Breast Augmentation

 

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Breast augmentation is a procedure most often performed on women to enhance the size/shape of their breasts and involved the surgical placement of an implant either directly behind the breast just above the Pectoralis muscle (subglandular) or behind the pectoralis muscle and above the ribcage (submuscular). While much less frequent, some genetic men have this procedure done to create the appearance of a female breast in transsexual surgery.

There are many reasons why a woman would want to have her breasts enlarged. These include

  1. to enlarge breasts which never developed to a desirable size after puberty.
  2. to enhance breasts which lost volume and shape after weight loss or pregnancy.
  3. to create symmetry for Breasts which developed unequally.
  4. to mask Chest wall deformities such as pectus excavatum and Poland’s Syndrome.
  5. To improve the shape of some breasts which have a tubular shape or a very high inframammary crease or other shape problems.
  6. or, simply to enlarge what some would consider "perfectly normal" breasts to a more desirable size.

The Procedure:

The procedure is performed differently by different surgeons, depending upon their preferences and prior experiences. However, it would be safe to say that the usual methods are as follows:

  1. Incisions:
    • Under the breast (submammary) where the incision is in the fold under the breast.
    • Around the nipple/areola (circumareolar) where the incision is placed at the junction of the dark and light skin around the nipple.
    • Axillary, where the incision is in the axilla (armpit).
    Each incision has its pros and cons and should be discussed with your surgeon beforehand. However, when saline implants are used, as they are filled after insertion, the incisions will be rather small in most cases (about one inch long).
  2. Implant Placement:
    Subglandular (above the muscle): In this method, the implant is placed behind the breast gland and above the pectoralis muscle. While many surgeons preferred this method when silicone gel implants were used, in many cases if saline implants are used, the results will be suboptimal. This is because saline is water and does not feel as much like breast tissue as does silicone. If the breast tissue, skin, and subcutaneous tissue are too thin, one can see the outline of the implant, actually feel the implant edges, and often see rippling (ridges in the skin). In these cases, it would be better to place the implant under the muscle.
    Submuscular (Under the Muscle). In this method, the implant is placed behind the pectoralis Muscle. Because of the thickness of the muscle, the problems stated above can be improved with this technique, but it, too, has limitations, some of which include:
    • Size limit to between 300 to 400cc’s.
    • Not applicable for use in slightly drooping breasts or in breasts "B" cup or larger that will droop later in life.
  3. Types of Implants:
    1. Surface
      • Smooth Wall: The outside of the implant (bag) is made of silicone rubber with a smooth feel.
      • Textured Wall: The outside of the implant is covered with a textured (rough) surface of silicone rubber. It is intended to minimize the shrinkage of the scar that the body places around the implants (Fibrous Capsule) that could cause hardening.
    2. Shape
      • Round: The majority of breast implants are of this shape.
      • Contoured/Tear-Drop, etc.: Some Doctors prefer a shaped implant in selected patients for a variety of reasons.
    3. Post-Operatively Adjustable (Expanders):
    4. This implant has a filler-tube attached to the implant with a tiny infusion port which can be implanted under the skin near the incision. It is extremely useful for a variety of reasons which include:
      • Size: As there is a size limit to submuscular augmentation, if a woman with "AA to A" cup breasts wishes a significant augmentation (greater than 400cc’s), then this is the method of choice. Sizes of even greater than 1000cc’s are possible with this method.
      • Shape: Many shape problems can be overcome by the slow stretching method with this implant. A "natural" looking breast can be created with this implant, even with very large Volumes.
      • Scar tissue from prior procedures can inhibit a good result with ordinary implants. This implant can overcome these problems.
    5. Silicone Implants:
      In certain cases, at the present time silicone implants can be used. This should be discussed with your Doctor.

What you should know:

The risks of the procedure are generally minimal and include

  1. Hematoma (bleeding) postop.
  2. Infection.
  3. Hardening by scar contracture around the implant.
  4. Deflation of Saline Implants.
  5. Poor scarring.
  6. Diminished sensitivity of the nipples or breasts.

All of these risks and others not listed should be discussed with your doctor prior to consenting to the operation

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breast enlargement