breast augmentation enlargement

Beverly Wilshire Medical Centre Sdn Bhd (878344-V) Last updated: 07/12

Level 9, Dijaya Plaza, 237, Jalan Tun Razak, 50400 Kuala Lumpur | General: +603 2118 2888 | Fax: +03 2118 2822 www.beverlywilshiremedical.com | [email protected] http://www.facebook.com/BeverlyWilshireMedical (Breast Augmentation Source:

www.plasticsurgery.org)

Cosmetic Surgery: Breast Augmentation (Enlargement Mammoplasty)

This guide is for women who are considering having an operation to enlarge their breasts. We advise that you talk to a plastic surgeon and only use this information as a guide to the procedure.

A Breast Enlargement (also known as Breast Augmentation/Mammoplasty) operation usually involves placing an

artificial implant either under your breast tissue, or under your chest muscle behind your breast.

Breast augmentation can:

Increase fullness and projection of your breasts

Improve the balance of your figure

Enhance your self-image and self-confidence

Why have breast enlargement operations?

Every woman is special in her own way and similarly the reasons for having a breast enlargement surgery differs in

all. The most common reasons why you may choose to enlarge your breasts include:

to enhance the body contour of a woman, who for personal reasons feel that their breasts are too small

loss of breast volume after pregnancy and breastfeeding (although enlargement will not lift them)

to restore breast shape after partial or total loss of breast for various conditions.

a difference in size between your two breasts, hence for symmetry

reduced breast size after losing weight

to replace existing breast implants for cosmetic or reconstructive reasons

Breasts implant surgery is contraindicated in women with untreated breast cancer or pre-malignant breast disorders,

active infection anywhere in the body, or individuals who are currently pregnant or nursing. Individuals with a

weakened immune system (currently receiving chemotherapy or drugs to suppress the immune system), conditions

that interfere with blood clotting or wound healing or have reduced blood supply to the breast tissue from prior

surgery or radiation therapy treatments may be at higher risk for complications and poor surgical outcomes. A woman

must be at least 18years of age for cosmetic breast augmentation.

What it won’t do

Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be

lifted in case of sagging, a breast lift may be required in conjunction with breast augmentation.

Breast lift can often be done at the same time as your augmentation or may require a separate operation. Your plastic

surgeon will assist you in making this decision.

Consultation with your surgeon

What to expect during your consultation?

The success and safety of your breast augmentation procedure depends very much on your complete candidness

during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss: (please do fill the medical questionnaire provided to you before meeting the surgeons)

Why you want the surgery, your expectations and desired outcome

Medical conditions, drug allergies and medical treatments




Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs

Previous surgeries

Family history of breast cancer and results of any mammograms or previous biopsies

Your surgeon may also:

Evaluate your general health status and any pre-existing health conditions or risk factors

Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement

of your nipples

Take photographs for your medical record

Discuss your options and recommend a course of treatment

Discuss likely outcomes of breast augmentation and any risks or potential complications

Discuss the use of anesthesia during your breast augmentation

Preparing for surgery

Prior to surgery, you may be asked to:

Get lab testing or a medical evaluation ( Pre- Operative Tests)

Take certain medications or adjust your current health needs

Stop smoking well in advance of surgery (6 weeks prior to surgery)

Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive from the Surgeon or Anesthetist:

What to do on the day of surgery

Post-operative care and follow-up

Informed Consent form to cover all the risk

Your plastic surgeon will also discuss where your procedure will be performed. Under normal circumstances you will be

in the hospital for 1– 2 nights after surgery.

Procedural Steps:

Step 1 – Anaesthesia

Medications are administered for your comfort during the surgical procedure. The breast augmentation surgery is

done under general anesthesia. Your anesthesia will be explained during or after your consultation with the surgeons

and also after the results of your pre-operative check.

Step 2 - The incision

Incisions are made in inconspicuous areas to minimize visible scarring. You and your plastic surgeon will discuss which

incision options are appropriate for your desired outcome. There are 3 main incision options;




Inframammary incision Placing the incision in the crease under the breasts, slightly

above where the breast and rib cage meet, is known as an

inframammary incision. It is very popular with surgeons.

