Breast augmentation overview
- Breast augmentation refers to an increase in the size/volume of the breasts and changes in the shape of the breasts by using breast implants under the breast tissue or chest wall muscles.
- Changes in the breasts may occur due to several factors such as after childbirth, aging, weight-loss, weight-gain, gravity, etc.
- Breast augmentation is done in order to restore breast size to satisfy women who wish to enhance their figures.
Why does someone need breast augmentation?
Cosmetic purpose
- To resolve the dissatisfaction that a woman feels with small-sized breasts which may lead to negative body image, low self-esteem, feeling of inadequacy that affects a patient’s interpersonal relationship, sexual fulfillment, and quality of life
- To Adjust the change in the size of the breasts after pregnancy or significant weight loss.
Reconstructive purpose
- Such as after mastectomy for breast cancer.
Goals of surgery
- To create a natural-appearing breast that fills the patient’s tissue adequately.
- To minimize the risk of complications that can result from placing a medical device into a patient for cosmetic reasons.
- To improve the body image and self-esteem of a patient.
Types of incision
An incision made in the crease under the breast (Infra-mammary)
- Provides excellent access and does not require dissection within the breast parenchyma.
- A noticeable scar may be visible.
An incision around the nipple (Peri-areolar)
- Little visible scarring
- May cause changes in the sensation of the nipple and areolar region
An incision under the armpit (Transaxillary)
- It creates no scar on the breast
- More difficult to create pockets through this approach
Location of the implant
Subglandular
- The implant is placed behind the breast tissue, superficial to pectoralis muscle fascia.
- Less risk of implant distortion
- Rapid postoperative recovery
Subfascial
- The implant is placed above the muscle to avoid muscle distortion
Subpectoral
- The implant is under complete muscle coverage, that is implant is placed behind the muscle.
- Less chance of developing capsular contracture
- Nipple sensation is protected
- Longer recovery time
- More postoperative discomfort
Types of implants
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Prerequisites of the surgery
- According to FDA, the women must be at least 18 years old to get the saline implant and at least 22 years old to have the silicone-based implant.
- Avoid smoking at least 6 weeks before surgery to promote healing.
- It is preferably done under general anesthesia.
- The patient should be fit for anesthesia.
The time required for breast augmentation surgery
- The average time of surgery ranges from 1-3 hours.
- Breast augmentation requires a hospital stay for 1-2 days after surgery for recovery and healing.
Complications of surgery
- Bleeding
- Hematoma formation
- Breast pain
- Wound infections
- Diminished sensation in nipple-areolar complex
- Capsular contracture
- Implant deflation
- Implant rupture
- Implant displacement
- Breast Implant Related Anaplastic Large Cell Lymphoma (BI-ALCL), a rare type of non-Hodgkin’s lymphoma
FAQs
What happens when an implant ruptures inside the body
- If a saline implant ruptures, it deflates and the saline is safely absorbed by the body.
- In case of silicone implant rupture, the silicone gel may either stay inside the shell or leak outside. However, it does not cause any obvious symptoms and hence it is called Silent Rupture.
- In case of implant rupture, the implant has to be removed from the body.
Is breastfeeding possible after implant?
Yes, most women after implants are able to breastfeed after surgery as the ducts to the nipple are not cut. However, less milk may be produced.
Do breast implants need to be replaced over time?
If an implant ruptures, then replacement is recommended.
The shell of an implant begins to weaken over time after about 10 years and this increases the risk of rupture.
Breast augmentation recovery after surgery
- No compression dressing
- Sports bra for extra support and positioning of the implant
- No strenuous activities/heavy work for at least 2 weeks
- No sexual activity for at least 2 weeks
- Avoid smoking
- Patient can resume her daily activities within 2-3 days after surgery
Follow up after surgery
- Routine monitoring with MRI breasts after 3 years is recommended after implant placement to screen for silent implant rupture
- Having a mammogram after a breast implant is safe but often difficult. X-rays cannot pass through the implant, therefore mammograms need to be performed in a different way so that as much breast tissue as possible can be seen.
Breast augmentation surgery price
The cost of breast augmentation depends on the type of implant used, qualification of the surgeon, and the location of implant placement
Typically the price ranges from $5,000 to $10,000 in the UK
In Bangladesh/ India, the cost varies in different hospitals. On average, it may cost around $ 2000 to $ 5000 depending on the type of implant used.
Pros and Cons of Breast Augmentation Surgery
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