Breast Augmentation

Breast surgery performs the very important role of helping a woman feel better about their body. Breast augmentation could be beneficial if you:

• Have very small breasts or hypoplastic breasts
• Have lost breast size due to weight loss or pregnancy
• Have saggy breasts due to aging, pregnancy, or weight loss
• Have asymmetrical breasts because of a birth deformity
• Have tuberous breast deformity where the shape of the breast is very tubular and narrow
• Are a breast cancer survivor and need breast reconstruction surgery

Women who are healthy, not pregnant, or currently breastfeeding are generally good candidates for breast augmentation. Being a non-smoker is an added advantage. And most importantly, you should be above 18 years of age.

Understanding the process of the breast augmentation process is vital before you choose to go ahead with the procedure. Your knowledge of the type of implants, type of incisions, and method of placement will help you discuss your long-term plastic surgery goals with your surgeon.

There are three major types of implants –

• Silicone Implants– Silicone implants are extremely popular. These implants are available in both round and teardrop shapes (natural anatomy shape). They are basically silicone shells, made of silicon rubber, infused with silicone gel. They feel and appear to be more like real breasts as compared to other options. With recent advancements in research, the quality of the shell and the gel has improved, thereby increasing the validity of the implants. The newest addition is the highly cohesive silicone gel breast implants which are colloquially known as ‘gummy bear breast implants’. The structure of the gel in these implants is identical to gummy bear sweets which gives the implant an added advantage as the gel never drips out in case of a mishap.Silicone-filled implants come in different sizes, shapes, and textures. During your consultation with the specialists, you will see and understand the pros and cons of Motiva, Mentor and Sebbin implants.
• Fat Grafting– In this procedure, instead of placing a silicon implant, the specialist will extract fat from an alternate part of your body (liposuction), and after doing so; will infuse it into your breasts, in order to help gain volume. This method is most suited when you need to go for a mild enlargement procedure (1 bra cup size), or a post-op measure for a reconstructive breast cancer surgery.
• Saline implants– these are filled with sterile salt water and it has an outer silicone shell, similar to the silicone implants. The advantage of Saline is that it can be filled after being inserted in the targeted location, making the surgeon in control of the size, and also causing minimal scarring. On the other side, Saline implants feel less natural than silicone implants. In addition, you need to have a fair amount of breast tissue to opt for a Saline implant, else you may see rippling surrounding the outer edges of the breast after the insertion of the implants.

There are threeplaces on your body that the specialist can perform the incision to place the implant:

• Below your breast — at the breast fold line: This is called Submammary or Inframammary Incision and is the most preferred incision spot by patients and surgeons.
• Below the areola — in the shape of a half-moon: This is known as Periareolar Incision and is recommended for women with a large nipple-areolar complex.
• In the umbilical area — It is also called Transumbilical Breast Augmentation (TUBA). This is the least recommended method.

Most specialists or surgeons place the implants in:

• Submuscular (Retromuscular): This procedure includes placing the implant under the chest muscle to ensure that the muscle covers it completely and is not easily felt through the skin.
• Subglandular (Subfascial): This is placed on top of the muscle but under the breast glands. It is a faster process both during the surgery and during recovery time.
• Dual plane or Partial Submuscular: This procedure involves placing the upper portion of the implant under the pectoral muscle, while allowing the lower half of the implant to sit directly under the breast tissue, over the pectoral muscle. Since it is neither completely ‘under the muscle’ nor ‘over the muscle,’ but a combination of both, the dual plane technique allows the breast implant to sit in the most natural position.

As with other surgeries, in breast augmentation surgery, the first step is receiving anaesthesia. Your surgeon will help you decide on the types of anaesthesia most suitable for you. The procedure usually takes 1 to 2 hours but will vary depending on the type of surgery and implant is recommended for you. Closing of the incisions is again chosen with care by your plastic surgeon to ensure minimal scarring and can include skin adhesive, sutures, or surgical tape.

Your plastic surgeon and the breast implantation team will give you specific instructions on the dos and don’ts to be followed. During this time (the consultation and pre-operative stage) your breast augmentation specialist surgeon will walk you through the procedure, discuss the types of breast implants and help you choose the best boob job solution that will help you achieve your goals.

Some common pre-care procedures include doing required blood tests and an ultrasound of the breast as well as sizing of the implants and the post-surgery support garment. In addition,

• Do not smoke at least four weeks ahead of the surgery
• Do not eat anything the morning of surgery
• Avoid vitamins or medications on the day of surgery, unless cleared by your doctor
• Do not wear any perfume, creams, lotions or hairspray on the day of the surgery
• Dress in comfortable clothing that is loose especially tops that button up or zip in the front
• Fill your prescriptions to have your medications ready to take after surgery

Post your surgery the plastic surgeon and the team attending to you will help you understand the procedures to be followed during your boob job recovery phase. Following all the procedures will help in a fast and smooth recovery. Some common instructions to be followed are:

• Do not bend, lift and engage in any vigorous movement for the remaining day after the procedure and rest in a comfortable position on your bed or couch.
• Eat a light meal, such as soup.
• Drink plenty of water every two hours.
• Take the pain medication as prescribed.
• The swelling, bruising and sensitivity in your breasts may take two to three weeks to subside. Apply gel or ice packs to help with swelling and bruising.
• Wear your compression garments as instructed.
• Do not lift heavy objects for the first three weeks and avoid lifting your arms above your head for the first two weeks.
• You may resume gentle walking after the first few days and drive after one week.
• Keep your doctor’s contact information near you at all times in case you have questions or experience complications.
• Over time, due to the expiry of implant life, hormonal issues, weight fluctuations and aging, your breasts might change and you may want to come back for a quick breast lift or implant replacement to get back the desired shape.

It is important to note that this is a general list of guidelines. Your plastic surgeon will tailor your list according to your personal goals.