Breast augmentation: The all inclusive guide

The breasts are pivotal in the appearance of the female physique, are the centre of grace, the visual developmental milestone of fertility, and most importantly serve for a nurturing purpose. Numerous theories were constructed to trace back the origins of the significant aesthetic value of the mammary glands, while no solid conclusion was contrived, proof that the general alluring appeal of the breasts can be traced back to tens of thousands of years. As a consequence of the persistent desirability of the trait, breast augmentation surgery has become increasingly more sought after.

The public opinion on the matter is split into contradicting sides of normalisation and stigmatisation of the surgical procedure. Without further ado, in the following article, the breast augmentation surgery will be discussed from various aspects, from history to benefits and risks, process and finally, the varying costs around the globe.

What are breast augmentations?

Breast augmentation is a cosmetic surgical procedure that focuses on enhancing the size of the breast to make them appear fuller or proportional by implanting saline or silicone under the fat or muscle tissue [1].

Breast augmentation procedure

A breast augmentation procedure is a procedure that revolves around the placement of an implant through creating an incision, as a port to insert the implant [3]. There are three main types of incisions listed below; one of these incisions will be decided upon by the patient and the surgeon together. After creating a single cut, the surgeon carefully separates breast tissue from connective and muscle tissues. The separation of tissue creates a niche in front of the most exterior muscle or behind it. The implant will then be placed in the niche created and centred behind the nipple.
Once the implant is secured in the sac created, saline implants are filled after placement, whereas silicone implants are pre-filled. The incision is then closed with stitches and bandaged with surgical tape and dermal adhesives.

What is the best material for a breast implant?

The two current materials most used are silicone and saline [1]. Each of the elements has its own benefits and own downsides, and it’s up to the patient and the surgeon to procure a decision together.

The first difference to be noted is that the material making the content of the implant is the varying factor. Whether saline or silicone, the exterior of the implant is made of the standard silicone exterior. The altering of the content of the implant influences factors such as consistency.

1- Saline implants

Saline implants are implants filled with saltwater and are placed differently from silicone implants. Prior to filling the implants with saline water, they are placed empty and once secured in place are then filled with saline water.

Saline implants are available to women starting from the age of 18 years and onwards.

2- silicone implants

Silicone implants are pre-filled, unlike saline implants, with silicone gel and placed as a full sac in the desired location and secured in place.
Silicone gel as a material is characterised by a sticky thick fluid consistency that is thought to mimic the texture of human fat, making silicone implants a popular option among women for its natural feel.

Saline implants vs silicone implants

1- Rupturing

Silicone implants in comparison to saline implants are more prone to rupture, although the two are generally not immune to leaking. However, with saline implants, ruptures have more prominent physical symptoms where deflation becomes apparent, allowing for early intervention.

In the case of silicone implants, incidents of ruptures have no symptoms, unless the patient runs annual MRI scans to track the progress of the implant, identifying a breach can be challenging. While this may come across as an advantage rather than the issue at first glance, it’s essential to understand that the silicone gel can penetrate and reside in organs. The longer the leak remains unnoticed, the harder it is to remove the leaked gel from the affected organs.

Saline implants can be in your favour if you don’t plan on committing to annual MRI scans to monitor the progress of the implants.

2- Costs

This may already be obvious, but money-wise, saline implants cost relatively less than silicone implants. The discrepancy in the cost is attributed to the cost of the material. Silicone gel requires much more to create than would a sterile saline solution.

3- Natural appearance

Obviously, an authentic finish is directly the result of the surgeon’s skill and agility of work. Although both implants look natural, given the texture of silicone gel, particularly recent innovations of cohesive silicone gel, silicone implants have a more natural allure than saline implants.

Saline implants have a heavier firmer look since they’re often overfilled as an immunity precaution to rupturing.

Indeed, if the mild difference matters in your case and you’re keenly interested in getting the most natural aesthetic result, then you should consider silicone implants. However, if you prefer a firmer more substantial appeal, then saline implants are what you should look into.

4- breast tissue

For someone with not much existing breast tissue considering breast implants, silicone implants are the superior option. Saline implants have a higher propensity to wrinkle and ripple due to having a higher viscosity value in comparison to saline implants.

