What is Breast Augmentation with implants?
Breast Augmentation is enhancing the size of the breast, it can be done using one’s own tissue like we do in structural fat grafting which will be explained separately, now we will stick to Breast Enhancement with use of implants. Breast implants are usually made of silicone. They are in clinical use for almost half a century.
What are the types of Breast implants that are available today ?
Breast implants have evolved over a period of time to the present generation of implants they have improved and are improving in their quality and durability minimizing possible side effects and they are more long lasting than before.
There are 2types of Breast implants:-
1.Saline filled
2.Silicone Cohesive gel implants
In our practice at Nypunya Aesthetic clinic we do not use saline filled implants that often. We use Silicone Cohesive gel implants. In Silicone Cohesive gel implants are filled with silicone gel the amount and the density of it is decided by what kind and texture and consistency of breast implant which we choose and the purpose. These implants are covered by a double layer of nano textured sheet which causes very very minimal formation of a tissue called capsule. The cover of these are pretty strong so what myth it is there that they will burst when you travel in an airplane or when you go under water are all not true. Even if the implants are cut the silicon won’t leak in the way it is depicted in a lot of internet videos. The surface of these breast implants can have texture which is coarse or micro textured or nano textured or smooth. We prefer to use nano textured Silicone Cohesive gel implants.
There are 2 Shapes of breast implants:-
1.Anatomical
2.Round
We choose the implant depending upon what is the purpose of the breast enhancement surgery & how it is done. So the choice of whether Anatomical or Round implant is individual. We decide depending upon what your requirement is & what suits you the best.
Can a breast implant last lifetime ?
Breast implants are designed to last for lifetime i.e., 40-50years & these implants when placed properly for the proper indication are like placing it and forget it. They most often 95-96% of the time will not cause any problem to you. The chances of causing problems are low as a nose stud causes a problem to you.
What are the side effects of having Breast implants?
Breast implant has very very minimal side effects., It is placed behind a layer called pectoral fascia which is a layer of tissue called facia behind the breast glands. Many times we place it as bilanar. This implant is not inside the breast gland but behind it. So it doesn’t affect the functioning of the gland too much. It does not alter the sensation of the breast or the nipple. It doesn’t affect the lactation function or it also does not increase or decrease the aging of the breast.
Breast Augmentation with Silicone Cohesive gel implants is one of the most commonly performed cosmetic surgeries worldwide and so in Nypunya Aesthetic Clinic.
How Breast Enhancement Surgery with Silicone Cohesive gel implants are performed?
There are various methods of performing this surgery. Normally routinely we follow what is called subfascial breast implant placement which means we place the breast implants behind a layer of tissue called fascia which is behind the breast tissue and in front of the chest muscle i.e., pectoralis major muscle. Technically we dissect of the pectoral fascia with the electro dysection upto the level of nipple areola we use endoscopic assistance and lighted retractors and fine cautery and electrocautery and RF cautery to do this dysection once we are above the level of nipple areola we dysect the pectoral fascia with the help of our special breast dissectors which also act as measuring devices. This helps us to create an accurate pocket in which Silicone Cohesive gel implants will be placed. Once the pocket is created we size the pocket and see if enough has been dissected to achieve the preoperative estimate of what we had done in discussion with you. Then appropriate size cohesive gel implants are placed inside this pocket which is the subfascial plane after checking for any bleed then the fascia is closed and subsequently are sutured above this. We give a regional Anesthesia called brilma block which gives very good postoperative pain relief, we will talk more about it later. We also follow what is called bi plainar breast implantation in certain cases in which the pectoral muscle is divided and our implant is a one plane behind the fascia in another plane under the muscle. The choice between subfascial & biplaner is a very clinical and scientific one and we follow a very nice routine which helps us give excellent results almost all the time.
Anesthesia for breast enhancement with implant is either general anesthesia or it is thoracic epidural anesthesia. We prefer short general anesthesia as it is more comfortable and we combine this with brilma block which works very well for postoperative pain relief.
What is the daily routine? How does a breast implantation surgery go for our client?
8AM you arrive at our centre, you are received by a concierge and you are taken to your deluxe room where you will change to a sterile disposable gown and a body scrub is given with a surgical scrub so that any bacteria which is on the surface of the skin gets washed off. We rehearse the volume, the approach, the procedure and the implants which would have procured everything with you after taking the consent again we move to the operative room which has been fumigated, sterilized and kept ready only for you. Operation room for this implant surgery is laminar flow and it is modular and all the equipment that is used for your surgery is double sterilized and we do not compromise on the quality of the implant. A senior consultant Anesthesiologist puts you to sleep and then we proceed with the surgery when you fall asleep listening to your favorite music. Normally we take about an hour to two to do this procedure very meticulously and once the procedure is done when you wake up from your sleep and you are absolutely pain free only pain you may feel is in the throat which is more of an irritation and you may feel that your chest is little tight or heavy that is because of the implants which are additionally present on your chest. You get used to it within just a couple of days. Once you’re back to your room you relax and then you are allowed to take oral. After breast implant surgery you are made to walk around within an hour and within 3hours you take something to eat and you move around we double check and then you are good to go home with a new complex. Breast augmentation surgery at Nypunya Aesthetic Clinic is a day care procedure where you come in the morning and then go home in the evening with a new complex and a renewed body image.
What are different types of breast implant surgery approaches?
One which is very common and we follow most often is submemory approach i.e., there is a crease under the breast skin crease in which we make about 4cm or less than 2inches incision and then the dysection as i explained is carried out and the implant is placed.
Another approach which we follow is through underarm, it is called transaccelary approach. This also we perform but one practical issue we have with our Indian clients is that they prefer to wear sleeveless blouses and this transaccelary approach sometimes shows as a very fine line between hairy underarm and non hairy underarm. So, this option is very well dispersed before.
Another approach is to put a breast implant through your belly button. It is a very tedious process and we reserve this only for very very specific occasions and in this only inflatable saline implants.
So in the approaches most commonly performed is the Sub Memory approach, next is through the Axela or Underarm approach and third is through the Belly button which is very very rarely done and only saline implants will be placed.
How will the recovery be on Day01 after breast implantation surgery?
When you are back to your normal there will be a tight dressing or garment which is just there to keep the implant and the surgical side under little pressure. You are good to take shower and then you can resume your daily activities as normal. I advise not to be involved in strengthening exercise and you are advised to move your arms above the shoulder and below the shoulder a few times so it releases muscle and actually helps in your recovery. Combining the hair is a very good exercise which I advise so that it helps you relax the muscle and the tissues. Day 2-7 you progressively get more used to the new you and the pain & tightness everything comes down. Very very rarely there will be an excessive swelling which takes some time i.e., a couple of weeks to settle down. The approach incision which is made for the implant usually heals within 5-7days, this is when i change the dressing and remove if at all any knots have to be removed from the sutures if you are from abroad or you have to travel back then we take care that we don’t put any removable suture and you don’t have to visit us, we will only follow up you on daily consultation. After a week’s time the swelling of the breast tissue gradually comes down and in about 6weeks time the swelling of the breast tissue gradually comes down and in about 6 weeks you arrive at the shape, position & the size of your new breast. Nipple sensation is not altered much if it is reduced a little it is regained back again by this time. After this the follow up is routine friendly visit after a couple of months and then once in a couple of years. Just to ensure you are doing absolutely fine.