Breast augmentation (augmentation mammaplasty) is a plastic surgical procedure performed to give a woman fuller breasts. It involves inserting a breast implant under the breast tissue or behind the chest muscle to give the breast more volume and projection. Around the world breast augmentation with implants is one of the most popular cosmetic surgery performed by plastic surgeons. The implants can either be filled with silicone gel, saline or polyurethane however silicone filled implants is by far the most popular choice in Europe and Asia. Breast augmentation is performed to enhance the projection and contour of the breasts and this will give a more balanced proportion to the patient’s physical appearance.
Breast implant can also be done for breast reconstruction after mastectomy. Breast augmentation cannot correct severely ptotic (droopy breasts). For these patients a breast lift is required.
Candidates for breast augmentation surgery ranges from younger ladies who want more volume to their breasts to older women who present with deflated and ptotic (droopy) breasts after pregnancy and breastfeeding. Each individual patient is different and consultation with the surgeon is important in determining their expectations and wants. The implants come in various shapes and sizes and only after a thorough consultation will the correct implant size and shape be chosen for each patient.
PROCEDURE
The procedure is performed under general anaesthesia and usually takes between 1-2 hours. The implants are placed via incisions under the breasts or around the areolar. Once the implants are placed and the surgeon is satisfied with the shape, drains are placed and the wounds are closed. The breasts are then taped to prevent excessive swelling and fluid accumulation. The drains are usually removed the next day and the patients can be discharge from the ward with oral medications. The surgeon will advise you on how to take care of the wounds at home and you will be given a follow-up appointment.
CANDIDATES
- Generally healthy individuals with well-controlled medical conditions such as hypertension or diabetes (if they have any)
- Individuals with clear and realistic expectations of their desired result.
- Women who wants to have fuller breasts.
- Women who presents with deflated and ptotic breasts after pregnancy and breastfeeding.
- Women with abnormal or asymmetrical breasts.
RISKS
Although serious complications from breast augmentation surgery is uncommon, potential candidates should understand that every procedure comes with it a certain risk for possible complications and has a recovery period (down time). Preoperative preparation and postoperative care can help to minimize their incidence.
The more common complications from breast augmentation surgery are:
- Bleeding (primary or secondary)
- Swelling
- Bruising
- Infection and implant extrusion.
- Poor wound healing (especially in smokers)
- Numbness
- Scarring
- Skin discoloration
- Asymmetry
- Possibility of revision surgery
- Anaesthesia risks
- Fluid accumulation
- Breast implant leakage
- Wrinkling of the skin over the implant
The risks mentioned above can be minimized if proper preoperative and postoperative instructions are followed.
PRE-OPERATIVE PREPARATION
- Stop all non-medical supplements for at least one week before surgery.
- Stop taking any anti-inflammatory pain medications , blood thinning medications (anti-platelets, anti-coagulant), and aspirin one week before the procedure.
- All medical conditions (hypertension, diabetes, etc) need to be optimized prior to surgery.
- Smokers need to stop smoking well in advance.
- Some individuals might require prior blood investigation or further medical assessment.
POST-OPERATIVE
After the surgery, there will be some swelling, bruising, discomfort, numbness and discoloration for several days that can be controlled with oral medications, cold compression and ointments. The swelling and bruising usually last between 2-3 weeks but in some patients, this can last longer.
Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively. A support garment or bra will also be provided and patients are advised to wear them for 6 weeks after the surgery. This will help to support the breasts during the healing period. The final surgical result may take a few months and the surgical scar can take up to 1 year to mature.
CARE
- Cold compression with an ice pack the first day and night after surgery.
- Wear support bra for 4-6 weeks after surgery.
- Avoid strenuous arm activities and swimming for 4 weeks.
- Regular antibiotic ointment on the surgical wounds.
- No smoking.
