UNFAVOURABLE FORMS OF BREASTS – SMALL BREASTS/EMPTY BREASTS

Breast augmentation is an option that can create beautiful breasts for women who are unhappy with the shape and size of their breasts. It is a procedure that makes women feel more feminine and attractive, as it creates breasts that are uniquely sized to complement their body.

Breast augmentation is the surgical enhancement of the breasts using implants. The implants are filled with either saline or silicone and are available in an array of sizes, shapes, and textures. Some are round, while others are in the shape of a teardrop. Successful breast augmentation depends largely on choosing implants that are the best fit for you.

Breast enhancement is recommended for women with disproportionately small breasts, or asymmetrical breasts. Even women whose breasts have become deflated due to child birth and breastfeeding are also good candidates. For women that have undergone a mastectomy can consider breast augmentation as a method of reconstructing the breast.

SYMPTOMS

  • Small breasts
  • “Empty” breasts
  • Asymmetrical breasts
  • Loss of volume in breasts due to pregnancy and breastfeeding

TREATMENT

HOW DO YOU TREAT SMALL OR EMPTY BREASTS?

  • Breast augmentation (enlargement): The incision for breast augmentation is usually made along the areola, below the breast, or under the armpit. The location of the incision is one of the factors that you should discuss with your plastic surgeon prior to the surgery. In instances where there is significantly droopy of the breasts, a breast lift may be done along with breast enhancement.
  • There are two types of breast implants (Silicone and Saline): Silicone breast implants are the preferred choice of implant material, as they look and feel much more natural compared to saline implants. Silicone implants are safe, and do not heighten the risk of women developing breast cancer or any other diseases.
  • Silicone breast implants are available in two basic designs: Anatomical and round. The anatomical implant is shaped like a tear drop, less full in its upper pole and more full in its lower pole. The round implant is dome shaped, equally full in its upper and lower parts (poles). The round implant tends to produce additional fullness in the upper pole of the breast that a natural breast does not have. The anatomical implant on the other hand, is shaped more like a natural breast, therefore it produces a natural profile in the upper pole of the breast without excessive fullness. Most of the fullness is in the lower pole of the breast, just like in a natural breast.In recent years, breast augmentation has undergone a shift with the focus now on shape rather than just volume, thanks to the availability of the tear drop shaped anatomical silicone implant.Anatomical implants have given an extraordinary degree of versatility, because for each size (volume), there is a wide range of shapes available. There are three dimensions that determine the shape of the implant: heightm width and projection. Each of these parameters can be varied so that the implants selected can be highly customizable according to each patient’s  unique breast and chest wall anatomy. Furthermore, this versatility allows for correction of asymmetries between left and right sides much more effectively than before.Breast implants can be placed both under the breast and on top of the pectoralis major muscle of the chest wall, or they can be placed under the muscle. By placing the implants under the muscle, additional tissue padding helps to make the implant margins less obvious. This is especially useful in the upper inner part of the breast, where the patient’s own tissues are often thin.However, placing the implant totally under the muscle has a significant disadvantage. This very strong muscle, will gradually pull the implant upwards and outwards as it contracts, causing the implant to sit too high up on the chest and too far out to the side. The breast will then look too full in its upper pole and its overall shape will be distorted.

WHAT CAN YOU EXPECT DURING RECOVERY?

Pain after surgery is mild and can be well controlled by taking oral pain medication. Bruising and swelling are also mild, and are reduced by taking the appropriate medications and wearing a special recovery device on the chest. Normal activities can be resumed within one to two days. Work can be resumed in two or three days. A special compression band is worn around the upper chest above the breasts for the first one to two weeks, which will help to reduce the swelling and keep the implants in the correct position. The stitches are removed after two weeks.

A proactive scar management program is then started to ensure the best looking scar possible. Bras should be avoided for the first one month so as not to push the implants upwards and allow them sufficient time to stabilize in their correct position. Exercise can be restarted after one month, but all strenuous upper body exercises should be avoided for the first three months.

HOW OFTEN ARE CHECKUPS REQUIRED?

Typically, reviews are scheduled on the second postoperative day, at the end of the first week, then weekly till the end of the first month. Thereafter, reviews are scheduled every two weeks till the end of the second month, then at three months after the operation. Reviews are then carried out every three months until the end of the first year.

The interval is then increased to six months until the end of the second year, after which the interval is push to yearly.

If the patient is a foreigner who can only stay in Singapore for a limited time, postoperative reviewing schedules will be modified accordingly, and her recovery will be monitored long distance.

WHAT ARE THE RISKS AND COMPLICATIONS?

The risks of surgical complications such as bleeding or infection or both are extremely low. The main long term risk is capsular contracture. This is the  hardening and distortion of the implant caused by thickening and contraction of the capsule of scar tissue that forms around it. Anything that causes inflammation, such as the presence of blood or bacterial contamination can cause the capsule to thicken, thus increasing the risk of capsular contracture.

If this occurs, the aesthetic result will be compromised, and further surgery may be necessary in order to correct it. However, this is not considered  dangerous.

There is also a small risk of losing some nipple sensation, due to the fact that when the implant pocket is being created the sensory nerves of the nipple can sometimes get in the way. Most of the time, however, any sensory loss that occurs is only temporary.

Finally, there is also a very low risk of a complication known as a delayed seroma. A seroma is a collection of fluid known as serum – a clear yellowish fluid is blood without red blood cells – that partly surrounds the implant and is produced by the inner surface of the capsule. A delayed seroma can occur as a rare and late complication several months or even years after breast augmentation and is most likely caused as a result of blunt traumatic impact to the breast, extremely vigorous exercise, or extremely rough handling of the breast). As a result of this fluid, the breast becomes swollen and firmer. The best treatment for this is rest and anti-inflammatory drugs.

DIAGNOSTIC SERVICES

  • History taking and physical examination: Your doctor will discuss with you about your overall health, including any previous medical history as well as any complaints you have. He will carefully examine your skin, discuss with you the weak points and ask you about your desires and expectations, afterwards he or she will explain possible treatment options available for you.

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