Breast Augmentation

Types of procedures

Several types of breast enhancement surgery exist, including:

• Breast augmentation
• Breast reconstruction
• Breast lifting

Breast Augmentation involves making the breasts larger. Breast reconstruction usually occurs after a woman has breast surgery (for breast cancer, for example), and needs to re-shape or re-build her breasts. Some women have breast reconstruction after an accident. Breast lifting involves raising the breast upso that a woman's chest appears as if she is wearing a bra, even without one. Many women opt for this surgery as they get older, or after they have breast-fed their children.

Procedure options

When you choose breast augmentation surgery, your breasts may either be placed over (subglandular) or under (subpectoral) your pectoral muscle. The advantages and disadvantages of both are listed below. When choosing breast augmentation surgery, you can also decide on the placement of your incision. Information on incision locations is also listed below.

Implant placement over the muscle (Subglandular)

A subglandular implant is placed above the pectoral muscle but below the mammary gland (breast tissue). This can only be done if there is enough fatty tissue to cover the implant. The surgery is less invasive, quicker and can frequently be carried out under local anesthetic if desired. This method can, however, interfere with mammographic examination. There is usually less post-operative discomfort allowing you a speedier return to normal activity than the following method.

Advantages:

• Less complicated surgery
• Usually less pain
• Quicker recovery time

Disadvantages:

• Can make mammography difficult to do
• Possibility of visible rippling of the implant
• Capsular contracture (hardening of tissue surrounding the breast) is more likely

Under the muscle (Subpectoral or Submuscular)

Subpectoral implants are placed under the pectoral muscle only (known as subpectoral surgery) giving a layer of muscle between the breast tissue and implant; or between other muscles (including the pectoral muscle) of the chest wall and the ribcage (known as submuscular surgery) covering the lower edge of the implant. This offers less chance of interference with mammography. The surgical procedure is however more invasive than the previous method and more discomfort may be experienced.

Advantages:

• Less risk of capsular contracture (hardening of tissue around implant)
• Less risk of visible rippling
• Makes mammography easier to do

Disadvantages:

• May be more painful
• Visible rippling still possible on bottom of implant
• Lack of support for weight of implant may make future surgery a necessity
• Less natural appearance in women with sagging breasts; implant may sag, too (can get a "double bubble" effect)

Breast implant incisions

Depending on the surgeon's experience, your personal anatomy, the size of the implant and your desires, the incision through which the implant is inserted into your body may be in a number of places:

• In the crease (inframammary fold) where the breast meets the chest (i.e., under the breast where the bottom edge of a bra would be). This is the most common incision site. The fullness of the breast helps to hide scarring unless viewed from underneath. Silicone implants are usually inserted via this route.
• Around the areola (periareolar, the dark skin surrounding nipple). The difference in skin color helps to camouflage the scar, which is usually between 3 and 6 centimeters long. If you have a small areola, this option might not be available to you.
• In the armpit (axilla). This procedure is more difficult and can lead to more widespread post-operative discomfort due to the larger area involved. There are also a high number of delicate structures here which the surgeon needs to work around; often leading to longer operating time.
• Through the belly button Surgery will be performed under general anesthetic or local anesthetic with sedation after which you will return home soon after.