Breast augmentation- also known as augmentation mammoplasty, is a surgical procedure to increase breast size. This procedure involves putting an artificial implant either under the muscle, over the muscle or in dual plane (half under and half over the muscle placement).
This procedure is one of the most frequently performed breast procedures today and is an established surgical technique that aims to improve not only a woman’s body image but also her self-esteem and general well-being. Clients who are seeking to have this procedure may have one or more of the following feelings or conditions that may indicate a need for breast augmentation:
- Your breasts are too small for your body.
- Asymmetrical breasts.
- Your breasts have become smaller due to weight loss.
- Lost fullness of the breasts due to aging.
- Reconstruction after surgery to treat breast cancer.
- Drooping or sagging breasts after pregnancy and breastfeeding.
- Clothes that fit well around your hips are often too large at the bustline.
- You feel self-conscious wearing a swimsuit or form-fitting top.
Preparation For Your Operation
You will usually have your breast enlargement under a general anaesthetic. This means you will be asleep during the procedure. No food is allowed at least 8 hours prior to any surgery, this includes any sweet like chewing gum. If there is no fasting instructions given, you must not consume any food or drink from midnight before your scheduled surgery. Clients who do not comply with this requirement risk having their surgery delayed or risk being denied surgery.
DO NOT take any Aspirin and NSAIDS drugs for at least 2 weeks prior to surgery. (Aspirin may be re commenced after 48hrs post op.) If you take Aspirin or any other form of blood thinning medication for a medical condition, please discuss this with Dr. Thanakom.
Smoking must be stopped atleast 3-4 weeks. If you cannot quit, cut back as much as possible. Smoking constrict the blood vessels, which can delay wound healing. While drinking alcohol must be stopped at least a day or two prior to surgery.
The procedure usually takes 2-3 hours and you are required to stay in hospital overnight.
Do not wear contact lenses, makeup, nail polish, jewelry, including any body piercings, hair accessories containing metal (such as barrettes or clips with metal springs, etc.) on the day of your surgery.
Step 1 – Anesthesia
Medications are administered. The choices include intravenous sedation or general anesthesia.
Step 2 – Incision
Incisions are made in inconspicuous areas of the breast to minimize visible scarring. You and your plastic surgeon will discuss which incision options are appropriate for the type of your breast implant, degree of enlargement desired, your particular anatomy and patient-surgeon preference. Incision options include:
- Under breast fold (inframammary incision)
- Around the lower portion of the areola, or dark-colored skin around the nipple (periareolar incision)
- Armpit (transaxillary incision)
Step 3 – Placing the Implants
After the incision is made, a breast implant is inserted into a pocket either:
- Under the muscle (Submuscular)
- Over the muscle (Submammary/ Subglandular)
- Dual Plane (The upper pole of the implant is placed under the muscle, while the lower pole is placed over the muscle.
The method for inserting and positioning breast implants depends on the type of implant, degree of enlargement desired, your body type and your surgeon’s recommendations.
Step 4 – Closing the Incisions
The incision is then closed with stitches. Your surgeon may place temporary drains in the incision prior to closing it to prevent fluid or blood accumulation. Catheters to deliver pain medicine at the site of the incision may also be placed prior to closing the incision. The drains or catheters would be removed during a follow-up visit after surgery.
Breast augmentation recovery typically requires that patients minimize physical activity for 3 to 7 days before slowly resuming more strenuous tasks.
Dr Thanakom will provide set of medications such as pain killers, antibiotics, anti-inflammatory etc. These will be provided following breast surgery.
You may be instructed to wear a support bra around the clock for the first week or two. It will be important to keep your incision clean and dry at all times. Be sure to follow all instructions carefully.
The stitches are taken out after about a week. If you have dissolvable stitches, the amount of time they will take to disappear depends on the type of stitches. However, for this procedure, they should usually disappear in about six weeks.
Physical activity is limited for the first several weeks, with most patients able to return to work and their normal activities within two to three weeks.
You should contact the clinic where the operation was carried out as soon as possible if you have severe pain or any unexpected symptoms, such as redness of your breast skin, a burning sensation or unusual swelling.
