WHY AND WHEN IS A BREAST AUGMENTATION (ENLARGEMENT) PERFORMED?
The size of a woman’s breast will largely be determined by genetics but it will also be influenced by fluctuations in weight, pregnancy, breast feeding and hormonal changes. Some women have problems with asymmetry (one breast much larger than the other). Others have very small breasts, breasts that are out of proportion for their frame or breasts that decrease in size after pregnancy.
WHAT IS INVOLVED IN THE OPERATION?
Breast enlargement surgery is performed under a general anesthetic and takes 1-2 hours. The surgery involves placement of an implant either under the skin and breast tissue or deeper under the muscle under the breast. There are many different types of implant available. They all have a silicone outer layer but may be filled with silicone (cohesive gel that doesn’t run if cut) or saline (salt water). The choice of implant should be discussed with your surgeon and the position of the scars should also be discussed. There are different techniques which result in different scars either under the breast, around the nipple, through the belly button or in the armpit. We recommend having a mammogram performed before and after having surgery for your medical record.
ARE THERE ANY COMPLICATIONS?
There are general risks associated with a general anesthetic such as aspiration of stomach content into the lungs which can cause serious illness or death. Therefore, to help prevent this it is mandatory that you do not eat or drink anything (usually 8 hours) preceding your surgery. Other risks include DVTs, (clots in the veins of the legs) which can break off and travel to the lungs, this is known as an embolus and although very rare, can be life threatening; especially in smokers. You will be encouraged to get up and walk around as soon as possible to reduce these risks. Bleeding can lead to bruising and excessive bleeding is known as hematoma and may require surgery for removal. Problems with wound healing and infection can occur, particularly in those who smoke. In some cases infection might result in the implant having to be removed and replaced later. In most cases, scars will fade and be hardly noticeable and would not be visible in normal underwear or swimwear. Scars vary enormously from one woman to the next and some people can have problems with red, raised, and lumpy scars. Internal scarring around the implant, known as a capsule, occurs to some extent in up to 10% of women. In the worst cases this leads to hard painful breasts and may require further surgery. Asymmetry (one side different in size or shape) can occasionally be a problem as can numbness or altered sensation. Rupture or leakage of the implant is rare. Despite media reports, there is currently no convincing evidence linking implant to increased risk of breast cancer or other health problems such as autoimmune diseases and rheumatoid arthritis. It is possible to have mammograms after breast enlargement surgery and it may also be possible to breast feed in many cases.
WHAT HAPPENS AFTER THE OPERATION?
After the operation you will need someone to drive you home and look after you for the first 24 hours after surgery. You may experience some pain which should be alleviated by the pain medications. You will need to wear a supportive bra day and night. This bra as well as any tape that may be under your breasts are to assist in your healing process and should only be removed by your surgeon. You may have dissolvable stitches but any permanent stitches will need to be removed around 10 days.
WHEN CAN NORMAL ACTIVITIES BE RESUMED?
You should avoid lifting, driving and strenuous activity for up to 3 weeks. Depending on your job, you should be able to return to work within a few days after the operation.
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