:: what it is...
We speak of a breast augmentation when a plastic surgeon brings a breast implant in the breasts. The best positioning of the implant, type of implant and incision place should be discussed in a personal consultation with preferably the surgeon who will do the operation.
:: the procedure....
One of the most important decisions to make will be the type of implants that will suit you best; silicone or saline filled breast implants. The silicone types which are used these days are a much improved version of the silicone implants from before, it now is more than unlikely that a silicone implant will leak into your body or that it will ‘explode’ in a plane. They now are filled with a silicone cohesive gel, existing out of long and crossed linked molecules which make the gel sticky, stops it from running and is able to return into its original shape when it is pulled or compressed.
When deciding to go for the silicone implant, there is a choice between a textured covering that will reduce the chance of capsule contracture, and a smooth covering that in some situations could look more natural. Saline implants are filled with a salt water solution and has the biggest advantage of a smaller incision that is needed. First the implant envelope will be implanted followed by the saline solution inserted into the envelope through a control device. The biggest disadvantages of these implants is that they are more than likely to wrinkle due to you are sweating out some of the substance over time and a higher risk of leakage, after which the body will absorb the saline.
The next step is to think about the shape of the breast implants, which depends heavily on the result you would like to achieve and the amount of breast tissue that already exists. Of course the amount of cc will heavily decide the size of the implants, but there are more characteristics of the implants that need to be considered to reach the actual desired result.
Symmetrical round implants will give the entire breast a fuller shape and is commonly chosen if there is sufficient breast tissue or enough breast shape and by women who want fullness in the upper part of the breast. Anatomical implants have a teardrop shape and are normally used when there is very little or no breast tissue, to create breast shape or when breast tissue has been lost due to significant weight loss or pregnancy.
High profile implants have a greater diameter and projection for the same volume of the breast implant, most suitable for women with a wider breast area or when more shape is needed. A rarely but existing risk with high profile implants is that they could twist. Low profile implants are used when the projection of the breast is sufficient and when a general augmentation is required.
The positioning of the breast implant could be either on top or under the breast muscle, mainly depending on the amount of breast tissue and required result. Even though subglandular muscle placement, positioning on top of the muscle, will generally be less painful, subpectoral muscle placement, positioning behind the muscle, reduces the chance of capsule contracture and gives a more natural look if there is not enough breast tissue to cover the implants and to camouflage the visibility of the rim of the implant. When you have chosen for the anatomical implants, it is also possible to choose for a dual plane placement; half on top, half under the muscle.
The incision could be made in the under arm, via the nipple or in the breast fold. An inframammary incision is the most common of the three, well hidden in the breast fold and gives the surgeon the best opportunity to adjust the implant size and location when the result is not what you wished for before the incision will get closed. This is one of the reasons why it is extremely important to have one or more consultations with the actual surgeon who will do the operation; to make them understand exactly what you want and for them to let you know what is reasonable to expect. An axillary incision will be made in the under arm and offers a great solution if you do not wish to have any scars around the breast area and an areolar incision means that the incision will be made around the nipple to make the pocket for the implant.
