breast augmentation with implants
A breast implant is a balloon made of silicone, filled with either silicone gel or a saline solution comparable to body fluids. Through a four to five centimetre incision in the fold under the breast the implant is inserted. Another possible incision is through the areola and around the nipple. According to the patients body shape and wishes, there are several options regarding the type of the prosthesis, its size as well as the operative technique. The operation is performed under general anaesthesia; a one night stay in the hospital is preferable to one day surgery.
Breast implants do not last forever (nor do hip or knee implants). They may have to be replaced or removed after ten to fifteen years. They may last longer, but they also might require much earlier removal.
Apart from the general problems and complications which may arise with any operation, breast implants may cause several specific problems. The body places an internal scar around the implant. If this scar becomes too firm the breast may feel harder than normal and even get an unnaturally round shape. This problem is called capsular contracture. In case of local infection implants have to be removed. Generally, the border of the implant can be felt somewhere with the fingertips. Even augmented breasts that feel very natural flatten out less than normal breast tissue in the recumbent position. When a saline filled implant leaks, it loses all of its volume over a few days. A leaking silicone gel filled implant sometimes produces an abnormally soft breast first. Later on the internal scar may become very hard. Any leaking implant should be removed. Sensation to a part of the breast, including the nipple may be lost as a consequence of augmentation, and this may be permanent. Mammography (radiography of the breast) is impaired by a silicone gel filled implants. Therefore breast augmentation is only a good option for the well-informed and motivated patient who realises that this is not a lifelong correction.
An excellent patient information brochure on breast augmentation can be downloaded from the website of The British Department of Health. The free Acrobat Reader ® programme is required to read the file. The companies that produce the implants, such as Inamed, Mentor, Nagor, also provide information about the implants and their application.