What is Breast Augmentation?
Breast augmentation is an aesthetic or cosmetic surgical procedure to increase the size of breasts. Breast augmentation may also correct slight sagging of the breasts and can increase breast firmness. It is also known as breast enlargement or augmentation mammaplasty or even as a ‘boob job’. It can also recreate a breast after mastectomy. For many women attractive breasts are an important part of their self-image. Breast augmentation can dramatically improve self-esteem.
When is Breast Augmentation desirable?
You may want breast augmentation if you feel your breasts are small or underdeveloped or out of proportion to your body. Breast augmentation is useful if your breasts are unequal in size or if they have decreased in size or emptied and sagged after having children.
A consultation with Dr Richard Sackelariou is your first step when considering breast augmentation. You should frankly discuss your goals and expectations. You should always keep in mind that the desired result is improvement, not perfection.
Your first consultation with Dr Richard Sackelariou will take about an hour or more. This is because there is a lot of information to take on board so you can make an informed decision. Most women these days come to the consultation very well informed, however the information available from the internet or other surgeons may not always be specifically relevant to any one woman. Each woman has individual characteristics that demand an individual approach. Be wary of advice that suggests everyone can have the same operation. Once you have decided to go ahead a second very important consultation is needed and again will take up to an hour. Here the most important consideration is choosing the right implant for you.
The Six Choices You Will Need To Make Are
- Saline filled or cohesive silicone gel filled implants
- Textured surface or smooth implants
- Round or teardrop (anatomical) shaped implants
- Placement of the implants in front or behind the pectoral muscle
- Approach under the breast, through the armpit or around the areola
- The size of the implant including volume, projection, height and width
In breast augmentation an artificial implant is placed beneath the breast tissues. The implant varies in size according to the wishes and proportions of the patient. The implant itself contains a jacket and "filler" that is contained within the jacket.
The Jacket: Silicone in its more solid "rubberlike" form is used to create the implant's jacket, which maintains the volume of the filler. In recent years, some patients have raised concerns about the potential for implanted silicone to cause diseases. To date, however, these claims have not been substantiated by carefully performed scientific studies that have examined the health of thousands of previously augmented patients.
The Filler: The old liquid silicone is no longer available. The most commonly used filler today is the cohesive silicone gel often referred to as ‘turkish delight’ in consistency available since 1995. Saline is still available but is rarely used largely replaced by the less problematic and far more natural feeling cohesive silicone gel. The implant shape may be round or teardrop. The teardrop shape can also come in a great variety of teardrop shapes.
Choice of Implant Placement
Breast implants can be placed either under the breast tissue or partly under the chest muscle. Where the implants are best placed depends on your preexisting breast shape and size, breast tissue cover in the upper pole, the amount of sagging as well as your preference. Excellent results can be achieved with the use of both placements. This will be discussed with you and determined at the time of consultation.
Choice of Approach
Three different incisions exist for breast augmentation
- Inframammary in the inframammary fold under the breast
- Transaxillary in the armpit
- Periareolar through the nipple
All three approaches can achieve excellent results. In general, the inframammary incision is the most commonly used as it is the quickest and most straightforward. Discussion at the time of consultation will determine the most appropriate approach for you.
Scars are an unavoidable result of the incisions required to place breast implants, but they generally are small and can be placed inconspicuously.
Do I need to stay in hospital?
The surgery is generally performed as day surgery under general anaesthesia. The operation usually takes about 90 to 120minutes depending on the approach taken. Drains are not used, the wounds are closed with dissolving sutures and tape, and your breasts are strapped in position and secured with sports bra and binder. Intravenous antibiotics are given during the procedure. Generally you will be able to go home a few hours after surgery.
Some discomfort arises from the stretching of the breast tissues, but it largely resolves within two to three days and is well controlled with simple oral medication such as Panadeine. Patients usually return to work within one week, but should avoid excessive physical activity for four to six weeks whilst the tissues heal.
What about Complications?
Breast augmentation is an open surgical procedure that is associated with a very low incidence of complications. At your consultation these will be discussed with you and you will be able to ask any questions you have about them.
Post-operative complications may include bleeding or infection. Both problems occur infrequently, but may necessitate a second operation or temporary removal of the implant. Because implants are a medical device, they may fail. This is very uncommon, but it would require implant replacement surgery. A small number of patients develop a firm layer of scar tissue around their implants that may make the breast hard to the touch or even tender. Called "capsular contracture," this may cause the breast contour to be asymmetrical and may require secondary procedures for improvement. Nipple sensation may be increased or be decreased by the procedure. Although this is almost always temporary, it may be permanent. Most patients are able to breast-feed following augmentation.
Scarring can be unpredictable and some patients may develop hypertrophic or even keloid scars. This is very unusual but may be improved with steroid injections and silicone sheeting.
Breast implants do interfere with mammography if only standard views are taken. All patients with breast augmentation need to inform their radiologists of their implants so the right views can be taken.
Despite these limitations, approximately three million women are estimated to have undergone breast enlargement surgery. The overwhelming majority is very happy with their results.
How important are psychological factors in relation to this procedure?
Emotional stability is the primary factor to be considered before any aesthetic surgery is performed. A "new body" does not guarantee a new life or an end to all personal problems. It is mostly the mental attitude of the individual that determines a successful outcome. Breast augmentation can improve your appearance and renew your self-confidence; the rest is entirely up to you.
Should there be any questions regarding breast augmentation, be sure you get them answered in advance by your surgeon. Well-meaning friends are not a good source of information. Find out everything before proceeding with the operation - a well-informed patient is a happy one.
Finally, there can be no absolute guarantee with any surgery. Remember the realistic aim of this operation is improvement, not perfection.
Please note: The above information mentions only some of the benefits and complications of a breast augmentation. This information should not be regarded as a substitute for information and advice provided by your surgeon during consultation.