Breast Augmentation

Breast augmentation is the operation where artificial means are used to increase the size and/ or improve the shape of the breasts. Estimates suggest that over 5 million women world-wide have had breast implants in the last 40 years, and each year tens of thousands of women continue to have breast augmentation surgery. Many women consider having breast augmentation to improve their size or shape because they think the breasts are too small, uneven in size or shape, or unattractive. Some women have breasts that do not fully develop or have significantly changed in size or shape after pregnancy, weight change or ageing.

As with any cosmetic procedure, breast augmentation will not resolve any of life’s major problems, but may help to boost a patient's own body image and self-esteem. All the potential benefits will be discussed and assessed at the time of your consultation.

The surgery

There are generally 3 types of incisions used for inserting the breast implants.

The inframammary incision is made under the breast at the fold or crease line. The incision is about 4 cm in length. This is the most common incision, and the natural fold of the breast usually hides the scar quite well. It will probably always be covered by any clothing-even the smallest of bikini tops. Because the incision gives immediate access to the space where the implant will be placed it is possible to very accurately create the size and shape of the pocket for the implant, and the carefully control the position of the implant within that pocket.

Another method is the peri-areola incision, which is made around the edge of the areola (the darker skin around the edge of the nipple). The disadvantage is that the scar is not hidden by any folds, and subsequent scarring may interfere with milk expression in breast-feeding.

The third method is the axillary incision, which is made in one of the crease lines of the armpit. This is used less often because it is more difficult to get proper placement of the implant in some patients, and if there is a problem in the future, an additional incision on the breast may be required. Although some patients thinking about this surgery may believe this approach is the least conspicuous, in truth this may not always be the case, particularly in light of sleeveless open type clothing which expose the armpit area quite readily and frequently.

There are four locations or pockets which are made and where the implant may be placed;
1.    Directly under the breast tissue, or the subglandular (in front of the pectoralis muscle),
2.    the subfascial(behind the breast tissue but in front of the muscle in a space developed by lifting the front lining of the pectoralis muscle-the fascia) ,
3.    the submuscular (behind the pectoralis muscle) and
4.    the dual plane position(partly under the muscle and partly under the breast or fascia). The pectoralis muscle is the chest muscle that is commonly developed in body builders.

Risks

As with any operation, normal risks of surgery and anaesthesia can occur with breast augmentation. These include infection, haematoma, and skin necrosis. Infection can occur despite our normal routine of administering antibiotics at the time of surgery as well as post-operatively. Signs such as pain, redness, swelling, or fever, following augmentation should be reported immediately to the hospital. Infection not reported could easily compromise the success of any surgery. If infection was to be serious and fail to respond to antibiotics, removal of the implants would be required and replacement would not be effected until such time as the infection had cleared.

Bleeding, as a result of a leak in a blood vessel will give rise to swelling and bruising of the breast. If this is slight then your body will be able to absorb it in time. If it is significant then it may be necessary to drain this. Your surgeon will be able to assess this.

Skin necrosis or skin decay occurs when there is not enough blood to supply the skin. This could happen if the surgeon were to select an implant size too that was too large for the pocket created

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