Breast Augmentation – Sydney & Canberra
The Anatomy of Breasts
The breast is made up of fatty, glandular and fibrous tissues. Within it are blood vessels, milk ducts, fat, glands and sensory nerves. A layer of fat surrounds the breast to give it a soft consistency and contour. Beneath the breast is the Pectoralis Major, a large muscle which assists in arm movement.
Women’s breasts vary greatly in both size and shape. The size and shape of breasts are determined by the amount of breast tissue and fat present in them. Size is also affected by factors such as age, past pregnancies, genetics and skin elasticity. Even breasts on the same body may vary, making one breast slightly different from the other. Such variations in size and shape are normal and occur in most women. By inserting an implant behind each breast, surgeons are able to increase a woman’s bust line by one or more bra cup sizes.
Types of Breast Implants
The most popular form of Breast Augmentation is breast implants, which come in many shapes and sizes, with differing inner and outer materials. Together, you and your doctor will select the options that are best suited for you and most likely to achieve the results you desire. In this section, we will discuss some of the most important differences between various types of breast implants.
All breast implants have an outer pliable envelope enclosing a soft-solid (gel) substance. The implant shapes are generally round, oval or contoured. The surface of the implants has traditionally been smooth to the touch, but now there is another option, a textured Surface.
The Silicone filled implants stay as one solid membrane, meaning that in the rare event of a rapture the implants will stay in once piece rather than leaking through the body as the old styles used to. This makes replacing an implant quick and simple.
The Body’s Reaction to Breast Implants
The body’s natural response to any foreign object is to reject it. The degree of this rejection response is partly dependent on the biocompatability of the materials that make up the foreign object. The more biocompatible a material is, the less the body will reject it.
Scientists are continuously researching new materials that are biocompatible to the body. At present, the most common biocompatible material utilized in breast augmentation implants is silicone. This material is used in many medical implants such as pacemakers and joint replacements, as well as consumer products like antacids and preservatives (see Potential Risks and Complications).
The body will form scar tissue, made from collagen, around the surface of the implant – this is called the capsule. Capsule formation is a normal reaction to any implant.
In some women, the collagen capsule can contract, causing a condition known as capsular contracture. This results in a firmer or hardened breast, which may cause discomfort or pain. However, the textured surface of the implant is designed to disrupt the body’s collagen interaction with the implant surface and the resulting capsule formation.
The Surgical Incision & Placement Choices
Usually breast augmentation implants are surgically inserted utilizing one of three traditional incisions:
- the inframammary incision,
- the periareolar incision, or the
- transaxillary incision.
All of these incisions allow the implant to be placed either submuscular (below the chest muscle) or subglandular (between the chest muscle and your breast tissue). No one incision and placement is right for every woman. Therefore, by knowing your options and discussing them with your doctor, together you can decide upon the best combination for you.
The inframammary incision is made in the skin fold below the breast, and the breast implant is inserted through this incision. The breast tissue is minimally disturbed, and the remaining incision scar is concealed within the fold of skin under the breast.
The periareolar incision is made along the edge of the colored area around the nipple, and the breast implant is inserted through this incision. The incision scar is well camouflaged in this area.
The transaxillary incision is made in the armpit and the implant is inserted through this incision.
An additional option that patients with ptotic or sagging breasts may elect to have during the breast implant surgery is a mastopexy (breast lift).
There are many important factors that may have an effect on your particular procedure, your recovery and your results. They should be well understood and carefully discussed with your doctor. Some of these factors are:
- Your overall health;
- Your chest structure and overall body shape relative to the breast augmentation you desire;
- Your healing capabilities (which can be affected by smoking, alcohol and various medications);
- Prior breast surgeries; and
- Bleeding tendencies.
During and After the Surgery
The implantation procedure can be performed as either an inpatient (requiring an overnight stay in the hospital) or outpatient (no overnight stay required) basis, depending on your doctor and the method of surgery chosen. At Cosmos Clinic, most breast augmentation procedures are done on an outpatient basis. You will be able to go home on the same day with strong pain killers and antibiotics.
You will experience the most discomfort during the first 24 to 48 hours after your surgery. Your breasts will remain swollen and tender for up to two weeks. Although every woman’s recovery time is different, you should be able to resume many of your regular activities after one week and will need to wait at least one month before resuming any strenuous activities. You will be given a compression bra to wear for six weeks and instructions on how to perform breast massage to reduce the risk of capsular contracture.
