There have been voices that claimed and predicted that plastic surgery, especially breast augmentation or enlargement, it will fall into a decline come the economic crisis of the past years. People considered that women would redirect their “beauty” budgets to staff that is more affordable. This matter of the high cost together with the new feminist era of “be my best in my own skin” were the two factors staying at the basis of these predictions. But those people couldn’t have been more wrong. The new feminists are now such strong female characters that started gaining more money than before because they gained confidence in their own powers. And even more, the “shamers” are now shamed, meaning that if someone tells a woman that she was wrong to get “fake boobs,” she will not bother to be ashamed of her breasts, but rather proud because it was her own informed choice. Therefore, plastic surgery, especially this important part of it, the breast augmentation surgery, has seen a constant rise in numbers, rather than any kind of fall.
Implants and their sizes
A great advantage of today is the fact that all major clinics, plastic surgery practices, and global or local plastic surgery associations, committees or boards have web pages full of extensive information of all aspects involved in making such a decision, dealing with both positive and negative parts. As a result, patients can be more informed, and they can ask good and pertinent questions in their doctor’s office. Understanding the whole process will enable the patient to become reasonable and to accept the surgeon’s recommendations.
So, let’s see what steps are involved in an augmentation surgery and try to understand what decisions you will have to make together with your surgeon.
Breast augmentation with breast implants is the most used and requested method of breast enlargement. There is another possibility, breast augmentation with fat grafting, but this is a procedure much more expensive and only able to enlarge your breast by no more than a cup at maximum. As a result, we will review the steps involved in breast enlargement using implants.
In the beginning, you will need to choose the type of implants and their size. There are only two major types of implants, and they differ only in the filler material. They are both made from a silicone shell, but the silicone implant is filled with a cohesive silicone, while the saline implant is fillet out with sterile saline water. The size of the implant is a very complicated matter since some patients are keen on having an exact measure or cup. Implants are not measured in cups, but in cubic centimeters and that means that in 1 cup you can say you have several cubic centimeters. This allows the surgeon to find the exact size that fits you perfectly. The size will be determined by your doctor after they perform a series of measurements (tissue elasticity, chest, natural breast tissue, etc.).
Most plastic surgeons consider the breast augmentation with implants to be a common surgery, performed regularly with no major issue arising from it. Still, you should know, that even if for your plastic surgeon this is easy, for you it will still be a surgery. It will be accompanied by swelling, pain, nausea, etc., usually, all that comes with surgery of any kind. And, yes, even if rare, it can come with risks and complications.
Not being one of the complicated procedures involving extensive after-care and monitoring, this surgery is usually performed in an outpatient facility. You will be under general anesthesia, so you will stay for a few hours inside the facility to be kept under observation until you recover from your anesthesia and you are able to go home. You will then go home and recommended to have a complete rest for at least two days.
What happens during the surgery?
Before you enter the surgical room, you will be drawn on by your surgeon. They will make a series of markings, lines, and curves and discuss with you once again your procedure. These markings help your surgeon with actual visualization and ensure you once again that all you have discussed with them was well understood.
You will be then taken to the operating room and administered the general anesthetic. Then the whole chest area is sterilized with a special antiseptic solution.
After that, the surgeon will make the incision. The incision is an important decision, and it should be taken by you at the recommendations of your chosen surgeon, before the surgery. There are various options for this incision to be placed. The classical and usually the one that is chosen more often is the one in the fold between the breast and chest. It is in a place that usually does not really show, and it allows the surgeon a perfect view of the surgical site. In this way, they can easily place the implant and out in the right position. Because this kind of incision can be wide if necessary, it is suited for any size of implant and for any kind. This is called the infra-mammary incision.
There is the peri-areolar incision, that is placed on the outer line of the areola. This has the advantage of being placed on a spot where natural coloration of the skin makes it almost invisible, so it will never be noticed. The disadvantages involved is that this kind of incision is best for those who want just a small increase in size or those that choose saline implants. Saline implants usually come deflated, so they are smaller, and only after being placed, they are filled with saline water. Also, this incision involves the risk of nerves or milk ducts to be sectioned.
The trans-axillary incision is made in the armpit. This incision is not made on the breast, so no cuts there, and the armpit offers the advantage of being a hidden part of your body. Therefore, you can wear any kind of swimsuit or top; nothing will be seen. The main issue with this kind of incision is the fact that it is more difficult for the surgeon to place the implant. This is done with special equipment, involving the use of a small camera that will allow them a full view of the surgical site.
There is one more incision called trans-umbilical (or TUBA). It is a difficult option because it is performed around the belly button. It allows only small implants, and it also requires a lot of skill and special equipment form your surgeon. But it has the advantage of being hidden and not being on your breasts.
After the incision is made, the surgeon will have to create a pocket inside you to place the implant in. And here comes another important apriority decision to be made, and that’s implant placement. Depending on the placement you’ve decided together with your surgeon, the pocket will be made in two different possible ways: subglandular or submuscular.
Sub-glandular means that the implant is placed directly under the natural glandular tissue of your breast. This technique works best for those who have enough glandular tissue, to begin with. The implant has to be covered by it. Otherwise, some complications might arise. Since no muscle will be manipulated in any way, the pain will be less and recovery faster for those who go for this placement.
Submuscular placement means that the surgeon will make the pocket below the glandular tissue and below the chest muscle. So, they will lift and pull the muscle and make space for the implant below it. Even though recovery is more painful in this case, many prefer this type of placement because the implant is better protected and can resist longer in time, and mammograms work better with this kind of placement.
After the pocket is made, the surgeon needs to place the implant. For this step, some use sizers or a disposable implant. Only after the perfect place is found, and, in the case of the saline implants, the perfect fill level is found, the real implant is inserted.
The incision is then sutured and wrapped in dressings. You will need to wear a surgical bra for one or two weeks. This will help with reducing swelling and supporting settling. Then, you will need to wear a sports bra for several months. You will not be able to lift your arms above your shoulders for a week, and then you need to avoid any strenuous activity for up to 4 months. You will probably be ready to get back to work and to your normal routine after one or two weeks, providing that you will observe all the recommendations given by your surgeon.
Probably the most important thing, once you enter the operating room, is to make a rule out of listening to any advice or recommendation your surgeon will give you from then on. The surgery will be his mastery, but then, recovery depends a lot on you. If you chose to ignore what they say, you might end up with complications that have nothing to do with the way your surgeon operated on you. So, try to put away any thought of cleaning your house or carrying your child in your arms, or going back to exercising too soon. Only if you do exactly what you are told, the surgery will surely be a success.