Enlarger Muscle
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Breast Enlargement Today
Breast augmentation remains the cosmetic surgery procedure most often requested by women in their twenties and thirties. The number of women who choose to have breast enlargement surgery performed each year has tripled in the past five years.
In the past, breast implants have most commonly been filled with silicone. In 1992, the FDA restricted the use of silicone implants to breast reconstruction, such as after mastectomy. Although the scientific evidence supports the safety of silicone breast implants, the FDA allows only saline implants to be used for cosmetic breast augmentation. Saline breast implants are filled with salt water (IV fluid) which is safe and completely compatible with the body.
The evolution of the surgery for breast enlargement has created a number of choices which allows women to achieve the results that are most consistent with their own personal wishes and desires. Dr. Nein offers all his patients choices in breast augmentation.
Choices
The woman wishing to have a breast augmentation has a number of options and choices open to her. This gives her the best opportunity to achieve the appearance and result that she wants. These choices include implant style, placement, and size as well as incision location. Just as there are many different sizes and shapes of women, so are there a number of choices that can give each woman the best possible result.
Submuscular vs. Subglandular
One of the primary choices in breast augmentation is whether to have the implants placed "under" or "over" the muscle (submuscular or subglandular). This muscle is the pectoralis major muscle which lies over the rib cage and underneath the breast. It is the chest muscle that is commonly developed in weight lifters.
Traditionally, when the majority of implants were silicone, implants were most often placed underneath the breast gland and on top of the muscle. With the more common use of saline filled implants, it was noticed in women who were thinner or who had relatively little breast tissue to cover the implants, that there was a tendency to develop "rippling" or a waviness in the skin overlying the implant.
This is especially true with the use of the "textured" or rough surfaced implants. In an effort to decrease the incidence of rippling and the potential for capsular contracture, there has been a move to place implants in the space beneath the pectoralis major muscle. Submuscular placement increases the padding overlying the implant offering more coverage and camouflage to the shape of the implant. Using this technique, rippling has become a rare problem.
Incision Choice
There are three incisions commonly used to place the implant. Either an inframammary crease incision (in the natural fold where the breast contacts the lower chest), a periareolar incision (around the areola where the skin of the nipple changes to the lighter breast skin), or an axillary incision (in the armpit). The decision as to which incision to have rests entirely with you. There are certain differences, however, of which you should be aware.
The inframammary crease incision made by Dr. Nein is 4 cm long (about 11/2 inches). It has the advantage of being in a natural skin fold where it is well camouflaged and is generally covered by the natural curvature of the lower breast. It will probably always be covered by any clothing - even the smallest of bikini tops. This incision is close to the pocket where the implant will be placed. The distance to dissect is short and it is possible to very accurately create the size and shape of the pocket for the implant and to carefully control the position of the implant within that pocket.
A periareolar incision can also be used to place the breast implant. The dissection is carried through the gland, down to the chest wall. A sub-glandular pocket is created for the implant. If the woman wishes to have the implant underneath muscle, the muscle is elevated and moved out of the way to place the implant.
The third option is an axillary incision. This incision is placed in the armpit and dissection is carried out either above the muscle or below the muscle bluntly to create a pocket for placement of the implant. Because the incision is at a remote distance from where the implant will be placed, it can at times be a little more difficult to get very accurate control of the exact position of the implant, especially with anatomical implants.
Implant Choice
Traditionally, implants were all round. Viewed from the front, they are circular and in profile they appear to be half moon shaped. Over the last few years there has been a significant increase in the use of the so-called anatomical implants. These anatomical implants are slightly taller than they are wide and are fuller in the bottom - having a slightly more natural shape to them.
When using the round implants, the breast has a slightly more circular appearance to it whereas the anatomical implants give the breasts a more natural look. There tends to be a smoother transition from the upper chest wall to the top of the breast and not quite so much of a "step-off" as is commonly seen using round implants.
Choice of Implant Size
The final consideration is size of the implant. Implants come in a wide variety of sizes and it is possible for any woman to comfortably carry a variety of sizes on her chest. The objective during the examination is to determine which implant will give the desired appearance. As you can imagine, any given implant in a very small framed woman will achieve an entirely different result than the same implant in a larger and heavier woman with different shaped breasts.