Should any problems occur after surgery, contact your doctor immediately. This is especially important if your temperature is elevated, or one of your breasts is noticeably more swollen and tender to touch, painful, red or inflamed.
Potential Risks & Complications
There are inherent risks and complications with breast augmentation as there are with any surgery. You should be aware of the potential risks and discuss any concerns you may have with your doctor before your implant surgery is performed.
Most common risks
- Capsular contracture: the scar tissue or capsule that normally forms around the implant may tighten and squeeze the implant. This is called capsular contracture. Over several months to years, some women have changes in breast shape, hardness or pain as a result of this contraction. If these conditions are severe, more surgery may be needed to correct or remove the implants. Newer textured implants have reduced the risk of this problem occurring.
- Making breast cancer harder to find: the implant could interfere with finding breast cancer during mammography. It can “hide” suspicious-looking patches of tissue in the breast, making it difficult to interpret results. The implant may also make it difficult to perform a mammography. Since the breast is squeezed during mammography, it is possible for an implant to rupture. It is essential that every woman who has a breast implant tell her mammography technologist before the procedure. The technologist can use special techniques to minimise the possibility of rupture and to get the best possible views of the breast tissue.
- Calcium deposits in the tissue around the implant: when calcium deposits, which are not harmful, occur, they can be seen on mammograms. These deposits must be identified as different from the calcium that is often a sign of breast cancer. Occasionally, it is necessary to surgically remove and examine a small amount of tissue to see whether or not it is cancer. This can usually be performed without removing the implant.
- Women should understand there is chance they will need to have additional surgery at some point to replace or remove the breast augmentation implant when and if it wears out. Also, problems such as deflation, capsular contracture, infection, shifting, and calcium deposits can require removal of the implants. Many women decide to have the implants replaced, but some women do not.
- Infection can occur with any surgery. the frequency of infection with implant surgery is not known and is uncommon. Most infections resulting from surgery appear within a few days to weeks after the operation. However, infection is possible at any time after surgery. Infections with foreign bodies present (such as implants) are harder to treat than infections in normal body tissues. If an infection does not respond to antibiotics, the implant may have to be removed. After the infection is treated, a new breast implant can usually be put in.
- Haematoma: a haematoma is a collection of blood inside the body (in this case, around the implant or around the incision). Swelling, pain and bruising may result. The chance of getting a haematoma are about 0.5% to 3% and if it does occur, it will usually be soon after surgery (It can also occur at any time after injury to the breast.) Small haematomas are absorbed by the body, but large ones may have to be drained surgically for proper healing.
- Delayed wound healing: in rare instances, the implant stretches the skin abnormally, depriving it of blood supply and allowing the implant to push out through the skin. This complication usually requires additional surgery.
- Changes in feeling in the nipple and breast: feeling in the nipple and breast can increase or decrease after breast augmentation surgery. Changes in feeling can be temporary or permanent.
- Shifting of the implant: sometimes an implant may shift from its initial placement, giving the breasts an unnatural look. Further surgery will be required to correct this problem. It may become possible to feel the implant through the skin. Other problems with appearance include incorrect implant size, visible scars, and uneven appearance.
- Breast-feeding and children: questions have been raised about whether or not breast implants present safety concerns for nursing infants. Breast implants do not interfere with lactation while children are often exposed to silicone in medications, food and drinks. There is no evidence to suggest that babies develop any health problems from mothers who have breast implants.
While the majority of women do not experience these complications, you should discuss each of them with your physician to make sure you understand the risks and consequences of breast augmentation.
Breast Augmentation can provide some excellent benefits in terms of your physical health and self-worth as well as your emotional wellbeing. You should ensure that you fully understand the procedure and ask lots of questions whilst you are deciding whether this is the right solution for you. It is a significant medical procedure performed by expert plastic surgeons under a deep sedation in a surgical environment. Recovery can take some time and you should plan for this. There are some risks to consider and you should also understand that further surgery may be required at a later stage to remove or replace implants. Finally, the decision should be yours and yours only however, having made the right decision for you, you will be on the path to joining the hundreds of women who undergo breast augmentation every year who are delighted with the results.