Breast enlargement, also know as breast augmentation or ‘boob-job’, serves to enhance breast size and shape and is one of the most common procedures performed by Mr Karri.
There are many reasons why women choose to have breast enlargement including restoring breast size after pregnancy or weight loss, or simply to achieve the breast size they have always desired. For some women with mildly sagging breasts, breast enlargement can also lift the breasts (read about breast lift). Certain breast asymmetries and congenital breast deformities can also be corrected through breast enlargement.
Whatever the reason for choosing breast enlargement, the change in breast shape and size can have a profound impact on body image and self-confidence.
Understanding breast implants
When considering breast enlargement, there are a number of things to consider about the breast implant.
Mr Karri only uses silicone breast implants which are composed of an outer shell made of silicone elastomer and pre-filled with cohesive silicone gel. Silicone implants come in a wide variety of shapes, sizes and profiles, and the following is an explanation of these characteristics;
Shell texture – the shell of the implant has a rough texture which is associated with a reduced rate of thick scar formation around the implant, a phenomenon known as capsular contracture.
Implant size – the size of breast implants is quantified in cubic centimetres (cc). During your consultation with Mr Karri, he will explain that the appropriate implant size is largely determined by your breast anatomy, notably breast width and skin elasticity. Although choosing your breast implant size is a personal choice, the size of the implant must be appropriate to the breast, to ensure the result is beautiful, long-lasting, natural and in proportion to your body.
Implant shape – breast implants can either be round or tear-drop (also known as anatomical). Round implants adopt a partial tear-drop shape when you stand upright. This is even more so when the implant is placed under the muscle. For women who do not need or want upper-pole fullness, tear-drop implants are the better option.
During your consultation with Mr Karri he will advise you on the most appropriate implant shape for you depending on your desires.
Implant profile – implant profile refers to how much the implant projects forward from the chest wall. The choice includes low profile (less volume and anterior convexity), moderate profile (intermediate volume and convexity), moderate-plus profile and high-profile (maximum volume and dome-like convexity). To achieve a long-lasting, aesthetic and natural result, Mr Karri often recommends a moderate or moderate-plus profile. In some women with narrow breasts a high-profile implant can give an excellent result.
Do Breast Implants Last Forever?
Breast implants are medical devices that are not expected to last forever and you should expect to change your implants after 10 to 15 years. As time progresses thereafter, the likelihood for implant exchange increases. However, if the breasts remain soft and appear normal, there is no reason to routinely exchange your implants.
During your consultation with Mr Karri, he will discuss three decisions central to breast enlargement. These are;
Access incision – the incision through which the breast implant is introduced
Pocket – where the implant is placed relative to the chest muscle (see figure below)
Implant style – implant size, shape and profile
These decisions are largely determined by your breast anatomy and desired outcome.
Deciding implant size is a personal choice with some women opting for a modest increase and others preferring a significant increase. Regardless, Mr Karri will explain all your options and what is achievable and what is not.
For implants placed under the muscle, Mr Karri uses a dual-plane approach in which the implant is placed partly under the muscle and partly under the breast gland. This provides multiple advantages including better coverage of the implant, reduced risk of capsular contracture and reduced risk of bottoming-out. Implants placed above the muscle is not necessarily an inferior option and for some women with sufficient breast tissue, provides a superior result.
For the majority of patients Mr Karri uses an inframammary fold incision as it provides the best visualisation of the implant pocket and the scar is inconspicuous. For some women with small breasts, a periareolar incision may be an option.
As with any surgery, breast enlargement does have some risks associated with it. Very rarely some of these risks can result in a second operation and/or removal of the implant.
Scar / poor scarring – the inframammary fold incision usually heals to leave a inconspicuous scar. In some patients the scar can thicken and remain red. The scars from breast augmentation can usually be hidden by bras and swimsuits.
Infection – very rarely a severe infection can arise which may require removal of the implant. It may be a number of months before a new implant can be placed to restore symmetry.
Haematoma – excessive bleeding into the breast can occur (known as a haematoma) and may require drainage. It is important that you you do not take any products containing aspirin, anti-inflammatories, blood thinners or vitamin E for 14 days prior to your operation as these medications can greatly increase the risk of bleeding.
Changes in nipple or breast sensation – while sensation typically returns within several weeks, some loss of feeling may be permanent.
Implant malposition – the implant may not remain in the correct position after breast enlargement. The implant may sit up too high, off to the side, or too low. The breast implant needs to sit properly behind the breast itself. It is important to remember that breasts come in many different sizes and shapes.
Capsular contracture – this describes a thick scar forming around the implant causing deformity and pain. There are varying grades of capsular contracture, from the breast feeling slightly firm to the breast becoming hard, deformed and painful.
Limited lifespan of breast implants – breast implants are not designed to last forever. Therefore all women should expect their implants to be replaced during their lifetime.
Difficulty with breast cancer detection – although there is no increased risk of breast cancer from breast enlargement, interpretation of mammograms may be more difficult. As such, further investigation with ultrasound or MRI may be necessary.
Implant rupture or leakage – an implant may rupture for a variety of reasons such as, improper manufacture, damage to the implant at the time of surgery or trauma to the breast.
Difficulty breast-feeding – some women might have difficulty producing enough milk for breast feeding after breast augmentation.
Need for revision surgery in the future.
Implant-associated Anaplastic Large Cell Lymphoma (ALCL) – there is some evidence that breast implants can cause a very rare cancer of the immune system called anaplastic large cell lymphoma. There is very limited data and the risk appears to be around 1 in 50,000 to 1 in 300,000. ALCL usually presents with rapid swelling of one breast some years after the implants were inserted. Treatment usually requires complete removal of the implant and the capsule around it.
Risks of general anaesthesia, such as feeling sick and vomiting, deep vein thrombosis, shivering and sore throat.