Breast augmentation surgery or breast enhancement surgical procedure is one of the most popular procedure of cosmetic surgery now a days. Its trend is increasing day by day and females with small size breast are very conscious because due to this small size breast they are suffering socially and psychologically and even feels problems from their partner / husband side. Even females feel difficulties in their profession due to this problem of small size breast. For this reason, trend of breast augmentation is increasing day by day and is becoming one of most common procedure now adays.
Types of Breast Augmentation
There are two main types or techniques of breast augmentation now a days in practice.
1. Breast augmentation with silicon implants
2. Breast augmentation with fat injection to breast / Lipo filling of breast
Assessment and preparation:
Patient / client is evaluated in detail at clinic . Detailed history is taken then detailed examination and assessment is done and concerned of patient is known . During examination and assessment it is evaluated about size of both breast , shape of breast , asymmetry between both breast , position of nipples and areolar complex , any breast or chest deformity , looseness of breast ,size of chest , and congenital breast problem , skin capacity of breast , breast parenchyma and inframmary fold is evaluated . Then donor area is assessed for fat harvesting for Lipo filling of breast and with sizer breast implant size is assessed. Then details about procedure , timing of surgery , recovery time , post operative care and complications and outcome is discussed with patient .
And base lines investigation are advised for fitness for anesthesia.
Procedure:
Both techniques of silicon breast implant and fat injection/ fat transfer to breast are performed under general anaesthesia.
After the marking in standing position, patient is placed in supine position . Infiltration is done , then in case of silicon breast implant
( incision is given , dissection done then pocket is made according to assessment whether in subglandular plane or sub muscular plane , after adequate pocket creation it is washed with gentamicin solution , then adequate size silicon implant which is now days ( smooth implant in practice approved by FDA ) is opened and inserted into pocket and placed in proper position on both sides . Then wound is closed in layers and dressing done
And in case of fat transfer to breast / Lipo filling , donor area for fat which is usually abdomen or thighs is infiltrated with solution containing ringer lactate , xylocain , bupicaine and adrenaline . After that with special Cannulas fat is harvested with negative suction pressure , fat is then processed.when fat is ready it is then injected into breast in multiple planes , subglandular and subcutaneous plane mostly . Then after injection of fat, symmetry is made and equal amount of fat is injected on both sides . In this process 20-30 percent overfilling is done than required amount considering that 30-35 percent will be absorbed over the time .
Then wound closed and dressing done
Post-operative care and recovery:
Patient is kept hospitalised for one day and next day patient is discharged . In case of silicon implant patient is advised to move her arms from day 1 slowly slowly so that implant can adjust to its position . After two to three days slow slow masage is advised over the breast for making adjustment of implant . Chest heaviness and pain can be observed with some swelling for few days but usually get settle in 3-7days . Stiches can be used absorbable and do not need to be removed and patient is advised sports bra to help support the breast with implants .
After stiches remvoal scar massage creams are advised to make scar camouflage.
In case of fat injection to breast compression garment are advised for donor area to wear and sports bra for breast. Swelling and brusing can occur on both areas and get settled in 2-3 weeks . 30-35 percent fat is absorbed over the time of 2-3 months and good shape is observed in 2-3 months time period .
Benifits and Side Effects
Each procedure/ technique has its own benifits and side effects .
Benifits of silicon implant are that
1- no donor site morbidity
2- implant size which is choosen remains same over the time .
3- more good shape and projection can be achieved
4- gives more confidence to patient to get back to society
5- recovery time is more quick as there is no donor site involvement
6- no risk of absorption like fat over the time
While side effects include
1- heamatoma formation
2- seroma formation
3- infection of wound
4- stiches breakdown / wound dehiscence
5- foreign body reaction
6- capsular contracture formation
7- implant malpostion
8- implant rupture if good quality implant is not used
9- movement of implant with muscle movement
While in case of fat injection , benifits include
1- own fat of patient , so risk of foreign body reaction
2-natural tissues of patients own which also contain stem cells and help in growth of fat
3- improved texture
4- less risk of infection
5- small wound size of both donor and recepient area
6- can decrease size of tummy or thighs by removing fat from there and increase size of breasts in same setting
While side effects include
1- absorption of fat 30- 35 percent which can make some asymmetry in 5-10 percent cases.
2- need revision procedure in 5-10 percent cases having asymmetry
3-donor site morbidity of abdomen or tummy
4- contour deformity at donor site
5- microcalcification inside breast which may make problem during ultrasound or mammography while assessing the patient for cancer development due to some other reason .
Cost
Cost is variable and in the range of 1 lac 50 thousand to 2 lac 70 thousand depending on whether silicon implant breast augmentation is done or breast augmentation is done with fat injection to breast / liopofilling of breast