Scar Less Breast Augmentation
Breast Augmentation with silicone implants is an extremely satisfying procedure for breast enlargement. It has been shown that silicone implants are safe or the body, does not cause any interference in lactation or cause any other problem at all. Since the availability of the best implants by MENTOR & ALLERGAN in various projections and profiles, we can almost customise the breast shape and size that the lady desires. We do stress to our patients to only go for implants manufactured by MENTOR or ALLERGAN since they are batch marked and offer warranties
Planning of the silicone implant breast enlargement surgery The chest diameter and the breast dimensions are marked. This gives us an idea of the cup size and the base diameter. The base diameter decides the maximum volume and projection of the implant that can be used. For a patient who required a larger projection for a given base diameter, we select high profile implants. All this planning takes place in the preoperative period and depends on the aspirations of the patient. We get the patient to try on a few sample sizes of the implant to give her a feel of the procedure, allowing her to estimate the best volume for her.
Surgical Incisions and Procedure Incisions like inframammary, periareolar, axillary, and transumbilical have been used. We prefer to use the inframammary and the transaxillary approaches. The positioning of the implant is either in the sub glandular, subpectoral or subfascial (described by Dr Ruth Graf, and preferred by the author).Transaxillary approach allows a virtual scarless breast enlargement with endoscopic control. Transaxillary technique of subpectoral augmentation has been available for many years; critics have observed difficulty in attaining precise positioning of the implant in the lower pole of the breast. Major advantages have been the absence of any scar on the breast surface, an avoidance of breast ductal transaction, and a low probability of sensory nerve injury
Scarless Breast Augmentation/ Endoscopic Trans-axillary breast augmentation Endoscopic assistance has enhanced the transaxillary approach by allowing more accurate placement of the breast implant.Described as scarless breast augmentation, here a pocket within the breast is made through an incision in the axilla. The implant is then placed through this incision itself, leaving the breast free of scars.
Silicone Gel Implants Silicone, a polymer of dimethylsiloxane, is present throughout nature. Currently, fourth-generation silicone implants (texturised implants)are used by the author. These implants do not rupture, have very low capsular contracture and do not leak. In some parts of Europe and Latin America, Polyurethane coated implants are being used. These implants are extremely soft, feel very natural, and have a long life. We are sure, that once these implants are available in India, they will become the most widely used
Breast Reduction
Large breasts are often a source of embarrassment along with problems of ill-fitting clothes, inability to wear modern, designer clothing as well as back pain, marks on the shoulder by the bra straps, fungal infection due to sweating below the breast line, and a generally reduced self-esteem.
Large breasts can be there from young age itself or may be due to childbirth and lactation. The treatment for these problems is surgical reduction known as reduction mammoplasty or reducing the size of the breast.
Breast reduction involves an actual removal of excess breast tissue & skin, with internal breast tissue rearrangement to create a more shapely breast. Commonly this involves two different techniques: The first is a Wise pattern (inverted ‘T’ scar pattern); the other is Vertical Short Scar Pattern. The latter technique is now well established, has a smaller scar, but can take up to 3 months to give the final breast shape
Male Breast Reduction (Gynecomastia)
Various young, as well as older men, suffer from the trouble of having an excess of tissue in the breast region. This, in clinical terms, is known as gynecomastia. Occasionally this may occur after certain disorders like liver or kidney disorders, some medicines such as steroids. This is commonly seen in young men, who are working out and take steroid supplements for muscle building. Gynecomastia is indeed embarrassing because men have to modify their clothing to lose style shirts. They also find it difficult to go for activities such as swimming; outdoor sports where there may be a requirement to take off shirts.
There may be an absolute increase of fat tissue (adipose type) or breast tissue (glandular type) or a mixture of both. Gynecomastia is classified into mild, moderate or severe depending on the projection of the breast.
Gynecomastia is a surgical problem. The treatment may involve liposuction, surgical excision or a combination of both. If the cause is mostly adipose, liposuction is beneficial. If predominantly there is increased glandular tissue, then liposuction is not effective, and a surgical excision needs to be carried out. Usually, however, there is combined use of liposuction and surgical excision for best results.
The results of gynecomastia correction are satisfactory. Following the surgery, the patient gets more confidence to wear better fitting clothes and undertake outdoor activities.If surgical excision is carried out, there is a scar around the areola, which takes time to become less visible. Liposuction for treatment is becoming very common as this avoids the scar and the appearance of an operated look
Breast Lift (Mastopexy)
Breast lift is a perfect solution to correct loose sagging breasts which are usually a result of age factor, pregnancy, breastfeeding that cause them to sag. This procedure can be performed alone, or in conjunction with breast augmentation to add more volume to the breast.
The procedure begins with the surgical removal of excess skin to reposition & lift the areola and tighten the breast tissue. The incision patterns may vary, depending on the degree of skin excess and amount of lifting required, as well as patient and surgeon’s preference. Performed under general anaesthesia, a breast lift is a safe procedure and recovery is immediate and swelling subsides in 2-4 weeks & breasts may take 1-3 months to fully refine.
Breast Ptosis (Sagging breasts) and Breast Lift (Mastopexy)Sagging breasts is medically known as Breast Ptosis. The breast tissue in these patients is adequate, but the women notice that the breast position is lower than normal, and they find it difficult to wear dresses and body-hugging dresses.
Physiology of Ptosis Normally the Nipple-areola complex is at the level of the 5th Intercostal space. In any situation when the nipple is lower than this is referred to as ptosis. It may be mild, moderate or severe depending on the deformity present.
Correction of Ptosis Mild ptosis may be corrected by simply putting an implant, in a process known as augmentation mastopexy. In situations where the breast tissue is adequate, and the use of the implant is not desired, various techniques are available. In milder cases, a peri-areolar approach is used, which leaves virtually no scar on the breast. In more severe cases, more radical procedures are required, but the scar usually fades very well in a couple of months. The author uses the Pectoral Sling approach
Breast Implant
Breast implants are sac-like structures that are synthesized from special medical grade silicone rubber. These structures are placed on the underlying areas of chest tissues. Cohesive silicone material is used nowadays for manufacturing the breast implants.
A number of implant types are available. They are classified based on the amount of forwarding projection. The different classes are low profile, moderate profile, high profile, and ultra-high profile. The moderate profile implants are chosen by most Indian women for a better match between body frame and breast projection.
Several conditions are to be kept in mind before the surgery. For performing the surgery, various incisions like infra-mammary, periareolar, axillary, and transumbilical incisions are utilized. The trans-axillary and infra-mammary incisions are most commonly selected.
Make sure that only the best implants are chosen. If a very cheap surgery is offered, then it is necessary that the specifications of the implant are clarified. Several specifications like implant label, manufacture date, barcode, etc., can be checked to ensure the quality of the implant. A card mentioning the implant volume is also given. The originality and quality of the implant should be assured.