A guide to breast augmentation and breast implants

Breast implant surgery, also known as mammaplasty or breast augmentation, involves enlarging the size of the breast through the use of implants. It is performed to enhance the fullness of the breasts. It is one of the most popular cosmetic procedures in the UK, and is generally done to enhance a woman’s body image. Breast augmentation surgery can also be performed to restore fullness of the breasts lost post-pregnancy, or after losing a lot of weight. Breast implants can be used to construct new breasts in women who have had one or both of their breasts removed during breast cancer treatment. Sometimes, breast implants may be used to balance the breast when there is a difference in size between them.

Breast augmentation does not lift severely sagging breasts. A different procedure is used to correct this condition.

Advantages of breast implants
They aren’t really any medical benefits of breast augmentation surgery, and most of the perceived advantages are psychological in nature. Women who feel inferior or inadequate because of the size of their breasts may receive a huge boost in confidence, and may have enhanced body image after having breast implants fitted. In cases where breast implants are used as part of breast reconstruction surgery after a mastectomy, breast implants can have major psychological benefits for the patient.

Even so, it’s always important to remember that breast implants are not a solution to your problems. For instance, if you’re having trouble at work or in love, getting breast implants won’t fix the situation. It is extremely important that the patient weigh all the benefits against the possible risks and post surgery complications, before they make a decision.

Are you eligible for breast implants?
Breast augmentation is a surgical procedure, and as such, should not be taken lightly. It is never a good idea to choose to have breast implants without weighing the pros and cons of the procedure. If you are in good physical health, and have fully developed breasts, then you are a good candidate for breast implants.

Your surgeon will conduct a complete physical and psychological evaluation before he goes ahead with the procedure. He will want to know your complete medical history, including any medical conditions you suffer from, any allergies, incidence of breast cancer in the family, and any previous surgeries. He will also evaluate your diet and lifestyle, including consumption of alcohol, smoking and drugs, to rule out any risk factors. He will examine your breasts, including the texture of the skin, position of the nipples etc. Only then, will he discuss the options for implants, and make a recommendation.

Your surgeon will also evaluate your psychological frame of mind, and will look for the presence of depression or other psychological conditions. Always remember that breast implants surgery is not recommended if you have just experienced a stressful life condition, like divorce or a death in the family. The stresses of these experiences can interfere with your post-surgery recovery.

Risk factors for breast implants
Women who are pregnant or lactating, or are under 18 years of age, may not be eligible for breast augmentation. In addition, if you are undergoing treatment for breast cancer or suffer from an infection, you may not be eligible for breast implants.

Nature and types of implants
There are two types of implants that are available – natural tissue or artificial tissue.

Generally, natural tissue breast implants are used to reconstruct the breasts following a mastectomy.  They are very rarely used for cosmetic purposes. Here, the tissue, including skin, muscle and fat, from another part of the body is used to create the breast. The muscles and blood vessels have to be redirected to keep this implanted tissue healthy. Natural breast tissue implants are more complicated and involve more side effects.

Synthetic or artificial implants can be made either from saline or silicon gel.
Saline implants are filled with sterile salt water that can change the shape of the breast. In case of a leak in the implant shell, the saline will be released into the body and expelled naturally. Silicon implants on the other hand, are filled with an elastic silicon gel. The main advantage with silicon implants is that they feel very much like natural breast issue.

Effects
Breast implants don’t normally interfere with breast-feeding, but if you plan to breast feed after your surgery, you should let your surgeon know this before hand.

They may interfere with breast screening, however. If you are undergoing a mammography, be sure to inform your radiographer about your breast implants, because they can interfere with the results. Your radiographer will take special steps to reduce the risk of interference.

How long can breast implants last?
You can generally expect your breast implants to last for about 10 years. However, very few women go though an entire lifetime with the same breast implants. The longevity of your implants will depend on individual factors.

Implants can break down over a period time, leading to health complications. In such cases, removing the implant becomes necessary. If you have to remove the implants, you can either choose to have new implants inserted or remove the implants permanently. Therefore, when you are deciding on the feasibility of breast augmentation surgery, bear in mind that you will be responsible for the additional financial cost of a surgery in the future.

Preparing for surgery
Before the surgeon begins the procedure, he will require you to get a complete lab test done. He may prescribe a course of medications, and may recommend a base-line mammogram. He will advise you to stop smoking, because smoking slows down your recovery rate and puts you at risks for infections. He will also advise you to avoid anti-inflammatory drugs and herbal medications. He will evaluate your breasts, and take measurements. He may mark the location of the surgical incisions on your breasts. He may take photographs to compare the results of the surgery to the previous appearance of the breasts. You will be required to bring along a supportive bra with no underwiring to wear after your breast augmentation surgery. Finally, you will be required to sign a consent form that confirms that you are aware of any risks or complications arising from the procedure, and have given your complete permission for the surgery.

How the surgery is performed
The surgery normally takes 1 to 2 hours, and is performed under general anesthesia. In some cases, your surgeon may recommend using a local anesthetic to numb the breast area, and may also give you a sedative. The procedure can be carried out as a day surgery, which means you will be allowed to leave the hospital the same day, or may involve an overnight stay in the hospital.

A surgeon will first make a cut or incision in one of three areas – around your nipple, near your armpit or under your breast. Making a cut in the crease under your breast is the most common type of incision. Making an incision around the nipple is the least scarring, although your nipple sensation may be effected. Cuts made in the armpit area may lead to the most amount of scarring.

After the cut has been made, the implant is inserted either behind your chest muscle or in the area between your breast tissue and your chest muscle. Your surgeon will inform you beforehand about the implant position that is most suited for you. Then, the incisions are sutured, and covered with a dressing. These sutures are usually dissolvable, and do not have to be removed in a special session after your surgery. Fine plastic tubes are left in your breasts to help drain away any excess fluids or blood into a bag. These may be left for up to 48 hours. The dressing is left intact until you return for a post-surgery consultation 7 days after the implants have been fitted.

In case of reconstructive breast implant surgery, your surgeon will use natural tissue implants or a tissue expander. A tissue expander is inserted just under the chest tissue, and is slowly inflated over a few months by injecting with saline. When the skin and muscle have been stretched enough for new tissue to be formed, the expander is replaced with the permanent implant.

Post-surgery care
Any pain that you have can be relieved through painkillers. If you plan on going home on the same day as the surgery, call a friend to stay with you. Your nurse will advise you about the proper procedure for bathing. If non-dissolvable stitches have been used, these will be removed a week after the surgery. You will be required to wear a support bra for up to 6 weeks after the surgery to prevent the weight of the breast placing pressure on the wounds. Strenuous activity should be avoided. If the pain doesn’t subside with painkillers or you develop a sudden fever, contact your doctor immediately.

Side Effects
You may feel sick for a few days after the surgery because of the use of the general anesthetic, but this will mostly subside in a few days. You can also expect your breast to feel swollen, and may also experience burning in your nipples. Pink scars will be noticeable at first, but will fade gradually.

Complications
Complications can include unforeseen reactions to the general anesthesia, development of blood clots, and severe bleeding. Other complications are rare, and include

• A difference in size and shape of the breasts.
• Crinkling of the skin.
• Infections.
• Change in nipple sensation.
• Raised scars.
• Development of fluid around the implant.
• Development of scar tissue.

Generally, complications are rare, and a vast majority of patients are satisfied with the result of their breast augmentation.