Many women seek breast augmentation as cosmetic surgery to improve the body figure.  Many women have small breast either due to familial inheritance, following pregnancy and aging.  In young women, it is only need silicone prosthesis, but in older women specially after pregnancy many need lifting breast with augmentation. 

How is breast augmentation done?
Details of surgery
Results of surgery
Complications of surgery

BREAST AUGMENTATION:

Many women choose to have their breasts enlarged in order to satisfy their own desire for a fuller bust line. Your breasts may not have developed to the size you want or one breast may be significantly smaller than the other. Often, after weight loss, childbirth or as a result of aging, the breasts lose volume and their shape changes. Breast augmentation can enhance your breast size and shape and give you a more proportionate figure.

Breast augmentation can be performed at any age after breast development has stopped. If you plan to breast feed in future, you can discuss with your surgeon to modify the procedure. You may be a good candidate for breast augmentation if you have any of the following conditions .

• You feel that your breasts are too small
• Clothes that fit well around your hips are often too large at the bustline
• 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

How is breast augmentation done?
Various incisions of insertion of prosthesis

Breast augmentation is done by silicone implants which are either filled with saline or silicone gel. With the help of the surgeon, you decide with help of surgeon what size of implants you wish to put in your breasts. There is no scientific evidence that breast augmentation increases the risk of breast cancer. The presence of breast implants however makes it technically more difficult to take and read mammograms. Placement of implant underneath the pectoral muscle may interfere less with mammographic examination. There is no evidence that breast implants will affect pregnancy or ability to breast-feed.

A small incision of 3-4 cm is put either under the breast, around the nipple or underarm. Through this incision the pocket is created under the muscle or directly behind the breast tissue and an implant of the chosen size and shape is placed in the pocket.

There are two types of implants available, saline filled and silicone gel filled. Both have various advantages and disadvantages and you need to take the decision as to which type of prosthesis should be used for augmentation.

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Preparation for Surgery

• Smoking and Aspirin can increase the chance of complications; so it would be advisable for you to stop or cut down on cigarette consumption 2 weeks before and 2 weeks after surgery.
• Notify the doctor or nurse of any cardiac or medical problems you may have, allergies to any kind of tape, drugs or medications must also be reported.
• You will need to purchase a soft cup sports bra and bring it with you on the day of your surgery. The size of the bra will be discussed during your consultation with the surgeon. We recommend that you purchase two sports bras that either hook or zip in the front.

Morning of Surgery

• Do not eat or drink after midnight the night before. Have a good body and hair wash with medicated soap (Betadine scrub)
• Please inform the office if you take any heart or blood pressure medications, some medications may be taken with a small sip of water.
• Do not wear your contact lenses., makeup, facial lotion or cream.
• Wear clothing that fits loosely and does not have to go over your head, preferably a button down shirt, sweat pants, and slip on shoes.
• Please do not wear any makeup, facial lotion or creams.

First week after surgery:

• The effects of anesthesia will pass slowly, which may take a variable amount of time. Pain medications may prolong the sense of fogginess or an upset stomach. The anesthetic and pain medicines tend to produce constipation, so it is advisable to eat high-fiber foods and/or take stool softeners during recovery. Start with liquids, and advance to a normal diet when you are sure your stomach is comfortable. Try to maintain a low-salt diet to discourage water retention.
• The use of frozen pea bags or ice placed over the breasts during the first 24-48 hours after surgery will help minimise swelling. Apply for 15-30 minutes on and 30 minutes off.
• There will be drainage tubes on each side of the breast. These will be removed when they are no longer necessary, which is usually within 24-48 hours.
• You will start to move around and will be able to do nonstrenuous work in a few days.
• The dressing will be removed and you will be wearing supportive bras on 3-4th day.
• You will be able to take a shower after the dressing and drains are removed. Till then, sponge bathing is acceptable.
• Immediately report any redness, pain and swelling from the incisions to the office.

After several weeks:

• Bruising, swelling and normal periodic discomfort will diminish
• Sutures will dissolve in approximately 4-6 weeks
• You can discontinue wearing a support bra after 6 weeks
• Sensation in the nipple and areola area will gradually improve
• You may return to most of your normal activities, including mild exercise.
• You can massage twice daily with any body lotion containing Vitamin E
• Your breast will start settling into a more natural shape
• Incision lines will begin to fade, but there will be permanent scar hidden in natural lines

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Results of Breast Augmentation:

Breast augmentation will make your breasts fuller and enhance their shape, whcih will boost your self-confidence. Except in the event of implant deflation requiring surgical replacement with a new implant, the results of your breast augmentation surgery will be long lasting.

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What are the risk and complication of breast augmentation?

Risk and potential complication of surgery are best discussed with your surgeon. Some of the potential complications are reaction to anaesthesia or blood accumulation that may need to be drained surgically. Although rare, an infection that does not subside with appropriate treatment may require temporary removal of the implant. Changes in nipple or breast sensation may result from breast augmentation, although they are usually temporary.

When a breast implant is inserted, a scar capsule forms around it as part of the natural healing process. The capsules may sometimes tighten and compress the implant, causing breasts to feel firmer than normal. Capsule contracture can occur to varying degrees. If it is severe, it can cause discomfort or changes in the breasts' appearance. In such cases, more surgery may be needed to modify or remove the scar tissue, or perhaps remove or replace the implant.

Breast implants are not lifetime devices and cannot be expected to last forever. They can rupture and the contents of the implant can spill out which may need a change of implant. Rupture can occur as a result of trauma to the chest, but commonly it occurs spontaneously with no apparent cause.

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