SILICONE BREAST IMPLANT SURGERY OPERATIVE TECHNIQUE
Operative techniques are usually for surgeons. We made this in the simplest of words for you to have a glimpse and have a clear understanding of what we do during a Breast Implant procedure.
1. INDUCTION OF GENERAL ANESTHESIA
Medication to put you to sleep will initially be given via IV (thru the vein), and then a tube will be inserted through your throat where gas anesthesia will takeover throughout the entire procedure.
2. PREPPING OF THE BREASTS W/ ANTISEPTIC SOLUTION
Povidone-Iodine cleanser and solution are applied over the breasts (including some areas above and below, and the sides) to make the areas sterile.
3. PLACEMENT OF STERILE SURGICAL DRAPES
Drapes cover the unsterile areas around the breasts to keep the surgeon from being contaminated during surgery.
4. REPEAT MARKINGS
Markings are typically made during photo taking. Prepping lightens the drawing, thus the surgeon repeats them.
5. SKIN INCISIONS
Depending on the choice or what was agreed upon by the patient and the surgeon, the incisions (placed in any of the locations - breast folds, areola, or axilla) is around 5-6cm (2 inches) long.
Some surgeons infiltrate tumescent fluids (mixture of local anesthesia and blood vessel constricting medications) prior to cutting. This serves them to estimate the implant volume the breasts can take, how it will look like with that volume, infiltrated, and to minimize bleeding during dissection.
6. CREATION OF IMPLANT POCKET
Pockets can be located above, partly behind, or completely behind the chest muscles. We prefer to place it above-the-muscles where the normal anatomical location of the breast is. This will result to a more natural look. The notion of getting higher risk of capsular contracture is not always true as the correct technique of above-the-muscle placement can offset the risk of this complication. Keeping a bloodless field, minimizing implant and around-incision trauma during insertion, and minimal implant exposure to air are important precautions surgeons need to follow.
The only time we recommend the behind-the-muscle placement is when the chest wall pinch thickness test is less than 2.0cm (common among thin women). Above-the-muscle placement will result to visible implant roundness over the upper poles of the breast among these subjects.
7. INCISIONS CLOSURE
8. APPLICATION OF ANTISEPTIC
9. ELASTIC COMPRESSION
10. END OF ANESTHESIA
BREAST IMPLANTS BEFORE AND AFTER PHOTOS
TYPES OF BREAST IMPLANTS
1. Saline implants
2. Silicone implants
a. Round
Smooth silicone
Textured silicone
b. Anatomical or teardrop-shaped implants
History of Breast implants
BREAST IMPLANTS trace its history during the early 1960's when it was invented by 2 American surgeons who performed the first implant augmentation of the breasts.
Since then, implants have evolved from Saline-containing to Silicone-filled with increased cohesiveness that will prevent leakage of the material out of the shell.
Todays implant's outer shell is even made tougher with Elastomer-coating, which can either be smooth or textured.
Smooth silicone implants have smooth outer surface. They were among the early generation implants that were manufactured to replace saline-filled implants, which did not have the normal feel of softness inside the breasts. Smooth implants do not attach to the surrounding body tissue or capsule that forms around them in the body. Because of the possibility of this capsule becoming thicker through time, they were associated with the medium-term complication of "Capsular Contracture" that results to different degrees of hardening of the breasts.
Textured silicone implants have outer shells with rough and irregular surface. They were developed to minimize capsular contracture and to lengthen the life of the implant. Before recently, cosmetic surgeons preferred to use this type of implant for lasting results. However, because of worldwide reports of its link to BIA-ALCL (Breast Implant Associated Anaplastic Large Cell Lymphoma), preference has shifted back to smooth shell implants. Although the incidence is very low (9 deaths), patient safety was always the priority for cosmetic surgeons.
Anatomical or teardrop-shaped implants are selected for slender women who have thin tissue over the upper pole of the breast. The shape of anatomical implants allows lesser visibility (bulging) over the upper chest, which is common in round implants, allowing a more natural look. The only drawback is that it is more expensive.