How often do I need to replace my breast implants?
Many people think that breast implants need to be replaced every five years, or ten years. However, this is incorrect. There is no need to replace the implants as long as you do not have any problems with your implants such as implant rupture, capsular contracture and that you are still happy with the shape and size of your breast.
How will pregnancy affect my breast augmentation?
Some sagging and deflation of the breasts often occurs after pregnancy and the added weight and volume of breast implants may make such changes worse than they would be if implants were not present.
Will breast surgery affect my ability to breastfeed?
Breast feeding is not affected with standard breast implants. Whilst breast lifts will almost always reduce the size of the areola, as well as raise it. There is a small to moderate chance that breast feeding will be affected by the breast lift. This is not due to the size reduction but rather to nerve or breast duct injury. Typically, we advise our clients to wait at least 12 months (from the last day of breastfeeding) before proceeding with a breast augmentation procedure. This is to allow time for the breast to settle down from lactation and to reach its ultimate pre-pregnant size. That way we know exactly what size the breast has settled to after breast feeding and we can choose the correct implant size.
How will I know if my implants have ruptured?
Only an ultrasound can detect implant rupture, so regular checkups are encouraged.
Will breast implants cause stretch marks?
Insertion of implants can cause stretch marks, but this is not a common problem. Choosing a small to moderately sized implant will help to minimize this risk.
Will the feeling in my breast or nipple change?
Many women complain of very erect and sensitive nipples after breast implant surgery. Don’t worry this is normal because the nerves and blood vessels are recuperating at this time. You can protect your nipples by using a Band-Aid (especially the large round ones), large corn pads, or nursing pads. These pads will protect your overly sensitive nipples from the abrasiveness of your clothing and shield your erect nipples.
What kind of bra should I wear after breast augmentation?
Generally, a soft, comfortable bra, without under-wires is most appropriate. Dr Thanakom usually recommend a very supportive bra to hold the bases of the implants in place. Support bra needs to be worn at least 6 weeks following surgery.
Is it normal for my breasts to make noises after breast augmentation?
Yes. These noises have been described as anything from a squeaking to a sloshing or gurgling. Noises from the breasts after breast augmentation are the result of air bubbles or fluid in the space around the implants. Within a few weeks after surgery, the air and fluid completely absorb the noises and the noises cease.
When can I shower after surgery?
The following day. Dr Thanakom will place a waterproof plaster on top of your incision sites, thus taking a shower is not prohibited after breast surgery.
Can breast implants rupture during a mammogram?
While an implant can rupture during mammography the risk of this is very low. It may occur when the pressure on the breast weakens the implant shell. The older the breast implant, the more susceptible it is to trauma. This is not a reason to avoid mammograms, since the benefits of a mammogram well out weigh any potential downside. Make sure to notify the mammography technician that you have breast implants, and he or she will take additional views and special care not to cause a rupture.
Will a large enough implant correct droopy breasts?
If you have sagging breasts, with your nipples located at or below the fold under your breasts, implants alone will not correct the problem. Implants will increase the size of your breasts, but the nipples will still remain too low and the breast will not look youthful. You will need a lift procedure along with your breast augmentation to achieve well- shaped attractive breasts. The type of lift needed will depend on the amount of drooping. Patients who are satisfied with the size of their breasts, but have lost shape and sagged due to pregnancy or weight loss, will find that a lift alone, without an implant may solve their problem.
What are the risks associated with breast augmentation?
Standard surgical risks intrinsic to any surgical procedure include breast augmentation, include reaction to anesthesia, bleeding, infection and poor healing. The following risks may occur after surgery.
- Collections of fluid or blood within your abdomen
- Sensation changes to the breast or nipple
- Delayed healing
- Bruising and swelling
- Irritation from dressings
- Nerve injury
- Poor scars
- Skin contour irregularities (stretch marks, rippling and wrinkles
- Changes in size and shape with age & weight fluctuations
- Capsular contracture
During your consultation, Dr Thanakom will explain all these risks, what they do to avoid and treat them, and the rates at which they occur.