Breast Enlargement

Aesthetic (Cosmetic) surgery is a branch of plastic surgery. It aims at improving look of the person by modifying an important part of her body.  Breast is an important organ of a woman’s body and is associated with her beauty. Aesthetic (Cosmetic) surgery of the breasts aim at modifying the shape of the breasts to give a better look to her.

Breast augmentation is a surgery done to increase the size of the breast.

For whom and who gets good result?

  • For a woman who thinks her breast are small. (Not because someone else tells her so)
  • For a woman who has one breast smaller and other bigger, the smaller breast can be  augmented.
  • To make a new breast after its removal for  cancer.
  • For those cases where breasts have become smaller after pregnancy. (Very Rare)
It is to be noted that the surgery improves the look of the woman and size of  her breasts. One should not associate this surgery with looking like someone e.g. a heroine, model etc.,. The woman who realizes this and who is self motivated for surgery, gets good result.What does the doctor do in operation?

The basic principle is to place an implant- a balloon like structure, behind the breasts. There are two types of implants available. The one filled with silicone gel and the one filled with saline. The saline filled implants are permitted for unrestricted use inUSA.. Gel filled implants can be used only if the patient is registering in an approved clinical trial.

However, in Europe and inAsia, both types of implants are used. A third variety is called an implant with cohesive gel. Here, even when the implant breaks, the gel remains in the shape and does not bleed or spread. Thus minimizing the risks. Currently it is advisable to go for cohesive gel implant if gel filled implant is to be selected.

The silicone gel implants give better projection and feeling to the breasts. It was believed that silicone gel implants can give rise to conditions like joint pain, breast pain, scleroderma etc. After extensive studies of all women who underwent silicone gel implant surgery, no such relation between implant and those diseases has been found.

The operation is done under general anesthesia. An incision is made close to the junction of the areola with the breast, or close to the lower border of the breasts or  in arm pit and implant is placed underneath. After the implant is placed, the incision is closed .

What is the course after operation?

The patient can be discharged on the same evening or next day morning. She will be able to move around in 24 hours. She might need to put on a special bra. The plastic surgeon will instruct in selected  cases. A change of dressing is required after 48 hours and on 5th day.  Stitches are removed around 7th to 10th day.  Dressing is also removed at that time.  Light duty can be resumed after a 5 days to 7 days. Around 10th day, one can resume full work.  Stretching the arms, lifting weight is allowed after 3 to 4 weeks. One can also consider going to work earlier if one feels comfortable and the docotr allows.

Breasts will remain tender – causing mild pain on touching – in some cases for about  3 to 4 weeks. There will not be any pain otherwise. The incision looks raised above the skin and pinkish red to begin with. It flattens and returns to normal color gradually. Over a period of time the incision will become invisible.

There will not be any problem with pregnancy or breast feeding after breast augmentation

What are the risks?

Breast augmentation in general, is a very safe procedure. Life threatening complications are very rare. Some other complications are

  • Capsular contracture : The body forms a thick skin like structure around the implant. This layer  may shrink over a period of time. This can cause some pain or a feeling of heaviness, hardness in the  breasts. It is possible to treat such cases by surgery.  Sometimes the implant has to be changed. Capsular contracture is less likely to happen with saline filled implant.
  • Implant rejection : Implant is essentially an external material. The body of some patient may not accept this material. If this happens, the implant is removed and the breast get back their original size and shape.
  • Implant rupture inside the body : This can happen with some injury to the body.  If this happens with the silicone gel implant, the gel leaks out in the surrounding tissue and has to be removed. If this happens with the saline filled implant, the saline that leaks out mixes with the blood. This saline is the same that is given in veins  by the doctors. It is therefore harmless. In any case the breasts  return to their preoperative size. The remaining implant has to be removed. It may be possible to place another implant while removing the ruptured one.
  • Change of sensation around nipple : In some cases there is a sensation of tingling and numbness or absence of sensation soon after operation. This returns to normal in about 6 weeks to 6 months.
  • Bleeding and Infection :
  • It is to be noted that all these complications are uncommon and not all the complications would occur in a given patient.

Can this operation cause Cancer?

So far it has not been noticed that putting an implant behind the breast can cause cancer. It is however essential to inform your doctor about the implant when he/she examines the breasts. If the breasts have to undergo  x-ray (Mammography), then the doctor should be informed so that he can change the x-ray factors.

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