Book an appointment with breast surgeon Dr. al Jaafar
(use contact form or send a message to +63 9189853668 Viber/Whatsapp).
Dr. Al Lee Jaafar, will personally do the procedure for you. He is the surgeon of Neu Advanced Aesthetics Centre in Centuria Medical Makati.
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1. BREAST IMPLANT SURGERY
When you want a definite increase in your breast size, silicone implant is the procedure of choice.
Implant sizes range from 150cc (smallest) up to 600cc per breast and they come in variety of shapes (round or anatomical). After breast implant surgery, the size observed is more or less permanent already (except for some minor shrinkage from the operative swelling).
Replacement may be needed after 5 to 10 years since implants don't last a lifetime.
Breast Augmentation using implants is one of the top Cosmetic Surgery procedures in women. It involves insertion of Silicone implants into the breasts to increase the size.
IMPLANT PLACEMENT
Implant placement locations can be behind the existing breast tissue (Retro-glandular) or under the chest muscles (Sub-muscular).
1. Retro-glandular or above the muscle implant placement
results to a more natural look because the location of the implant simulates the normal anatomical location of the breast tissue. After surgery pain is also lesser and recovery faster.
2. Sub-muscular implant placements
are reserved for very slim subjects with small breast tissue or those with less than 2cm skin-pinch test over the chest area. The muscle cover will prevent visibility of the implant's edge over the upper pole of the breast. Recovery period may be prolonged.
TIPS FOR SPEEDY RECOVERY
AFTER BREAST IMPLANT AUGMENTATION
Breast implant surgery using implants involves insertion of synthetic material into your breasts. It is important that after-surgery instructions are strictly followed in order that recovery will be swift and risk of complications are lessened.
Enumerated are tips you should follow for an unremarkable recovery.
1. REST
The period immediately after surgery should be spent resting in bed and staying indoors. This is important because the newly created implant pocket within the breast may bleed inside especially during the first 24 hours. Swelling will also progress at this period, thus you are advised not to remove the elastic compression applied in the operating room.
2. AVOID LIFTING YOUR ARMS
Your breasts sit on the chest muscles that are responsible for certain movements of your arms. A newly placed implant on this area may be displaced or healing may be delayed.
3. AVOID PHYSICAL EXERTION
Your newly stitched incision wounds are still fresh and your skin would need at least 2 weeks to heal to attain near-normal strength. Having constant physical exertion would result to poor wound healing and to ugly scarring. Worse wound dehiscence can occur.
4. KEEP WOUND DRY
Constantly moist wound will be prone to bacterial contamination and infection. Change the waterproof plasters placed by your surgeon every 2 days. The wound can be left without cover after 7 days.
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BREAST IMPLANT OR BREAST FAT TRANSFER?
Some women cannot decide on what procedure to choose for breast enlargement. The choice between breast implants or fat grafting may seem difficult especially when information on the advantages and disadvantages of both procedures are limited.
Consider getting breast implants when you want and can accept the following:
1. DEFINITE AND BIGGER BREAST SIZE INCREASE
With breast silicone implants, you can estimate the outcome of your augmentation with implant sizers placed inside your bra during your initial consultation. You can also choose the size of the implants (from 150cc to 600cc). Not all sizes however will fit you. The choice will depend on your body frame and your existing breast cup.
To determine which size will be best for you, the surgeon will measure the diameter of your breast, the thickness of the skin over the upper chest, and the distance of your nipple to the lower breast folds. This will give the surgeon the approximate size that can be inserted without creating too much tension and lesser risk of future complications.
2. NO ISSUES ON ALLERGIES OR IMMUNE HYPERACTIVITY
Because breast implants are still considered foreign materials (even though silicone is considered as inert and lease likely to cause reactions), patients with immune hyperactivity or with allergies have higher risk of implant rejections.
