Introduction

Breast augmentation, also known as ‘augmentation mammoplasty’ or ‘boob job’ increases or restores the sizes of the breasts using breast implants or fat transfer.

Women opt for Breast augmentation surgery as a part of reconstructive surgery or for cosmetic reasons.

When Can You Go for Breast Augmentation?

Breast augmentation helps women to gain confidence in the way they look. The surgery can enhance its size and help achieve fully round shaped breasts. If you are healthy, above the age of 18 years and have attainable expectations, then you will most likely qualify for a breast augmentation procedure.

Generally, women go for breast augmentation when:
• They feel that the size of their breasts is less.
• Their breasts become smaller after significant weight loss.
• One of their breasts is noticeably smaller as compared to the other.
• The breasts are not in symmetry with each other.
• The breasts become smaller after pregnancy or ageing.
• They want a more appealing and youthful figure.

Please note that the breast augmentation surgery cannot help with the sagging breasts. Your surgeon may recommend another procedure called a breast lift to improve dropping or sagging breasts along with the breast augmentation. You can express your desires and concerns to the plastic surgeon for proper guidance.

Choosing The Right Surgeon

The most vital decision that determines the success of your breast augmentation is choosing the plastic surgeon. Here are few important pointers in this regard.

Expertise: It is important to choose the right plastic surgeon based on their expertise in breast augmentation procedures. The chosen professional should have experience in performing breast augmentation surgeries and some good success stories to back it up. You can always request for pictures of the patients taken before and after the surgeries as a reference. This will give you an idea of the work the surgeon and decide if it is satisfactory enough for you.

Consultation: During the initial consultation with the surgeon, you will have the opportunity to clarify all your doubts. It is also the right time to assess if this surgeon is the right one for you. You should feel comfortable with the surgeon and be able to discuss your thoughts openly.

This is your time to be completely open up with the surgeon about the kind of improvements you are looking for – the change in the size, the firmness of breasts, the change in the shape, etc. Ask all the questions you have regarding the procedure including the side effects, risks, stage of recovery, etc. as all these factors plays crucial part in the success of the surgery.

Risks Associated with Breast Augmentation

Like with any other surgery, breast augmentation procedure also accompanies several risks. It is always better to know about them before undergoing the surgical procedure. Here are the most common ones:
• You may get a scar at the base of your breasts or on the side depending on the kind of surgery required.
• You may get infected during the surgery.
• Your implants may leak or rupture after the surgery.
• The blood or liquid may accumulate under the breasts for which you may require to go for another surgery.
• You may notice a different sensation in your nipples and breasts.
• You may experience pain in your breasts.
• You can experience an allergic reaction to the anesthesia.
• The result of the surgery can be unsatisfactory.

If you feel any weird lasting sensation or pain days after your surgery, it is best to consult your plastic surgeon.

Types of Breast Augmentation

Based on the material used for augmentation, you can choose from among any of the two breast augmentation surgeries, which include:
• Breast implants and
• Fat transfer

Breast Implants

Breast implants are artificial materials that enhance and modify the shape and size of the breasts. You can choose from among two types of breast implant materials, which include saline-filled implants and silicone gel-filled implants. The choice of choosing the implants depends on the patients, their requirements, and finally the call of the surgeon.

• Saline-filled implants: In this method, the surgeon uses sterile salt water to fill the implants and sometimes, adds a silicone-like structure to help hold the shape of the breasts better. The surgeon may fill the implants with water prior to the surgery based on the increase in the breast size. At times, he can also add water during the surgery to allow for minor modifications.

• Silicone gel-filled implants: This method involves filling the implants with soft silicone gel and sometimes, with a cohesive gel, which helps in getting firmer breasts with a well-defined shape. The surgeon should fill silicone gel-filled implants before the surgery and the breasts will require larger incision to place the implants inside.

Fat Transfer
In this procedure, the surgeon performs liposuction surgery to remove the fat from the areas where there is an abundance of fat, like the thighs and hips. The expert then injects these extracted fat cells into the breasts in small quantities based on the volume of size increase required.