Identical implant, different women with different breasts equals different results. The key, therefore, is to choose an implant that will give you the look that you desire. In order to accomplish this, we use a number of techniques. One of which is to take specific measurements of the size and shape of your breasts. This information, combined with the dimensions of the implants, and your desire for size and shape will help us determine which implant will most closely give you that look.
Bigger is not necessarily better. In choosing a very large implant it is important to be aware that as the volume of the implant goes up so do its dimensions, which includes the implant width. If you choose an implant that is excessively large, the edge of the implant may extend around beyond the breast and potentially even under the arm pit. This would be undesirable. Also, as the implants become excessively large, the potential for rippling and other long term adverse cosmetic consequences increases.
A very attractive look is a slight bulging on the silhouette of the lateral portion of the breast outside the chest wall and then down to the waist and hips to give that classic "hour glass" figure.
Complications
With any procedure, no matter how complicated or how simple, there are always certain risks of complications. As a general rule, breast augmentation is an extremely safe procedure preformed as an outpatient. You will have some breast soreness for a few days, however, that can readily be controlled by pain medication and most women do extremely well. After the recovery is complete there is no restriction on activities. One can go scuba diving, sky diving or any activities that you wish.
As a general rule, breast augmentation is an extremely safe procedure preformed as an outpatient.
Leakage
Like any other mechanical device, a breast implant is subject to mechanic failure. The fluid that the implant is filled with is IV saline; if it should leak, it is harmlessly absorbed by the body. All of the implants that Dr. Nein uses come with a lifetime warranty. Dr. Nein only uses implants made by either McGhan or Mentor.
Loss of Nipple Sensation
Perhaps the most serious consequence or potential problem associated with breast augmentation is the potential for loss of nipple sensation. The nerve to the nipple comes from between the fourth and fifth rib, travels through the side of the breast to the nipple itself. In the course of creating the pocket to place the implant, the nerve can be injured. If the nerve is damaged or cut, one can have permanent loss of nipple sensation. Fortunately, this is an extremely uncommon complication. In fact, it rarely happens.
Infection
There is an extremely small risk of infection during the immediate postoperative period. If a woman develops an infection around the implant, it is necessary to remove the implant. She must be on antibiotics and no sooner than six weeks later can the implant be replaced. This is a potentially correctable, reversible situation; but it is expensive by the time one pays for a second trip to the operating room and for a third implant. The good news is that this too is an extremely rare occurrence. In fact, it is so uncommon that for most plastic surgeons it may only occur only once or twice in their practice careers.
Hematoma
In the early postoperative period one can develop some bleeding around the implant which can cause a blood pocket to form next to the implant. If this happens, it may require a return trip to the operating room to have this washed out. In our experience in this practice, this has never happened.
Women who desire cosmetic surgery are encouraged to seek out plastic surgeons who are experienced in the various techniques available and who are certified by the American Board of Plastic Surgery.
About the Author
Adrien Brody is a business writer specializing in health and beauty products and has written authoritative articles on the industry. To learn more about breast enhancement, make sure you visit http://curvesenhancement.com
Breast Enlargement Fact Sheet
This factsheet is for women who are considering having an operation to enlarge their breasts.
A breast enlargement (also known as breast augmentation) operation usually involves placing an artificial implant either under your breast tissue, or under your chest muscle behind your breast.
The reasons why you may choose to enlarge your breasts include:
* feeling that your breasts are too small
* loss of breast volume after pregnancy (although enlargement will not lift them)1
* a difference in size between your two breasts
* reduced breast size after losing weight
Breast enlargement surgery may also be offered if you are having surgery for breast cancer or other conditions that may affect the size and shape of your breasts.
Your breast implant will be made of an outer layer of firm, elastic silicone, but may be filled with silicone gel or salt water (saline). Your surgeon will discuss the various options with you.
Breast implants leak in around 10 percent of women and this usually starts six or more months after surgery. The breast implant often has to be removed.
The contents of the implant can either leak slowly through the coating, or suddenly if the implant breaks open. This can lead to pain and an abnormally hard feel to the implant in the breast.
The body naturally forms a fibrous capsule around the implant, which helps to contain the contents of the implant. The newer designs of breast implants have features to reduce the likelihood of the implant leaking or breaking.
