Augmentation Mammaplasty (Breast Enlargement / Implants)

Procedure:

The size and shape of the breasts are enhanced using silicone or saline implants.

Duration of procedure:

1 – 2 hours.

Anaesthesia:

General anaesthetic.

In/Out patient:

Usually out-patient.

Post-operative:

Temporary soreness, swelling and bruising; breast and nipple sensitivity.

Recovery:

Back to work: 3 – 4 days. Physical contact with breasts: 3 – 4 weeks. Fading of scars: several months to a year.

Results:

Aesthetically pleasing breast enhancement.

Before/After Animation:

Due to new regulations, I have had to temporarily remove the sample pictures.

About This Procedure

Breast augmentation surgery is a relatively simple surgical procedure performed to create aesthetically pleasing breasts. Silicone or saline breast implants, which feel similar to soft breast tissue, are inserted beneath the glandular tissue of the breast. This operation can be done to increase breast size, to redefine the breasts after childbirth, or to recreate symmetry after a mastectomy. The following questions are often asked about boob job and breast enlargement; the durability of breast implants, their safety and their long-term effect on health.

What are breast implants like and are they safe?

Each prosthesis is a soft outer shell of silicone filled with either silicone gel or a saline (salt) solution. The shell may be lightly textured or smooth. In my experience, saline implants do not feel as natural as those filled with silicone and there is a tendency for them to leak over time. The choice of implant would be discussed beforehand. There is no evidence, based on current knowledge, that silicone implants are detrimental to health. Millions of breast enlargements have been safely performed worldwide since 1962 and only a small percentage of these have caused problems.

How are the implants inserted?

The operation will be performed under local or general anaesthetic. An incision will either be made under each breast or around the nipple and the implants will be inserted under the existing breast tissue. It is also possible to make the incision under the arm. A drain will be placed in each breast to remove any blood that may accumulate around the implant. You will be discharged on the same day, once fully awake. I will see you in my rooms two days later to remove the drains and change the dressing.

Will my breasts stay the same shape and size?

We will decide on the size of the implants before your operation. This decision will be based on your expectations, your body frame and also my experience. We will also refer to clinical ‘before’ and ‘after’ photographs. After the operation, your breasts will be a little swollen and painful. Your final breast size will only be apparent after six weeks and it may alter with weight gain or loss as it did before the operation. Aging can also affect the enlarged breasts and drooping can occur with time. This can be surgically corrected. It is important to understand that no person is perfectly symmetrical even before a surgical procedure. Every attempt will be made to surgically minimize your side to side dissimilarities but such differences always persist to some degree even after the most successful operation.

Will I be able to breast-feed?

Inserting an implant does not interfere with the glandular tissue of the breast or your inherent ability to breast feed.

Will my breasts become hard?

In the past, there was a 30% tendency for implants to become firm. The problems of firmness have since been reduced to less than 5% with the new, textured implants. I also advocate the use of a pressure garment and post-operative breast massage which helps prevent capsular contracture, or hardening.

Will my body ‘reject’ my implants?

This is unlikely. Silicone is an inert or non-living material and therefore not something the body rejects. An infection may develop around the implant in about one per cent of patients and for this reason I prescribe antibiotics at the time of the operation.. If an infection occurs it may be necessary to remove the implant and re-insert it a few months later. This infection is not seen as a ‘rejection’. Occasionally the implant can extrude on its own without an infection but this is very uncommon.

Are there other possible problems?

Sometimes you can bleed around the prostheses after the operation. If this is severe you will need to return to theatre to have the blood removed. This is an uncommon problem.

The sensation of the nipple can occasionally be altered. Some nipples feel numb after the operation and some become more sensitive. This change usually settles down after six months, but there is the possibility that it can be permanent.

The incision scar will initially be painful and discoloured to a purple tone. This settles with time as the scar matures over a period of three to six months. Massaging the scar with tissue oil accelerates its maturation.

How long will I take to recover?

You should plan to be off work for a week after the operation.

On leaving the hospital you may wear a soft supportive bra without under-cup wires as these will irritate your wounds. Do not buy new bras until the post-operative swelling has settled.

You can drive a car as soon as you feel comfortable and your arm movements are no longer painful or restricted. This will usually be about two weeks after the operation.

You can exercise after six weeks but remember to always wear a support or sport bra.

Will Medical Aid cover costs?

Medical Aid does not pay for breast enlargements and you will need to pay the surgical and anaesthetist fees in full before the operation. The implants are ordered before the operation and will need to be paid for before the order can be placed.

The hospital requires a deposit on admission.

General breast care

You should regularly examine your breasts, whether or not they have been augmented. Any suspicious lumps should be examined immediately. Ask your doctor to examine your breasts when you have your routine pap smear.

Summary

Breast augmentation is one of the most frequently requested cosmetic operations. It is a simple procedure used to enhance breast size or to correct symmetry. Modern and improved prostheses ensure that associated health risks are minimal. Should you have any further questions, I would be happy to answer them.