Despite some media reports long-term studies have not found any adverse effects from the use of silicone implants.     How long will I be in hospital? Breast augmentation surgery is best performed using general anaesthesia and it is recommended that you stay overnight following surgery although the procedure may be done as a day case in selected patients. How much time do I need to take off? Expect to be back to your regular routine in two or three weeks, although you may have to wait a little longer before doing any strenuous exercise. How soon you can get back to work is an individual matter- your surgeon will advise you. How do I get back to normal? Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid excessive physical contact. Aerobics and vigorous physical exercise should be avoided for six weeks. Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the mammographic technician should use a special technique to assure that you get a reliable examination as discussed earlier. COMPLICATIONS Breast augmentation is relatively straightforward. As with any operation, however, there are general risks associated with any surgery and specific complications associated with this procedure. 1) Rupture (Silicone gel implants). Following trauma or simply prolonged wear and tear and results in flattening, softening and tenderness. The gel may remain within the breast capsule or migrate, especially to the axillary lymph nodes. Ruture requires removal of the implant. 2) Deflation (Saline implants). As above but saline is essentially tissue fluid and is readily absorbed by the body. The flattened implant only requires removal for cosmetic reasons. 3) Capsular contraction. Clinically significant contracture, scar tissue around the implant causing firmness, pain and a misshapen appearance, occurs in approximately 10% of women. This usually occurs within 12-24 months of surgery. A retropectoral placement and textured implant surface may reduce the incidence. 4) Wrinkling. The implant surface can wrinkle and fold which may be apparent clinically and be a cause of rupture/deflation. 5) Altered sensation. Both altered breast and nipple sensation may occur. These changes can be permanent. 6) Extrusion. An implant may push back through the scar. 7) Infection. The implant may become colonised by bacteria both early and late in relation to surgery. Such implants need to be removed and the infection allowed to settle before replacing the implant. 8) Calcification. This is a rare late cause of symptoms, similar to contracture, and although benign can appear mammographically similar to pre-cancer changes leading to further investigations for diagnosis. 9) Interference with mammography. Implants can both inhibit complete mammographic examination of the breast and cause shadows impairing interpretation of the resultant X-ray. How much does it cost? The exact cost of your breast enlargement will depend on the length and complexity of the procedure. Your surgeon will be able to give you an accurate cost following consultation and examination. |