Think about Your Good reasons. Just before you decide on any operation you should have a clear understanding of your reasons for wanting to proceed. Take some time to think about what your expectations of the procedure are. Below are some questions you may want to ask yourself while considering breast augmentation.
- Do you want to have breast augmentation to please yourself or to please someone else?
- Is breast augmentation something you have considered for a while or have you made the decision during an emotional crisis, such as after a breakdown of a personal relationship?
- Are you pleased with your body weight or are you hoping to lose weight in the future?
- Are you in good physical condition or do you have a history of health problems?
- Do you plan to have children at some time in the future?
- Do you have an image of how you would like your breasts to look?
- Have you lost breast volume from past pregnancies?
Behavior about women’s breasts have always been influenced by fashion trends. In the Twenties, women bound their breasts; in the Forties, more volume was desirable; then, in the Sixties, a less restricted look was popular. Contemporary styles reflect a trend toward fuller, yet natural-looking lines. But regardless of your breast size, all healthy breasts have the same basic anatomy. When you’re considering breast augmentation, it helps to know your anatomy so you can make informed choices with your doctor.
Your breast history – and the breast history of the women in your family help determine whether you are a good candidate for breast augmentation. Your doctor will ask about results of any past mammograms (breast x-rays for early cancer detection), biopsies, and any personal or family history of cancer. You will also be asked about past pregnancies, the number of children you have, and whether you breast-fed them.
A second consultation will deal with your operation choices and reiterate the possible problems and complications with reference to your specific case. You must not proceed to an operation until all questions have been answered and all your reservations answered to your satisfaction.
The breast implant device – its brand, style, size and type will also be considered.
Understanding Your Options. If you have chosen to have breast augmentation or breast reduction, you will need to understand all of your options. Ahead of you lie four significant decisions that you and you doctor make together. Take the time you need to think about the procedure so that you can make informed choices. Clear up any further questions you may have before surgery is scheduled.
Breast Size and Shape. Your doctor will suggest the most appropriate sized implant for your body by assessing your proportions, your height and weight, and your body type. However, it is you, the patient, who makes the final decision on breast size. This process can be facilitated by the insertion of sizing implants into your brassiere and visualising the effect a particular sized device makes on your external shape. Mastopexy may also be recommended, a surgical procedure that may be performed at the same time as breast augmentation, but is often better undertaken prior to or instead of augmentation. Mastopexy uplifts drooping breasts by removing excess skin and lifting the nipple to a normal position. If this is recommended, further information will be provided. In some cases of excessively drooping breasts, a desirable cosmetic result cannot be achieved if breast augmentation is performed without a concomitant mastopexy.
The location of your incision is based on your personal preference, your body type and your doctor’s recommendation. A periareolar incision (around the areola) means the scar may be concealed by the colour and shape of the areola. An Axillary incision (under the arm) means you will not have a visible scar on the breast itself, but there will be a fine, almost invisible scar under the arm which may be seen only when the arm is elevated. An incision placed in the inframammary fold may be hidden by the breast itself when standing, but can be seen when the patient is lying down.
The implant may be located in front of the pectoral muscle (prepectoral) or behind it (postpectoral). If you have a moderate amount of breast tissue, over the muscle may be a good choice for you. If you have a small amount of breast tissue, under the muscle may be the better choice. Each location has different advantages for each woman. Prepectoral location is often more suitable if the breast is slightly droopy (or ptotic), or if you exercise with the upper body. Under the muscle can give a smoother line to the implant, but does have the disadvantage of movement and/or distortion with chest muscle compression.
There are different types of implants available. All implants are synthetic silicone rubber shells filled with a silicone gel or a saline (saltwater) solution. The outer wall of the implant may be smooth or textured (rough surfaced). Generally, rough surfaced implants do not need to be massaged post operatively. Smooth implants may need to be massaged to help prevent scar contracture (this is further explained in the section on capsular contracture).