Breast augmentation is a surgical operation performed to enlarge the breasts for a number of reasons:
- To enhance the body contour of a woman, who for personal reasons feels that her breast size is too small.
- To correct a loss in breast volume after pregnancy.
- To balance breast size, when there exists a significant difference between the size of the breasts.
- As a reconstructive technique to restore breasts after mastectomy or injury that has resulted in partial or total loss of the breast.
Replacement of breast implants following complications of enlargement with implants.
Implants should not be used for women who:
- have existing malignant or pre-malignant cancer of the breast without adequate treatment
- have active infection anywhere in the body
- are currently pregnant or breast feeding
Breast augmentation is one of the most common cosmetic surgical procedures performed.
Breast augmentation is an elective surgical operation that is normally performed under general anaesthetic.
Types of breast implants
In Australia there are 3 main types of breast implants – normal saline, silicone gel or a double lumen implant with a saline filled core and a silicone periphery. All breast implants have an external silicone shell and the internal material is either saline (salt water) or silicone .
Currently silicone implants from several manufacturers are readily available in Australia.
Breast implants are available with either a smooth surface or a textured surface. Surgeons have their own preference as to which they prefer.
Implants can be round in shape with differing diameters (sizes) and projection (heights)
“Tear drop” or anatomical shaped implants are also available and are popular with some surgeons.
Surgeons may have their own preference as to which they prefer.
Anatomy of a normal breast
The breast is made up of fatty tissue, milk ducts and glands covered with skin.
It is the fatty tissue that makes the breast soft and gives it its shape. Below the breast lies the pectoralis major or chest wall muscle. Breasts contain no muscle tissue, so there is no point in doing exercises in order to enlarge them.
Factors affecting breast size and shape
Breasts that are composed of a lot of glandular tissue and a little fatty tissue tend to be firm. With age, the glandular tissue gradually makes way for the fatty tissue and this is why breasts become a little flabbier in the course of time.
Gravity will cause the upper part of the breasts to become emptier, which means that the breasts droop more.
Weight loss causes loss of fatty tissue from the breast and sagging of the breasts.
Pregnancy and breastfeeding also affects the shape of the breasts.
The shape and size of the breasts prior to surgery will influence both the recommended treatment and the final results.
Breast enlargement is accomplished by inserting a breast implant either behind the breast tissue (subglandular) or under the chest wall muscles (submuscular).
The subglandular placement may make surgery and recovery slightly shorter and may be slightly less painful than the submuscular placement. However, subglandular placement may result in more palpable or visible implants and more difficult imaging of the breast with mammography.
The submuscular placement may make surgery and recovery slightly longer and may be slightly more painful. The possible benefits of this placement are that it may result in less palpable and visible implants and easier imaging of the breast with mammography.
Incisions are made to keep scars as inconspicuous as possible, usually under the breast or around the lower part of the nipple/areola.
The incision around the nipple/areola is well concealed, but may be associated with a higher likelihood of inability to successfully breast feed, as compared to the other incision sites. Numbness around the nipple may be more common with this incision.
The incision in the fold under the breast fades well but may not always sit exactly in the skin fold.
The method of inserting and positioning breast implants will depend on your preferences, your anatomy and your surgeon’s recommendation.
Implants may be more easily felt in the following circumstances:
textured implants, larger implants, subglandular placement and the lack of adequate skin/tissue available to cover the implant.
Implant size is one of the most important considerations in breast augmentation surgery. You should try to determine the desired size of your augment with your surgeon prior to your surgery.
When choosing size take care not to go too small as you will be disappointed in the long term. To the contrary choosing a size that is excessively large for your chest may result in complications such as visible implant edges, skin thinning and accelerated sagging of the breasts.
Please note that large implants in a large person may appear smaller than moderate size implants in a small person.
The final result that can be achieved from breast augmentation is very much dependant upon your initial appearance.
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