Getting a Lift: The Choices of Breast Augmentation Surgery
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Considering breast augmentation? Here's what you need to know about this procedure.
Breast augmentation is a type of plastic surgery that is used to change the size and shape of a woman's breasts. There are various reasons a woman may choose to have this surgery and various techniques and types of implants she can choose. Understanding all options and the risks that go along with each procedure is the key to having a successful and ultimately satisfying procedure.
The reasons a woman may choose to have breast augmentation vary. One of the most common reasons, according to Dr. Deborah Bash, spokesperson for the American Society of Plastic Surgeons, is that breasts may lose volume after breastfeeding and breast augmentation is one way to restore their former shape and size. But a woman's motivations for the surgery may also include a desire to make her breasts larger, to make uneven breasts more symmetrical or to change the shape of one or both breasts.
Whatever the reason, all women who are electing to have breast augmentation will first have a consulatation with a plastic surgeon to help them determine what type of surgery and implant, if required, is best for them.
Picking the Right Implant
Breast implants are round or teardrop-shaped pouches made of silicone.
Inside, the implants may be filled with a saline solution or a silicone
gel. Though there have been past concerns about silicone-filled breast
implants, as of 2006 the FDA has approved two brands of silicone-filled
implants for the use in women over the age of 22.
The FDA decision gives patients a choice and it also states that patients need to educate themselves about breast implants and surgeons should give them this information, says Bash. There are pros and cons with each type of implant.
Saline implants, in comparison, are approved for use in women age 18 or older. No matter what, it is recommended that a woman should not undergo breast augmentation until her breasts have stopped developing, that is, after puberty.
There are various sizes and shapes of breast implants available, but in addition, they may vary in their texture and the way they will look once implanted. The size and type of breast implant you ultimately choose will depend a lot on your goals for surgery. Therefore, it is important to be clear with your surgeon about what you want to get out of breast augmentation surgery and to listen to your surgeon's advice.
First, be realistic with what you want, says Bash. Work with the surgeon to find out what is possible.
Based on your desires, your surgeon will recommend the implant he thinks will suit you best. Be sure to ask about the pros and cons of choosing this particular implant and about the alternatives availalable.
Placement of Implants
Currently, three options exist for placement of breast implants,
according to their position relative to the muscles that form the chest
wall:
- Over the muscle
- Pros: In this placement, the implant is positioned under the breast tissue, but over the muscle. This makes inserting the implant easy with less discomfort and a shoter time needed for recovery. It is also the best choice for inserting large implants.
- Cons: This placement carries the highest risk for capsule contracture, a condition that occurs when scar tissure forms around the implant. It is also known for looking less natural and may cause noticeable rippling, especially with saline-filled implants and with women who have naturally small breasts. Though all types of breast implants will affect the reading of a standard mammography, with implants in this position, even more pictures will have to be taken to get a full view of the breast tissue.
- Partially under the muscle
- Pros: In this placement, the top two-thirds of the implant is placed under the muscle in the breast. This results in a more natural breast shape, as opposed to the roundness typically found in over-the-muscle placement. The risk for capsular contracture, a condition in which scar tissue hardens around the implant, is also reduced.
- Cons: The recovery period will be longer as the procedure is more invasive and the muscles will be stretched by the placement of the implant. Rippling of the breast tissue is also possible where the lower part of the implant sticks out from the muscle.
- Completely under the muscle
- Pros: In this placement, the implant is placed under two muscles in the breast. This procedure helps to disguise the edges of the implant and creates a support for the breast. It is also the placement that is least likely to interfere with mammograms.
- Cons: This procedure is not widely available, and it leads to more discomfort and a longer recovery period. Because the implant is completely placed under muscle, it may take some time for the muscles to stretch to the desired position, so implants may seem to sit too high at first.
Surgery Types
Breast augmentation surgery is typically perfomed under general
anesthesia and takes about two hours. Usually is it performed with an
endoscope, a tiny camera that helps the doctor position the implant
correctly with minimal scarring. With saline-filled breast implants, an
empty implant is folded up and inserted through a small incision made
in one of four places: under the breast, near the nipple, in the armpit
or in the bellybutton and pushed up into the breast. After the implant
is in place, it will be filled with saline to the size specified in the
surgical consultation. Silicone-filled breast implants must be inserted
into the body already full, so the only way a surgeon can get them into
place is with an incision made under the breast.
It is normal to be tired and sore for the two days following the procedure, and the post-operative breasts will likely swell. About ten days after the surgery, your surgeon will remove your stiches, but you may have to wear a surgical bra for a few days to ensure that your breasts heal properly. It will take up to five weeks for the swelling to subside and for the new look to be revealed.
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