What is Breast Augmentation?
Breast augmentation is a procedure where the size of breasts are enlarged. Breast augmentation can be performed using three methods – Silicone Implants, Saline Filled Implants and Fat Grafting.
- Silicone implants
Silicone implants can be inserted behind the breasts (called as subfascial or subglandular) or behind the pectoral muscle (called as submuscular or retromuscular).
There is also a new innovation, where the implants are inserted in “dual plane”, that means implant is located half under the muscle and half under the breast glands. This procedure is performed only in selected patients, post examination by a skilled plastic surgeon.
- Saline filled implants
Saline filled implants are made of silicone bags that are filled using normal saline solution and the implants expand like a balloon. This procedure is reserved for reconstructive breast enlargement or patients who are not interested in the silicone gel filled implants.
- Fat grafting
This is the most recent method of breast enlargement. In this procedure fat is harvested from abdomen, flanks or thighs by using technique of liposuction. The fat is prepared and injected in different layers of the breast to enhance the breasts.
Who needs Breast Augmentation?
Breast augmentation is indicated in following people
- Young women with very small breasts or hypo plastic breasts.
- Women after pregnancy or weight loss who have lost size of breasts.
- Women with mild to moderate sagging of breasts due to pregnancy, weight loss or aging process.
- Asymmetrical breasts due to birth deformity.
- Tuberous breast deformity where the shape of the breast is very narrow and tubular.
- Reconstruction of breasts after breast removal surgery in prophylactic subcutaneous mastectomy or breast cancer.
What are the types of Breast Augmentation?
Types of breasts augmentation by method of implantation
- Subglandular – In this method, the implants are placed under the breast gland and above the muscles. This is suitable for patients with thick skin and adequate breast and fat tissue that can cover the implants. It is also suitable for patient with mild to moderate sagging who are not yet a candidate for breast lift surgery, as the scars in this procedure are minimal.
- Submuscular or retromuscular breast augmentation – In this method, the implants are placed under the muscles. There are two subtypes in this method
- Complete retromuscular where the implants are placed completely under the muscle. This is suitable for patients with very thin skin and who do not have fat or breast tissue padding. This is also the procedure for breast reconstruction after subcutaneous mastectomy.
- Dual plane breast augmentation (DPBA) where the implants are covered by the muscle in upper part and is covered by breast tissue in the lower part. This is suitable for patients with slightly mobile breasts or sagging breasts.
Types of breast augmentation depending upon the incision
- Submammary incision – In this procedure the scar is placed under the breasts and is the most common method worldwide.
- Periareolar incision. In this method the scar is placed in the lower part of areola “half moon shape”. This is suitable in patients with large nipple areolar complex.
- Axillary breast augmentation. In this procedure the implant is placed through a scar placed in the Axilla. This is performed in very selected individuals.
- Transumbilical breast augmentation (TUBA). In this method the scar is placed in the umbilicus. This can be only performed if saline filled implants are used. It is not possible to insert a silicone implant through umbilicus.
Types of breast augmentation depending upon the material used
- Silicone gel based implant augmentation. In majority of the patient silicone gel based implants are used as they feel very natural and does not carry risk of rupture or deflation.
- Saline filled silicone bag implantation. This method is selectively used in patients who are undergoing breast reconstruction due to congenital breast deformities or post mastectomy reconstruction. It can also be used for Breast enhancement if the patient elects it.
- Autologous fat grafting. In this method fat graft is used from patients own body and the fat is injected in the breasts thus enlarging it. It is ideally suitable for patients who does not prefer implants, have birth defects such as tuberous breasts or emptiness in breasts due to weight loss.
What are the latest Technologies used in Breast Augmentation?
Recent advances in breast augmentation are following
- 5th generation silicone breast implants are cohesive in nature like “gummy bear” and it does not leak. The capsule are stronger and more stable. The implants come with a warranty of upto 15 years.
- Tumescent infiltration and surgical tools are much more refined and makes it possible to conduct this surgery within an hour. The postoperative recovery is smoother without any significant brushing, swelling or pain.
How much does Breast Augmentation cost?
The cost of the breast augmentation depends upon the technique used, anesthesia and after care required. The procedure can be performed under twilight anesthesia as day care procedure or in some cases may require general anesthesia with overnight stay. The cost may vary from 7000 USD to 10,000 USD
How to prepare for Breast Augmentation?
A thorough consultation is required with the surgeon to ensure you are the right candidate and you understand the risks and benefits of the procedure.
Preoperative work up with the surgeon and nursing staff is must to perform health checkup and also to measure your breast parameters. This will help you and your surgeon to decide the most suitable size of implant for your body. You may be required to do breast mammography or ultrasonography.
You need to refrain from smoking and medications that can thin your blood. It is recommended to keep yourself fit and healthy.
Ensure that the nurse provides you with all necessary support bras and prescriptions for post-surgery care.
What to expect after Breast Augmentation?
After the surgery the patient returns to her room with a bra. She is given pain medications to minimize discomfort. They are encouraged to walk around and move their arms and shoulders gently the day of the surgery. They need to take time off work for 5-7 days. After 10 days they are allowed to drive and exercise can be resumed after three to four weeks.
Initially the breast appears firm and mildly swollen. There may be increased or reduced sensitivity in the breast and it recovers within few weeks. The breast softens and appears normal in 2-3 months’ time. The complete healing and reshaping of the breasts may take about 4-6 months.
What are the risks of Breast Augmentation?
The risks of breast augmentation includes bleeding, hematoma, infection, implant rejection, wound healing problem, asymmetry, loss of sensation, loss of breast feeding capabilities and capsular contracture in the long run.
Your surgeons experience, skills and knowledge will help to minimize and avoid these complications. A regular postoperative visit and care will also help reduce risks.