Ideal Candidates for Breast Implants
A good candidate is a healthy female, 18 years of age and older, who desires an enhancement in the volume and shape of her breasts. A classic example is a female with an A or B cup size breast who wants to be a full C or a small D. There should be no active infection in the breast. If you previously had breast surgery or radiation treatment to the breast or chest, you should inform your plastic surgeon as this may increase the risk and complications of the procedure.
How to choose a Breast Implant Size?
Picking the right implant size, dimensions and shape is the most important decision and is made during consultation. Each implant has several dimensions, like the height, width and projection, and a corresponding volume. Many women presenting for breast augmentation have a certain cup size or implant size in mind, not realizing that the best breast implant is the one that has the same dimensions as their breasts’. The implant is inserted into a pocket created inside the breast. For the procedure to be successful on the long term, the implant’s dimensions should be as close as possible to those of the pocket so that it can fit comfortably without putting too much pressure on the surrounding breast tissue. If the implants dimensions are bigger, for example, this will cause the implant to move and push to outside the boundaries of the pocket, which results in misplacement, shape distortion, and ultimate failure of the procedure. This is why during consultation with Dr. Alghoul, precise breast measurements are taken and the appropriate range of sizes fitting the dimensions of the patient’s breast are determined. After that, the patient is given time to try on different silicone implant sizers within that range that are designed to be fitted inside a bra to see how her new size will look in clothes. Based on the size you choose and your breast dimensions, all of the numbers are put together to pick the implant that will give you the best results and accomplish your goals.
During your consultation for breast implants in our Amman office, Dr. Alghoul will evaluate every factor necessary to ensure that the proper implant size is chosen which will give you beautiful, long lasting results.
Incisions Used in Breast Augmentation
There are several incision options available for breast augmentation patients – the inframammary incision, the axillary incision, and the periareolar incision. Dr. Alghoul’s incision of choice is the inframammary incision, which is placed on the crease under the breast, also called the inframammary fold. This is the most commonly used approach and the scar is well hidden. It is also believed that this incision is the least associated with post-operative capsular contracture, a complication that results from scarring around the breast implant. The incision size is usually 3 cm to 4 cm in length depending on the size of the implant used.
What to Expect
Breast augmentation is performed as an outpatient procedure under general anesthesia or local anesthesia with sedation. Patients usually are able to recover quickly after surgery and return to normal activities within two to three days. Recovery may take longer if implants are combined with fat grafting. Usually there is some degree of swelling immediately after surgery, which resolves over one to two weeks. As the swelling resolves the breast size will shrink by 10 to 15 percent of the size immediately after surgery. It is recommended to wear a medical grade bra to support the breast during healing during the first 2 months after surgery. An underwire bra is not advised the first 6 weeks after surgery. Light exercise that does not involve the chest muscles can be performed two weeks after surgery. Activities leading to significant movement of the breasts, such as running or jumping should be avoided for the first 6 weeks.
Recovery from Breast Augmentation
After your breast augmentation, your pain will mostly consist of soreness in and around your “pec” muscles if the implants are placed under the muscles. It is normal for the pain to last a few days; however, you will be prescribed painkillers after surgery to help with this. After a few days, you will be able to transition to non-narcotic painkillers and slowly start to resume normal activity.
During consultation, a thorough breast evaluation is performed to determine the shape, volume, skin tightness and measurements of your breasts. Dr. Alghoul will discuss with you the details of your breast analysis and listen attentively to your goals and thoughts. You are not expected to know the size and specific type of implant you want. Samples of all different styles of implants are available in our office for you to feel and examine. Special sizing implants are also available that you can try under a bra to see how a certain size looks with clothing. Three-dimensional photos will be taken of your breasts, and a simulation is done using specialized computer software where different size implants can be inserted, generating images that are close to reality. Using this 3-D technology helps give patients an idea of what their breasts will look like with certain implants.
