Breast augmentation is an elective procedure recommended for women with small breasts or those exhibiting signs of moderate sagging of the breasts, women whose breasts were negatively affected by pregnancy and breastfeeding, as well as weight fluctuations. Aging, hormonal modifications, changes that occur in the breasts after pregnancy and breastfeeding or after menopause are also factors that can have a significant impact on the appearance of the breasts thus creating a need for breast augmentation intervention. About silicone implants In many cases, we use the silicone implants for breast augmentation. The silicone has the advantage of offering a sensation that closely mimics the feel of the natural breasts. This can’t be achieved when using saline solution implants. Silicone is a synthetic material that the body does not reject after insertion. Plastic surgeons from all over the world have been using the silicone breast implants for more than 50 years now. The new and modern silicone breast implants are made out of highly cohesive silicone gel covered by a silicone capsule that offers considerable resistance and elasticity, stability and safety. In most cases, there will be no need to replace the silicone implants, but the producers only offer a ten years warranty that can be extended. Of course, there are exceptional situations that would require the replacement of the silicone implant such as: rupture of the implants, deep tissue infection, and a severe case of capsular contracture or at the expressed request of the patient. Is breast augmentation with implants the right plastic surgery procedure for you? The breast augmentation procedure is recommended for women who: – Have small, undeveloped breasts due to various reasons including genetics; – Dissatisfied with breast shape and volume; – Have breast asymmetries; – Have a mild or moderate case of breast ptosis (the sagging of the breasts). At the same time, a breast augmentation is a treatment option chosen by women who desire larger breasts as an aesthetic enhancement. The patient needs to pay attention to all details relating to the procedure from consultation to pre-op preparation, post-op instructions for proper healing and recovery in order to ensure optimal results. The initial meeting with the plastic surgeon During the first meeting, you will be discussing with the plastic surgeon your reasons for undergoing breast augmentation surgery and your desires and expectations from the intervention. It is important for you to have an honest discussion about the shape, volume and the desired position of the breasts, the operative plan, the potential risks and complications as well as the conditions that need to be followed for a quick and successful post-operative recovery. The initial consultation is a crucial step in getting the most out of your breast augmentation procedure. This is the time when you make up your mind about whether you can trust the plastic surgeon to perform the surgery on you. Being able to trust the plastic surgeon and have an open communication with him is an important step in achieving optimal results after the surgery. If you feel confident in your choice of plastic surgeon, listen to the professional advice of your surgeon about the type of implant and the location of the incision. The plastic surgeon will recommend the best operative plan so you can likewise get the best results. To have a clear idea about what the surgeon recommends, you can even try on different samples with different volumes. At the end of the consultation, you will be able to decide exactly what the volume of the implant will be, as well as the surgical plan for the intervention. This is also the best opportunity to ask your plastic surgeon all the questions you have about the procedure. Don’t forget to ask to see before and after pictures of his other patients that went through the same procedure. The operative plan The surgical intervention is performed under general anesthesia and usually doesn’t last longer than two hours. The only scars left after the intervention will be on the inframammary fold, periareolar or in the axilla, areas that can be concealed by clothing. When discussing these options with the plastic surgeon, make sure you clearly understand his explanations. The submuscular placement of the implants is, in most cases, recommended as it has certain advantages compared to the subglandular positioning: – Gives a natural slope to the top of the breasts – The breasts feel natural when touched – Better results in time in terms of shape and appearance of the breasts Types of incisions when having a breast augmentation procedure The inframammary fold incision has fewer risks compared with the periareolar and transaxillary incisions. Aside from this, it has the least degree of visibility of the scars as they are small and hidden in the natural folds of the body. The suture area is about 4 to 5 cm and allows the surgeon to work closer to the implant area, which would help in better and proper positioning of implants. When considering the periareolar incision, keep in mind that the scars can be more visible. When using this type of incision, there is a limit to the dimensions of the implants that can be used and the placement is less safe in the submuscular position. More than this, the mammary gland can be injured when the surgeon cuts through the tissues during the surgery and this can result in lost of nippular sensation. For the transaxillary approach, the scars are hidden in the natural folds of the underarms, but can be visible at the lateral line of the bathing suit and even when wearing halter-tops. The intervention needs a larger quantity of anesthesia as it is more complex and the distance from the incision to the implant area is longer. There’s a higher risk for possible breasts asymmetry. On top of that, this is also the reason why the breast implants can easily migrate to the superior part after the procedure is performed. To be able to get the most out of your procedure, it is essential to follow your surgeon’s recommendation for the operative plan. Overriding the surgeon’s recommendation and choosing one type of incision or placement of the implants over the other on your own can result in less than optimal results. Why risk that? Your surgeon has the medical training and the experience that allows him to offer the best recommended plan for you. The post- operative recovery after the breast augmentation After the surgery, the patient might be required to stay in the medical facility overnight for monitoring by the medical staff. It must be stressed that when performed correctly and done by an experienced and board certified plastic surgeon, the breast augmentation procedure with silicone implants shouldn’t impact on your ability to breastfeed after the surgery. At the same time, multiple studies have shown that there is no connection between breast augmentation with implants and breast cancer. To get the finest results after the procedure, avoid strenuous physical activities shortly after surgery. The supportive compressive bra should be worn for at least a month or longer, depending on your surgeon’s advice. Your plastic surgeon might also recommend breast massages. Wait at least two weeks before starting to massage your breasts. You can resume regular activities within the first week and go back to work during the second week. Your plastic surgeon will recommend that you avoid possible pregnancy in the near future if you want to sustain the results of the intervention for a longer period. Combining the breast implants with fat transfer to the breasts Your plastic surgeon might also recommend combining the breast implants with fat transfer to the breasts to get a completely natural appearance of the breasts and thus, more impressive results. If this is the case, your surgeon will harvest a sufficient amount of fat from areas with a surplus (usually the abdomen or thighs), process and reinject it to the breasts. Combining the procedures results in fuller breasts with no asymmetries or other imperfections. This combination of procedures is especially recommended for patients with issues that can’t be simply corrected with just breast implants. Conclusion Plastic surgery is an elective surgical procedure and a personal decision that requires much consideration. This means that the patient decides to undergo the procedure at a time of her choosing. Because a breast augmentation procedure can be quite costly, it is only natural for the patients to want to get the most out of their procedure. Do keep in mind that achieving optimal results and sustaining them for a long period of time is also a matter of the patient respecting the surgeon’s recommendations. Before anything else, make sure you choose an experienced, board- certified plastic surgeon to perform your breast augmentation. Once you are convinced you have chosen the best plastic surgeon, it is time to trust him and listen to his recommendations when it comes to the type of implants, as well as the position of the implants and the incision type. In most cases, the plastic surgeon will recommend the inframammary fold incision and a sub muscular placement of the implants.