For patients with more breast tissue, saline implants are an ideal option as they are less likely to show rippling in case sufficient breast tissue is existing

5- Age

According to the FDA, it is recommended that women opt for silicone implants if they’d over 22 years of age. Saline implants are an available option for women of ages 18 and older. There are no health factors that create differences. However, implant manufacturers refuse to cover warranty for patients younger than 22 years of age. That being said, getting silicone implants at the age of 18 is legal.

6- versatility in shape

Silicone implants come in more varying shapes than do saline implants as silicone gel is far more form-stable than is saline water. For a more specific look in mind, it’s better to opt for silicone implants.

Why are breast augmentations popular?

The first-ever silicone breast implant was performed in 1962, a period of soaring popularity superseded the pioneering surgery followed by a decline in the 90’s due to failed surgeries, the adverse consequences of pioneering techniques.
Annually, approximately 200,000 breast augmentation surgeries are performed, and the numbers amplify when alternative breast surgeries are included.

The rapid increase is the direct result of continuous advocating for bodily autonomy and liberation of women. The stigma surrounding plastic surgery is dissolving like cotton candy in water. Some may hold prejudice against plastic surgery and likewise breast augmentation, but women are empowered to seek what they desire and dismantle the false connection between self-esteem issues and surgical body enhancements.

Patients opt for breast augmentation for various reasons, some to pursue a more dramatic look, while others are after more balance and proportionality in their overall appearance, and the reasons vary to fit the vicissitudes of fashion, seasons, and the miscellaneous self-expression attempts.

Breast augmentation incisions

There are four types of incisions through which implants can vary in insertion. The incisions vary based on numerous factor, your personal anatomy, the aesthetic result you’re opting for, and overall personal health have an influential factor in deciding the place of the incision. The decision is made between the patient and the surgeon. Therefore, you have the option to discuss all your needs and have your concerns addressed.
All the complication that could initially arise will also be discussed during the consultation.

The decision to opt for a certain approach over another is in some cases, a matter of preference and in others, a confined option with no flexibility. It all comes down to the type of implant used, anatomy, and general health.

Placing the implant

The implant is typically placed into two positions, either breast tissue or beneath the chest muscles. This varies based on the type of implant used and the shape desired and personal anatomy.

The three standard methods of incision placements in breast augmentation:

1- transaxillary Incisions

Transaxillary incisions are most desired as it’s the only method of insertion that doesn’t leave any scars on the breast or near it. A transaxillary wound is placed near the armpit and is an ideal option in the following cases [1] [2]

1– For patients who haven’t had breast enhancement procedures before
2– For patients who aren’t interested in a breast lift in the near future
3– For patients who are opting for saline implants over silicone implants. Since silicone and saline implants are inserted differently, the latter placed empty and later refilled, the location of the incision varies. Saline implants require a trans axillary incision, an incision created near the underarms, for insertion.

A transaxillary approach in breast augmentation surgery has many pros over alternative options. The biggest pro has to do with nipple and breast sensations. Breast augmentation is notorious for inflicting lack of sensation and numbness in the area. However, the prospects of numbness or nerve damage are initially dependent on the approach utilised during breast augmentation. Since a transaxillary wound is created on the armpit, and thereby, distant from the nerves responsible for sensation in the vicinity of the breast, it is one approach that is sure to eliminate numbness or nerve damage completely.

Some of the common drawbacks of the surgery include less precision in work as the surgeon is incapable of visualising or feeling the breast tissue to target the most ideal location to secure the implant. Loss of sensation in the armpit area is a common side effect, which, in comparison to nipple sensation and breastfeeding issues in the future, is a feeble inconvenience. An additional drawback would be the inability to use the location of the incision for future subsequent surgeries.

 

2- Inframmary incisions

The second type of incision placement in breast augmentation is the inframammary incision created under the breast on the breast crease where the breast meets the chest. The intersection is medically known as the inframammary fold, hence the name of the wound placement. The inframammary approach is ideal for silicone implants a lot more than transaxillary implants.