3. HAVE TIME FOR A 2-WEEK RECOVERY
Breast implant surgery entails making an incision and dissection to create an implant pocket on each side of the breast. Healing of the wound and the inside may take 2-4 weeks.
4. BIGGER INCISIONS
Although skilled plastic cosmetic surgeons have the ability to insert the implants using incisions smaller than its diameter, the incision are still longer compared to breast fat grafting.
5. IMPLANTS REPLACEMENT AFTER 5 TO 10 YEARS
Breast implants are not permanent. Smooth types last between 5 to 7 years, while the textured types 7 to 10 years.
STEP BY STEP PROCEDURE FOR BREAST FAT GRAFTING
The following is a detailed process that you will undergo, from beginning to end, to attain your dream of bigger breasts using silicone implants.
1 INITIAL CONSULTATION
- Concerns
- Review of medical history like past/recent procedures, hospitalisations, allergies, and medications
- Physical examination
- Explanation of the procedure
- Discuss expectations
- Additional procedures, if any
- Expenses
2 PRE-OPERATIVE WORK-UP
- Can be done the same day (before 2 pm) with consultation schedule.
- Takes at least half-day to accomplish
- Blood tests, X-rays and ECG
- Medical clearance or Cardio clearance (if needed).
- Results released the next day.
3 SURGERY DAY
- Strict fasting from midnight of previous day (no food, no drinks).
- Full body bath
- Report to surgeon at 10am
- Photo-taking and body markings (drawings)
- Proceed to operating room complex via VIP lift
- Proceed to Dressing Room
- Change outside clothes with operating room gown, booties, and head cap.
- Proceed to Pre-Anesthesia Room
- Review of medical history and vital signs check by Nurse
- Review of medical history and physical examination by the Anesthesiologist.
- Explanation of anesthesia to be given
- Proceed to Operating Room Suite
- Lie down and relax on the OR table
- Attachments of ECG leads (chest and back)
- Insertion of IV line over one of the hands
- Put to sleep with IV medication
- BREAST IMPLANT PROCEDURE by the DR. JAAFAR
- Getting awake in the Recovery Room
- May experience chills, dizziness, nausea, and vomiting
- Recovery and monitoring for 4-5 hours until able to tolerate some liquids and soft diet
- Adjusted to high back rest
- IV out, ECG leads removed
- May be discharged when able to ambulate without assistance.
- Or transferred to the Recovery Suite for overnight stay when not cleared for discharge.
BREAST AUGMENTATION
(BREAST IMPLANTS OR BREAST FAT grafting/TRANSFER​)
Most women, who choose breast enlargement surgeries, want to improve their self-image and self-esteem. Small breasts or asymmetrical breasts are the usual indications. This procedure can also be done to correct congenital deformities of the breasts.
There are 2 methods currently being used by cosmetic surgeons to augment the breasts. The first one is the insertion of synthetic silicone implants and the other is the injection of the patient's own natural fat (breast fat grafting).
Each has its own advantages and limitations.
INCISIONS FOR BREAST IMPLANTS
INCISIONS for breast implant surgery are made on any of the three (3) inconspicuous locations to minimise visible scarring. The choice will depend on the condition (anatomy) of the your breast, the type and size of breast implant desired, and your preference where the scar will be placed. Your surgeon will discuss the options before the operation to decide on which one is the best for you.
Incision options are the following:
1. Within the crease of the armpit (Trans-axillary)
the incision is followed by the dissection of a tunnel towards the breast where the implant is inserted and placed.
2. Border of the areola (Peri-areolar)
which half of the lower circumference of the areola is incised to gain access into the breast where the surgeon creates the implant pocket.
3. Under the breast fold (Infra- or Sub-mammary)
the most common where the incision is hidden beneath the breast.
Breast implant procedure is done with the patient under local anesthesia with sedation or under general anesthesia. The operation lasts around two (2) hours. You may be discharged on the same day of surgery. Recovery is fast and you may be doing light activities in 2 week's time. Compression garments are required to be worn for 4-6 weeks.