Breast Augmentation is an aesthetic surgical procedure performed to increase the size and alter the shape of breasts using breast implants, for reasons including:Enhancing the body contour of a woman who feels her breasts are too small Correcting a reduction in breast volume following pregnancy Correcting a reduction in breast volume following pregnancy Reconstruction following mastectomy for cancer.
Breast augmentation can enhance appearance and boost self-confidence, but it won’t necessarily achieve an ‘ideal’ image. Before you choose to have breast surgery you must think carefully about your expectations and possible outcomes, and most importantly discuss them with your surgeon.
The best candidate for breast augmentation is a woman who is looking for improvement, not perfection, in the way she looks. Discuss your individual expectations regarding the change you seek in the shape and size of your breast with your surgeon who will be able to choose the best surgical approach to achieve your desired outcome.
A breast lift or Mastopexy removes excess breast skin to raise, reshape and firm breasts. The nipples and areolas are repositioned, and the areolas are sometimes reduced in size. A breast lift can improve the appearance of a breast in many ways. It elevates the breast tissue, repositions the nipple and areola, and enhances the shape of the breast
It is important to note that a breast lift can improve the positioning of the breast but it will not make the breasts larger. If a patient undergoing a breast lift wishes to increase the size of her breasts then breast augmentation can be performed simultaneously with a breast lift.
Breast Implants are prosthetic devices manufactured from Silicone and inserted into the body to increase the size of existing breast tissue.
Silicone is a chemical compound comprised of silicon, oxygen, carbon and hydrogen molecules, resulting in a liquid, gel or solid end-product. Silicone is used in many household products such as cosmetics and moisturizers, as well as medical devices including heart pacemakers and intra-ocular lenses.
Silicon is a common chemical element occurring in nature, found in sand, rocks and glass. Silicone is a chemical compound manufactured from silicone. Breast augmentation using silicone implants was banned by the FDA (Food and Drug Administration in America) in 1992 due to concerns surrounding the safety of silicone. The restrictions have since been lifted and the Institute of Medicine of the Academy of Sciences has declared the implantation of ‘silicone’ breast implants to be safe.
The breast implant consists of an outer silicone shell filled with either saline or silicone gel. Various sizes and shapes are available, depending on the outcome you wish to achieve.
Your plastic surgeon will examine your breasts and take photographs for your medical record. Your surgeon will consider factors such as the size and shape of your breasts, the quality of your skin, and the placement of your nipples and areolas. If your breasts sag then a breast lift may be recommended in conjunction with an augmentation.
During your consultation you will be required to discuss your medical history, including information regarding medical conditions, drug allergies, medical treatments, previous surgeries and medications you currently take. Your surgeon will also ask whether you have a family history of breast cancer and about results of any mammograms.
When meeting with your surgeon for the first time, you must discuss what you would like to achieve from a breast augmentation as well as determining your ‘ideal’ breast size.
Your surgeon will do a series of measurements to determine the required implant size, but do remember that patients who are actively involved in the decision process about implant size are more likely to be satisfied with the surgical results.
Implants are made in a variety of different textures, profiles, gel consistencies and shapes. Much of the choice in implants is reliant on your surgeon’s experience, honesty and integrity. You can trust that your surgeon will recommend the implant with which she or he can get the best aesthetic result.
Breast Enlargement is performed by making a pocket behind the existing breast tissue, either behind (fig. 1) or in front (fig. 2) of the pectoral muscle and inserting a breast implant into the pocket. The implant can be inserted via a small incision made either in the crease of the breast (inframammary incision), through the areola (peri-areolar incision) or through the armpit (trans-axillary incision). The surgery is individualized and is dependent on the size and type of implant used, the patient’s anatomy and breast shape and the patient’s desired result.
The procedure is routinely performed under general anesthetic and will last 1 to 2 hours depending on the extent of the breast augmentation surgery. To ensure the highest standard of personalized patient care, you will be required to spend the appropriate time before and after the surgery within the clinic/hospital, allowing time for pre-operative procedures and post-operative care.
Breast augmentation procedures are routinely performed in a Hospital or Day Clinic.
The extent of the surgery will determine the length of stay in the hospital, but you are likely to be discharged the same day as the surgery is performed, depending on your general health and your surgeon’s preferences. It is recommended that you arrange for someone to drive you to the clinic/hospital and collect you upon discharge.
Results are individual. A successful breast augmentation will result in fuller breasts that are proportional to your overall body size and physique.
Initially, swelling and bruising may distort the outcome of your surgery. Your surgeon will advise you to wait for a period of time for the swelling and bruising to dissipate. Your surgeon will discuss this possibility prior to surgery.
Breast Implants are contraindicated for women who:Have an infection present in their body Are pregnant or breastfeeding Have a pre-existing malignant cancer of the breast 4. Are undergoing treatment for a pre-existing malignant cancer of the breast
It is advisable to stop smoking at least 2 months prior to surgery. Smoking can result in slower recovery times and poor wound healing. Smoking after surgery is not recommended for at least eight weeks after surgery.
