Many Women are choosing to have Breast Augmentation to correct inadequate or irregular breast size and shape, and a minor degree of drooping of the breasts (Breast Ptosis). Alternatively the choice is made for purely aesthetic reasons to enhance the body’s appearance and contours.
It is important that women considering Breast Augmentation should be fully informed about the safety of the surgical procedure, the choice of implants available and the correct location for the placement of the implants.
The recent media focus on Poly Implant Prosthese (PIP breast implants) is an example of being informed and aware of the safety of available implants. Dr. Bobby Kumar has been aware of the complications and problems of these PIP implants for many years; consequently he has chosen NOT to use these breast implants in any of his patients. As a result, our patients are secure in the knowledge that the breast implants used by Dr. Bobby Kumar are safe and have appropriate approval from medical authorities. A thorough discussion regarding PIP breast implants can be found on our blog page at Bare Aesthetics blogsClick for Breast Augmentation Images
Breast implants have a finite lifespan, after which time they often require replacing due to reasons associated with Capsular Contracture, rupture or leak of the breast implant, or the patient deciding that the breast shape, size and contour is no longer appropriate.
During the consultation Dr. Bobby Kumar will thoroughly discuss the surgical and aesthetic management with regards to Breast Augmentation.
Breast Augmentation is performed in an accredited day surgery and under general or sedation anaesthesia provided by an accredited fully trained anaesthetist.
Typically most patients will require day only stay in the day surgery unit.
What are patients looking for when considering Breast Augmentation/Enlargement?
Breast Augmentation patients in Sydney, NSW mid north coast( Port Macquarie, Kempsey & Coffs Harbour) and Adelaide simply are looking for a Natural and Aesthetic result.
The features that distinguish a Natural and Aesthetic result from a “boob Job” are;
- Tear drop shape and often a “perky” breast;
- Seamless sloping of the upper part of the breast to the Nipple areola complex;
- In most instances a defined and natural cleavage is possible;
- Breasts that react, lie and move like natural breasts;
- No visible scars, rippling or other untoward signs of a breast implant;
- Many women want to feel confident and natural in clothing and in swimwear or quite simply, bare.
Prior to discussing Breast Implant Surgery patients provide a detailed medical history and undergo an examination. There are many considerations when considering Breast Augmentation; they include a history of Breast Cancer, other significant medical illnesses or conditions, use of medications or herbal remedies, social habits (for example smoking and drinking) and allergies or anaesthetic related reactions.
If there are no compelling reasons not to have Breast Enlargement surgery then during the consultation Dr. Bobby A. Kumar will assess and take measurements of the Chest wall and breast size as well as distance from constant anatomical landmarks. Also the thickness of the skin and underlying breast glandular tissue is assessed as this is important when deciding to place the breast implant under the muscle (Submuscular breast augmentation) or above the muscle and under the breast glandular tissue (Subglandular breast augmentation).
Finally patients will simulate a breast augmentation by placing breast implants into a bra. Whilst this is not an absolutely true representation of the final result it is a helpful tool for Dr. Bobby Kumar to determine what size, shape and appearance the patient wishes to have following breast enlargement surgery.
Together with the collection of measurements and an idea of Implant size, shape and aesthetic appearance, a mutual plan is developed between the patient and cosmetic surgeon.
Saline or Silicone Breast Implants
There are two types of implants available, these being Saline or Silicone. Both types of Implants are contained within a Silicone Shell. The newer generation of breast Implants have been remarkably improved compared to the older style Implants that were initially implicated in what were incorrect links between silicone and underlying Immune diseases. Since then there have been many medical studies presented in plastic surgery journals that demonstrate no abnormal physiological or anatomical link between breast augmentation surgery or breast implants made from silicone.
The saline breast implants are silicone elastomer shells filled with physiological saline. The saline is harmless to humans and its constituents form the same saline found in our plasma. The advantages of a saline breast Implant is that the size of the Implant can be adjusted at the time of operation or with a particular type of saline Implant gradual increased size is possible post operatively.
The major disadvantages of Saline breast Implants are that the breasts tend to feel like a “bag of water” rather than the natural feel of silicone filled breast Implants. Also rippling, Implant leak and deflation can be common with saline breast Implants.