As a wound placement approach in breast augmentation, the technique of the approach creates a butterfly effect of benefits not found in the remaining techniques. Like the transaxillary method, the inframammary technique of implant placement does not initiate any nerve damage or sensation loss to the nipple or create obstacles in breastfeeding. The scar, although present in the vicinity of the breast is not visible as the breast fold keeps it eclipsed.
However, unlike the transaxillary approach, Inframmary approach because of its location allows for more precise placement of the implant. Furthermore, the position of the incision allows for the location to be reused for subsequent surgical procedures.

3- Areolar and periareolar incisions

The areolar incision is a circular opening created where the intersection of the areola and surrounding skin meet. In some instances, the incision is created around half the areola in a semi-circle style. It is referred to as the Periareolar Incision, and the implant is inserted through it.

Given the small size of the incision in comparison to alternatives, the healing rate is faster and recovery periods shorter. In addition, the scars of this type of approach often heal into invisibility and are hard to notice with the naked eye as they blend with the natural colour of the areola. Owing to the central position of the areola, the surgeon can have a non-biased angle of the breast and carefully place the implant to allow for maximum evenness and high precision. The scar can be opened again to allow for subsequent surgeries.

The downsides of this approach make its desirability significantly diminish. Initially, the surgery is not ideal for patients with small nipples as they don’t make for eligible candidates. Additionally, for women looking to breastfeed in the future, this option should be completely eliminated as it severs the nerves in the nipples and the milk ducts impacting and complicating the process of breastfeeding and decreasing sensation in the nipples and possibly create numbness in the area as a consequence of the nerve severing near the area.

Additionally, given the visibly prominent location of the incision, the scar in the case of non-steady healing, will not become translucent or blend with the surrounding tissue; instead, it will acquire a hard visible texture.

How to care for breast implants after a breast augmentation?

Breast augmentation post-op care is an important aspect of recovery and one that can impact the results even years down the line. For a safer uneventful free of complications recovery, the Vera Clinic has compacted a list of post-op care in an easy to digest format. The surgeons at the Vera Clinic hospital will ensure that our patients are not dismissed until they have had their concerns addressed, and the breast augmentation post-op care thoroughly explained.

During the first few days

During the first few days, the Vera Clinic recommends that patient get as much rest as needed. Maintain a stress-free tranquil state of mind and look out for any abnormal symptoms. Patients should have an assistant through this period, a friend or a family member. On top of all this, look to the leaflet of breast enhancement post-op care for information on how to alleviate most of the discomfort symptoms and for a smooth recovery with no complications.

Medications

1- Nausea

The procedure is typically an outpatient procedure performed under the effect of general anaesthesia. Therefore, the patient is discharged and allowed to go home. That being said, post-op care is a process that begins immediately after surgery.
Nausea often takes over once the anaesthetic begins to wear off. The surgeons at the Vera Clinic will have prescribed anti-nausea medications, and indicated their use, for the patient to eliminate or have the feelings of nausea subside. The anti-nausea medication can be administered every six hours for the first 48 hours. Patients may not need the medication before 48 hours, nausea can subside much earlier, but the period varies from one person to the other.

2- Pain

The pain will also become an apparent symptom as soon as the effect of the anaesthetic wears off from the body. The pain will most be felt around the surgical incision and place of operation; it’s completely normal and not a source of worry. To counteract the pain, the surgeons at the Vera Clinic will have prescribed pain killer medications to take when patients begin to feel unbearable discomfort. Generally, over the counter medications such as ibuprofen and cold compresses can alleviate pain. However, if neither solution is reducing the pain, then patients should resort to the prescribed painkiller medications and follow the instructions.

3- Muscle cramping

Muscle cramping and muscle aches are common symptoms after breast augmentation surgery. Again, the cramping should not be a cause for worry. In the post-op care package, patients will find a muscle relaxant has been prescribed by their surgeon. The medication can relieve muscles and eliminate discomfort from cramps. Patients can apply the relaxants on the back, neck, shoulders, and chest.

It should be noted that muscle relaxants and pain killers should not be mixed together. Instead, create a minimum of an hour time gap between the intake of either medication. The separation should prevent the rise of uncomfortable symptoms such as disorientation or drowsiness.

4- Wound infection

Wound infection is among the biggest fears patients have. Luckily, infections aren’t inevitable and can be avoided by following a strict aftercare routine. Patients will be prescribed antibiotics and given a sterilisation routine to keep the surgical site clean.

