BREAST AUGMENTATION
Breast Augmentation is an operation where we enlarge the size of your breasts by placing an implant underneath each breast in order to increase the breast volume.
BREAST AUGMENTATION
Breast augmentation is an operation where we enlarge the size of your breasts by placing an implant underneath each breast in order to increase the breast volume.
Key Motivations
The key motivation for patients to undergo breast augmentation is sometimes a general dissatisfaction with the existing size of the breasts either because they always had small breasts or lost a lot of breast tissue after having children. It is very important that your expectations of the outcome are discussed in detail with Dr Paul McGarr.
Safe, Quality Implants
I use silicone gel implants in the majority of my breast augmentation patients. They feel extremely natural and are very durable. I trust and utilise Motiva Implants which I purchase from their local agent. I believe they are the cutting edge implants due to the nanotechnology used on their surface and their natural cohesive gel.
Motiva are ratified by the European Union medical devices committee (See https://ec.europa.eu/growth/sectors/medical-devices/pip-action-plan_en). The company provides a lifetime warranty for their implants. In the past there has been controversy over silicone implants due to fears that if they leaked or ruptured, they could cause disease, specifically breast cancer or an autoimmune disease like rheumatoid arthritis.
The United States food and drug administration (FDA) has undertaken exhaustive studies and confirmed that there is no evidence to prove such fears (See https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/).
Saline implants are the main alternatives to silicone gel implants used in breast augmentation, but whilst they may look the same, they don’t feel the same and are not as durable. When inserting implants, I use either a moderate profile or a high profile. A high profile provides more projection and can make the top of the breast fuller. Moderate profile implants are generally used in patients where there is a desire to have a more natural look and broader breast.
The implants are guaranteed for life so unless patients have a problem with their breasts, there is no need to change them.
A 4-5 cm incision is made in the breast fold and space is made to insert the implant.
The amount of breast tissue the patient has will determine whether the implant is placed in front of or behind the muscle. If there is sufficient tissue, the implant can comfortably be placed in front of the muscle whilst maintaining a natural shape that won’t be visible.* If there is insufficient tissue to cover the implant, it will be placed behind the muscle.
Once the implants are placed, the wound is closed. I seldom place drains.
Before your surgery:
- You must avoid consuming alcohol for a week prior to the procedure.
- You must not take anything that may thin your blood in the two weeks prior to the procedure.
This includes the following:
- Anything with aspirin such as Grandpa, Anadin, Disprin, some cold and flu medications and combination pain killers (note: you may take Panado).
- All multi vitamins, vitamin supplements, omegas, fish oils and green tea.
The above is to ensure that your blood clots normally.
Following your surgery:
- After the procedure, you are taken back to the ward and after 2-3 hours, if you are feeling fine with no pain or nausea, you are able to return home if you desire.
- It is important that you return home to rest and relax. Even if you feel good, you should keep any movement to a minimum and don’t consider doing any housework, gardening, driving or carrying anything heavy.
- If you have small children, have someone help you put them on your lap as you may find it painful to lift them yourself.
- You will experience pain for the first few days. The pain will be greater if the implants were placed behind the muscle. You will be given painkillers to control pain. It is important that you take these even if you don’t feel pain. They must be taken strictly as ordered, even if that means getting up in the middle of the night to take them. The idea is that you stay ahead of the pain.
- You will wear a strong supportive bra to take pressure off the implant during the healing process and ensure the weight of the implant does not stretch out the bottom of the breast. Patients are advised to wear this bra at all times for at least the first six weeks post procedure, ideally for a full 3 months.
- It is important that you do not exercise for six weeks as this may cause the implant to shift, causing pain and discomfort. Exercise may also increase the risk of infection.
- During the first week following the procedure, it is important that you do not get your dressings wet. You may bathe in a shallow bath or just use a basin.
- I see all patients the day after surgery to ensure no problems have developed and again a week later, at which time I change the dressings and teach you how to look after and minimize your scars. I will see you again three months after the procedure.
Before and after breast augmentation photos for patient with 315 High Profile, Dual Plane, Submuscular.
Before and after breast augmentation photos for patient with 450 ml high profile, dual plane.
Breast Augmentation photos : 355 ml high profile.
Photos pre and post op. 380 moderate profile breast augmentation.
Photos pre and post op. Age 38. Size 320 moderate profile. Motiva implants 4 months post opp.
The below photos show a patient 46 years old, 355 HP and Dual Plane Submuscular.
The below photos show a patient 37 years old with a 375 ml high profile. 3 months post opp.
The below photos show a patient 32 years old with a 325 high profile.
RISKS
Don’t be shy about discussing your concerns at your consultation. It is important that you feel comfortable talking to me.
- Very rarely my patients have reported that they lose feeling in their nipples and may feel the outer rim of the implant if they have thin tissue covering the side of the implant.*
- It is uncommon to develop a haematoma,* which is bleeding from the wound. It is for this reason that pre the procedure; you must not take any blood thinning substances.
- As with any operation, there is a risk of infection. This risk is greater with breast augmentation because the implants do not have their own blood supply, which means that if there is infection around the nipple, routine antibiotics cannot get rid of the resulting infection. To get rid of the infection one has to remove the implant. Whilst this remains very uncommon,* we do not want this to happen to you. So, it is important that on the day of your surgery, there is no sign of infection on or in you such as flu, a bladder infection, a cat scratch that has gone septic, and a tooth ache that could be a root canal or even something seemingly harmless like a pimple. We advise you postpone in the event of any such event until a later date when no sign of infection remains. To further minimize the risk of infection, we leave antibiotics in the breast cavity and everything is soaked in betadine or an antiseptic. Patients are also given a shower before the procedure and antibiotics, both before they are put to sleep and to take home afterwards.
- When implants are placed behind the muscle patients may experience what’s called dynamic breast. This refers to the movement of the breast when the major pec muscle is contracted. Dynamic breast is only really an issue for patients who do a lot of gym work/weight lifting as if they are wearing tight clothing, this movement of the breast may be visible. Normal clothing in normal circumstances, however, will not cause this to occur.
- The final complication that can occur, and often many years after the procedure, is the development of capsular contracture.* A capsule is the lining that the body forms around the implant. Whilst the cause of this is not quite understood, it is now much less common than 30-40 years ago. Should this develop it is corrected by removing the capsule and replacing the implant.
- In most cases the scar heals very nicely and a patients past history can be used as an indication of how well the wounds will heal. It is impossible to guarantee no scarring however, and if an unfavorable scar remains, it can be revised.
- With implants, you can still have mammograms. Should you fall pregnant you will be able to breastfeed because the implant will not interfere with the ducts. Assuming you lose your pregnancy weight gain and do not breastfeed for an extensive period of time, most breasts will look the same as prior to the surgery.
- It is natural to feel some anxiety, whether it’s excitement for your anticipated new look or stress about the operation.
Disclaimer:
There is no guarantee of specific results and the results can vary from person to person. Safety concerns will be discussed during your consultation. Please refer to my concise disclaimer for more information.
Copyright© Dr Paul McGarr, Plastic & Reconstructive Surgeon, Durban
MBBCH (Wits), FCS (Plast), Practice No. 042-000-0142158
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