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Who is a candidate for breast augmentation?
Women who choose to have breast augmentation surgery do so to improve
their self image. Some feel dissatisfied because their breasts never
develop to a size to meet their expectations. Others wish to bring
balance to a breast that is somewhat smaller than the other. Often,
women want this procedure to restore their natural breast volume
which may have decreased as a result of pregnancy, weight loss or
aging.
Good candidates for breast augmentation include those who are
bothered by the feeling that their breasts are too small. Breast
augmentation should only be considered when breast development is
complete. The patient must be emotionally mature and understand
her own motivations for wanting this procedure. Realistic expectations
are also important and one must understand that the procedure can
bring improvement but not perfection.
How is breast augmentation performed?
No two cases are exactly alike and every operation must be tailored
to the specific needs of the individual. The technique used for
the surgery depends not only on the surgeon's preferences but also
on the patient's desired results.
There are typically three types of incisions that can be used
in this operation. One is located underneath the breast, just above
the crease. Another is around the lower edge of the areola. Another
is within the armpit. Some doctors also offer an endoscopic procedure
performed through the umbilicus. Once the incision is made, the
surgeon creates a pocket into which the implant is inserted. This
pocket is made either directly behind the breast gland or beneath
the pectoral muscle located below the breast gland and above the
chest wall.
What types of breast implants are available?
There are different shapes available and different implant surfaces
available. Primarily, there is a round shape and there is the so-called
anatomical shape. These may be covered with a smooth silicone surface
or a textured surface. Which implant is right depends on the patient's
individual needs and surgeon preferences, and implant size and shape.
Depending on the desired shape, the patient and the surgeon may
choose a round or contoured implant. Generally, the larger the cup
size, the larger the breast implant the surgeon will consider.
What are the risks?
All surgery carries some risk. The primary safety issues include:
- Capsular contracture or build-up of scar tissue
around the implant that can cause breast firmness. When severe,
this may require corrective surgery.
- Deflation is generally harmless, but carries
the risk of additional surgery for replacement. Current data shows
a deflation rate of 5.8 percent for implant models currently in
use, according to the University of Minnesota study.
- Infection associated with breast augmentation
is rare, and can usually be treated with antibiotics. Multiple
studies have consistently failed to demonstrate that women with
breast implants have a higher rate of breast cancer, and two major
studies have shown a lower than expected rate. Women with implants
and in whom breast cancer has been detected have not been shown
to have a later stage disease or poorer prognosis than other women,
according to a recent study at the University of Southern California.
Interference with Mammography
An implant may interfere with finding breast cancer during mammography
and may also make it difficult to perform a mammography. It is therefore
essential that one tell the mammographer that this procedure has
been done, so that the technologist may use special techniques to
minimize the possibility of rupture and to get the best views possible.
More X-ray views are necessary with this technique, therefore women
with breast implants will receive more radiation. It is thought
that the benefits of mammography in finding cancer greatly outweigh
the risks of additional X-rays.
Further Considerations
The surgeon will also evaluate the existing tissue to determine
if there is enough to cover the breast implant. An excessively large
breast implant may cause problems postoperatively, it may speed
up the effects of gravity and result in an earlier droop or sag.
How much does breast augmentation cost?
The cost of this procedure varies depending on your location. The
costs usually range from $3,000 to $6,000. The implants themselves
cost approximately $1,000. It is important to keep in mind that
health insurance does not cover this surgery. Some carriers will
not even cover a complication that may require surgery.
How do I find a qualified surgeon?
One of the most important factors in the success of any type of
surgery is the surgeon you choose. Before scheduling a consultation,
it is important to find out whether the surgeon is certified by
the American Board of Plastic Surgery. Surgeons with this certification
have completed a minimum of five years of surgical training following
medical school including a plastic surgery residency program.
During this intensive program, surgeons learn to perform surgical
procedures for the entire body and face. At the same time, they
have developed their skill and aesthetic judgment. After training,
a surgeon must pass a comprehensive oral and written exam before
being granted certification.
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