Exercise, Sleep, and Personal Hygiene

1- exercise

Patients during the first few days of recovery should keep a sedentary repose. Restrict movement to the bare minimum of walking, standing, and sitting. Any activity that does not require big movements, stretching, or apply force on the surgical site is allowed. While big movements pose a threat to the healing of the wound, small movements as suggested help prevent clotting of the blood.
Particularly focus on preventing the use of the arm and chest muscles to promote healing. Do not carry any weights more than 2 kilos; this includes lifting yourself up, carrying children, and any activity that requires the lifting or supporting if a hefty object. Therefore, it’s imperative to have an assistant during this period. A friend or a family member can ensure your quick and smooth recovery through taking over most of the takes that require both effort and force.

Patients can resume daily activity after the first week of recovery had they abided by their surgeon’s breast augmentation aftercare instructions. It should be noted that although daily activity can be resumed, lifting of heavy objects and strenuous physical activity is not permissible yet.

Carrying on with normal exercise and lifting of weights will be stated by the surgeon. Therefore, keep contact with the surgeon and take permission for any changes you see yourself making during recovery.

2- Sleep

Most surgical procedures require patients to maintain a particular repose for optimal recovery. Likewise, breast augmentation will have patients sleeping on their back for several weeks after surgery. Sleeping in the stomach or sides will hinder recovery as it can rupture the wound.

3- Personal hygiene

Personal hygiene is a pivotal process as it eliminates infection, but if done incorrectly, can actually cause it. The breast augmentation post-operation instructions provided by the surgeon will include a thorough explanation regarding handling wound dressings, showering, and surgical bras.

Starting on the second day after breast augmentation, patients are allowed to remove the bandages. However, the steri-strip bandages placed along the incisions should not be removed or altered. Showering can be allowed; however, the bandages on the incisions should be patted dry with care. Bathing, hot showers, and swimming pools are not allowed for several weeks to reduce the risk of infection.
Patients will be equipped with a surgical bra, a medical bra designed to support the implants and maximise wound healing.

What lifestyle changes do I need to make after breast augmentation to accelerate healing?
Aside from the list of instructions stated above and the instructions that will be dictated by the surgeon, patients should note that consumption of alcohol, smoking, and use of blood-thinning medications should be eliminated for a minimal period of 10 days for safe recovery. The Majority of medications prescribed in the post-op package do not blend well with alcohol — blood thinners, such as aspirin increase the risk of bleeding. Finally, cigarettes, in addition to alcohol, slow down recovery.

How long do saline and silicone breast implants last?

The average life expectancy of a breast implant, whether silicone or saline is anywhere between 10 to 20 years. The structure of an implant is not designed to last a lifetime. It’s important to be realistic with the facts preceding surgery to take the right financial measures for maintaining the aesthetic appearance. Although the breast implants have the potential to remain intact for two decades, the average life span is around ten years. Within ten years, the implants will be I need for renewal.

Breast augmentation recovery timeline

Patients need to become familiar with the recovery timeline of breast implants or breast enhancement surgery to take preparations measures accordingly. Factors to include would be requesting time off work due to relative physical impairment right after surgery, arranging for childcare, finding an assistant, to avoid unnecessary conflicts in schedule. Although patients are discharged almost immediately after stabilising post-surgery, they aren’t ready to resume daily activity.

Recovery rates vary between patients, but the period of recovery in breast augmentation occurs apace in comparison to other types of cosmetic surgery.

What to expect during the first week of breast enhancement recovery

Recovery begins initially when the surgery begins, and the body prepares for the innate process of wound healing. Patients will not feel any pain during the two hours of surgery as the procedure is typically performed under the effects of local anaesthesia. The procedure does not require hospitalisation after surgery, if no complications arise, then the patient can be safely assisted home.

It is a general rule that much of the discomfort will become more apparent as the anaesthetic wears off. Tightness, soreness, and pain are common symptoms around the surgical location that many patients report. Despite being prescribed painkiller medications, patients shouldn’t resort to the prescribed treatment unless the threshold of pain is unbearable. Otherwise, it is safe to opt for over-the-counter pain medications and utilise cold compressors to alleviate the pain. Numbness and tingling around the nipple and breast are common feelings after surgery. However, neither the tingling nor the numbness around the nipples is permanent unless the patient opted for an areolar incision approach during breast augmentation.

