Breast Augmentation

Synonymous to : Breast Enlargement, Augmentation Mammoplasty, Breast Enhancement

Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure that enhances the size and shape of a woman’s breasts with the use of breast implants (silicone or saline). The procedure also enhances breast contour and volume after pregnancy. A breast implant, which is composed of silicone gel or saline within a silicone shell, is different from silicone oil. Most cosmetic plastic surgeons all over the world don’t do silicone oil injection to enhance breast size and volume. This technique is condemned both locally and internationally by most surgeons since the result is unpredictable and often compounded by numerous complications such as extrusion, skin necrosis, and infection. Patients should not allow themselves to be subjected to this procedure because the risks for unwanted complications are very high and results are unpredictable and could lead to deformity. Most surgeons use a breast implant which is composed of material that is non-toxic, non-allergenic, non-teratogenic and bio-compatible to human tissues and thus have less risk for any unwanted results, and with a more predictable outcome.

This is one of the most common cosmetic procedures done worldwide, especially in the United States. It is a straightforward procedure with a very instantaneous and pleasing result. For this reason, the public’s attention and interest have focused on the search for a very safe breast implant material. Breast augmentation is the only procedure in cosmetic plastic surgery specialty that is surrounded by controversy and scrutiny. In the past, especially during the late 70’s and early 80’s, a lot of medical conditions such as breast cancer and auto-immune diseases were wrongfully associated with the use of silicone implants. This prompted the US Food and Drug Administration to regulate the use of silicone breast implants for cosmetic breast procedures until mid-2007. After an extensive clinical research study that involved more than a thousand breast-augmented women, it was found that a silicone breast implant does not cause any malignant disease or breast cancer, or any auto-immune disorder. This led to the approval by the US-FDA of the use of the silicone implant in cosmetic breast procedure.

There are two basic types of breast implants: saline and silicone implants. The implant has an outer membrane composed of a silicone shell. This shell contains either saline (fluid) or silicone (cohesive gel) material. It is prudent for every patient to discuss extensively the advantages and disadvantages of each implant type with their surgeon before they finalize their decision.

We perform our breast augmentation procedure under deep sedation with local anesthesia or general anesthesia. The procedure can be done either as an out-patient surgery, or the patient can be admitted or confined for a day or two in a hospital, depending on the surgeon’s and patient’s preference. Whether the procedure will be performed as an out-patient or as a hospital procedure, pre-operative laboratory and medical clearances are required. The surgery usually takes one to two hours to complete. The breast implant can be inserted through an incision at the armpit or breast fold, or at the areolar border. Each choice of incision site has its own advantages and disadvantages in terms of scar cosmesis and nipple sensation. Among the three incisions, the transaxillary approach has the best scar cosmesis since it is concealed and nipple sensation is well preserved. But it is advisable for the patient to further discuss this issue if scarring is a significant concern. After the procedure, there will be some swelling and mild bruising that last for several days to a few weeks. Patients are required to wear breast binders for three to six weeks. This will hold the breast implant in place during the healing process and also help control the swelling. Sutures are removed after seven to ten days.

Any patient planning to have this procedure will require ten to 14 days for the initial consultation, laboratory, medical clearance, surgery, follow-up, suture removal, and early recuperation. After these, patients are safe to travel since wounds are dry and healed.

Possible risks and complications:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Poor healing of incisions
• Changes in nipple or breast sensation, may be temporary or permanent
• Capsular contracture, or the formation of firm scar tissue around the implant
• Implant leakage or rupture
• Wrinkling of the skin over the implant
• Anesthesia risks
• Fluid accumulation
• Blood clots
• Pain, which may persist
• Deep vein thrombosis, cardiac and pulmonary complications
• Possibility of revisional surgery