Breast augmentation


Breast augmentation is one of the most popular cosmetic surgery procedures. Thousands of women are operated on each year and the vast majority are delighted with the result.

Breast augmentation using silicone implants has been done for decades but in the 1990s concerns were raised regarding the safety of silicone implants. As a result, the FDA banned them in the USA and commissioned large studies. These showed no evidence of problems and as result silicone implants were approved and are now available again.

Women have breast augmentation for a variety of reasons and they include

  • Increasing the size of small breasts
  • Correcting differences in size between the breasts
  • Improving the shape and volume of the breasts after breastfeeding
  • Changing the shape and volume of the breasts due to aging, weight loss, or surgery.

The two types of implants available are saline (saltwater) and silicone. Both types of implants are basically strong capsules with either saline or silicone gel inside them. They come in a variety of sizes and can be round or teardrop-shaped.

Silicone gel feels much the same as fat so silicone implants often feel and look more natural. Saline implants are thought to look and feel less natural than silicone and are prone to wrinkling which is often visible in thin women.

They each have advantages and disadvantages and your cosmetic surgeon should explain them in detail. He or she will have implants to show you as well as before and after pictures. Ask your surgeon to talk you through the options so you can make an informed choice.

There are four surgical approaches to breast enlargement.

They are

  • Transaxilliary – The incision is made in the armpit and the scar is hardly visible.
  • Periareolar – The incision is made around the bottom half of your areola, which is the round area around your nipple. The scar usually heals quite well
  • Inframammary – The incision is made in the crease underneath the breast. The scars are longer than in the other options but heal well
  • Transumbilical – A small incision is made just above the belly button and a tunnel made up to the breast.

Just to make things a bit more complicated the implants can be placed either above or below the chest muscles. Placement under the muscles takes longer but usually, the implants are less palpable and mammography (X-ray of the breast to screen for cancer) is easier. Placement over the muscles is quicker but the implants may be more palpable and mammography is more difficult.

Discuss the options with your surgeon but don’t despair, as it’s not half as difficult as it seems.

Breast implants may make mammography difficult. There is a possible risk of missing early cancers. However, as long as the radiographer knows implants are present there are a variety of methods they can use to get around the problem.

Breastfeeding after breast implants may be difficult for some women but not all. Problems are most common after periareolar operations. It is not thought that silicone gets into the breast milk or has an adverse effect on babies.

Modern surgical techniques give great results and although breast augmentation, like all surgical operations, has some risks they are small compared with the huge boost to self-esteem and confidence.


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