Patients are normally advised to rest for several days following surgery. Within 2-3 weeks you will be able to resume your normal activities. Strenuous activities and exercise are not recommended for at least 6 weeks following surgery.
You will have some bruising and swelling immediately after the procedure, as well as tightness of the breasts, normally subsiding within a few weeks. A well padded dressing is firmly applied to the breasts to assist in the reduction of swelling and bruising. Patients experience varying degrees of pain after surgery, with the discomfort easing after 3-4 days.
Pain can be fairly well controlled with medication administered after surgery. Your surgeon will prescribe suitable pain medication in the form of analgesics to assist in easing discomfort levels.
Some scarring is involved in breast augmentation, but the scars are normally a few centimeters long and become barely noticeable as they fade with time. Ethnic skin tends to result in poor quality scars. If you have a tendency to scar it is advisable to mention this to your surgeon. Patients may be advised to tape the scars for the first 2-3 months following surgery. Your surgeon may recommend a suitable topical scar treatment for use after the procedure.
The breast will feel firmer than a natural breast and at times the edge of the implant may be palpable.
The presence of a breast implant will have no effect on the ability to become pregnant or deliver a baby. The placement of the implant will however affect the ability of the patient to breastfeed. Techniques that involve incisions through the nipple and areola may reduce the ability to successfully breastfeed. It is important to discuss the options of breast feeding with your surgeon prior to your operation.
Lip enlargement is achieved through a variety of procedures including fat injection, dermal fat graft, Alloderm and V-Y lip advancement. Each approach has advantages and disadvantages. Details about each lip enhancement surgery are listed below. Determining which approach is best for you is achieved by learning a little about each alternative and clarifying your objectives. Consulting with a board certified plastic surgeon for his or her evaluation and expert recommendations would help determine exactly which plan is best for you.
Some patients receive fat injections when the goal is to treat multiple areas, such as the lips and smile lines. Advantages of fat injections include a natural donor (from patient’s own body), unlimited availability and a very small donor site.
The fat is obtained from another area of the body (typically the abdomen) through a very small, hidden incision. Therefore, the minimal donor site is cosmetically acceptable and healing time is minimal.
Unlike collagen, which is totally resorbed in six to eight months, 30-50% of the fat injected is permanent. Although uncommon, in some patients the fat can be totally reabsorbed. Rarely is the fat reabsorbed asymmetrically
Dermal Fat Graft
In a dermal fat graft procedure, a thin strip of skin and fat is threaded through a tiny incision at each corner of the mouth. This approach is typically used if there is skin left over from a simultaneous plastic surgery procedure such as a facelift. However, a dermal fat graft can also be performed as an independent procedure (typically a low abdomen donor site) and is sometimes requested if fat reabsorbed from a previous fat injection.
The advantage of dermal fat grafting is again a natural donor (from your own body) and increased permanency when compared to collagen injection. With a dermal fat graft more of fat survives because the dermis (skin) acts in a similar fashion as a skin graft and nourishes the fat. Therefore, the likelihood of the fat surviving long-term is better. Disadvantages include a separate donor incision if not performed simultaneously with another plastic surgery procedure where skin is left over.
Unfortunately, dermal fat grafts are contraindicated in people with thick, heavy hair growth in donor areas. Dermal fat grafts can also have upwards of 30-50% resorption when final results are evaluated at one year’s time.
V-Y Lip Advancement
V-Y lip advancement is typically reserved for patients who want the maximal amount of result with a permanent correction. In this lip augmentation procedure, small incisions are made inside (under) the lip and then closed in a fashion that rolls the lip outward a bit.
One advantage of the V-Y Lip Advancement procedure is no donor site. Patients are educated ahead of time to a temporary disadvantage; the lips can feel tight for several months. Also temporary is the numbness that is associated with V-Y lip advancement. V-Y lip advancement procedures result in more swelling, which takes about four weeks to resolve.
As with all lip augmentation surgery, final results are assessed at one year. Determining which lip augmentation procedure is best for you requires expert recommendation from your plastic surgeon.
One of the most common requests from patients is for fat transplantation into smile lines. It’s a less invasive procedure and uses an individuals own tissue for cosmetic improvement. Fat injection is one of several ways to address smile lines and lip wrinkles. However, if smile lines are due to excess skin and muscle laxity, fat injection surgery will not replace the benefits of a facelift (removal of excess skin). One of the most commonly requested procedures is to harvest fat with neck liposuction during a facelift for injection into smile lines and lips. For superficial wrinkles and fine lines around the mouth, one could combine fat injection with a skin resurfacing procedure. Skin resurfacing is the removal of the outer layer of the skin – using dermabrasion, chemicals or laser – resulting in smoother, younger-looking skin with less wrinkles such as crows feet, face lines, lines around the mouth and laugh lines. Skin resurfacing is one of the most popular plastic surgery procedures because often the results enhance one’s natural beauty. Skin resurfacing results in a more youthful appearance.
For patients who want improvement in their smile lines and area around the lips but aren’t ready for plastic surgery, alternative options can be found at Q the Medical Spa at Lindsay House. Toxin and Filler are just two of the many ways to maximize your beauty temporarily for a special event or until you are ready for plastic surgery.