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What you need to know about breast augmentation surgery
For breast augmentation, implants are still the safest and most reliable option. The new anatomical, cohesive gel implants give wonderful natural looking (and feeling) results. Medium-term fillers for the breasts are also available but are costly if they are made from FDA-approved substances. Long-term fillers have been found to have an uncertain safety track record so far and perhaps are best avoided.
Surgery, how it's done
Breast enlargement is an operation commonly sought after by women in their 20s and 30s as well as those in their late 30s and 40s whose breasts may have drooped or shrunk after breastfeeding.
The breast implant is placed in one of two locations -- deep in the natural breast tissue or even deeper, behind the pectoral chest wall muscle. The incision is made through the lower part of the areolar region (only possible in patients with large areolas); or through an incision just above the spot where the breast and chest meet, also known as the lower inframammary fold (the most common); or through the axilla or armpit (more suited for saline-filled implants).
Through the access incision, the surgeon creates the pocket for the implant. The implant is then placed into the cavity and the breast is shaped to the desired position. The incision is then closed carefully by suturing.
The silicone breast implant is the most popular and reliable for breast augmentation. All implants have silicone shells and the silicone "bag" can either be filled with saline water or silicone gel. The shell can either be smooth or rough, with the latter known as textured implants.
The textured implants are usually placed behind the breast tissue while the smooth implants are best suited behind the deeper pectoral chest wall muscle, as this is where the muscle acts as an additional layer to "protect" the implant.
Suitable candidates
- Patients should ideally be fit and healthy, with no major heart, lung or bleeding problems. As diabetics are prone to infection, they will need to take a course of antibiotics.
- Patients are usually required to tell the surgeon exactly why they want the surgery and what their expectations are, to enable the surgeon to decide whether these can be achieved with the surgery.
Possible complications
Hardening of breasts due to a layer of scar tissue (capsule). This is the body's response to implantation of the breast prosthesis, which it recognises as foreign.
The capsule progresses from grade 1- 4:
- Grade 1: Breast feels soft and normal
- Grade 2: Breast feels firmer and appears normal
- Grade 3: Breast feels hard and its shape may be distorted
- Grade 4: Breast feels hard, looks distorted and is painful
At grades 3 and 4, usually another operation would be required to remove the capsule (capsulectomy) and replace the implant, or manipulate it (capsulotomy). This complication is liable to crop up again.
Asymmetry
- Symmetry of the breast, as in all cosmetic surgery, cannot be guaranteed. Very few women have breasts that are totally symmetrical anyway, and unless the difference is greater than 25 cc, the discrepancy cannot be matched (gel implants come in increments of 25 cc). With saline implants, however, additional volumes of saline can be added into the implant.
Bleeding
- Generally rare. On average, about five per cent of patients may need to return to the operating theatre because bleeding is detected within four to six hours after surgery.
Infection
- Rare but possible. Antibiotics will be prescribed.
Scarring
- There's always a risk of bad scarring especially in Asian skin.
High breast position
- This tends to occur in A-cup patients. Flat-chestedness means the tight skin of the chest wall would need to stretch out to the new enlarged breast size in order to be pulled into the natural lower breast position, aided by gravity's pull. It usually takes up to one year to achieve the final natural breast position.
Non-surgical enlargement
The most natural is, of course, pregnancy. Frequently advertised breast enlargement techniques using pumps and natural plant extracts are certainly not as reliable and assured of success as surgical breast implants. |
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