Breast Augmentation: Various Techniques Involved; Recovery Period

Breast augmentation is a cosmetic procedure designed to alter the size and shape of a woman's breasts

. Often referred to as enlargement, mammoplasty, or implant, this type of surgery is the most popular cosmetic procedure in the USA.

Breast augmentation is commonly used to replace tissue that has been removed due to cancer or trauma, correct previous reconstruction surgery, or to increase size for cosmetic reasons. The ideal patient for this type of surgery is someone in overall good general health with realistic expectations that feels comfortable discussing their concerns and wishes with their doctor.

Variations in breast augmentation surgery involve different incisions, implant materials, and pocket placement. Incisions may be below the breast in the inframammary fold, along the areolar border, or in the armpit. Occasionally, if a patient is combining this type of procedure with abdominoplasty, the surgeon may elect to tunnel toward the chest cavity from the abdomen.

Implant materials used include saline and silicone gel. During the 1990s, saline was the most popular implant due to restrictions on silicone, but they are more likely to cause rippling, wrinkling, and can look (and feel) less natural.

Silicone gel implants are considered superior for women with very little tissue or those that are replacing tissue after cancer treatment. Silicone gel implants have undergone a series of changes and improvements over the years. Presently, the semi-solid gel is safely encased and rates of capsular contracture and rupture are very low.

The saline or silicone implant may be placed subglandular, subfascial, subpectoral, or submuscular. Subglandular placement occurs between the breast tissue and pectoralis muscle. It is the position that most closely resembles normal tissue and is thought to achieve the best aesthetic results.

Subfascial is similar to subglandular, but underneath the outer layer of the pectoralis muscle. The benefits of this placement are believed to be better coverage and positioning. Subpectoral implants are placed beneath the muscle layer and is the most common technique in the USA. Subpectoral gives the implant maximal coverage, but may allow for excessive movement. Submuscular placement is similar to subpectoral, but does not release the inferior muscle attachments. This allows maximal coverage.

Recovery from breast augmentation varies, but patients can often resume their previous activities within a week. Submuscular placement requires longer recovery time and may involve more post-operative pain. Scars typically take six weeks to heal and will fade over the ensuing months and years.

by: Abigail Aaronson

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