Breast augmentation is an aesthetic surgery done to improve the size and firmness of the breasts. The techniques of surgery and the implants used have evolved from the initial attempts. At present, saline filled implants are the most commonly used implants.

If you have decided to go ahead for breast augmentation, it is important to choose the plastic surgeon carefully. Do and evaluation of the practice of the surgeon, get the references of the clients who have had the surgery with the same surgeon and talk to them. The surgery would affect the presentation of your body, it might be more painful if you do not get the desired outcomes.

The period before and after the surgery is very important.

breast-augmentation_before-and-after-the-surgery

Who is an ideal candidate for breast augmentation surgery?

1.  An ideal candidate for breast augmentation surgery would be a woman seeking to improve her self image. These are grown up women and are in stable relationships.
2.  There are women who would come to the surgeon on the insistence of their male partner, or women who seek a potential male partner. The ideas and expectations of these clients have to be discussed in detail, as there are higher chances of disappointment with these people.
3. The women who have post partum atrophy of the breasts. They would say they were happy about the appearance of their breasts only during the pregnancy.
4. Young women who have minimal breast development.

breast-augmentation_process

Pre-operative management of the patient:

1. The surgeon would consult you before the breast augmentation surgery. During this initial visit, the expectations of the client are discussed in detail.
2. The family history of the individual is taken, with attention to incidence of breast cancer.
3. A physical examination of the breast is done to assess for any nodes or axillary lymph nodes.
4. If the client is over 35 years of age, a pre operative mammography is also done.
5. The preoperative photographs are also taken during the visit to the surgeon.
6. The expectation of the patient regarding the size of the breast is also discussed during the preoperative visit to the surgeon. The surgeon and the patient would have to come to an informed decision together regarding the size of the implant to be used.
7. The patient is advised to avoid aspirin for a week before the surgery. It is advised as aspirin is associated with increased bleeding.
8. Smoking and alcohol is also to be avoided during the pre operative period.

 Post-operative management of the patient:

1. After the surgery, minimal care is required. the patient can return to her normal daily activities from the next day of the surgery.
2. An analgesic may be given to reduce the amount of pain.
3. Any significant pain, not controlled by the analgesics is to be reported immediately.

 Complications:

There are very few complications that happen after a breast augmentation surgery.

1. A hematoma is the occasional complication that occurs after the surgery. It would present as inflammation and pain, and some times as echymosis. If it is small, it might resolve on its own. But in case of a bigger hematoma, the patient might have to undergo evacuation in the operation theatre.
2. Infection is another very rare complication. In case of infection, the surgeon is left with no other option than to remove the implant.

According to the existing documented history, breast augmentation was first attempted in 1904. it was done using injection of paraffin and the patients were left with hard masses and draining sinus tracts, not to talk about the pain the patients had to go through. Later in 1950s and 1960s, the practitioners tried injecting liquid silicone to augment the breast. This procedure was considered success, as during the initial period after the injection, the results were very good. But the patients inevitably developed nodularity and inflammation some time later and the surgeons had to resort to mastectomy to correct the problem. This practice was later abandoned by plastic surgeons, but may still be used by some unconsiderate practitioners.

Once this was also ruled out as a technique for breast augmentation, attention turned to developing an implant to be surgically placed in the breast resulting in augmentation. The first used surgical implant was made of Ivalon sponges, in 1958. It was made from polyvinyl alcohol. There were problems associated with this technique as well. Fibrous tissue would grow into the sponges and cause them to shrink in size. Once this happens, there is no other option than taking out the sponges. Efforts were made to cover the sponges with plastic covers, one or several of them, to protect it from the growth of fibrous breast tissue, but all of them failed.

Breast augmentation again became a surgery of questionable future. The prospects seemed a little better when in 1963, Cronin and Gerow reported the use of silicone gel prosthesis. This became a standard practice for breast augmentation and the practice boomed.

Silicone gel prosthesis was the choice for breast augmentation implant till recently and the question was risen only when some organizations raised issues on the development of several diseases as secondary to the exposure of silicone. Due to this hue and cry, the government has restricted the use of these implants and it can be said that the use of silicone gel prosthesis in breast augmentation surgery has ended.

During this time, saline filled implants also became popular along side of silicone gel implants. And the practice of using saline filled implants increased once the axe fell on silicone. It is the most common implant in use in the present times.