This article has been reviewed and approved by Dr Quazi Ahmad for authenticity and medical correctness on 29 Jan 2020

All about Breast Augmentation

Breast augmentation is a surgery to increase the size and uplift the shape of your breasts. Augmentation mammoplasty is another name for this procedure. The surgery increases your breast size by placing breast implants under your breast tissue or chest muscles.

If you feel that your breast size is small as compared to the rest of your body or if the breast is sagging down, a breast augmentation can increase it to a proportionate size.

The surgery will help improve the size, fullness, and shape of your breasts. The new look of your breasts will have a positive impact on your personality and self-confidence.  

Though usually done for enhancing the body shape, the surgery is beneficial for those who had a mastectomy or lumpectomy procedures.

These are procedures to remove the whole or a part of the affected breast due to breast tumors. Fat grafting is beneficial in restoring the volume in such cases.

The duration of the surgery will be about 1 to 2 hours. Recovery will happen in about one week. The results will be visible immediately after surgery.

Though a safe procedure with very little or no complications in most, breast augmentation may have difficulties in some. Hence, you need to discuss with your surgeon in detail about the risks and complications.

If the surgery is for purely cosmetic reasons, you should have realistic expectations regarding the results. 

Candidates for breast augmentation

Breast augmentation is for you, if

  • The natural size of your breasts is small as compared to the rest of your body
  • Your breast size and shape have changed lately due to weight loss, pregnancy, breastfeeding, etc
  • If your breast is sagging and small
  • You feel there is an asymmetry in size or shape, between your two breasts

 

If you want a silicone implant, you should be above 21 years.

 

Breast augmentation is also useful for those who had any surgery that involves the removal of breast tissue. In those with breast cancers, the usual treatment is the surgical removal of the breast tissues affected by cancer. Breast augmentation can help create the natural appearance of a breast.

As it is elective surgery, the choice is yours alone. Hence you must have a thorough understanding of the results, as well as the possible risks and complications. You also need to know about what will happen after a few years of the surgery.

A breast implant is usually long-lasting. The effects of surgery often start diminishing after about ten years. You may need additional procedures as aging is a continuous process.  

If you plan to have a baby shortly, you may want to reconsider having this surgery. Since the procedure will affect the milk-producing glands and tissues, it may impact your breastfeeding capability. 

How to prepare for breast augmentation?

While it is a safe procedure, few things will still help you prepare better. You should prepare yourself both physically, mentally, and emotionally before surgery.

As the breast augmentation is elective surgery, the decision to have it is yours alone. So, you should have realistic expectations regarding the results.

You will need to away from work for a couple of weeks. If your job is not physically demanding, you will be able to go back to work in a week to 10 days. Otherwise, you will need to wait for another one to two weeks. So, make proper arrangements in your workplace during your absence.

If you smoke, you will have to stop, preferably four weeks before the surgery. Smoking can delay your recovery from surgery. 

You should notify the surgeon if you are taking any medicines like blood thinners or supplements.

Before surgery, you will have a thorough medical examination to assess your health status. Your blood sugar levels should be within normal limits. You should not also have any severe heart or lung diseases that can complicate the surgery. 

Types of Breast Implants

During a breast augmentation, your surgeon will place an implant under the breast tissue and over the chest muscles. The doctor will determine the size and shape of the implants based on the assessment and considering your requirements.

There are two commonly used types of breast implants. They are  saline implants and silicone implants.

Silicone implants-A silicone implant consists of a silicone shell filled with a silicone gel. The size of the implant will vary according to the volume of gel. A silicone implant is supposed to give a more natural feel to the breasts. It is the more commonly used implants.

Saline implants-A saline implant consists of a silicone shell that gets filled with normal saline up to the desired volume. The volume of saline used will depend on the size to which your breasts will be enhanced. This type of implant is not that common.

As regarding texture and form, three types of breast implants are common. They are

  1. Round
  2. Smooth 
  3. Textured

 

The surgeon will decide the implant that is best for you by analyzing your requirements, cost, and suitability. 

What happens during a breast augmentation?  

You will have to be in the hospital on the day of surgery. The surgeon and his team, along with the anesthetists, will assess your fitness for surgery one more time.

You will be under general anesthesia for this procedure. It will make you sleep throughout the surgery. In some instances, you may have local anesthesia that numbs only a select area of your body. In such situations, you will be awake, but there will not be any pain.

The surgeon will make an incision close to your breast in a hidden skin crease. This incision is to place the implant through it. The resultant scar due to the incision is usually not seen outside.

