Breast Augmentation (Breast Implants)

This is a cosmetic surgical procedure to improve the size and shape of a woman's breasts using implants.  Many women suffer from small or irregular sized breasts and therefore suffer from loss of self-confidence and problems with establishing relationships.  These problems can easily be corrected by the use of breast implants.

Breast implants are elastic pouches filled with liquid silicone, high-density silicone or saline solution.  There are choices of either round or natural breast shape.  They can also have plain or textured surfaces, which has a role in the formation of tissue around the implant.

Implants do not last for a lifetime.  According to the manufacturers' recommendations, implants need to be replaced every 10 years even if no complication occurs.

The procedure is performed under general anaesthetic.  The chosen implant is placed under the glandular tissue or the pectoral muscle.  Placement of the implant can be made by making an incision in the hidden sub mammary line or through a 4cm incision on the nipple or through the axillary region.  The incision is secured using a plastic suture.  An opening is made for a drain to help discharge fluid.  This is removed the next day.

After the operation, an elastic bandage is to be worn for a week.  After the first week the bandages are removed and a suspension bra needs to be worn for 5 weeks to establish the right implant position.  Stitches are removed after 2 weeks.  You will get used to the weight and shape of the implant between 2 and 3 weeks.  During the consultation with you we discuss the post-operative treatments such as applying massages to prevent contracture.

Possible post-operative complications

As with any surgical procedure, breast implants may cause side effects.  As indicated earlier, breast implants are not for a lifetime.  Each implant is different as well as your tendency and lifestyle.  There is no risk-free breast implant procedure.  Although quite rare, the following complications may occur:

1. Capsular Contraction - the body creates a capsule around the entire surface of the new implant.  This may tighten and squeeze on the implant causing the breast to feel hard.  This could happen at any time after the operation.  This is rarer in the case of textured implants.
2. Leaking - as with anything that is liquid-filled, implants can also leak.  With a normal lifestyle this is almost impossible, since the modern implants are made up of several layers.  Leaking only usually occurs due to accidents, old implants or mechanical impact.  In the new "cohesive" implants the gel does not get absorbed and can be easily surgically removed and replaced.  In the case of saline solution implants, the solution is easily absorbed causing no harm to the body and the implant can be surgically replaced.
3. Gel-leaking - Microscopic gel-drops may leak through the layers.  These drops can be found in the surrounding tissue but can also find their way to other parts of the body.  It is not proven that this causes capsular contracture or any side effects.  The possibility of this occuring are significantly reduced by the use of modern high-density cohesive gel-filled implants used at our clinic.
4. Infections - When this happens the signs (irritation, tightness, pain, fever) are visible soon after the operation.  Treatments can be antibiotics, or rarely removing or replacing the implant.  If the removal is necessary, a new implant procedure can only be performed after 6 months of recover.
5. Other complications:
   1. Haematoma, or seroma after the operation or later.
   2. Skin dying; usually caused by intense internal pressure blocking circulation.
   3. Breast Asymmetry: our surgeons aim to achieve the best symmetry possible, however capsular contraction, shifting or implant or posture asymmetry of the patients can cause differences either side.
   4. Temporary or permanent changes in the feeling of the nipple or breast.
   5. Shifting of the implants: caused by mechanical impact or capsular contracture.  This will affect the shape of the breast, and may require further surgery.
   6. Wrinkling of the breast: these problems may occur depending on the type and size of the implant, especially when loosing weight.

Other complications are rare, but may occur such as:  silicone sensitivity, bleeding, haematoma, seroma formation, sometimes several months after surgery.  Patients may experience keloid scars which cannot be predicted before the procedure.  Before a mammography examination, the x-ray specialist has to be informed about the implant as it can be misleading.

Further questions asked: can silicone implants cause mutation of surrounding tissue?  Research has shown no relation between the mutation of tissues and the silicone implants.  Can children of mothers with silicone implants have immunology problems?  A recent article shows that there may be a relation between children's stomach problems and mothers with silicone implants.  However, the advantages of breast feeding and the wide use of silicone products in paediatrics contradict this assumption.  Women with silicone implants should consult their doctor about the newest researches in this matter if they wish to breast feed.

Recovery

Avoid direct sunlight, sunbed while the wounds are healing

Avoid sport activities which cause shifting of the implants

The final shape will only form a few months after the operation.  This period of time is needed for your body to surround and fix the implant.  This period of time is also necessary for you to get used to the new you. 

After many years of having an implant, the breast may become flaccid.

 

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