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Breast Implant Surgery - Technique Types, Scars & Side Effects

Breast implant surgery is a type of breast augmentation to increase breast size. It involves using prosthetic/artificial implants, which are inserted beneath the breast tissues to enhance their shape and size. 

It is the most common type of augmentation mammoplasty. Most women around the world prefer this method instead of using padded bras or trying out home remedies and exercises. 

Reasons to Get Breast Implants 

A woman can choose to get breast implants for cosmetic reasons or medical reasons. The treatment is also a good option for women who wish to reconstruct their breasts after mastectomy or other surgical procedures in which the breast tissues were removed. 

The key reasons to opt for breast implant surgery are- 

  • To change or improve the appearance of the breasts if they are small. 
  • To make the breasts symmetrical if one of them is smaller than the other. 
  • To add volume to the breasts after pregnancy or significant weight loss. 
  • To reconstruct the breasts after mastectomy. 
  • To improve your confidence and self-esteem. 

Breast implant surgery is a good option to enlarge the breasts, considering the woman who undergoes the procedure has fully developed breasts. 

Types of Breast Implants 

Basically, breast implants are of two types- saline and silicone. But, there are also other variants based on the implant’s shape and size. The most common ones are the following- 

  • Saline Breast Implants- This type of implant is filled with a saline solution, and the shell is made from silicone. These are used to give a uniform shape, and firm feel to the breasts. Saline breast implants are safe for use in women older than 18 years. 
  • Structured Saline Breast Implants- These are special implants that have a different inner structure to provide a more natural feel to the breasts. 
  • Silicone Breast Implants- This type of implant is filled with silicone gel and feels almost like natural breast tissue. These implants are approved to be used for women of age 22 or older. 
  • Gummy Bear Implants- Also known as form stable implants, these implants don’t lose their shape like other types of implants when ruptured. They have more projection at the bottom and are tapered towards the top. 
  • Round Breast Implants- These implants make the breasts appear fuller than other types. It is the best option for women who want better projection. 
  • Smooth Breast Implants- These give the softest feeling to the breasts compared to other types of implants. Moreover, they also ensure that the breast movements are more natural. 
  • Textured Breast Implants- These types of implants are designed in such a way that they create scar tissues and restrict the movement of the implant in the breast pocket. 

All breast implants are created differently, and their shape and sizes can also be customized according to the patient’s requirements. To determine which type of implant is best for you, it is always better to discuss your needs with the doctor. 

Preparation Before Breast Implant Surgery 

When you consult a plastic surgeon to plan the breast implant surgery, he/she will provide you with brief instructions regarding what needs to be done before the surgery. 

The standard preparations before breast implant surgery involve the following- 

  • Get a complete blood test done to ensure that you don’t have a blood-related disorder that can impair your healing abilities. 
  • The doctor is likely to ask you to stop taking some medications and prescribe other or alternative medications that won’t impact the surgery. 
  • The most important thing to do before the surgery is to stop smoking and using tobacco products either one month or two weeks before the surgery. 
  • Alongside this, the doctor will also recommend that you avoid using recreational drugs and blood-thinning medications, such as aspirin. 

The doctor’s support team usually stays in touch with the patient to ensure that the patient is following the necessary pre-operative instructions. If you fail to do so, then the surgery will be delayed. 

Day Before Surgery 

If everything goes right, you will be asked to get admitted to the hospital the day before surgery. You will also receive the following instructions for the day of surgery- 

  • Take your prescribed medications as directed but with a small sip of water. 
  • Do not forget to take your heart medicines, BP medicines, birth control pills, steroids, thyroid medicines, etc., unless advised otherwise by the surgeon. 
  • Avoid drinking or eating anything from midnight (12 AM), including all food items, such as water, milk, chewing gum, coffee, juice, rice, etc. 
  • Wear loose and comfortable clothes that can be removed easily. 
  • Do not wear makeup, jewelry, dentures, contact lenses, hearing aids, etc., as all of them will be removed prior to the surgery. 
  • Ask your friend or family member to accompany you to the hospital, drive you back from the hospital, and stay with you for the first days after the surgery. 

While you are preparing for the surgery, one smart thing that you can do is arrange the things you are likely to need after the breast implant surgery. 

On the Day of Surgery 

Before taking you to the operating room, the nursing staff will take the vitals readings. You will be given a hospital gown, and once the OT is prepped, you will be taken to the room for surgery. 

Before beginning the procedure, the anesthetist will administer anesthesia. Typically, general anesthesia is used for breast implant surgery which puts the patient to sleep and numbs the body. 

