Who is the best candidate for breast augmentation?
The best candidates for breast enlargement surgery are:
- 18 years of age or older
- Not pregnant or nursing (at least 6 months after nursing)
- Healthy physically and mentally
- Unhappy with size of them Breast
- Realistic in their expectations
- Seeking breast enlargement for the first time
Breast surgery risks
Breast augmentation does have some risks and complications associated with it. This section bellow is not meant to scare you as all risks and complications are extremely rare, but it is our responsibility that you should know about the following before proceeding with breast enhancement.
This is certainly the most serious long term complication that you need to be aware about, and consequently you will need another surgery to treat this problem. It is a fact that whenever we implant a foreign material into our body, the body react to that implant as being foreign. The body automatically creates a scar tissue around the implant and this is normal. This happens whatever is the type of the implant.
What is abnormal is for this scar tissue around the implant to thicken gradually. Finally, the thickness of the scar tissue leads to a contraction causing implant hardness. This has an impact on the shape of the implant and usually patient can sometimes start feeling some discomfort. This is called capsular contraction. The treatment is to remove the scars tissue (Capsulectomy) and implants replacement.
Capsulectomy and implant replacement
Capsulectomy refers to a surgery procedure designed to removal of the capsule which is the contracted scar tissue formed around the implant. During this procedure the scar tissue around the implant along with the implant itself is removed and the implant is replaced. Often, it is necessary to make a new pocket or/and reduce the size of the implant. Sometimes the surgeon will change the type of the implant when replacing it.
Normally infections after breast enlargement surgery are rare, when they do happen it can be very serious problem. We always try to inform our patients about the early signs are redness, swelling around of the breast and feeling sick. At first, the surgeon always try to treat the infection with antibiotics, but if the infection cannot be stopped then it is inevitable that the implant will need to be removed and the infection allowed to settle. Three to six months later, a new implant will be inserted.
Haematoma and Blood Clots
Excessive bleeding or a hematoma can occur, which may require surgical drainage. This means that another operation is needed. It is important that you do not take any medication, which contain aspirin, anti-inflammatories, blood thinners or vitamin E for 14 days before your operation as these medications can increase the risk of bleeding. A very dangerous complication that may happen in any surgery in which the patient is under general anesthesia is a so-called pulmonary embolism – blocking of the pulmonary artery with a blood clot.
Any surgery or any incision in the skin will produce scar. Usually, scarring after a breast enlargement is discreet and hidden within natural crease lines. Sometimes, scarring can be a problem. The surgeon at first will recommend scar massage and the use of creams or ointments. The next step, the surgeon may perform injections into the scar to help reduce some of the itch and discomfort. We always advise our patients to avoid exposing the scars to the sun as may lead to scar tanning. Sometimes, patients may also develop scars within the blood vessels below the breast and these can sometimes present as painful cords (these are called Mondor’s cords); Usually, this tend to heal within weeks.
Often, the surgeon will need to use 2 different size implant to correct an uneven breast. It is a fact that a perfect symmetry is impossible and therefore we always warn our patient to be realistic with them expectations. However it is important to know that after breasts enlargement the breast can droop or sag after some time. Also asymmetries may occur, when one side droops more than the other.
Wound Healing Delays
Sometimes, the wound may re-open, become infected and lead implant exposure. If the infection is only superficial, the surgeon may choose to re-suture the wound. The implant may also need to be removed in rare circumstances.
After a Breast augmentation, the nipples become very sensitive. This is sometimes uncomfortable. This normally settles over a few weeks, and during the healing time, nipple protection may help improve the discomfort. Nipples may also become less sensitive.
Breast enlargement surgery sometimes lead to reduced sensation around the nipple and the lower part of the breast. This is often a temporary problem, but can take up to 18 months to improve. Rarely, the loss of sensation around the nipple can be permanent.
Not the right size Breast Implants!
Silicone Implants don’t come in cup sizes and therefore it is always difficult to know exactly what cup size you will be after the breast enlargement. It is paramount that you discuss this issue honestly and clearly with your surgeon.
Feeling hardness around the implant could be either the implant edges or the signs of a capsular contraction. If you are unsure about something that you are feeling, you should ask your cosmetic surgeon.
The risk of being able to see or to feel a breast implant depends on the amount of breast tissue available before the breast cosmetic surgery. If you have a flat chest the surgeon would most probably insert the silicone implant behind the muscle to reduce the risk of Rippling. You need to discuss this option with Dr Mounir at your first cosmetic consultation.
Breast Implant Migration
Breast silicone implant need about 6 months to settle into their final position. Sometimes, they may move into the wrong position, and they can be lower, higher than desired. In these situations, you may need another operation called pocket adjustment. Dr Mounir prefers to wait several months for the implants to settle before planning another surgery to readjust the implant pocket.
Breast Implant Extrusion
Rare situation often associated to seroma formation. When this happen the implant needs to be removed and replaced 6 months later.
Breast Implant Rotation
Complication often seen when the chosen breast implant is anatomic (so –called tear drop breast implant. You need to discuss this option with you your surgeon. You should be aware that although anatomical implants can produce a natural looking appearance, they will not look natural if they rotate.
Breast implants are made of different type of silicone. Cohesive silicone is more solid and do leak less. Non-silicone implant is more liquid and tend leak more. This can lead to silicone migration and siliconoma formation. Surgery is always needed to remove the leaked silicone.
The Need For new implant
All implants have a life-span that is limited. We advise our patients to consider implant replacement after max period of time 15 years. Indeed, implants do age like our body does. This makes them vulnerable for leaking.
The Effect Of Larger Breasts
After making your breasts larger, you may start suffering all the natural effects of having larger breasts – bra strap marks, drooping of the breast tissue with time, development of prominent veins, etc. Wearing a well supportive bra will help reduce this, but nothing completely stops the effects of gravity and time.
BREAST IMPLANTS SURGERY – EXPLANTATION
For personal reasons, some women would chose to get their breast implants removed and not replaced. They should be aware that may end up with excess skin. This means that the surgeon may suggest breast uplift to reduce the loose skin.
Navigation Breast Augmentation, Dr Mounir (Manchester)
European Society of Aesthetic Surgery
American Academy Of Cosmetic Surgery
Canadian Association for Neuroscience