Published in Vijay Times
What you need to know about breast augmentation
Breast augmentation is gaining popularity as a means of enhancing the overall cosmetic appearance of women, across continents. It is done primarily to increase breast size or to correct an imbalance in breast size, reveals Dr.Ahmed Marzouk, Cosmetologist. While in almost 99% of instances, the reason for augmentation is cosmetic, in 1% of cases, is it used as a reparative measure following surgery in breast cancer patients.
In what ages of people can breast augmentation be done?
While the procedure is usually done in women above the age of 20, most women going in for it are those in the child bearing ages, between twenty and forty five years.
Does breast augmentation always imply the use of implants?
No. There are two modalities of augmentation to achieve the desired results: injections and implants. The injections too are of two types. One is the Polyacrylamide Gel, which increases the breast size spontaneously, at the moment. The second type of injection is one which may increase the breast tissue itself; so the breast will be augmented. These two have their own advantages and disadvantages. The advantage of the first type of injection is that it is spontaneous but it may last for about five years only, after which period the breast size will reduce, though it will not come back to the pre-augmentation size. So the injection has to be repeated after 5 years. The second injection will naturally increase the breast size, which lasts life long and hence will not need to be repeated.
What is the injection schedule that is followed for these two types of injections, to achieve the desired augmentation?
The polyacrylaminde injection might be a one shot injection whenever it is done, once in five years. However, 1 or 2 months after the primary injection, the women should come in for examination because whenever we inject the gel, it takes sometime to completely take the final shape. So we need to know whether she requires an additional dose of the gel to be injected or not. The second type of injection that I mentioned, has to be repeated monthly for 3 - 4 consecutive months after which there is no need for a
So this procedure would be done as an out-patient one?
Yes, that's so. It may take about ½ to 1 hour at the maximum. When we inject, we manipulate the amount we inject and try to concentrate it in those spots which will give the shape. We examine the woman's breast and identify 3 to 4 areas which are best suited for the desired shape.
What about the components of these two injections? Do they carry any risk factors for the women taking them?
In 99% of cases, there is no risk of any side effects of the injections whatsoever. Even in the 1% of cases where an element of risk is present, it is not because of the injection per se but because of unhygienic handling conditions of the injection or the bottles containing the substance. The components of the injections do not cause any adverse side effects since they have been tested for a number of years now. The material used in the second type of injection is a purely natural one which our bodies already have but not in sufficient quantities. So we inject it into the breast.
What do the breast implants involve?
As I mentioned earlier, implants are also of two kinds, those made from silicone gel and the saline implants. Saline implants are very much safe to use. There is a lot of controversy over the use of silicone get implants in recent times because certain sections of doctors argue that the silicone gel may leak into the blood stream, cause infection and embolus, which is a serious condition. So to play it safe, we are using saline implants. The only possible side effect of saline implants is that it can burst but this will not cause any harm to the women. All that we need to do in such a situation, is to remove this implant and put in a new one. But the real disadvantage of the saline implant is that it is not giving that much shape as desired or expected by the women. But nowadays there is a new gel which is silicone based but without the leak effect. But it has not yet been
approved to be marketed.
Implants obviously involve surgery. The implant is inserted through a small incision in the armpit, directly under the areola, or in the crease of the lower section of the breast, the most commonly used area. Implants are placed in front. The whole procedure taking up to 1 - 1 ½ hours. As with any surgery, this surgery carries the risk of infection at the site of incision, also to count the risk of anesthesia.
Is it true that women who've had breast augmentation carry a higher risk of breast cancer later?
No, not at all.
Are the implants, silicone gel or saline ones, permanent?
No. Though a lot of people do not ask us this question. But they need to be aware that these implants are not permanent. They need to be changed after 10-15 years; they could be hazardous if not removed after this period of time. The implants may burst and the silicone may get into the blood circulation.
How easy is it to have the implants removed should a woman decide she wants
it no longer at some future date?
Usually, it is easy, though harder than putting it in. But in the hands of experienced plastic surgeons, it is rather simple.
Can women with breast implants, breast feed?
Yes, because we are not interfering with the glandular tissues of the breast; the surgery doesn't affect the glandular tissue any way.
What are the immediate dos and don'ts following an implant?
Personal hygiene is very important. Antiseptic solutions should be used at the site of the incision. There should be no trauma at all of any kind. The woman should not wear tight brassiere. She should abstain from strenuous physical activity and lifting heavy thing for a few weeks following surgery.
If an injection can do the job with practically no risk, as an outpatient procedure requiring no hospitalization, then why implants?
Yes, that is true. Almost 80% of women coming in for breast augmentation go for the injections. But there are candidates for injections, candidates for the type of injections and candidates for implants. In women with very small breasts, or in those women in whom the breast tissue which have receptors, do not respond to the injections, implant is the only option. Finally, since in 99% of cases, breast augmentation is done for cosmetic
purposes, women have a pre-determined shape of the breast in their mind, which they want following augmentation treatment. This cannot be done with injections.
If injections can't be used on some women, the silicone gel has its share of risks and the saline implants do not necessarily produce results to the extent desired, then what option do these woman really have?
Basically we have to examine the women on a case-by-case basis and see what technique is best suited to their anatomical structure. Secondly, we have to assess her mental makeup to evaluate what is the shape she really has in mind which she wants. Based on these two factors, we will provide her the best fit solution.
Are there women who would not make ideal candidates for breast augmentation,
whether by implants or by injections?
99% we can perform it on all women. It is a completely safe procedure with no side effects at all. The 1% of people on whom it cannot be done include women with serious medical problems like HIV, those having low immunity, women who are highly diabetic, or have high infections, have high or low blood pressure and those having skin disease.
What about women having a strong family history of breast cancer or who have
cysts in the breast?
In these women, we recommend certain types of breast augmentation which could be either of two things: breast implants or injection of some kind of silicone which is not a silicone but a gel, the polyacrylamide gel. For women having cysts in the breast, the cysts type should be identified first and then treated accordingly. Then augmentation technique suited to the woman, can be done.
What about women who are pregnant or those currently breast-feeding.
Augmentation is best avoided in these women till such time that they stop breast feeding.
Is it true that breast augmentation is better not done on women who are actively losing or gaining weight?
Yes, that's true because weight loss or gain can change the shape and size of the breasts. However, these people can go in for augmentation once they are through with their weight-gaining or losing process. But these are a very small percentage of people.
Does breast augmentation also help women with droopy or sagging breasts?
If the sagging is minor, we would be raising the sagging skin and then go ahead with the augmentation. But if the sagging skin is large, we first have to do some plastic surgery to cut down the skin of the breast and make it that much smaller or appropriate to their body measurements and then go in for augmentation if they wish to.