With a breast augmentation you can change the shape and volume of the breasts. The reasons for wanting to undergo breast augmentation are many – too small own breast tissue, breasts after breastfeeding and pregnancy having lost volume and firmness or perceiving the breasts as having different sizes. Whatever the underlying reason is the aim is adding volume to create a breast shape, size and firmness that one can feel happy with.
The most typical way to implement a breast enlargement is by adding volume with implants. Every woman and her breasts are unique and therefore it requires careful planning to find the implant that fits best. One must adapt to personal preferences, height, weight and how your body looks.
The implants can be of various kinds having in common that they have a silicone shell that encloses either silicone, saline, or a mixture of these. The shape of the implants can be either round or teardrop shaped (anatomical). With the so-called cohesive gel implant we mean an implant consisting of form-stable silicone that if damaged the capsule around the implant behaves like a jelly and does not leak into the tissue. This type of implant is now the most common.
We only use implants of brands Mentor and Allergan, which are the most used implants in the world, with many years of experience and product development and are approved for use in the US by the FDA, the American counterpart to the Swedish National Board of Health and Welfare.
Consultation and surgery
During the consultation before the surgery, you and your plastic surgeon agree on which implant size is to be used. You get the chance to try out the right size and feel different implants and after the evaluation of your skin quality and depending on the breasts and thoraxic shape you can then correct the chosen implant. Careful planning before surgery and the choice of implants are the most important factors in getting the best possible results.
The operation is performed under general anesthesia in combination with local anesthetics.
The most common procedure is that the implant is inserted through an incision under the breast. This gives a scar that is hidden in the crease under the breast. In some cases you can even insert the implants through the armpit or the edge of the areola. The implant can be placed either under the breast muscle (pectoralis major) or between the mammary gland and breast muscle. The best results are achieved when placed under the pectoral muscle as the muscle coverage smoothes the contour of the implant especially in the upper part of the chest. A further advantage is that it is easier to perform a mammogram with the implant placed under the muscle.
Surgery is always a risk, but with careful planning before the operation and maximum safety the risk of complications can be reduced.
Although it is rare, one can immediately after surgery have a bleeding or infection. Numbness in the chest may occur during the first six months. Sensation returns usually by itself, but occasionally sensory impairment may persist.
At a later stage damage of the silicone cover may occur after an accident or mechanical strain. Although modern implants are designed so the silicone does not leak out into the tissue it may still be a cause for the implant to be replaced.
Capsular contracture always appears as this is the body’s way of reacting with the formation of scar tissue around the implant. In five per cent of the cases the scar tissue thickens which leads to the chest feeling tight, changes the shape and shifts upwards. Such cases are tackled by dividing or removing the capsule and sometimes you have to replace the implant. If you have suffered from capsular contracture, there is always a risk that this condition will come back despite a renewed operation.
After the operation
Most go home on the day of surgery and sleep in their own bed. You always have the option to contact the surgeon from home if something were to happen.
During the first week, most patients need to use painkillers regularly. To optimize the results it may sometimes be necessary to use a so-called chest band during a few weeks after surgery. The scars have to be taped with surgical tape for at least six months for best results. This tape is changed from time to time but not too often to avoid skin becoming fragile.
It can take up to 6 months before the final results can be seen. A return visit is planned after that period in order to evaluate the final result.
Large breasts can be the cause of pain in the neck and shoulders and as a consequence incorrect posture and repetitive strain injuries. It can be difficult to try out clothes or performing certain activities or just being unhappy about the shape. Whatever the underlying cause is it is important to reduce the risk of complications after the operation by not being too overweight. Most often a breast reduction is combined with a breast lift and sometimes there is need to remove excess tissue by liposuction or using implants to achieve the desired shape of the breast.
The operation takes approximately two hours and takes place under general anesthesia. The breast’s scar runs around the areola, then straight down from the nipple under the crease of the breast. Usually there is a need to be on sick leave for 2-3 weeks after surgery and to avoid exercise up to 6 weeks after surgery. The wound is taped up to six months You may use a support bra in order to achieve optimal results and wound healing.
The operation can affect the ability to breastfeed and give reduced sensation in the nipple. You can discuss this with your surgeon before the operation. Unfavorable scar formation can generally be avoided if you follow the instructions for wound care but if you are a person with severe scarring you should also discuss this with the surgeon before the operation.
After the operation
You return home the same day or the day after the procedure. The surgeon books two follow-up visits, one week and six months after the operation.
The elasticity of the breast depends on which type of skin, age, breastfeeding and pregnancy as well as how much breast tissue one has in proportion to fat. A breast lift is intended to re-create the desired shape and volume and there can be a need to besides doing a breast lift also doing a breast augmentation with implants. The scale of the operation and the procedure is then determined by the size and shape of the breasts as well as the degree of sagginess and personal preferences. In general a breast lift does not impose any limitations on breastfeeding. The instructions for after the operation care and taking care of the wounds are basically the same as for breast reduction surgery.