Cost of Breast Augmentation

The cost of the implants alone is around Rs. 50,000 to Rs. 1 lakh. The total cost of the breast augmentation surgery ranges between Rs. 1 lakh to Rs. 2 lakhs depending on the kind of the procedure and your expectations from the surgery. Besides, medications, mammography and several other pre-procedure tests incur separate costs.

How Can You Get Prepared?

Physical Examination: The surgeon will physically examine your breasts to decide on the right breast augmentation procedure. The surgeon will photograph your breasts and take measurements for analysis and reference during the surgery. You will go through mammography before and after the surgery to compare and see the results of the procedure.

Medical History: The plastic surgeon will ask for your medical records to assess if you are the right candidate for the breast augmentation surgery. The surgeon will also explain the entire surgery procedure and if your expectations are attainable. The surgeon will also inform you of the risk associated with it, if any, according to your medical history.

Things to Do Before The Surgery :

• If you are undergoing breast augmentation through fat transfer, the surgeon may ask you to wear a special bra before the surgery to get the muscles prepped in time for the surgery.

• If you are a smoker, then you need to quit smoking at least for a month before the surgery.

• You also should avoid taking aspirin in the weeks leading to the surgery.

Influencing Factors: Be clear with your expectations from the surgery. Also, be sure to inform the surgeon if you are planning for weight reduction or pregnancy after the surgery. Though there is no such evidence of breast implants affecting the feeding of the baby after the surgery, still, it is better to get assurance from the surgeon directly.

The Procedure of Breast Augmentation

Anaesthesia: The surgeon will perform the procedure in their clinic or at a well-equipped hospital. The surgeon will administer anesthesia before the surgery.

Some surgeons administer only local anesthesia wherein only your breasts will become numb while you will be totally conscious throughout the surgery.

Some others may provide general anesthesia where you will be unconscious during the entire procedure. You may also feel a little wobbly for a few hours after the surgery till the effect of the anesthesia wears off.

Operating Procedure: After administering the anesthesia, the surgery starts with the incision made under the breast, in between the breasts or near the underarm. The surgeon then places the implant under the breast centred around and behind the nipple. He uses sutures to close the breast.

The surgeon will bandage your breasts to hold the implant in place and he will keep you under observation for a few hours after the surgery.

Post-Surgery Care

After observation, if there is no issue with the implants or the fat transfer, the surgeon will discharge you on the same day. It is better to ask someone to pick you up after the surgery so that you do not involve in any strenuous activity that could disturb the implants.

Precautions

Due to bandaged breasts, the surgeon will advise you to wear a special kind of bra or dressing for support. He will remove the bandages in a week after the surgery but will still suggest you to wear special bras. You will be able to take shower anywhere between two to seven days after the surgery depending on your procedure. But make sure to consult your surgeon before going for it.

In The First Week
You may feel some pain on the first day after the surgery and this pain will soon decrease as the days pass by. You may experience some discolouration or swelling which will no longer be visible a month after the surgery. You may also feel more sensitive in your breasts.

After The First Week
It is best not to indulge in any heavy exercises or heavy work like lifting and pulling as it could hinder the setting of the implants placed in the breasts. Be gentle and careful enough with your breasts for at least a month after the surgery. Consult your plastic surgeon before you engage in any activity that could disrupt the recovery.

Follow-Ups
If your surgeon has used drainage tubes, then go for follow-up appointments with the surgeon. Also, a few days after the surgery, the surgeon will recommend a mammogram to compare with the mammogram taken before the surgery. This mammogram will also monitor the condition of the implants or fat transfer.

Additional Factors to Know

The breast augmentation surgery can boost your self-esteem and self-image. Although, it is better to have realistic expectations.

Replacement of Implants: Breast implants are not always a one-time surgical procedure. Sometimes, you may need replacements for the implants and therefore, you need to go for regular check-ups after the breast augmentation to monitor the status of the implants.

Changes in Breast Size After Surgery: The size and shape of your breasts may change due to weight loss, weight gain, hormonal factors, ageing or after pregnancy. If you are again not satisfied with the way it looks, you can go for further surgical procedures.

On any account of discomfort or pain long after the surgery, it is best to contact the surgeon immediately.