Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast.

Indications:

• To enhance the body contour of a woman, who, for personal reasons, feels her breast size is too small
• To correct a reduction in breast volume after pregnancy
• To balance a difference in breast size
• As a reconstructive technique following breast cancer surgery

By inserting an implant behind each breast, surgeons are able to increase a woman's bust line by one or more bra-cup sizes.

There are two types of implants: a breast implant is a silicone shell filled with either silicone gel or a saline solution.

Planning your surgery:

During the initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor may also recommend a breast lift. Be sure to discuss your expectations frankly with your surgeon. He or she should be equally frank, discussing your alternatives, along with the risks and limitations of each procedure. You may want to ask your surgeon for a copy of the manufacturer's insert that comes with the implant proposed to be used, just so you are fully informed. Be sure to tell your surgeon if you smoke, or if you are taking any medications, vitamins, or other drugs. Your surgeon may also discuss the type of anesthesia to be used, the type of facility where the surgery will be performed, and the costs involved. Most insurance companies do not consider breast augmentation to be medically necessary, and hence do not cover the cost of such procedures.

Preparing for your surgery:

Your surgeon will give you instructions on preparing for your surgery, including guidelines on avoiding certain vitamins and medications.

The actual procedure:

Incisions are made in such locations as to keep the scars as inconspicuous as possible, either in the breast increase, the nipple or in the armpit. Breast tissue and skin is lifted to create a socket for each implant. The implants, positioned behind each breast tissue, are then centered beneath your nipples. The breast implant may be inserted directly under breast tissue or beneath the chest muscles. Stitches are used to close the incision. A gauze bandage may be applied over your breasts to help with healing.

The Aftermath:

You are likely to feel tired and sore for a few days following your surgery, but you will be up and about in 24 to 48 hours. Most of the discomfort can be controlled by medications prescribed by your doctor.

Within several days you may be given a surgical bra to wear as directed by your surgeon. There may be a burning sensation in your nipples for about two weeks. Stitches will come off in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear.

You should be able to return to work within a few days, depending on the level of activity required by your job.

Follow your surgeon's advice on when to begin normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so avoid physical contact. After that physical contact is fine, once your breasts are no longer sore.

Your scars will be firm and pink for at-least six weeks, they may then remain the same size for several months, or may even appear to widen, but will eventually fade.

Routine mammograms should be continued after the procedure for women who are in the appropriate age group. Regular examinations by your plastic surgeon can help ensure that any complications, if they occur, can be detected early and treated.

All surgeries carry some uncertainity and risk:

Breast augmentation is a relatively straightforward procedure. But as with any other operation, there are risks associated with surgery and specific complications associated with this procedure.

The most common problem, capsular contraction, can cause the breast to feel hard. Bleeding may cause some swelling and pain. A small percentage of women develop an infection around the implant, most often seen within a week after surgery.

Nipples may become over-sensitive, under-sensitive, or even numb. However, these symptoms disappear with time.

There is no evidence that breast implants affect fertility, pregnancy, or your ability to nurse a baby. There is also no evidence to suggest that breast implants cause cancer.

Breast implants may break or leak following severe injury to the breast area.

All said and done, your decision to undergo a breast augmentation procedure is a highly personal one, and not everyone is likely to understand. The important thing is how you feel about it. If your goals have been met, then the surgery is a success.

Dr. Vinod Vij Plastic Surgeon Laksh-Deep Hospital