Periareolar Incisions

Periareolar approach a small incision underneath

the nipple-areolar complex which camouflages

beautifully with the darker pigment of the areola.

A periareolar incision is made between the pink or

brownish skin that surrounds your nipple (the areola) and the regular skin of your breast. This type of incision

is a good choice for inserting breast implants if you are also having an areola reduction or certain types of

breast lifts.

There is a small chance of decreased nipple sensation with areolar incisions, but this is usually temporary. You

also may be more likely to experience difficulty breast-feeding with periareolar incisions. This is an important

consideration if you are thinking about having children. If you choose the periareolar incision and become

pregnant, you might also want to consult with a lactation specialist if you decide to breast-feed.

A periareolar incision also carries an increased risk of a staph infection compared to the other breast implant

incisions, because staph bacteria can be found in the milk ducts of the nipple. These ducts may be cut during

this type of insertion.

Transaxillary (Armpit) Incision

Breast implants can also be inserted through incisions in the armpits (transaxillary incisions). Inserting breast

implants this way can be done endoscopically. The surgeon creates tunnels to the sites where the breast

implants will be placed. Usually, transaxillary incisions are between 1 and 1.5 inches long, depending on the

type of implant. Some surgeons consider this to be the best incision for full submuscular placement.

Just as with implant placement, and implant type and size, breast implant incision patterns should be

discussed during your initial consultation with a board-certified plastic surgeon. Ask your surgeon what he

recommends for your surgery, and why.

Step 3 - Implant choice

Breast size and shape are important, so be honest and open about your expectations when talking with your surgeon.

Implant type and size will be determined not just on your desired increase in size but more importantly on your breast

anatomy, skin elasticity and body type.

Options for Breast Implants

Saline implants are filled with sterile salt water. They can be filled with varying amounts of saline which can affect

the shape, firmness and feel of the breast. Should the implant shell leak, a saline implant will collapse and the saline

will be absorbed and naturally expelled by the body.




Silicone implants are filled with an elastic gel. The gel feels and moves much like natural breast tissue. Current high

cohesive silicon gel implants do not leak.

An ultrasound or MRI screening can assess the condition of breast implants.

Implant manufacturers occasionally introduce new styles and types of implants, so there may be additional options

available.

Currently Saline implants are FDA-approved for augmentation in women 18 years of age and older.

Currently Silicone implants are FDA-approved for augmentation in women 22 years of age and older.

Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.

Beverly Wilshire Medical Centre only uses leading brands for Silicone breast implants.

Our surgeons recommend Silicone gel filled, high cohesive, textured implants for our clients.

Beverly Wilshire Medical Centre is the pioneering centre in Malaysia for the latest generation of breast implants; the

Furry Brazilian implants, that received FDA approval in March 2012, but more importantly they received FDA

approval for a new high strength gel and for shaped implants making them the only manufacturer to receive this.

The implants are covered in a layer of polyurethane-foam that creates a ‘furry’ feel to the outer shell. It is supposed

to feel like suede or fur which is why they are often referred to as “furry Brazilian implants”. The outer shell,

reportedly reduces the risk of Capsular Contracture, which is a risk that every woman considering breast surgery

should be aware of. These ‘furry brazilian implants’ cause a different reaction, instead of one large capsule forming,

many ‘micro capsules’ form. This means that it doesn’t contract like a tight bag around the implant. Studies have

shown that in a first time breast augmentation, the chance of capsular contracture (CC) is around 17% over the first 7

years. Studies into Furry Brazilian implants suggest a rate as low as 1% over 15 years- (the range being 0-9% in

different studies) which is a significant reduction.

Step 4 - Inserting and placing the implant.

After the incision is made, a breast implant is inserted into a pocket either:

- Under the pectoral muscle (a submuscular placement), or

- Directly behind the breast tissue, over the pectoral muscle (a submammary/

subglandular placement)

The method for inserting and positioning implants depends on the type of implant,

degree of enlargement desired, your body type, and your surgeon’s

recommendations.

Step 5 - Closing the incisions: Incisions are closed with layered sutures in the breast tissue and with sutures, skin

adhesive or surgical tape to close the skin. Over time the incision lines will fade.

Step 6 - See the results

The results of breast augmentation are immediately visible. Over time, post-surgical swelling will resolve and incision

lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of

your goal for fuller breasts.