There have been concerns that leaking breast implants may be linked to serious health problems such as cancer but there is no conclusive evidence to support this.
Having breast implants does not usually interfere with breastfeeding, and there is no evidence that silicone is found in breast milk. But, it is important to tell your surgeon before your operation that you plan to breastfeed because this can affect the decision about where to make the cuts for your operation.
Breast implants interfere with mammography, a low-dose X-ray of the breast tissue used to detect cancer. You should let the radiographer or nurse know that you have implants as special X-ray views can be taken to minimise this interference.
Breast implants generally last for at least 10 years. Eventually some of the advantages of the enlargement surgery will be lost and you may need further surgery.
It is important to discuss with your surgeon what you are hoping to gain from the operation and the result you can realistically expect.
Your surgeon will discuss how to prepare for your operation. For example, you may be asked to stop smoking before surgery. Smoking increases the risk of chest infection, deep vein thrombosis (DVT) and slows the healing of wounds.
Before surgery you will talk to your surgeon about the operation and you will be asked to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.
Your surgeon will measure your breasts and assess their shape, your skin and the position of your nipples. He or she may also draw on your breasts to mark the operation site.
Your surgeon may want you to have a mammogram taken. He or she may also suggest that you have a photograph taken of your breasts before the operation so that the results of surgery can be compared with your original appearance.
If you are having a general anaesthetic, you will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.
The operation
Breast enlargement usually takes between one and two hours and is done under general anaesthetic, which means that you will be asleep throughout the procedure and will feel no pain. Usually it requires an overnight stay in hospital, but occasionally may be done as a day-case, which means you can have the operation and go home the same day.
Your surgeon will make some cuts, the exact position of which can vary. They may be in the crease under your breast, around your nipple or towards your armpit.
Your surgeon will then make a space, or pocket, for the implant. The pocket will probably be beneath your breast or under your chest muscle.
The cut will be closed with stitches. If these are not dissolvable, they will be removed about a week after surgery. Bandages or dressings will be applied over the operation area.
You will be given painkillers to help relieve any discomfort as the anaesthetic wears off.
Before you go home your nurse will give you advice about caring for your breasts, hygiene and bathing. He or she will also give you advice about wearing a special supportive bra in the days after the operation.
Once home, you can take more painkillers if you need to, as advised by your nurse or surgeon.
There are some important things to remember while recovering from a breast enlargement:
* don't shower for four to seven days after the operation
* don't lift heavy objects
* don't do any strenuous activity for the first two to three weeks after the operation as advised by your surgeon - if the implant is placed under the muscle, activity may be restricted for longer
It's important not to rush into the decision to have any cosmetic operation. And it's sensible to discuss the options with your GP, who may be able to recommend reputable surgeons or give advice about how to choose which hospitals to be treated in.
Breast enlargement is a commonly performed and generally safe operation. For most women who want the operation, the benefits in terms of improved appearance outweigh the risks. However, if you are deciding whether or not to have this procedure you need to be aware of the possible side-effects and the risk of complications.
Side-effects are the unwanted but usually temporary effects of a successful procedure. An example is feeling sick after the general anaesthetic.
Anyone having a breast enlargement can also expect:
* pain, swelling, tenderness and bruising for at least a few days
* a burning sensation in the nipples for a few weeks, but this should go away as you heal
Complications are unexpected problems that can occur during or after the procedure. Most people are not affected. The main complications of any operation are bleeding during or soon after the procedure, infection and an abnormal reaction to the anaesthetic.
Specific complications of breast enlargement include those listed below.
* There may be a difference in size between the two breasts, possibly caused by natural differences that are highlighted by the surgery.
* You may get an infection in the breast. If this happens, the implant may need to be temporarily removed to allow the infection to be completely treated.
* Abnormal scar tissue can form around the pocket in which the implant sits. This may squeeze the implant and cause firm, painful breasts. This is known as capsular contracture. If the breast goes hard, further surgery may be required.
* There is usually a temporary difference in skin and nipple sensation following breast enlargement but this can be permanent.
* Fluid can build up around the implant. This is called a seroma and may require further surgery to remove.
About the Author
Adrien Brody is a business writer specializing in health and beauty products and has written authoritative articles on the industry. To learn more about breast enhancement, make sure you visit http://curvesenhancement.com