Special sizing implants are also available that you can try under a bra to see how a certain size looks with clothing.
- What does breast augmentation do?
- What are the types of implants?
- Is the implant placed over the muscle or under the muscle?
- Do breast implants need to be changed every 10 years?
- What are the main long-term complications after breast augmentation?
What does breast augmentation do?
Breast augmentation enlarges the breast volume as a whole and increases the fullness in the upper breast. The implant is placed in the center of the breast footprint and enhances the already-present features and dimensions of the breast. For example, if the breasts are small in volume but their footprints are close to each other, adding implants will enhance cleavage. However, if the breast footprints are further apart from each other, then adding an implant will not enhance cleavage. In addition to changing the size of the breast, a round breast implant gives the breast a rounded appearance.
In certain instances, the breast features have to be altered to accommodate an implant. A very important breast dimension is the distance from the nipple to the fold under the breast, also called the inframammary fold. The skin spanning this distance forms the lower pole or curve of the breast. If this distance is short or the skin in the lower pole is tight, then it has to be lengthened to accommodate an implant; otherwise the implant will move up high on the chest and look unattractive.
What are the types of implants?
Implants come in a wide variety of sizes, shapes and textures. The two main types are silicone gel and saline. Both have a silicone shell; one is filled with cohesive silicone gel while the other is filled with saltwater. Silicone gel implants have a more natural feel compared to saline implants. Silicone implants can have either a smooth or textured (rough) surface. The advantage of the textured surface is that it creates more friction with the surrounding tissue and prevents the implant from migrating or moving to undesired location inside the breast pocket.
Silicone implants can be round or shaped. Shaped implants (known as gummy bear implants) have a highly cohesive gel and are tapered at the top, resembling the natural silhouette of the breast. Given the recent concerns of the texture of some of the shaped implants and their possible association with ALCL (Anaplastic Large Cell Lymphoma), there use have been largely abandoned except in cases where the lower pole of the breast is constricted (tight and short) as seen in tuberous breast. In the case of lower pole constriction, a shaped implant helps expand the lower pole compared with a round implant.
Is the implant placed over the muscle or under the muscle?
The implant can be placed under the breast tissue (above the muscle) or under the muscle. Placing the implant under the muscle is more suitable in smaller breasts when there is not enough breast tissue to hide the edges of the implant, especially in the upper breast. Visible implant edges give an unnatural augmented appearance.
Do breast implants need to be changed every 10 years?
It’s not necessarily true that a breast implant must be changed after 10 years. However, a breast implant is not meant to last forever. Like any other device, there will be wear and tear that will ultimately result in weakness and a break in the shell of the implant. This is why, based on long term studies performed by the different implant manufacturers, it is estimated that by 10 years, there is a higher chance of having a break in the implant’s shell and therefore replacement is recommended. It should be clear however that a break in the implant shell and therefore silicone leak may occur earlier than 10 years and it may not occur at all. The best way to tell if there is a problem with the implant is through exam. In other words, if the breast feels soft then it is unlikely that there is a leak or rupture in the implant. A breast MRI is also an accurate way of detecting problems with the implant.
What are the main long-term complications after breast augmentation?
Implant malposition is basically a less than ideal position of the implant in relationship to the breast. This is usually evident by the appearance of a too high or too low of an implant. It could also manifest as an implant that displaces to the side particularly on lying down flat. It occurs because of loss of control of the pocket that is larger than it should or loss of the support of the breast. This complication is minimized by meticulous technique and pocket dissection. It can also be avoided by using appropriate size implants that are no too big compared to the breast pocket.
The other complication that could occur is capsular contracture which is the formation of scar tissue around the implant which results in a firm feel or can push the implant to a high position and can also cause pain. This complication is minimized by using meticulous aseptic technique that minimizes touching of the implant during surgery.
If you would like to discuss breast augmentation in Amman, please call to schedule a consultation with Dr. Alghoul.