Breast augmentation surgery:
You will benefit from silicone breast augmentation, if the volume of your breast is too small, and you are self conscious about it. If you are above seventeen years of age. if clothes that fit your hips are too big for your chest. It can be either genetic from your constitution, or due to weight loss, or after pregnancy.
It is a very popular procedure, with a long track of safety record. The procedure is usually done in the hospital as an outpatient procedure, same day admission surgery. It could be also done under local anesthesia or local block with intravenous sedation.
Breast augmentation, incisions can be around the areolas, in the fold under the breast or in the axilla. Dr Paul Audi will explain to you, depending on your anatomy, which incision will be better for your case. And will recommend inserting the silicone implants above or under the pectoralis muscle, after measuring your pinch test. If the skin pinch test is less than 2 cms, a submuscular insertion is recommended. Sometimes if the nipples have early ptosis or pseudoptosis, a dual plane breast augmentation will be indicated, where the superior part of the implants are under the pectoralis major muscle and the inferior part of the implants are behind the breast parenchyma. If the breast are sagging a breast lift can be done at the same time.
Also Dr Paul Audi, after examining you might recommend a hybrid breast augmentation. Where the breast augmentation will be done and in the same procedure, some fat will be harvested from another part of your body body by liposuction, and will be injected in the superficial layer of the breast providing a better contouring specially in thin skin patients. This will also allow the use of smaller implants, and carry a lesser risk of breast ptosis down the line.
Types of silicone implants:
Saline filled breast implants:
Silicone implants can be filled on the table with sterile saline water. This will allow minor modifications of implants sizes in case of breast asymmetry.
Silicone-filled breast implants are filled with soft, cohesive silicone elastic gel and are available in a variety of shapes. All silicone breast implants are pre-filled. Cohesive silicone gel implants are form stable.
Breast augmentation can be combined with a breast lift, if there is any sagging of your breasts. This will be determined in the initial consultation.
Incisions:
Breast augmentation can be done through three different incisions.
Inframammary: Underneath the breast, just above the crease
Transaxillary: Near the armpit, where the arm meets the chest area
Periareolar: Around the lower edge of the areola (the dark area surrounding the nipple)
It is important for women with breast implants to have periodic breast examination, with your plastic surgeon, to monitor your implants.
Before planning your breast augmentation, your weight should be stable. This will avoid your breast from sagging after the procedure.
If you think that you may want to become pregnant in the future, you will be able to breastfeed. are similar to yours and answer any questions; 3D imaging may be used to help choose an appropriate implant for you.
Questions to ask your aesthetic plastic surgeon
Breast implants procedure:
You will come fasting in the morning to the hospital. Dr Paul Audi will draw the breast landmarks and the incision on your chest.
Then in the operating room, an incision is made and a pocket is created to insert the implants. Depending on your anatomy the implants, will be placed behind or above the pectoralis muscle. Following insertion and placement of breast implants, Dr Paul will use sutures to close the surgical incisions.
A surgical compression bra to provide support and assist with healing, will be worn. Very rarely drainage tubes may be used for a short time following surgery.
Breast augmentation by fat transfer:
Breast augmentation with autologous fat transfer requires two procedures: liposuction and fat injection. Using liposuction techniques, fat cells from a predetermined location with a cannula, the fat will be washed and decanted and reinjected in your breast, you will wear compression garments over the liposuction areas and your breasts.
Hybrid breast augmentation:
will combine breast augmentation and fat filling to the breast
Aftercare and Recovery
You will be avoiding strenuous physical activities and exercises for six weeks . You will be wearing your support bra for one month. The pain after breast augmentation will be controlled by oral pain medications and will decrease each day. Your breast will be swollen and tight and it will disappear progressively. Some bruising and skin numbness is normal as well and will decrease after few days.
The first week
You will be permitted to shower between one and seven days after surgery.
If you have external sutures, they will be removed in about a week. If your surgeon used tissue glue or tape, it will fall off on its own in a week or two.
You may be able to return to work within a few days to a week, depending on the nature of your job.
Intimate contact will be guided by your comfort.
Long-term
Your surgeon will encourage you to schedule routine mammograms at the frequency recommended for your age group. Following breast augmentation, you should continue to perform breast self-examination.
How Long Will the Results Last?
Under normal circumstances, the results of your breast augmentation surgery will be long-lasting; however, it’s important to know that breast implants need to be replaced if they leak. Routine follow-up with your surgeon is important.
Fat transfer surgery has different expectations, including losing some volume over time.
After a number of years, if you become less satisfied with the appearance of your breasts, you may choose to undergo a breast revision to exchange your implants, or a breast lift to restore a more youthful shape and contour.
Possible Complications : although
Hematoma/seroma: accumulation of blood/fluid around the implants, it happens early in the postoperative period, it may require removal.
Infection: it can be superficial in the skin and soft tissues, happens after seven to ten days, usually with antibiotics it will subside. If the infection involves the implant, we might have to remove the implant for three months. After then new implants will be reinserted.
Changes in sensation is very frequent, and will recover after two to four weeks.
Unsatisfactory results that may necessitate additional procedures, are possible but rare.
All surgical procedures have some degree of risks. With breast augmentation, minor complications occur occasionally, but do not affect the outcome. Major breast augmentation complications are very unusual.
Possible long terms risks specific to breast augmentation are :
Capsular contracture: can develop month to years after the procedure, the breast become hard and painful, with the progression of the capsular contracture, breast deformities can occur. If this happen, Dr Paul can recommend a medical treatment early on. Total Capsulectomy and new implants replacement is the treatment of choice.
Implant rupture: is a rare but possible occurrence requiring implant replacement.
Late seromas: suddenly one breast will swell up, overnight. A breast ultrasound will be done to diagnose fluid around the implant. Under ultrasound guidance, fluid will be sent for culture and cytology, and CD 20 to rule out anaplastic large cell lymphoma (ALCL) possibility. Most of the time it is a recurrent seroma of unknown origin. It is thought to be a low grade chronic infection, or biofilm seeding on the implant surface.
Treatment will be capsulectomy and implant exchange.
