Category: Breast Augmentation, Breast Implants, Breast Enhancement, Breast Enlargement
An introduction to Breast Augmentation
Breast augmentation is one of the many cosmetic surgery procedures performed by plastic surgeons nationwide. This procedure, also referred to as “breast implants” or “breast enlargement,” entails the insertion of an implant into a female’s breasts for purpose of enlargement. Breast augmentation procedures also feature a breast lift, a procedure which is performed to reduce sagging in the breasts. Breast augmentation can be used to repair a breast that has been damaged or removed as the result of an accident, disease (primary reconstruction breast augmentation), or birth defect. Some choose undergo the procedure to enhance the results of a prior augmentation (whether from a cosmetic or functionality point-of-view). This is known as a revision augmentation or reconstruction procedure. Finally, there are those who have strictly cosmetic motivations. These individuals undergo a primary augmentation procedure. Those undergoing sexual reassignment surgery have also shown interest in undergoing breast augmentation. The implants which are used for such purposes differ from those used under typical circumstances. As of current, breast augmentation ranks in as the number one plastic surgery procedure performed in the United States, with an estimated three hundred thousand procedures being performed on a yearly basis.
A breast enlargement candidate has the choice of choosing between a gel and liquid filled implant. The gel implant utilizes a silicone gel to give the breast its shape, while the liquid one uses a saline solution. Both have their pros and cons. The saline solution implants are prone to rupturing, however, the solution causes no harm to the body. Silicone implants have fallen under criticism several times, more recently due to suspicion that they may cause specific diseases.
You should discuss your breast augmentation options with your plastic surgeon. He or she should be better able to elaborate on the silicone vs. saline breast implants debate.
Breast implants have a long history stemming from the late 1890s. Since that time, doctors attempted to utilize various materials and techniques to increase breast size. However, some of these techniques proved hazardous. Such a technique was the injecting of silicone directly into the breast. This later proved to be dangers – many women had learned that their breasts developed complications as a result of the injections. Some were forced to undergo a mastectomy.
Studies into the types of people who choose to undergo breast augmentation have revealed the majority of patients are young and financially better off than the rest of the population. A more disturbing revelation was that those who chose to undergo plastic surgery had low self-esteem and thus higher occurrences of depression and other related conditions. Fortunately, most patients report an improvement in their condition following their breast enlargement procedure. For some patients, this improvement is merely temporary while for others it persists on a long-term basis.
A breast augmentation procedure can be performed in one of many ways. Various techniques exist for an implant procedure and are used in accordance to a patient’s circumstances. The first factor which varies from implant procedure to procedure is the incision type. Five types of incisions currently exist for breast enhancement procedures. These include an inframmary incision, periareolar incision, Transabdominoplasty incision, transumbilical incision, and transauxillary incision. The first type of incision, which also happens to be the most popular, makes use of the bottom portion of the breast. The incision allows for ease in insertion and orientation of the breast implant. Inframammary incisions are preferred for gel implants, as they require bigger incisions. However, this type of incision can leave unsightly scars.
The periareolar incision is made along the skin surrounding the nipple (referred to as the areola area). This type of incision is preferred for saline implants, as they require much smaller incisions. The scars from this incision are more easily hidden. Their visibility will vary depending on the shade of skin found in this area. Patients who are given this incision may suffer from capsular contracture, an abnormal immune response triggered by the implants.
A Transabdominoplasty incision is only performed when a patient is undergoing an abdominoplasty in conjunction with a breast enhancement procedure. The implant is fed through the abdominal area into the appropriate location.
Transumbilical incisions are made in the naval area and are typically reserved for saline implants. This incision removes the possibility of scarring.
Transaxillary incisions are made in the armpit and can be used for both silicone gel and saline implants. The breast is spared of scarring with this type of procedure.
As with breast enlargement incisions, augmentation patients can have their implants inserted in one of four ways. Subglandular placement puts the implant between the breast and the pectoralis muscle. This technique is successful for those with typical breast tissue but can cause problems for those with thinner tissue (such as the appearance of ripples). Women that are predisposed to capsular contracture should not opt for this type of implant placement.
Submusclar placement puts the implant under the pectoralis muscle, allowing it to cover the implant in its entirety. This type of placement tends to be used in reconstruction procedures.
Subfasical placement is similar to submuscular placement, the only difference being that the implant rests behind the fascia of the muscle. This is believed to allow for better implant stability. Capsular contracture is unlikely with these types of implants.
Most patients can recover from a breast augmentation procedure in a relatively short amount of time, typically a week or less. Again, this will vary depending on the specific technique used to install the implant. Patients should refrain from physical activity until appropriate. The appearance of surgical scars will begin to deplete with time, however, not fully.
Although breast augmentation tends to be a rather safe procedure, it does have some complications. For one, a patient may have an adverse reaction to sedation medications. This is a possibility with all surgeries, thus the risk is expected. Other complications which could arise from breast augmentation can also include irregular bleeding from the operation site, infection, etc.
While breast implants are designed to last for several years, they do have the potential to rupture (and this is expected). Saline implants, as we’ve said earlier, simply release their contents into the body without any sort of adverse affects. The shell of these implants can then be surgically removed.
Ruptures in breast implants can occur either as a result of standard wear-and-tear, or improper implant insertion.
Silicone gel implants, like saline implants, may also fall victim to ruptures. Seepage of the silicone gel into the breast area can cause problems, including the developing of granulomas. Problems arising from seepage may constitute drastic action, such as a mastectomy.
One’s body doesn’t always respond well to foreign objects it encounters. In the case of breast implants, one may fall victim to capsular contracture. This occurs when the body has an immune response to the implants. The fibers that act on this immune response squeeze the breast to the point that it can skew the appearance of the breast. This immune response can also be painful. Some factors which are believed to contribute to capsular contracture include a rupture or breakage in the implant or an infection within the implant area.
Contracture may be relieved surgically (by removing the implant or the capsular fibers) or via less-invasive means (such as a massage).
Breast implants can pose an obstacle to those getting screened for breast cancer. However, studies indicate that women with implants are just as likely to be diagnosed with cancer at similar stages to those without breast implants. Fortunately, cancer tumors that appear in implant recipients tend to be more visible (not due to their size). This tends to detract from the obstacles the implant poses in undergoing a mammography. Cancer patients receiving treatment need not worry about their breast implants. Radiation can penetrate the implants to make its way to cancerous cells located within breast tissue.
Patients who undergo breast augmentation will likely require follow-up surgery to re-enhance the appearance of their breasts. The frequency of these surgeries will vary depending on the patient’s history with implants. Those who’ve gone for restructuring procedures tend to require more frequent surgeries.
Those who have implants on a purely cosmetic basis can avoid the operation table for several years at a time with proper implant selection and placement.
Choosing to undergo a breast enhancement procedure can be a life-changing experience that can benefit you for years to come. One should consider their options carefully and not rush to make a decision. If you have any further questions about breast augmentation, we encourage you to consult with a local plastic surgeon.
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