Breasts: Augmentation vs Implants vs Lift

Breast augmentation and breast implant surgery are two different names

Breast augmentation and breast implant surgery are two different names used interchangeably for the same procedure. It is a surgical procedure that involves the placement of an inert or non-reactive implant below the breast tissue or muscle of the chest (pectoralis major). Plastic surgeons perform the procedure to cosmetically enhance the size, shape, and volume of the breasts.
 

Breast augmentation is done to increase the size of your breasts. It may also be done to change the shape of your breasts or to correct a defect you are born with (congenital deformity). Other reasons include:

• Reconstruction of the breast after cancer surgery or trauma
• For men, who want to increase their breast size
• For men/transsexuals, who are undergoing gender reassignment surgery

The selection of implants is a joint decision made by the patient and surgeon based on the physical assessment, indication for surgery, and aesthetic goals. 

• The most commonly used implants are filled with silicone or saline to enhance and enlarge the size of the breast.
• Autogenous tissue (using tissue from one’s own body) injections like fat, muscle, etc. can be used, but the results are unpredictable. There are risks of scarring, calcium deposition, and visible uneven texture.
• A suction pump device has been used to enhance the shape of the breast, but the overall aesthetic results were not satisfactory.

A breast lift surgery is performed to enhance existing breast tissue by lifting and tightening them, giving the breasts a natural contour, correcting asymmetry, and reducing the sagging. It restores the natural youthfulness of the breasts. Breast lift is a good option for women who have a sufficient volume of natural breast tissue. It does not involve inserting implants.

It has become increasingly popular for women to combine breast augmentation with a breast lift procedure. The combined procedure has the benefit of performing two surgeries at the same time, which is more cost-effective as the anesthesia cost and hospital expenses would be a one-time cost. The patient would also not have to undergo the recovery process twice.

Women who have gone through pregnancy, childbirth, and breastfeeding may benefit from a combined surgery, since the breasts undergo significant changes, such as loss of shape, firmness, and volume.

Both surgeries have their own advantages and disadvantages. They are both commonly performed surgeries, with relatively low mortality and morbidity. They both provide good aesthetic results, but it is important to have realistic cosmetic goals. Consulting with a professional, board-certified plastic surgeon can help you decide.

The surgery involved multiple periods:

Preoperative period:

• Physical assessment by the surgeon
• Routine blood and radiological investigations
• Advised to stop smoking, drinking alcohol, and blood thinning medication before the surgery

Intraoperative period:

• Surgery is performed under general or intravenous sedation. There will be no pain during surgery.
• The type of incision used is based on the surgeon’s discretion, type of implant, breast shape and size, and the scar appearance.

Postoperative and recovery period:

• Pain killers and antibiotics may be administered
• The patient may be advised to wear a surgical bra to provide support and help the healing
• The patient is advised to rest upright with back elevated
• The patient can be discharged within 24 to 48 hours after the surgery
• Swelling and bruising resolves in 1-2 weeks
• Assistance with routine activities like bathing and dressing may be required in the first week.
• The surgeon may advise certain exercises and massage techniques to be done in the first 2- 3 weeks.
• Light activities can be resumed after 2 weeks.
• Avoid rigorous exercises, sports, and lifting heavy objects for the first 8-12 weeks.
• After 4-6 weeks, patients can switch from surgical bras to bras of their choice.
• Patients can resume work based on the nature and requirement of the job and own comfort level after the surgeon’s approval.
• The scars generally heal very well and barely visible with time.
• A regular follow-up would be required to monitor healing.

The surgeries are relatively safe, but like any surgery, there is a risk of complications, which usually resolve on their own or with treatment. Some possible complications are:

• Hematoma (collection of blood/blood clot)
• Edema (swelling)
• Infection
• Temporary loss of sensation around the surgical site
• Thickening of scar, keloid formation, or hyperpigmentation (darkening of the skin)
• Asymmetrical breasts
• Contour irregularity
• Capsular contracture (response of the body’s immune system to foreign material): It is characterized by a change in the shape of the breast appearing round, increasing firmness, feeling of tightness, and pain.
• Malposition of the implant
• Rupture of implants
• A long-term complication of the Implant: As it is a foreign body, there is a risk of hardening of the implant over time due to calcium deposits.