Breast implant surgery information
Breast enlargement surgery or breast implant surgery, technically called Augmentation Mammoplasty (AM) is a surgical procedure to enlarge small breasts or breasts that have lost their fullness. For patients with mild to moderate breast sagging, it will also improve the shape of breasts and also position of the nipples.
Among the gender reassignment surgery, the breast enlargement surgery is one of the most popular cosmetic procedures for transsexuals. It is not unusual to combine this procedure with sex change surgery in one setting.
About the operation
Breast enlargement usually takes between one and two hours. Your surgeon will make cuts in the skin on your breast. The exact position of the cuts can vary. They may be in the crease under your breast, around your nipple or towards your armpit.
Your surgeon will then make a space for the implant. The implant usually lies under your breast tissue on top of your chest muscle, but is sometimes put under your chest muscle. This reduces the chance that the edges of the implant will show, and reduces the risk of a complication called capsular contracture. But it makes it harder to place larger implants and may mean more pain afterwards. Your surgeon will decide which method is best for you.
The surgeon will close the cut with stitches (which may be dissolvable), and wrap your breasts in a supportive dressing or support bra.
Fine plastic tubes may be left in each breast for a few days afterwards. These allow excess blood and fluids to drain into a bag.
What is the breast enlargement procedure?
The procedure itself takes around 1.5 to 2 hours to complete and is usually performed under a general anaesthetic. There are two techniques used in respect of the positioning of the breast implants. These are:
Subglandular: the implants are placed above the major muscle of the chest.
The advantages of this are less post-surgery pain, quicker healing and a better anatomical position for enlarging the breasts.
The disadvantages are increased risk of capsular contracture, increased visibility and palpitation and problematic for mammography.
Submuscular: in this procedure the implants are inserted above the major muscle of the chest.
The advantages of this are fewer risks risk of capsular contracture, easier for mammography, deeper placement and less visibility.
The disadvantages are longer recovery time, more post-operative pain and worse results for athletic women.
Your surgeon will make an incision either underneath the natural ‘crease’ beneath the breast or via the armpit or around the edge of the areola.
Your surgeon has a choice of four incisions:
- Axillary
- Inframammary
- Periareolar
- Umbilical
Axillary: this incision is made in the site of the armpit.
Inframammary: this is the most popular incision. It is made in the crease beneath the breast.
Periareolar: the second most popular incision. It is made in the areola (the circular area surrounding the nipple). This incision is most likely to cause reduced nipple sensation.
Umbilical: this incision is made in the belly button. However, it is very difficult to place the implants below the chest muscle.
The breast implants are silicone rubber shells which are filled with medical grade silicone gel or saline solution. Your surgeon will then insert the implants through one of these incisions. If you have chosen to have the incision through the armpit then he/she will use an endoscope to do this. He/she will also ensure the implant is positioned either subglandular or submuscular – again, this is a matter of individual choice.
Your choice of technique and incision is based upon personal preference, current breast size, body type and your surgeon’s advice.
Once inserted, the incisions are closed with a series of stitches. These are either the removable or dissolvable type. Your surgeon will then place a light, supportive dressing over the chest area. This bandage must be kept dry for up to two weeks following surgery. After that time it will be removed so that the incision can be inspected and cleaned.
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