Implants: silicon and saline
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Breast augmentation is simply intended to enlarge the breasts. This will improve body image, self-confidence, and resolve clothing issues such as the need to wear padded bras and problems with swimwear. However, it is neither intended nor successful as a remedy for psychological problems or to improve an unstable relationship.
There are two types of implants: silicon and saline. Both saline and silicone gel implants have the same outer cover made of solid silicone plastic. Silicon implants today are filled with cohesive gel and this is expected to have a protective effect in preventing silicone migration once the outer plastic cover has worn out many years after implantation. Silicon implants are more used in Europe than saline implants.
Breast implants can be placed either through an incision in the armpit (very rare), under the breast, or at the edge of the areola. Factors that influence incision location include age, implant type, areolar diameter and breast anatomy.
Breast implants can be placed either in front of or behind the pectoral muscle. The decision is influenced both by individual physical characteristics and safety concerns.
The body normally forms a thin layer of pliable scar tissue around any foreign substance placed beneath the skin. This process is beneficial because it maintains implant position. Sometimes this scar layer, or capsule, will contract around a breast implant and render the breast hard in consistency. This is a biological and not a surgical cause of breast hardening and essentially represents an over-reaction by the immune system.
Implant size selection is guided by a woman’s wishes but is also influenced by her height, chest size, and the amount of normal breast tissue present. A natural appearance is an important goal of this procedure
There are two main implant shapes available today: “tear-drop” shape and round. Implants can have a textured or smooth surface.
The process of making a pocket for a breast implant can stretch sensory nerves and diminish nipple sensation. This is usually transient when it occurs but it typically takes many months to resolve. Rarely, diminished sensation can be permanent. Breast-feeding potential should not be affected by placement of breast implants.
Complications from breast augmentation are rare. Infection or bleeding problems can occur and may require additional surgery. Potential aesthetic problems include implant asymmetry and a palpable implant edge, the latter most often seen in very thin women. Most asymmetry problems are minor and do not require correction. A palpable implant edge is not a health hazard and does not require treatment.
Breast augmentation generally takes about one-two hours. It requires general anesthesia. Aftercare is minimal. An elastic binder is usually placed at the time of surgery. The amount of discomfort is variable but is generally more when the implants are placed behind the muscle. Most discomfort subsides within 48 hours. Skin stitches do not require removal. It is often possible to return to sedentary work after one week. Most normal activities can resume by two weeks. Strenuous physical exercise involving the upper body must be avoided for at least six weeks. Eventually there are no restrictions of any type.
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