Breast Augmentation
Augmentation mammoplasty, or breast augmentation increases the size of your breast. It can also partially correct breast droop.
Candidates for Surgery
Any woman unhappy with the size of her breasts is a candidate. In my practice, pregnancy induced change is a common reason for breast surgery.
Although there is relatively low risk, breast augmentation does require the use of an implant.
Implants
Saline filled implants are the only implants currently approved for cosmetic surgery. Silicone gel filled implants are currently limited to use in reconstructive surgery patients enrolled in research coordinated with the FDA. According to study guidelines, reconstruction is not limited to post-mastectomy patients.
Saline implants use an empty silicone bag, which is filled with sterile IV fluids during your surgery. While there is no evidence to date that silicone gel filled implants are unsafe. Due to the fact the bag is still made of silicone,if any increased risk is found, your theoretical risk from silicone will be the same with a saline implant as with the gel filled implant.
Implants are warranted (by the manufacturer) against failure (leakage) for as long as you have the implants. If the implant fails during your lifetime, the manufacturer will replace the failed implant, but only for the same size and style implant. If the implant fails during the first 10 years after surgery, in addition to replacing the implant, you will be eligible for additional compensation for out of pocket expenses (to have the implant replaced).
Implant Selection
Implants are available in differing sizes & shapes. Before surgery, an implant of appropriate size & shape will be selected. Your desired breast fullness and your existing breast size will affect your implant selection. You will ultimately decide your implant size, with Dr Branson helping ensure your selected size is appropriate to your.
When considering implant size, there are several factors you should consider. If children are planned, remember that pregnancy will affect your breast size and shape. You might consider deferring implant surgery, or consider a smaller size, allowing room for a larger implant (to help lift your breast when your are done having children).
Since excessively large breasts can cause problems, such as back pain, neck pain, and shoulder grooving, Dr. Branson may suggest a smaller implant size.
Implant Surgery
Treatment is done as an outpatient. In all cases, the implant is centered under your breast tissue. The implant can be placed either below the breast tissue, or below both the breast tissue and the chest wall muscle.
When the implant is placed beneath the breast tissue (above the chest wall muscle), the incision is usually placed in the fold where the breast meets the chest wall. If the implant is placed beneath both the breast tissue and chest wall muscle, I usually use an incision in the armpit, just in front of your armpit hair.
When your implants are placed below your chest wall muscle, the parts of the muscle must be cut. Post-operative pain is greater than when placed above the muscle. This occurs for the same reason that an athletic muscle injury takes several weeks to recover.
Anesthesia
Implant surgery is usually performed in the outpatient surgery center. If the implant is placed above your chest wall muscle, "twilight" anesthesia can be used. In twilight anesthesia, you are sedated, but not asleep. A local anesthetic is used for surgical pain.
If you choose to place your implant beneath your chest wall muscle, general anesthesia is required.
Complications: Implant
The most common complications related to implants are the risk of implant failure and capsular contracture.
Implant failure means your implant begins to leak. Failure is rarely related to trauma to your chest area. If your implant begins to leak, it will need to be replaced. Implant replacement does not require urgent surgery. If your implant is leaking, you will begin to notice you no longer fill out your clothing (such as your brassiere or bathing suit) as you once did. If this occurs, call the office.
Capsular contracture is the result of scar tissue tightening around your implant. Consider your implant to be a water balloon, and the healing (scar) tissue that forms around the implant to be a plastic bag. A water balloon in a plastic bag still feels like a water balloon. If you begin to twist the bag around the balloon, it will tighten around the balloon, making the balloon feel "hard." Neither the bag nor the water balloon changes, only the relationship between them changes. In simple terms, the same effect occurs when capsular contracture makes your breast feel hard. Just as the balloon feels "softer" by untwisting the bag, releasing the scar tissue around your implant treats capsular contracture.
Less common complications include calcifications forming around the implant, shadows on your mammogram, and possible loss of some of your natural breast volume. Implant surgery does not change your risk of breast cancer.
While there was dramatic press coverage of a possible link between silicone and immune disease, recently published data finds no link between silicone and any disease. Although there is no apparent link between silicone and immune disease, if you have a family history of immune-related disease (like rheumatoid arthritis or lupus), there a remote chance that implants could change your risks of immune disease. If your family history is positive, I suggest you see a rheumatologist to assess your personal risk for immune disease.
Complications: Surgery
Surgical complications for implant surgery are the same as for any other operation. They include (but are not limited to) bleeding, infection, scarring, implant malposition, and the possible need for additional surgery.