Breast implants is performed to reconstruct or alter the size and shape of a woman’s breast by placing a silicone pouch under the woman’s chest muscle. The implant can be performed on women who had lost their breast after mastectomy or for cosmetic reasons. There are two types of implants, saline-filled and silicone-gel-filled implants. Saline-filled implant is a silicone pouch filled with saline liquid and silicone-gel-filled implant is a silicone pouch filled with silicone gel.
Breast implants reconstruction can be either primary reconstruction or revision reconstruction. Breast augmentation can be either primary augmentation or revision augmentation.
• Primary reconstruction is performs to replace breast tissue that has been removed as a result of breast cancers or tumor and to correct severe deform breast.
• Revision reconstruction is performs to correct or improve the result of the primary reconstruction of breast.
• Primary augmentation is performs to increase breast size for cosmetic reasons.
• Revision augmentation is performs to correct or improve the result of the primary augmentation of breast.
Implant Reconstruction Procedures
Women who lost their breast after mastectomy may consider breast implants to restore the lost breast. The procedure for implant reconstruction is either one-stage reconstruction or two-stage reconstruction (immediate or delayed).
• One-stage reconstruction is performed at the time of mastectomy. Once the breast tissue has been removed by the surgeon, the implant is performed by plastic surgeon.
• Two-stage reconstruction can be immediate or delayed. If radiation therapy is not required after mastectomy, two-stage reconstruction is performed at the time of mastectomy. If radiation therapy is required after mastectomy, two-stage reconstruction is delayed until radiation therapy has been completed.
Two-stage reconstruction is performed when there are insufficient tissues in the chest area after mastectomy. The first stage involves expanding the chest tissues with the use of tissue expander. The second stage involves surgery to remove the tissue expander after several months and the implant is put in place to reconstruct the new breast.
Implant Augmentation Procedures
There are four different types of augmentation procedures that can be performed and these include transaxillary incision, periareolar incision, inframammary incision, and TUBA (transumbilical breast augmentation) incision.
• Transaxillary involves making incision of about 2 to 4 cm in the armpit. This technique allows the implant to be place under the chest muscle. The scar from the incision is hidden in the armpit and not easily visible.
• Periareolar involves making incision around the lower part of the areola where the darker skin meets the lighter skin of the breast. This type of incision hides the scar that blends in with the darker skin of areola. This technique allows the implant to be place above or under the chest muscle.
• Inframammary involves making incision of about 4 to 5 cm in the crease under the breast. The scar from the incision is hidden under the breast and not easily visible. This technique allows the implant to be place above or under the chest muscle.
• TUBA involves making incision in the rim of the bellybutton. This technique results in less scarring and allows the implant to be place above or under the chest muscle. This procedure is less common compare to the other three.
During augmentation procedures the implant can be place above or under the chest muscle. The advantage of placing the implant above the chest muscle includes less complicated surgery and shorter recovery time. The disadvantage with this type of placement increases the risk of capsular contracture and visible implant rippling.
The advantage of placing the implant under the chest muscle decreases the risk of capsular contracture and visible implant rippling. The disadvantage with this type of placement includes more complicated surgery, longer and more painful recovery.
The size of the incision also depends on whether the implant is inflatable or pre-filled. Inflatable implant (saline implants) requires small incision as the implant is inserted empty and filled later after surgery. Pre-filled implant (silicone implants) is larger and therefore requires larger incision in order to insert the implant.
The shape of the implant is either round or contour. Choosing the shape of the implant is a personal choice as some women prefer round shape because it enhances the fullness of their breast and other prefers contour shape because it provides a more natural look.
There are many risk factors associated with implants and these include possible complication and poor results, loss of breast sensation, asymmetrical breasts, and capsular contraction. Breast implants is not a lifetime device and future surgery is required for replacement.
Other risk factors also include infection, a broken or leaking implant, painful scar and repeated surgeries due to broken or leaking implant. The implant may affect the ability to produce milk for breast feeding and it can also interfere with routine mammography screening.
Taking the risk factor into consideration
and to improve the possibilities and outcome for breast implants
reconstruction and augmentation, it is important and helpful to have
presurgical discussions with the surgeon before undergoing the surgery.
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