Breast augmentation or breast enhancement surgery is one of the most leading surgery in the field of cosmetology, according to The American society of Plastic Surgeons (1).
Breast augmentation is usually sought by women who want to boost their breast size and enhance breast shape. It is carried by placing silicone or saline breast implants. The skill of the cosmetic surgeon is determined by achieving symmetrical looking, aesthetically appealing at the same time maintaining the natural proportion of the breasts (2).
More often than not, it is performed to increase the aesthetic appearance and has a vital role to play in boosting the self esteem, creating a positive body image and offer sexual gratification. However, it is imperative to have a detailed screening by the team of doctors and psychiatric evaluation of the female to understand the agenda behind the requisite for breast enhancement (1).
The type incision to be made depends on the type of implant selected.
The Periareolar Incision – it is the commonest and the most preferred type. This tends to be one of the most popular types of incisions, as the scar tissue gets camouflaged because of the dark colour of the nipple. Also, this approach gives easy accessibility later on during post surgical complications.
Inframammary Incision – is the second most preferred incision owing to its advantage of uninhibiting the ability to breastfeed
Transaxillary Incision –the incision is the smallest and is preferred for would want less visibility of the scar apparently.
Trans-umbilical Incision – is performed in cases where one wants the minimum visibility of the scar. However, the rate of complications is higher (3)
Breast implants consists of two types of breast implants that are considered for mammoplasty, breast reconstruction, and breast augmentation procedures:
saline implant inflated with sterile saline solution.
silicone implant implanted with viscous silicone gel.
Breast reconstruction is performed to achieve near to normal shape, appearance, symmetry and size of one or both the breasts following mastectomy, lumpectomy or congenital deformities (4)
The surgery is done in sequences and can be performed at the time of mastectomy or be done later. Breast reconstruction can be implant-based reconstruction or flap reconstruction. Implant reconstruction constitutes of placing breast implants in such a way so as to form a new breast mound. Flap (or autologous) reconstruction makes use of the patient’s own tissue retrieved from anywhere in the body (4)
Risks of Breast Implants- there are certain inevitable complications associated with breast implants-
There might arise a need for additional surgeries, to remove or replace the implant.
There may be formation of a scar tissue surrounding the implant, that may lead to contracture.
Pain in the breast
Deviation in normal sensation in nipple and breast.
Rupture of the implant, leading to deflation (5)
Post surgery, the area is secured by gauze or bandages. An external aid to support the reconstructed breast in the form of elastic bandage or support bra is to be worn to reduce post surgery swelling and will minimize the swelling. A draining tube is kept in situ to aid in draining of any excess blood or fluid (6).
RESOURCES –
(1) https://www.webmd.com/beauty/features/how-will-breast-implants-change-your-life#1
(3) https://www.breastenhancement.org/surgery
(4)https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm064106.htm
(6) https://www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction/recovery