Breast augmentation surgery or breast enhancement surgical procedure is one of the most popular procedures of cosmetic surgery nowadays. Its trend is increasing day by day and females with small size breasts 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, the trend of breast augmentation is increasing day by day and is becoming one of the most common procedures nowadays.
Dr Abdul Malik is doing this surgery in Multan at Medicare Hospital Multan (0345-4492128).
Types of Breast Augmentation Surgery
There are two main types or techniques of breast augmentation surgical procedure nowadays in practice.
- Breast augmentation with silicone implants
- Breast augmentation with fat injection to breast / Lipo filling of breast
Assessment and Preparation
The patient/client is evaluated in detail at the clinic. A detailed history is taken then a detailed examination and assessment are done and the concerns of the patient are known. During examination and assessment, it is evaluated about the size of both breasts, the shape of the breast, asymmetry between both breasts, the 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 inframammary fold are evaluated.
After that, donor area is assessed for fat harvesting for Lipo filling of breast and with sizer, breast implant size is assessed. Then details about the procedure, timing of surgery , recovery time, post-operative care and complications and outcome of breast augmentation surgery is discussed with the patient.
And baselines investigation is advised for fitness for anaesthesia.
Both techniques of silicone breast implant and fat injection/ fat transfer to the breast are performed under general anaesthesia during the procedure of breast augmentation surgery.
After the marking in the standing position, the patient is placed in the supine position. Infiltration is done, then in the case of silicone breast implant incision is given, dissection done then the pocket is made according to assessment whether in the sub-glandular plane or submuscular plane. After adequate pocket creation, it is washed with gentamicin solution, then an adequate size silicone implant which is nowadays ( smooth implant in practice approved by FDA ) is opened and inserted into the pocket and placed in proper position on both sides. Then wound is closed in layers and the dressing is done.
And in case of fat transfer to breast / Lipo filling, the donor area for fat which is usually abdomen or thighs is infiltrated with a solution containing ringer lactate, xylocaine, bupivacaine 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 the breast in multiple planes, sub-glandular and subcutaneous plane mostly.
After the injection of fat, symmetry is made, then an equal amount of fat is injected on both sides. In this process, 20-30 per cent overfilling is done than the required amount considering that 30-35 per cent will be absorbed over time.
Then the wound is closed and dressing is done
Post Operative Care And Recovery
The patient is kept hospitalised for one day and the next day patient is discharged. In the case of a silicone implant, the patient is advised to move her arms from day 1 slowly so that the implant can adjust to its position. After two to three days slow slow massage is advised over the breast for making adjustments to the implant. Chest heaviness and pain can be observed with some swelling for few days but usually, get settle in 3-7 days. Stitches can be used absorbable and do not need to be removed and the patient is advised sports bra to help support the breast with implants.
After stitches removal, scar massage creams are advised to make scar camouflage.
In case of fat injection to the breast, compression garments are advised for the donor area to wear and a sports bra for the breast. Swelling and bruising can occur on both sides and get settled in 2-3 weeks. 30-35 per cent fat is absorbed over the time of 2-3 months and good shape is observed in a 2-3 months time period.
Benefits and Side Effects
Each cosmetic and plastic surgery procedure/technique has its own benefits and side effects. These mentioned benefits are based on the knowledge and experience of Dr Abdul Malik Plastic Surgeon who is serving his expertise and services in the field of plastic surgery for more than 10 years in Pakistan.
Benefits of Breast Augmentation Surgery via Silicone Implants:
- No donor site morbidity
- implant size which is chosen remains same over the time
- More good shape and projection can be achieved
- Gives more confidence to patient to get back to society
- Recovery time is quicker as there is no donor site involvement
- No risk of absorption like fat over the time
Side Effects of Breast Augmentation Surgery via Silicone Implants:
- Hematoma formation
- Seroma formation
- Infection of wound
- Stitches breakdown/wound dehiscence
- Foreign body reaction
- Capsular contracture formation
- Implant malposition
- Implant rupture if the good quality implant is not used
- Movement of the implant with muscle movement
As you already know that Breast Enhancement Surgery is of two types i.e. 1. via Silicone Implants & 2. via Fat injection. That’s why we’ll discuss here the benefits and side effects of breast augmentation surgery via Fat injection also,
So in the case of fat injection,
Benefits of Breast Augmentation Surgery via Fat Injections:
- Own fat of patient, so the risk of foreign body reaction
- Natural tissues of patients own also contain stem cells and help in the growth of fat
- Improved texture
- Less risk of infection
- Small wound size of both donor and recipient area
- Can decrease the size of tummy or thighs by removing fat from there and increase the size of breasts in the same setting
Side Effects of Breast Augmentation Surgery via Fat Injections:
- Absorption of fat 30- 35 per cent which can make some asymmetry in 5-10 per cent cases
- Need revision procedure in 5-10 per cent cases having asymmetry
- Donor site morbidity of abdomen or tummy
- Contour deformity at the donor site
- Microcalcification inside breast which may make problem during ultrasound or mammography while assessing the patient for cancer development due to some other reason
The cost of breast augmentation surgery in Pakistan (Lahore, Multan, Dera Ghazi Khan) is variable and in the range of 1,50,000 to 2,70,000 depending on whether silicone implant breast augmentation is done or breast augmentation is done with fat injection to breast.