Breast Implants or augmentation mammoplasty is a procedure used in cosmetic surgery to remodel the shape of the breast with the objective of making them bigger, this procedure can also be used to reconstruct the breast for example in the correction of genetic deformities or after a mastectomy, or also during male-to-female sex reassignment surgery
Breast Augmentation has been done at least since 1865. The earliest known implant occurred in Germany, in which fat from a lipoma (benign fatty lump) was removed from a woman’s back and implanted in her breast. In the following years, the medical community experimented with implants of various materials, most commonly paraffin.
The first use of silicone for breast augmentation was immediately following World War II, when doctors in Japan and Las Vegas began injecting it to enlarge women’s breasts. Initially they used the industrial kind of silicone that goes into making furniture polish and transformer fluid. Complications like cysts, sores and painful hardening of the breasts were in some cases so severe that women needed mastectomies.
In 1961, plastic surgeons Thomas Cronin and Frank Gerow developed the first silicone breast prosthesis with the Dow Corning Corporation, and the first woman was implanted in 1962. The implant was made of a silicone rubber or sac, and was filled with a thick, viscous silicone gel.
The cost of this surgery may be between $2.200 – $3.500 USD in total here in Costa Rica. Most surgeons in Costa Rica charge this amount including plastic surgeons fee, operating room, all material used, follow ups, anesthetist, medication, over night stay when needed, lab; cardiologist if needed is $60-$100.
The cost of antibiotics such as Ceclor, Ciproxin or Zithromax #14 500 mg, and administered starting two days before surgery for a period of one week is approximately $70.
There are two types of breast implant filler materials with many different shapes and textures available:
Saline breast implants , which have a silicone rubber shell filled with sterile saline liquid. Click Here to read more about the Saline Breast Implants.
Silicone gel implants , which have a silicone shell filled with a silicone gel. In the 60 countries where silicone implants are available, they are used in approximately 90-95% of implant operations. Click Here to read more about the Saline Breast Implants.
In the United States the implantation of silicone gel-filled breast implants is currently restricted to clinical trials but in many other countries such as Costa Rica they are in regular use.
This procedure generally takes one to two hours to complete. The whole technique of inserting and positioning your implant will depend on your anatomy and your surgeon’s recommendation as well as the incisions he works with. The incision can be made either in the crease where the breast meets the chest, around the areola, in the armpit or through the navel (for more information, please read our incision section). Your doctor will make every effort to assure that the incision is placed so resulting scars will be as unremarkable as possible.
Working through the incision, your surgeon will lift your breast tissue and skin to create a pocket. This can be located either directly behind the breast tissue (submammary or subglandular placement) or may be placed beneath the pectoral muscle and on top of the chest wall (submuscular placement); for more information concerning the advantages of each placement, please read our ‘implant placement’ section. Once the implant is placed within this pocket and the desired look is obtained, the incisions are closed using sutures. A gauze bandage may be applied over your breasts to help with the healing.
Breast Implant Techniques
There are several techniques used in the insertion of breast implants. The choice of technique may depend on the surgeon’s personal preferences as much as the patient’s relevant anatomy. These methods are:
Sub-Glandular – sub-glandular implants are placed in a pocket between the pectoralis major muscle and the breast tissue and subcutaneous fat. A surgeon may select this technique in a patient with a moderate amount of pre-existing breast tissue .
Subfascial – in this technique the implant is placed into a pocket between the pectoralis major and its covering.
Sub-Muscular – with this technique the implant is placed entirely or partially beneath the pectoralis major muscle, lying on the ribcage.
You may also choose different Types of Incision:
Peri-Areolar – a semicircular incision around the lower half of the areola.
Infra-Mammary – a transverse incision following the line of the inframammary fold.
Axillary – an incision in the armpit with a tunnel made through to the breast.
TUBA – an incision at the rim of the navel, the implant is rolled up subcutaneously behind the breast .
Local Anesthesia combined with a sedative (that allows the patient to be conscious but relaxed
Duration of the procedure:
Approximately two hours.
When the bandage is removed a surgical bra may be given to the patient, the stitches may removed in approximately a week. To go back to normal daily living it may take approximately a week. By the end of four weeks swelling will reduce 75% and it may also take around that time for direct physical contact of the breasts , scarring goes through various stages and may finish anywhere from a couple of months to a year.
From 8 to 24 hours after the surgery.
Infection– An infection may be very common the first week after surgery , it may be treated with antibiotics or in severe cases the implant may be retrieved for a couple of months until the infection is gone and a new implant may be placed.
Capsular Contracture– Capsules of tightly-woven collagen fibers naturally form around a foreign body tending to wall it off. Most of the time, these tissue capsules are soft-to-firm, and unnoticeable. Capsular contracture occurs when the capsule tights and squeezes the implant. This contracture is a complication that can be painful and distort the appearance of the implanted breast.
Dissatisfaction with Cosmetic Results-Dissatisfying results such as wrinkling, uneven sizes, implant shifting, incorrect size, unanticipated shape, ability to feel implant, scar deformity, irregular or raised scarring may occur. Careful surgical planning and technique can reduce but not always prevent such results.
Hematoma/Seroma-Hematoma is a collection of blood inside a body cavity and a seroma is a collection of the watery portion of the blood around the implant or around healing. A small scar can form or a rupture may occur if the implant is damaged during draining the incision. Post-operative hematoma and seroma may contribute to infection or capsular contracture.
Changes in Nipple and Breast Sensation-Feeling in the nipple and breast can increase or decrease after implant surgery. The range of changes varies from intense to no feeling in the nipple or breast after surgery.
Extrusion-Unstable or weakened tissue covering of wound healing may result in the breast implant coming through the skin. Surgery needed to correct this can result in unacceptable scarring or breast tissue loss.
Regardless of the type of implant, it is likely that women with implants will need to have one or more additional surgeries over the course of their lives. Common reasons for re-operations include cosmetic concerns, capsular contracture, and rupture.
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