If you have often desired that your breasts should be larger in size and fuller than they are presently, Breast Augmentation surgery may be the choice for you. Breast augmentation or Augmentation mammaplasty is a cosmetic procedure that uses either silicone implants or your own fat (known as Autologous fat transfer) to enlarge the breasts. A pleasing result will give you a greater freedom with the clothing of your choice and will improve your self-image.

You are a good candidate for breast augmentation if :

  • You feel that your breasts have not developed sufficiently and are too small.
  • If previous weight loss has changed the size and shape of your breasts.
  • If after pregnancy and breast feeding, your breasts have become smaller and/or lost their firmness.
  •  One of your breasts is noticeably smaller than the other.

Please understand that only Breast augmentation will not correct severely drooping breasts. In such a case, if you want your breasts to look fuller and to be lifted, then another procedure known as a breast lift or mastopexymay be required alone or in conjunction with breast augmentation.

This can often be done at the same time as your augmentation or may require a separate surgery. Your plastic surgeon will assist you in making this decision.

IMPLANTS

Silicone breast implants are filled with silicone gel. They are soft and pliant and feel a lot like natural breast tissue. Cohesive and highly cohesive (form-stable / gummy bear) silicone gel implants which are currently used do not rupture; the gel will always remain within the implant shell and never leak into the surrounding tissue. 

After a breast augmentation with implants, please note that regular follow-up visits to your plastic surgeon are wise to ensure that the implants have settled well. An ultrasound or MRI screening can also assess the condition of breast implants.

Types of Implants

  • Round - These implants have a tendency to make breasts appear fuller in all dimensions. Implants with low, moderate or high profile options are available to improve projection. Since round implants are the same shape all over, there is no concern about them rotating out of place.The overwhelming majority of implants placed in patients over the world are round implants.
  • Anatomical  - These implants are pear-shaped rather than round. They have more projection in the lower half and are tapered towards the top, thereby giving a more natural lower projection and shape as often desired by older women. If anatomical implants move within their capsule, it may rotate leading to an unusual appearance of the breast.

Breast augmentation/lift/reduction

Consultation with your Plastic Surgeon

During consultation, it is important to clearly discuss :

  • Your concerns, desires and goals
  • Any Medical conditions, drug allergies, and medical treatments
  • Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
  • Previous surgeries

Please note that your plastic surgeon will also :

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Examine and measure your breasts, including detailed measurements of their size and shape, skin quality, and placement of your nipples and areolas.
  • Take clinical photographs with your consent
  • Discuss all your surgery options. The implant size will be decided as per your goals as well as your body characteristics. The use of  external breast “sizers” in the clinic during consultation can help you to make an informed decision.
  • Recommend a course of treatment
  • Discuss likely outcomes of and any risks or potential complications

It’s very important to understand all aspects of your procedure. Some anxietyand preoperative stress is expected. Please discuss this with your cosmetic surgeon in detail prior to surgery.

Preparing for Breast augmentation

In preparing for surgery, you may be instructed as follows :

  • To do a full panel of laboratory tests or a medical evaluation for fitness for anaesthesia and surgery. You may be asked to have a mammogram done to assess the existing breast tissue for any pathological lesion.
  • Take certain specific medications advised by your surgeons or adjust / stop some or all ofyour current medications
  • Stop smoking for at least 1 week prior to surgery
  • Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding
  • How is breast augmentation performed?

The surgical procedure is performed in an Operation Theatre under general anaesthesia. Your surgeon will mark the areas and identify the planned incisions for you pre-operatively while standing.

Incisions are made in as inconspicuous areas as possible to minimize any visible scarring. You and your plastic surgeon should discuss which incision options are appropriate for your desired outcome. Incision options include: axillary (armpits), peri-areolar (around the areolar border) and infra-mammary (in the skin crease under the breast). Most surgeons world-wide prefer the infra-mammary incision as it provides easy and optimum access, does not go through a potentially contaminated area like the armpits, leads to a natural looking result and results in a barely noticeable scar.

breast-augmentation

After the incision is made, the breast implant is inserted into a carefully dissected pocket which may be either under the pectoral (chest) muscle (a submuscular placement) or directly behind the breast tissue, on top of the pectoral muscle (a submammary /subglandular placement). This decision is largely based on the available soft tissue padding available on the breast and should be discussed with you by your plastic surgeon.

breast-augmentation4

The incisions are then closed in layers with the skin being closed by buried self-dissolving sutures. A protective dressing is applied over the incision area and you will be advised to wear a supportive sports bra for 4-6 weeks.

The procedure may be performed as a day care procedure or you may be advised to stay for one night in the hospital.

Recovery

There may be some discomfort and tightness felt for a few days but you can definitely be up and about within 24 hours. The discomfort is well controlled by oral medications. You will be advised to use a sports bra regularly for at least 4-6 weeks. You must avoid sudden and excessive movements of the shoulder and chest. Sleeping on your tummy is prohibited by at least 2 weeks.
You may be asked to do a self- massage of the breast after 2 weeks. Your surgeon will explain the details of the massage during your follow-up visit.
The scars will be firm and pink for at least 6 weeks after which they generally begin to fade.

Please note that there is no scientific evidence to suggest that Breast augmentation with Implants

  • Directly causes breast cancer
  • Affects fertility, pregnancy or hampers future breast feeding

Possible Risks

Breast augmentation is a surgical procedure like any other and has some potential problems associated with it. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

Possible breast augmentation surgery risks include :

  • Anesthesia risks
  • Bleeding
  • Infection
  • Changes in nipple or breast sensation, usually temporary
  • Poor scarring of incision line
  • Wrong or faulty position of the implant
  • Implant leakage or rupture
  • The formation of tight scar tissue around the implant (capsular contracture)
  • Fluid accumulation (seroma)
  • Wrinkling of the skin over the implant
  • Possibility ofrevision surgery

Breast Augmentation using your own fat (Autologous fat transfer)

Your own body fat can be transferred to your breasts for breast augmentation as a significant percentage of breast is actually fat. This procedure uses liposuction to first harvest fat from other parts of your body such as the tummy, inner thighs, outer thighs. This is then processed by different techniques and only the best fat tissues is selected for transfer it into your breasts by injection into different planes to enlarge and reshape the breasts.

The present scientific limitations are that approximately one cup-size of augmentation (175-200cc) can be achieved with long lasting results in one sitting. If more augmentation is desired, it can be done in a similar manner in a second sitting after 6-9 months to 1 year.  This is an option for women who are looking for a relatively small increase in breast size and have sufficient fat that can be harvested from other regions of their body.