Alternatively Dr. Bobby A. Kumar finds that Silicone filled breast Implants are used in the majority of breast augmentations in Sydney, Port Macquarie and Adelaide. The correct choice of Implant will augment and enlarge the breast to produce natural and aesthetic breasts. The breasts feel natural and tend not to have the aesthetic problems associated with saline breast Implants.
The choice of Implant type is dependent on several factors including the patients Skin type, the amount of Native Breast Tissue prior to Augmentation, the age of the patient and any underlying irregularities such as Breast droop (Ptosis) or shape of the Breasts.
There are supposed advantages of one type of implant over another in the scientific literature with regards to Capsular Contracture and Implant rupture. To date there is no conclusive evidence of a particular type of implant being absolutely better that another, and the choice at the time of consultation and surgery is dependent on the Surgeon’s assessment.
Breast Implant manufacturers have attempted to modify the surface of the Implants to reduce the incidence of Capsular Contracture. Textured breast implants attempt to “breakup” the capsule scar that forms around all breast Implants. The capsule scar is particularly a problem of Subglandular breast augmentation so most surgeons use a textured breast Implant.
There is another silicone breast Implant with a Polyurethane coating sometimes referred to as the “furry Brazilian” or “fuzzy Implant” mainly because the Implant surface has a textured coating which is “foamy or furry” and they are produced in Brazil. This Implant has been used in cases of intractable Capsular contracture formation and during reconstruction cases in an attempt to reduce further risk of capsular contracture. Dr. Bobby A. Kumar recommends this type of Implant for appropriate breast augmentation cases but not as the standard breast augmentation.
There are two shapes of breast implants, these being round and tear drop (Anatomical) shaped. The round Implant is the most common type of breast Implant used and requested in breast augmentation. The round Implant has different profiles and thus more or less projection. The anatomical Implant is used based on patient preference and used in cases where the Nipple areola complex needs to be lifted typically in cases of mild breast droop. Its main drawback is with the risk of rotation resulting in an abnormal breast shape; this is corrected by further surgery. Also anatomical Implants have less ability to enlarge a breast compared with a round implant.
Incision Placement for Breast Augmentation Surgery
There are three types of Incisions that are used for breast augmentation and inserting the breast Implants into the created pocket. The most commonly used incision is in the crease of the breasts (Inframammary incision); on healing the scar is hidden in the new crease formed. The advantage of this approach is adequate visualisation of the pocket created and the dissection required during breast augmentation surgery. Also the plane of dissection is much more manageable with this approach and bleeding vessels are easily visualised, treated and therefore reduces any subsequent complications.
Another type of incision is one placed around the Nipple (Periareolar); this is particularly common in Asian women. There are limitations with this approach; women with a small Nipple areola complex are often excluded from having this type of Incision as a Silicone breast Implant is unable to be inserted through the incision unless it is a saline breast Implant. Also there is a risk of poor scarring, loss of sensation and difficulties breast feeding in some women.
Alternatively armpit crease (Transaxillary) incision is an attempt to completely hide any signs of breast augmentation. This can be a difficult approach as the cosmetic surgeon has much less control of the medial pocket (cleavage area) and complications such as bleeding may convert a Transaxillary approach into an Inframammary approach to control any bleeding.
There is another approach which has been popularised in the USA. The incision is placed around the belly button (Transumbilical) this is only used with saline breast Implants and it is not an approach that Dr. Bobby A. Kumar uses for breast augmentation in Sydney, Port Macquarie or Adelaide.
Recovery & Complications
Typically the majority of patients will have a relatively unremarkable recovery. The main symptom is minor pain and tightness as the skin has to adjust to accommodate the enlarged breasts. Over time the skin and the firmness of the breasts will settle and soften, the results however, are almost immediate.
Common complications are: Bruising, swelling, changed skin sensitivity.
Rare complications are: Infection, bleeding and poor scar formation.
All Implants form a thin membrane around the implant; however, some women may form a particularly thick capsule causing symptoms and contracture of the implant. Unfortunately this is not predictable in patients who have never had a Breast Augmentation. As detailed above, various attempts are made during breast augmentation surgery to help reduce capsular contracture rates.
There are a range of potential complications evident during the taking of your medical history and examination which will be discussed during your consultation.