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What is Breast Enlargement / Breast Augmentation?

Perky and full looking breasts seem to make a woman feel more complete. Thanks to advances in science, this can be a reality for any woman. More importantly, breast implants have been proven to be safe and does not affect functions of the breast. Nor do they cause or increase the chance of tumors or breast cancer. Even breast feeding can be done normally later.

Implants are available in various sizes and the right choice of implant depends on the amount of existing breast tissue, the chest size and personal choice.

The scars of surgery are well hidden and the breasts look and feel natural.

A state of the art operation theatre using sterile techniques, complete range of sophisticated instruments and above all meticulous care during surgery are key to avoiding complications.

The surgery is done as a day care procedure. Upper body exercises and fondling of breasts are to be avoided for a month. Desk jobs and light physical activity can be resumed in a few days.

The operation is carried under general anesthesia on an outpatient basis. An implant (prosthesis) is placed through an incision, under the breast tissue or under the muscle. The incision can be made under the breast, around the nipple or in the armpit. It generally takes two to three hours to complete the entire procedure. A breast implant is composed of an outer shell filled with saline (salt water). The outer surface may be smooth or textured, and implants come in various shapes to meet the individual woman & rsquo;s needs.

Types of implants

Surgery India Breast Augmentation, Cost Breast Augmentation, India Breast Augmentation Surgery Hospitals

Figure : Where breast implants are placed Implants can be broadly classified as SALINE and SILICON implants depending on its contents.

1. Saline Breast Implants

Before one undergoes breast augmentation surgery with implants one can make choices regarding the surgery. One can either choose to implant saline or silicone implants. A saline breast implant is a pouch made of silicone rubber or elastomer. This is surgically inserted under the chest tissue or muscle and then filled with saline water through a valve. The texture of saline implants varies. Saline implants cause visible rippling and appears less natural than silicone gel implants. If the saline implants ruptures saline is released and the empty implants can be removed and replaced.

2. Silicone Gel Breast Implants

In 70s the silicone implants had thick shells and thick silicone gels but today silicone implants have multiple layers of silicone elastomer around the implant. These implants are pre filled and are ordered by the surgeon. The shape of a silicone gel implant cannot be changed. Longer incisions are to be made to implant them and they produce a firmer and softer effect than saline implants.

Am I a good candidate for breast augmentation?

One or more of the following feelings or conditions may indicate that you are a good candidate for breast augmentation:

you are bothered by the feeling that your breasts are too small

clothes that fit well around your hips are often too large at the bustline

you feel self-conscious wearing a swimsuit or form-fitting top

your breasts have become smaller and lost their firmness after having children

weight loss has changed the size and shape of your breasts

one of your breasts is noticeably smaller than the other

Pre surgical evaluation

After the initial consultation, a clinical examination is performed to assess the breast architecture including size, symmetry, proportion to rest of the body and any other anomalies. The surgical plan will depend on the findings of the clinical evaluation. The presence of any breast diseases also needs to ruled out.

The size or volume of the implant to be used will depend on 5 key factors:

Your expectation/desire
Chest size
Amount of existing breast tissue
Skin envelope of the breast
Any drooping of the breast

Blood tests, a baseline mammogram or ultrasonography of the breasts and other tests for anesthesia also form part of the pre surgical evaluation.

Access/ incision for breast augmentation

Two most commonly used approaches to breast augmentation are the infra mammary crease approach and the circum areaolar approach.

1] Infra mammary approach

In the infra mammary approach, a fine 5 cm incision is made beneath the breast in such a way that the final scar falls in the crease below the breast. As the final scar falls in a natural crease, it fades well over a period of time. The infra mammary crease is the most hidden portion of the breast and most women prefer to have the access from this area.

2] Circum areaolar approach

In the circum areaolar approach, the incision is made in the lower half circle of the areola. The advantage in this approach is that the final scar blends in well in the natural color interface of the areola and breast skin.

3] Trans axillary approach

Trans axillary approach employs an incision in the crease in the under arm area. TUBA or Trans umbilical breast augmentation uses access from the navel using endoscopy instrumentation. Both these approaches are possible with saline implants, the use of which is decreasing since best performance for cohesive gel implants received.

The procedure

The surgery is performed under general anesthesia.The surgery takes about 2 hours to complete. The space /pocket for the implant is made in any of the following locations :

Below the gland (sub glandular)

Below the muscle (sub muscular)

Dual plane (where the upper half of the implant is below the muscle and lower half below the gland)

The decision to create a particular pocket in each case is made considering the type of implant and tissue characteristics of the breast..

The pocket is created with meticulous technique using fibreoptic special illuminating devices and magnification. The adequacy of the pocket is checked during the surgery using disposable sizers.

Small tubes to drain off the collecting fluid may be placed, which are removed in 24-48 hours. .


Before	After


Before	After

Post surgery

The post operative period following breast implant surgery is generally pleasant and well tolerated. Minor discomfort, feeling of stretch, swelling and bruising can be expected. Most patients are able to start normal daily activities starting the next day and return to office work in 2-3 days time. Decreased sensation over the breast can occur and usually recovers in a couple of weeks.

The 24 Hour Breast Augmentation

For most of our patients, getting back to work early is a priority (return to work the very next day is even possible now). Fifth generation silicon gel implants are preferred for augmentation as their feel is closest to being natural.

What are the risks?

Breast enlargement is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications.

Side-effects

These are the unwanted, but mostly temporary effects of a successful treatment, for example, feeling sick as a result of the general anaesthetic. For a few weeks after surgery, your breasts will feel sore, swollen and hard, and you will feel a burning sensation in your nipples. Using extra pillows when sleeping can help reduce the swelling around your breasts. You will have scars, they will be pink and noticeable at first, but they should fade gradually.

Complications

This is when problems occur during or after the operation. Most women are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT). Specific complications of breast enlargement are rare, but can include:

An unevenness in size and shape - possibly caused by natural differences highlighted by the surgery
Creasing, kinking and ripples on the skin over the breast
Infection - this may need antibiotic treatment, sometimes the implant needs to be removed temporarily
Abnormal scar tissue forming around the implant - this may cause a firm, painful swelling called capsular contracture, requiring further surgery
Change in skin and nipple sensation - can be permanent
Build up of fluid around the implant (seroma) - may require further surgery
Unusual red or raised scars (keloids) - can take years to improve

It's possible that you still won't be satisfied with your appearance after the operation.

The exact risks are specific to you and will differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you..

Recovering from breast surgery

At home, if you need them, you can usually take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice.

General anaesthesia can temporarily affect your co-ordination and reasoning skills, so you should not drink alcohol, operate machinery or sign legal documents for 48 hours afterwards.

Follow your surgeon's advice about driving. You shouldn't drive until you are confident that you could perform an emergency stop without discomfort.

You will need to wear your support bra for four to six weeks after the operation. This helps to stop the weight of the breasts pulling on the healing wounds.

Don't lift heavy objects or do any strenuous activity for the first two to three weeks after the operation. If the implant is placed under your chest muscle, activity may be restricted for longer.

If you have any concerns or get pain that can't be controlled with painkillers, a high temperature or your breasts feel unusually hot to touch, contact your GP or the hospital as you may have developed an infection.

At your follow-up appointment, your surgeon will give advice about when you can resume your usual activities and return to work.

It may take several months before your breasts settle into their new shape.