Breast enlargement is a procedure whereby the breasts shape and size is altered by means of an implant inserted under the breast. This can be done for breasts that have not developed adequately for various reasons or for those who want their breasts to be larger or more shapely, and indeed for those patients who have lost volume and shape to their breasts following weight loss or after pregnancy.
Implants are made from medical grade silicone, have been extensively studied and are safe. The silicone within the implants used by Dr Patel is “highly cohesive”. This means that it is more like a formed “jelly” than a runny “liquid”. Dr Patel believes that implants should enhance the size and shape of the breast within relative proportions to the size of the torso and height of the client. Breast surgery is not merely about inserting silicone but an artform that takes into account the slight differences that every client has with respect to chest wall shape, breast shape, and skin dynamics.
Each client will be individually assessed by Dr Patel at a consultation and the decision of which operative procedure and which implant suits you, is one that is made together within the bounds of what is reasonable and natural.
Hospital stay :
Time off work :
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same day or night
The implant can either be inserted directly under the breast (subglandular) or under the pectoralis muscle (submuscular) (press your hands against your hips and feel the muscle on the side of your chest). The positioning of the implant is determined at the time of your consultation with Dr Patel, and is dependent on characteristics like body type, body fat etc. The positioning of the implant in the submuscular area is slightly more painful postoperatively but that is not a determining factor for placing the implant in that position. The placement of the implant is determined at the time of pre-operative assessment with Dr Patel, taking into account each individuals activities, wishes, physical examination and quality of skin. The incision (cut) used to access the area is either done around the areolar in a semicircular shape or in the inframammary fold (lower breast crease). The cut is about 4cm in length and usually heals very well and inconspicuously.
Mammograms are definitely possible once you have had an augmentation. A special view called an Ecland view is able to displace the implant and view the breast tissue for any abnormalities. Patients who have breast augmentations are more likely to detect abnormalities as they are normally more aware of their breasts and any lumps that may develop. If mammography cannot adequately screen a breast, the use of ultrasound and magnetic resonance imaging (MRI) is widely available today in order to confirm or exclude breast pathology.
There is no absolute time period after which an implant should be changed. However regular (yearly or 2 yearly) follow up is advisable. In general most women do have an implant change within 12-15 years. The operation is usually for a breast lift combined with a replacement of implants. As ageing occurs so the remaining breast tissue will drop with time, especially if the client has had a pregnancy or two. The larger the implant, the higher the chance a revision procedure will be necessary in a shorter period of time. Dr Patel is of the opinion that differences in implant gel, shell makeup etc, amongst the major manufacturers world wide of implants is relatively small and in the greater scheme of breast augmentation surgery no one make has proven itself to be outstandingly superior to another. Do ensure however that your implants are from a reputable manufacturer. (A CE or FDA mark of approval is usually a good guide).
A consultation with Dr Patel means that you will be taken through the process of the procedure, that you will have a chance to meet your surgeon and also discuss all aspects of the case with him. This is an interactive process whereby you will be shown pre and post operative pictures, asked questions regarding your general health and medication taken as these are all important aspects that have to be considered for your procedure. You will be asked to fill in a general health questionnaire. Dr Patel will do a general examination and a breast examination and take standardized clinical photographs for review. The initial interview with Dr Patel takes about 45min- 1hour and a complimentary second consultation is offered for all patients who wish to discuss the procedure further. You will have the opportunity to ask questions regarding any aspect of the surgery.
A full information sheet will be given to you at the first consultation outlining the risks and complications of the procedure. This information sheet will need to be signed and returned to the office and an opportunity will be given to you to ask any questions and clear up uncertainties.
Capsular contracture (CC)
This is a particularly talked about complication with respect to breast surgery whether it be cosmetic or reconstructive and therefore deserves consideration. When a breast implant is inserted, the bodies natural response is to form a capsule around it. This is normal. However, sometimes this response cannot be explained. Infection and silicone leakage (in the past) were theories put forward for this response. The end result is a tightening of tissue around the implant resulting in varying degrees of symptoms.
However, even with modern devices, there is a significant incidence of CC. Cumulative six-year data reported to the Food and Drug Administration (FDA) by Mentor Corporation revealed that 7.7% of patients receiving saline implants and 9.8% of patients receiving cohesive silicone gel implants for augmentation developed Baker III or IV contracture. Often, correction of CC requires reoperation.