Important facts about the safety and risks of breast augmentation

The decision to have breast augmentation surgery is extremely personal and you’ll have to decide if the benefits will

achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon will explain in detail the risks associated with surgery. You will be asked to sign consent forms to

ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks include:

Unfavorable scarring

Bleeding (hematoma)

Infection

Poor healing of incisions

Changes in nipple or breast sensation, may

be temporary or permanent

Capsular contracture, which is the

formation of firm scar tissue around the

implant

Implant leakage or rupture

(Saline implants)

Wrinkling of the skin over the implant

Anesthesia risks

Fluid accumulation

Blood clots

Pain, which may persist

Deep vein thrombosis, cardiac and

pulmonary complications

Possibility of revisional surgery

Other side effects (Please note the list is

not exhaustive)

Breast implants do not impair breast health. Careful review of scientific research conducted by independent groups

such as the Institute of Medicine has found no proven link between breast implants and autoimmune or other

systemic diseases.

Other important considerations:

Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or

both implants.

Pregnancy, weight loss and menopause may influence the appearance of augmented breasts over the course

of your lifetime.

Your recovery

After a post-surgical recovery period of 24 to 48 hours and an additional reduced-activity period of a few days, you

will likely experience soreness and swelling for a few weeks.

Exercise and normal activity can resume at the direction of your plastic surgeon. Over time, post-surgical swelling will

decrease and incision lines will fade.

You will be given specific instructions that may include: How to care for your breasts following surgery,

medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with your

plastic surgeon.




Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery

period.

Where will I be taken after my surgery is complete?

What medication will I be given or prescribed after surgery?

Will I have dressings/bandages after surgery?

When will they be removed?

Are stitches removed? When?

When can I resume normal activity and exercise?

When do I return for follow-up care?

When you go home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately.

Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no

guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and

another surgery may be necessary.

Be careful Following your physician’s instructions is the key to the success of your surgery. It is important that the

surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will

give you specific instructions on how to care for yourself.

The results will be long-lasting

The results of your breast augmentation surgery will be long-lasting. You will find it easier to wear certain styles of

clothing and swim wear.

Like many women who have had breast augmentation, you may also have a boost in self confidence.

Implants may need to be replaced or revised

It’s important to know that your breast implants are not permanent and may require replacement during your

lifetime. You should expect to have future visits with your plastic surgeon to discuss changes in your breasts.

Over time, your breasts can change due to aging, weight fluctuations, hormonal factors and gravity. If, after a period

of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast lift or

implant exchange to restore a more youthful contour.




Duration of stay in Kuala Lumpur Malaysia: The recommended stay in Malaysia for this as a single

procedure is 10 days, depending how well you recover post operation. The surgeon may recommend a

longer stay if you combine your breast surgery with other procedures.

For more information or to request a medical questionnaire and quotation please email [email protected]

The final explanation and decision for your cosmetic surgery treatment/s will be made at the time of the consultation with the respective plastic surgeon. Following your consultation with the consultant plastic surgeon you will be asked to sign a consent form prior to surgery. The below statement should be understood before signing the consent to surgery form.

I recognise that the practice of medicine is as much an art as a science and therefore acknowledge that no guarantees have been or can be made regarding the likelihood of success or outcomes. The aim is to give you significant improvement and not perfection. Cosmetic Surgery I understand that the effects of cosmetic surgery may not be immediately visible. I understand that the effect of cosmetic surgery is much more limited for smokers, that mild asymmetry is normal and that the rate of healing will depend upon age, skin type, compliance with doctor's advice or factors beyond control. I have carefully read, understand and fully agree with the above declaration and the information I am providing is true and accurate to the best of my knowledge.

Our procedures guide is intended to give you a general outline on all aspects of our standard cosmetic surgery procedures. It is not in any way meant to be a substitute for a thorough consultation with the surgeon, as each of our client cases are bespoke to the individual’s needs and medical background. Please take time to read through and familiarize yourself with the procedures available at our Medical Centre

and use our after surgery guide to help estimate how long you will need to stay in Malaysia for after surgery

before flying home or returning to work.

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breast augmentation enlargement

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