Augmentation Mammoplasty / Breast Enlargement / Breast Enhancement
This is one of the most common cosmetic procedures done world wide specially in the United States. It is a straight forward procedure with a very instantaneous and pleasing result. Because of this, the public's attention and interest focused on the search of a very safe breast implant material. Breast Augmentation is the only procedure in Cosmetic Plastic Surgery specialty that is surrounded by controversy and scrutiny. In the past, especially during the late 70's and early 80's a lot of medical conditions such as breast cancer and autoimmune diseases, was wrongfully associated with the use of silicon implant. Because of this the US Food and Drug Administration had regulated the use of silicon breast implant for cosmetic breast procedures until recently in mid 2007. After extensive clinical research study that included more than a thousand breast augmented women, it was found out that silicon breast implant does not cause any malignant disease or breast cancer or any autoimmune disorder. Because of this the US - FDA had approve the use of silicon implant in cosmetic breast procedure.
Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure that enhances the size and shape of a woman's breast with the use of breast implant (silicon or saline). The procedure also enhances breast contour and volume after pregnancy. Breast implant is composed of silicon gel or saline within a silicon shell. Breast implant is different from silicon oil. Most Cosmetic Plastic Surgeon all over the world doesn’t do silicon oil injection of breast to enhance breast size and volume. This technique is condemned both locally and internationally by most surgeons, since the result unpredictable and compounded by numerous complications such as extrusion, skin necrosis and infection. Patients should not allow themselves to be subjected to this procedure because the risk for unwanted complications are very high and results are deforming or unpredictable. Most surgeons use breast implant which is composed of material that is non toxic, non allergenic, non teratogenic and biocompatible to human tissues and thus have less risk for any unwanted results, and with more predictable outcome.
There are 2 basic types of breast implants, saline or silicon implants. The implant is compose of an outer membrane compose of silicon shell. This shell contains either saline (fluid) or silicon (cohesive gel) material. It is prudent for every patient to discuss extensively the advantages and disadvantages of each implant type with their surgeon before they finalize their decision.
We perform our Breast Augmentation procedure under deep sedation with local anesthesia or general anesthesia. The procedure can be done either as an outpatient surgery or patient can be admitted or confined for a day or two in a hospital, depending on the surgeon and patient's preference. Whether the procedure will be performed as an out-patient or as a hospital procedure, preoperative laboratory and medical clearance is required. The surgery usually takes one to two hours to complete. The breast implant can be inserted through an incision at the armpit or breast folds or at the areolar border. Each choice of incision site has its own advantages and disadvantages in terms of scar cosmesis and nipple sensation. And among the three incisions, the transaxillary approach has the best scar cosmesis since it is concealed and nipple sensation is well preserved. But it is advisable to the patient to further discuss this issue if ever scaring will be a significant concern. After the procedure there will be some swelling and mild bruising that last for several days to a few weeks and this is only a transient change. Patients are required to wear breast binder for 3 to 6 weeks. This will hold the breast implant in place during the healing process and also helps control the swelling. Sutures are removed after 7 to 10 days. Any patient planning to have this procedure will require 10 to 14 days for the initial consultation, laboratory, medical clearance, surgery; follow up, suture removal and early recuperation. After this patients are safe to travel since wounds are dried and healed.
Individuals planning to undergo breast augmentation are prepared prior to scheduled surgery. Patients are advised to avoid the following for 2 to 3 weeks before surgery; smoking, alcoholic beverages, steroids, NSAIDs or pain medications like mefenamic acids and naproxen, herbal tea, herbal medications, Vitamin E, blood thinning medications like aspirin, heparin and coumadin, regulated drugs like valum, prohibited drugs like methamphetamines, diet pills and oral contraceptive pills. These medications and social activity may delay healing, prolong bleeding during surgery and may interact with the medications used during surgery. It is advised that patients discuss this further with their surgeon to minimize possible risks and complications.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.
The decision to have a breast augmentation is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.
Author: Dr Rino Lorenzo is a Filipino Plastic Cosmetic and Reconstructive Surgeon based in Manila, Philippines. He is a Board Certified and fully trained Cosmetic Plastic Surgeon, with 6 years of formal training in the field of Aesthetic, Reconstructive and Burn Plastic Surgery. Dr Lorenzo is a Fellow of the Philippine Association of Plastic Reconstructive and Aesthetic Surgeon.
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