Types of incisions for breast augmentation

  • Inframammary incision – The incision is under the crease of your breast
  • Transaxillary incision- The incision is in your armpit
  • Periareolar incision- The incision is around the areola, which is the pigmented area around your nipple.

 

The scars that occur due to these incisions remain mostly invisible due to its positioning. The type of incision will depend on several factors.

The extent of breast enlargement needed, the type of implant used, your breast anatomy, and the surgeon’s preference are the main ones.

Through the incision, the surgeon will separate your breast tissue from the chest muscles to create a pocket. In this pocket, the surgeon will place the breast implant and make it secure.  

The surgeon will then suture the area around it as well as in the skin. Drains to remove any fluid accumulation will be placed before suturing. 

After the surgery is over, you will be in the recovery room, where you will wake up slowly from the effects of anesthesia. You will be shifted to your hospital room when you regain consciousness.

What happens after a breast augmentation surgery?

Once you recover from the effects of anesthesia completely, it is natural to feel some discomfort in the breasts. You will have painkillers to reduce the pain. 

In some cases, your breasts may swell. For reducing this, you will need to wear special compression vests or bandages.

You will have to walk around in the hospital room to promote better blood circulation in your body. Proper blood circulation ensures faster wound healing and recovery. It also prevents the formation of blood clots in the large veins.

Once the surgeon is satisfied with the progress you are making, you can go home the same day evening or next day morning. You will have to follow the instructions given at the time of discharge for a speedy recovery.

How will be the recovery from a breast augmentation?

The recovery from breast augmentation will be steady and gradual. 

Within two to three days, you will stop feeling any pain. But the breasts may still feel tender to touch. 

The swelling and bruising will show signs of reduction. Mostly it will take about two to three weeks for it to go off.

In the first few days, you should not do anything hard. To avoid putting pressure in the chest area, you should not bend down or lift anything heavy. Sleeping on your tummy also needs to be avoided.

You should keep the surgical wound clean and dry to avoid instructions. Antibiotics will have to be taken for 5 to 7 days to prevent any wound infections.

You can start bathing after 3 or 4 days. But care must be taken to keep the wound area dry.

If your work is light by nature like routine office work, you can go to the office after a week. If your job is physically demanding, you will have to wait for a few days more.

You can start driving in a few days after getting permission from your surgeon.

Light exercises that do not involve too much jumping, bending, squatting, etc. can be resumed after the first week. 

There will surely be a change in the way your breasts will look. Your figure will be more balanced and well-rounded than before. You will feel more confident about how you look, which will have a positive change in your outlook as well.

It is a very safe and satisfying surgery.   

What are the risks and complications of breast augmentation?

The chances of complications happening after such surgery are less than two percent. Some of the common risks and complications of breast augmentation are

  • Anesthesia risks
  • Bleeding
  • Pain and tenderness
  • Surgical wound infections
  • Hematoma

 

While these are common to all types of surgeries there are certain risks though rare, specific to breast augmentation, they are

  • Altered sensation in the breasts and nipples- This is usually temporary and resolves without any treatment
  • Fluid accumulation around the implant- Called a ‘seroma’, the cure for this is to drain the fluid out. 
  • Rupture of the implant- Though very rare, this is a possibility. If saline implants rupture, the saline that breaks out into the breast tissue, will be absorbed by the body without any problem. You may have additional surgery to remove the silicone gel in such cases.
  • Scar formation in the incision wound- Though the surgeon will place the incisions in areas where the scars are not noticeable, improper wound healing may make them visible at times.
  • Scar formation around the implant- Called a ‘capsular contracture’, scar tissue may form around the implant. It may be a source of pain and tenderness. Additional surgery will be necessary for correction.
  • Movement of the implant from its position- If this happens, the shape of the breast may change. Additional surgery can correct this condition

Breast Augmentation procedure in India
Breast Augmentation procedure in India

References / Additional Reading
This article has been reviewed by Dr Quazi Ahmad for authenticity and medical correctness on 29 Jan 2020
Dr Quazi Ahmad
Dr Quazi Ahmad
MBBS, MS (Surgery), DNB (Surgery), MRCS (EDINBURGH), MCh (Plastic Surgery), MNAMS
Dr Qazi Ahmad completed his medical graduation with a gold medal from the prestigious AMU, one of the oldest university in India.He has a busy practice in KDA(Kokilaben Dhirubhai Ambani Hospital, Mumbai) and caters to all types of complex and challenging plastic surgery cases. He is frequently invited for lectures and surgical demonstrations in plastic surgery conferences and workshops.
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