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In Perfect Shape
Breast augmentation or enlargement is a surgical procedure to increase the size of breasts, improve symmetry, correct drooping, balance the symmetry between the shoulder/chest and hips or to re-fill the breasts after emptying associated with breast feeding. Augmentation is commonly used to reconstruct breasts following cancer surgery.
There are a number of decisions to be made with breast augmentation. A carefully individualized plan will select the best option for you. These vary with body type and preference. The can be round or shaped as a teardrop which simulates the breast shape. The surface of the implants is either smooth or textured. The fill of the implants may be silicone gel or saline. It is important to note that even saline implants contain silicone in the shell or envelope of the implant. Silicone is considered to have a more natural feel and look. There is a rupture rate of approximately 1-3% per year associated with the saline implants. Saline implants may also wrinkle.
Implants are inserted through incisions either under the breasts, around the areola, across the nipple or in the armpit. Breast implants can be placed behind the chest muscle or in front of the muscle but under the breast tissue. The advantages and disadvantages of each of these variables will be discussed and explained by your doctor. Dr Kippen will give you various options and guide you in the final choice.
Another important decision is choosing the size that is required. Implants can be inserted into your bra to simulate different sizes. Wearing dark, tight-fitting clothes and using a full-length mirror, the effect of the enlargement can be assessed.
Recent studies and review of previous studies have shown silicone to be safe. There has not been a definitive link shown between silicone and breast cancer, immunologic, arthritic or neurological disease.
Newer implants have three layers in the envelope and this is bonded to the filling. The filling is now thick and viscous ‘cohesive gel’ that does not leak or run. Even if cut, the implant maintains its shape. The outer surface may be textured or rough and this helps to decrease the formation of a capsule. This is scar tissue that forms around the implant and may cause hardening. It is still possible to breastfeed with implants.
Surgery is performed in the hospital or day surgery with twilight or general anaesthetic. Supplemental local anaesthetic decreases the pain immediately after surgery. Plastic drainage tubes are usually not used. Depending on the incision and implant placement, surgery can be performed as a day-stay or an overnight stay.
Immediately after the procedure, breasts will be swollen and may be slightly bruised. If numbness occurs, this usually resolves with time. A graded exercise program will be formulated for you. You will be given a detailed plan of post-operative wound care.
It is still possible to have mammograms after breast augmentation. Alert the radiographer that you have implants and they will perform a displacement technique and an additional view may be required. Implants placed deep to the chest muscle obscure less of the breast tissue.
Breast augmentation is a commonly performed procedure. Dr Kippen has had additional and specific cosmetic surgery training and has a special interest in breast augmentation surgery.