The plastic surgeon determines the incision site to make the scarring inconspicuous. The incision can be peri-areolar (along the areola edge), inframammary (under the breast fold/crease), or transaxillary (in the armpit). The most suitable type of incision is chosen based on the type of implant, degree of enlargement, and the patient’s anatomy. 

There are two ways of inserting and placing breast implants. The first one is a submuscular placement where the implant is placed under the pectoral muscle. The second one is submammary or subglandular placement, where the implant is placed over the pectoral muscles directly behind the breast tissues. 

Once the implants are positioned properly, the incisions are closed, and the sutures are covered with adhesive tape. If saline implants are used, the implants are filled after placement, then the incisions are closed. Often, drainage tubes are also placed to allow the fluid to drain properly. 

The surgery takes around 60 to 90 minutes approximately, and the patient is discharged on the same day after a few hours of close observation.  

Techniques for Breast Implant Surgery 

The techniques used for breast implant surgery are categorized on the basis of incision placement. The techniques are explained below- 

1: Inframammary Fold or Sub-pectoral Technique

This technique involves making an incision underneath the breast crease or fold. This type of incision allows the surgeon to gain more access to the internal tissues. Furthermore, the implant can be positioned more precisely through this incision. 

Around 70% to 80% of breast implant surgeries are performed through this technique. One of the main advantages of using this incision placement is the minimal impact on the milk-producing glands. It is preferred in older women whose breasts have a natural amount of sagging. 

2: Peri-areolar Technique

This technique involves making an incision around the nipple or areola. This makes the scar blend into the dark skin and less noticeable. Peri-areolar incision is preferred for women who have small breasts and don’t have any folds under them. 

As the incision is made near the milk glands, the surgery can impact the milk production or sensations in the nipple. 

3: Trans-axillary Technique

In this technique, the incision is made in the armpit or axilla to insert the implant. Only 10% of breast implant surgeries are performed using this technique. The key advantage of this technique is that the surgery won’t leave a scar on the breast itself. 

However, this technique is more difficult than other methods as the placement of breast implants is somewhat trickier. 

4: Trans Umbilical Breast Augmentation (TUBA)

It is a new approach that involves making an incision in the belly button. The surgery is performed with the help of an endoscope. A tunnel is created with the help of the endoscope, and the implant is inserted through that tunnel. 

This technique has limited application as only subglandular saline implants can be placed using this technique. Other implants can increase the damage to the skin tissues. 

The technique chosen for breast implant surgery has a significant impact on the outcome. Thus, the plastic surgeon carefully analyzes the breast anatomy and the overall health of the patient to choose the best technique. 

Post-Surgery 

Immediately after the surgery, you will feel disoriented, hazy, and nauseous due to the side effects of anesthesia. The anesthesia will take around 1-2 hours to wear off, and you will be kept in the recovery room until then. 

After you wake up, you will be transferred to your room, where your vitals will be monitored for a few hours. If your condition is stable, then you’ll be discharged on the same day. 

Before you leave, the doctor (or nurses) will give you detailed and specific post-op instructions regarding the follow-up schedule and recovery guidelines for best results. 

The recovery guidelines will include the following points- 

  • Wear a support or compression garment 24x7 for the first two weeks after breast implant surgery. This will help to reduce the swelling and prevent the implant from moving around while the scar tissues are forming. 
  • You may have to change your dressing on your own. If so, then detailed instructions will be provided to clean the wound and how frequently the dressing needs to be changed. 
  • In the first few days, get ample rest and avoid moving around to allow scar formation. 
  • To keep the implants in the proper place, you will be advised to sleep with your back elevated. 
  • Take the prescribed antibiotics and pain medications as directed to prevent infection and reduce discomfort after the surgery. 
  • Resume normal activities after a week and talk to your doctor whenever you have any doubts. 

Risks & Complications 

The side effects of breast implants are- 

  • Hardening or capsular contracture 
  • Implant rupture 
  • Ripple or palpable implants 
  • Position changes 

Besides these, there are other side effects, such as infection, breast implant scar, pain, loss of sensitivity, etc. 

Do Breast Implants Need to be Removed After Some Time? 

Using breast implants is the most effective way to enhance breast size, as they usually last for one or two decades. However, the implants are not meant to last a lifetime. In some scenarios, you may have to consider breast implant removal surgery. These scenarios are- 

  • If the scar tissues around the implant contract and causes pain or cosmetic changes. 
  • In case the implant ruptures and affects the symmetry. 
  • If the breast implant material seems rippled and causes dissatisfaction. 
  • In case the position of the breast implant changes and the shape is affected. 
  • If the breasts have sagged a lot and the implant life has exceeded 15 years. 

Depending on the breast implant material, the plastic surgeon will suggest regular screening to ensure that you don’t develop implant-related complications. If any complication arises, then breast implant removal surgery is the best option. 

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