Breast enlargement is for women with underdeveloped breasts and women have lost their gland after pregnancy or loss of weight. It consists in introducing through a small opening (located under the breast, under the areola or in the armpit) a prosthesis that will go under the gland or under the pectoral muscle. This prosthesis can be filled with a saline solution or silicone. There again, a good assessment of your condition will allow you, after discussion with your surgeon, to determine the access route, implant site, type and volume of the prosthesis matching best your expectations. You further need to understand that your effort does not end on the day of the procedure: you also need to assume the responsibility of observing afterwards the recommendations of your surgeon and of going through regular checkups.
Breast implants, although now highly sophisticated, will never imitate with accuracy mammary tissue. You have to be aware of this and accept its limitations. They are not a permanent solution; they undergo ageing and need to be later replaced (approximately 10 to 15 years). Rejection also occurs in a small number of cases. Hardening of the breast is then observed. Finally, for each year following the surgery, 1% of these implants will break down prematurely.
Where will the incision for breast enlargement be made?
The most frequent sites for incisions are the periareolar region, the inframammary fold and the armpit. Incisions have their particular features.
- Periareolar region: This is an area where the skin is thin and allows fine and near-invisible scarring since it is located in a natural color-transition site. This area also allows the superior juxtaposition of the tissues, which reduces the risk of exposing the implant. Some studies report sensitivity alteration while others do not confirm such findings.
- Armpit: This area is preferred by those who refuse to have a scar on the thorax; the incision heals well and leaves hardly any trace. But there are drawbacks with this particular area: longer surgery time, occasional difficulty reaching a vessel that bleeds with the risk of having to resort to a counter-incision, higher risk of altering the areola and the arm’s internal side sensitivity, as well as the sometimes slightly too high position of the prostheses in relation to the breasts.
- Under the breast: This is the classic site for an incision because the scar will be relatively well concealed in the natural fold under the breast. However, the scar will, in general, be of inferior quality compared to the areola or armpit areas; it is also the most visible for the spouse.
- The umbilicus (TUBA): A popular site in the United States, it leaves only a small scar between 12:00 and 6:00 in the umbilicus. According to some articles, there are also the advantages of being less painful, having a lower risk of infection and hematoma and hard shell formation (capsular contraction).
Where can breast implants be inserted?
There are two possible positions: under the gland or under the muscle.
- Behind the pectoral muscle: This procedure is usually necessary when physiological saline implants are used that could be too visible (small waves) or palpable under a small gland and a limited skin thickness (under 2 cm). The muscle covering the upper position of the implant provides, when relaxed, a milder and more natural transition between the thorax and the breast.
It should be noted that the use of pectorals causes visible mobilization of the prostheses, which is nevertheless beneficial by reducing the risk of capsular contraction complication. When your natural breasts will tend to drop with age, particularly if left without good bra support, a double contour may appear as the prostheses will remain under the muscle and in a higher position.
- Behind the mammary gland (in front of the muscle): For this position, it is possible to use only local anaesthesia and preferably silicone implants. The breast will have a rounder look at its upper pole but, with time, the implant and breast will tend to droop together. Over time, this may prove more natural, albeit with some reduced upper pole fullness. Implant position behind the mammary has also increased risk of capsular contraction.
Silicone or saline breast implants?
To find out which implants would be suitable for your breast enlargement, please visit the page dedicated to breast implants.