Breast augmentation

breast-augmentation-milanBreast augmentation, or augmentation mammoplasty, is a procedure performed to enhance the size and shape of a woman’s breasts using an implantable prosthesis. By inserting an implant in each breast, the surgeon is able to increase a woman’s bust line by one or more cup sizes.

Is Breast Augmentation right for you?
Augmentation mammoplasty may be performed for a number of reasons:
- To correct undesired breast size and shape, or achieve balance between asymmetrical breasts;
- To restore breast volume and/or firmness lost due to age, weight loss or following pregnancy;
- To create or improve breast appearance when a breast has been removed or disfigured by breast cancer surgery, trauma, or congenital abnormalities.

Breast augmentation can have a very powerful impact on a patient’s self-esteem. It is important, however, to have realistic expectations about how the change in your appearance will affect your life. The best candidates for breast augmentation are well-adjusted women in good health who are looking to improve their body contour and appearance for their own personal satisfaction.

Breast augmentation cannot be performed on:
- Women under the age of eighteen;
- Women with existing malignant or pre-malignant cancer of the breast;
- Women who have an active infection anywhere on the body;
- Women who are currently pregnant or nursing;
- Women with autoimmune diseases.

How is the surgery performed?
Breast augmentation surgery involves making a small incision to insert an implant into the breast area. The breast tissue is raised to create an open pocket under the breast tissue or beneath the pectoral muscle. Surgery typically lasts from one to two hours.

The procedure may vary depending on incision type, implant material, and implant pocket placement.

Incision types
The introduction of breast implants requires small surgical incisions, which will leave small permanent scars. Incisions are generally around 4-5 cm. in length and may be made at:
- The edge of the areola (periareolar) ;
- The axillary fold (through the armpit);
- The inframammary fold (the crease between the base of the breast and the chest wall).

Breast implants
While other breast implant materials are available for use, Dr. Lanfranchi highly recommends the use of cohesive gel silicone implants.

Cohesive gel silicone implants contain the same ingredients as other silicone gel implants, but are manufactured to contain extra “crosslinkers.” The additional crosslinkers make the implant firm yet malleable, allowing it to last longer and maintain its shape in any position. Should breakage occur, the gel’s consistency prevents the silicone from migrating into other areas. Shape is also easier to control with this material, so the implants look and feel more natural, and offer the most beautiful results.

Two types of implants can be used – anatomic or round implants. Anatomic implants have the shape of a drop, while round implants are as the name implies, and carries a rounder shape. Each have different sizes and profiles. Dr. Lanfranchi will recommend the implant he considers best for your case and will help you choose the size that fits your body better after carefully listening to your desires and expectations.

Despite the misconceptions relating breast implants to breast cancer, there is no evidence to suggest that they are indeed interrelated. On the contrary multiple studies have demonstrated that there is no estadistic correlation.

Implant pocket placement
There are two possible locations for placement of the implants. The implants can either be placed beneath the breast tissue, but on top of the pectoralis muscle, or placed beneath the pectoralis muscle, between the pectoralis and the ribs (dual plane).

Each type of breast augmentation procedure has its advantages and disadvantages, so it is best to discuss which procedure is most suitable for you during your initial consultation.

What to expect after surgery
Right after surgery, bandages are applied to aid the healing process and to minimize movement of the breasts. Once the bandages are removed, a specialized surgical bra is provided to be worn for several weeks. You may experience minor pain or discomfort, however this can be treated effectively with oral medication.

Depending on the level of activity required, you should be able to return to work in approximately one to two weeks time. If your job requires strong physical activity, a longer period of recovery and rest will be necessary. Driving can be resumed two weeks after the procedure.

Scars from a breast augmentation surgery are most visible six weeks or longer and usually begin to fade a few months after surgery.

Risks of Breast Augmentation
Every surgical procedure involves a certain amount of risk. Although the majority of patients do not experience complications, it is important to understand the risks, potential complications, and consequences of breast augmentation.

Bleeding (hematoma formation)- Although the risk is minimal, bleeding into the space around the implant can occur after the operation. Should this happen, the patient will be taken back into the surgery room to control the bleeding. Disregarding this could produce an abnormal breast shape and potentially lead to hardening of the breasts.

Infection – Some of the tissues of the breasts normally contain bacteria and are likely to come in contact with the implant during augmentation surgery. For this reason, all patients are placed on antibiotics during surgery and for several days afterwards. The risk of infection is less than 1%.

Loss of nipple sensation – Some patients will notice a change in nipple sensation following breast augmentation surgery. The change may result in either an increase or a decrease in sensation and can last several weeks. Nevertheless, the change is usually temporary. Permanent loss of sensation is highly unusual.

Possible Long Term Complications

Capsular contracture (hardening of the breasts due to the presence of a scar compressing the implant) – Every individual forms some scar around the implant. This is a normal response of the immune system to a foreign body. For reasons that remain unclear, some individuals form thicker scars than others. A thick scar may distort the breast and even cause discomfort. This problem has decreased since the use of silicone implants and submuscular placement; however, if additional treatment is warranted, the scar is incised or removed and the implant is replaced.

Implant Rejection – In the event that the implant is rejected, a relatively brief and simple surgical procedure is required to remove the old implant and replace it with another.

Visible rippling – Individuals with small breasts who have had a large augmentation can be at risk for visible rippling of the overlying skin. This problem is more common with saline implants, and can be avoided by placing the implants under the pectoralis muscle.

Interference with mammography – Implants may make performing and reading mammograms technically difficult. Implants placed behind the pectoralis muscle allow the breasts to be pictured more effectively through a method called the Eklund Technique. Using this technique, the presence of implants does not pose a risk for patients in early stages of breast cancer.

Interference with breast-feeding – This case is extremely rare but is noted to educate patients on all the possibilities. It is possible for breast augmentation to divide the ducts that empty the breast gland and thus interfere with lactation. Additionally, the breasts may be too uncomfortable when engorged and this may hinder lactation as well.

For more information about Breast Augmentation, or to schedule a consultation with Dr. Lanfranchi, please contact us.