Breast
Augmentation
What
is breast augmentation?
Breast
augmentation, also known as breast
enhancement, involves the surgical
insertion of an artificial implant
into a woman’s breast in order
to increase its size. Breast implants
can be used to enlarge a woman’s
natural bustline, to reestablish the
shape of her chest after another breast
surgery, or to even out a difference
in breast size.
Who
is a candidate for breast augmentation?
Before
considering breast augmentation surgery,
a woman should be physically fit.
In addition, she should be informed
on the procedure and its outcomes,
so that she will be reasonable in
her expectations. Breast augmentation
is only designed to enhance the breasts,
and may not have the dramatic social
or personal impact that some might
expect.
That
being said, good candidates for breast
augmentation include most women who
are self-conscious about their breasts.
Self-consciousness may result from
any number of circumstances. Childbirth
can cause a woman’s breasts
to shrink or lose shape. The same
can result from weight loss. Or it
may be that one of the patient’s
breasts is larger than the other.
How
is breast augmentation performed?
The
patient begins to prepare for breast
augmentation a few months prior
to the date of surgery. She must undergo
a series of mammograms to
make sure that her breasts are healthy
and to allow the surgeon to view the
area. A few weeks before surgery,
the surgeon usually directs the patient
to discontinue most drug use, which
will include smoking and consumption
of alcohol.
Breast
enhancement surgery is typically performed
on an outpatient basis. An
anesthesiologist usually administers
local anesthesia in conjunction with
an IV sedative, in which case the
patient may feel a slight amount of
discomfort. In a few cases, general
anesthesia may be used.
The
breast
augmentation surgeon begins the
surgery by making an incision in one
of four spots: in the crease under
the breast, at the bottom of the skin
surrounding the nipple, in the armpit,
or in the navel (transumbilical method).
These four spots all provide access
to the region under the breast tissue
and are fairly inconspicuous. The
breast implant is placed either behind
the breast tissue but above the pectoral
muscle or directly behind the pectoral
muscle. The surgeon lifts the breast
tissue, creating a pocket
in the desired location. An empty
silicone sack is inserted and then
filled with saline. These steps –
formation of the pocket, insertion
of the empty sack, and expanding it
with saline – are performed
through a long tube in the case of
the transumbilical approach. After
it is filled, the implant is then
centered behind the nipple. The surgeon
closes the incision with stitches
and places tape over it. Gauze bandages
are typically wrapped around the area.
What
is recovery like?
Immediately
following breast enhancement surgery,
the patient is typically tired
and sore for 24 to 48 hours.
The doctor can prescribe medication
that will alleviate most of the pain.
Ordinary effects of the surgery include
swelling in the breasts and
increased or decreased sensitivity
in the nipples, though both subside
with time. The gauze bandages are
removed after a few days, at which
time a surgical bra may be required.
The stitches are removed after seven
to ten days.
Of
the more severe complications that
may arise due to breast augmentation,
the most common is capsular contracture,
in which scar tissue that inevitably
builds up around the implant contracts,
making the implant and the breast
hard. Scar tissue may have to be cut
or removed or, in very rare cases,
the implant may have to be removed
and another surgery scheduled in a
few months.
Other
side effects include infection around
the implant, excessive bleeding, or
rupture of the implant. These may
require additional surgery or removal
of the implant to allow the area to
heal. Rupture of the implant is typically
not a significant health risk any
longer, as all implants currently
used in the United States are filled
with saline, not silicone gel. Saline
can be safely absorbed by bodily tissues.
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