To speed recovery, it is important to remain sedentary with light activity such as walking and performing light movements to prevent blood clots from developing. Otherwise, remaining at rest, getting sufficient sleep, and abstaining entirely from carrying heavyweight items or items that exceed two kilograms or five pounds of weight is prominently advised.

It is essential to have a partner to assist you with daily activities, help lift you up, and manage the tedious work around the room. Big movements that involve the muscles of the arms, breasts, and chest; are to be avoided entirely during the first week.

Before leaving, your surgeon at the Vera Clinic will make sure you have the necessary information required for your post-op care. You’ll be equipped with Special medical bras to lift the breast and speed recovery. Once past the first-week mark, swelling, bruising, and pain will become increasingly diminished. You can resume your previous daily routine and get back to work. However, you should avoid strenuous physical activity.

Smooth vs textured implants?

Implants can either be smooth or textured and each possesses their unique benefits to address the versatile cosmetic needs. For starters saline implants exclusively come with a smooth textured surface as textured saline implants proved a massive fail post their manufacturing.

Therefore, only silicone implants come as textured or smooth surfaces. Textures implants allow for more grip which is beneficial when considering shaped implants in contrast with the regular implants.

How much does breast augmentation cost, and what are the best countries to get the procedure done?

There are several countries that have rose to fame to earn a name in the field of plastic surgery. While the UK, Europe, and the US, are countries well known for high medical quality operations, eventually the financial barriers initiated by the high costs of the procedure have led the citizens of Europe and the US to seek medical care abroad.

During the period of transition, and as the diaspora of the west scattered around the world for the purpose of finding equally good medical care at fractions of the prices in Europe and the US, medical tourism began establishing as a solid market, where certain countries excelled more than others in attracting medical tourists. Fueled by the economic differences around the world, medical tourism has brought an entire definition to affordable medical care. Being the trend of the decade, medical tourism is a market of vicious competition, where countries around the world are earnestly attempting to excel in the field by giving the patient the highest standards of treatment and care.

In the UK the average breast augmentation surgery would cost around £4000-£7000, excluding consultation and extra-medication fees. The price is exclusively for the surgical procedure. In the rest of Europe, a breast augmentation would oscillate between $5,000 to $10,000, likewise excluding extra medication fees and consultation.

In Brazil, a popular destination for breast implants, the surgery would cost around $4,731 and $5,260.

In Turkey, that has become exceedingly successful in the various sectors of tourism including medical tourism, the surgery can cost around $3,360 to $4,500.

Turkey and Brazil have become among the world’s safest and ideal medical tourism attractions. Aside from the affordable prices, patients are drawn by the thrill of wandering in unknown cities and forming an intimate familiarity with the culture and the hidden secrets of the city at such an important point in the patient’s life.

Do breast implants affect breastfeeding?

Among the many fears that women conjure from any breast-related cosmetic procedure, are adverse effects imposed on the milk ducts and future breastfeeding problems. It is important to note that breastfeeding problems are not necessarily conjectured with breast augmentation. However, that being said, the appearance of breastfeeding complications after surgery is entirely due to the method of incision placement. Unless the implant incision was performed around . the areola, there should be no worries for any breastfeeding complications in the near or far future. Unless the nerves around the nipple and milk ducts are altered, there is absolutely no fear. Discuss your fears with your surgeon to contrive an ideal surgical approach that will not sabotage your over-all well being or plans for the future.

In summary

Breast augmentation is a surgery that alters the size of the breast through increasing the size. Typically there are exclusively two types of breast implants: Saline implants and Silicone implants. Both implants have are made of silicone shells, however, the content of the shell varies. In saline implants, saline water is used, and in silicone implants, silicone is used as a filling for the implant sac. The type of implant is decided upon by the patient and the surgeon together. Each technique has its own benefits.

Contact the Vera Clinic

For more information on breast augmentation and professional guidance, contact the Vera Clinic.

 

 

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