Classification: plastic; therapeutic
Anesthesia type: General
Duration: 1 – 2 hours with additional 2 hours in the recovery room and one night at the hospital
Breast augmentation and augmentation mammoplasty are plastic surgery terms for the breast implant and the fat graft mammoplasty approaches used to increase the size, change the shape, and alter the texture of the breasts of a woman. As a primary reconstruction, augmentation mammoplasty is applied to effect a post–mastectomy breast reconstruction, the repair of the chest wound consequent to the removal of a cancerous breast to correct congenital defects of the breast and to correct congenital defects of the chest wall. As an elective, cosmetic surgery, primary augmentation changes the aesthetics of size, shape, and texture of healthy breasts.
For breast reconstruction, three types of breast implant devices are available:
- Saline implants filled with sterile saline solution
- Silicone implants filled with viscous silicone gel
- Alternative composition implants, filled with miscellaneous fillers (soy oil), polypropylene string, that are no longer manufactured.
The modern prosthetic breast was invented in 1961, by the American plastic surgeons Thomas Cronin and Frank Gerow, and manufactured by the Dow Corning Corporation in due course; the first augmentation mammoplasty was performed in 1962. There are five generations of medical device technology for the breast implant models filled with silicone gel each generation of breast prosthesis is defined by common model manufacturing techniques. Since the mid1990s, the Fifth generation of silicone gel breast implant is made of a semisolid gel that mostly eliminates the occurrences of filler leakage (“silicone gel bleed”) and of the migration of the silicone filler from the implant pocket to elsewhere in the woman’s body. The studies Experience with Anatomical Soft Cohesive Silicone gel Prosthesis in Cosmetic and Reconstructive Breast Implant Surgery (2004) and Cohesive Silicone gel Breast Implants in Aesthetic and Reconstructive Breast Surgery (2005) reported low incidence rates of capsular contracture and of device shell rupture and greater rates of improved medical safety and technical efficacy than that of early generation breast implant devices
The plastic surgical emplacement of breast implant devices, either for breast reconstruction or for aesthetic purpose, presents the same health risks common to surgery, such as adverse reaction to anesthesia, hematoma (postoperative bleeding), seroma (fluid accumulation), incision site breakdown (wound infection). Complications specific to breast augmentation include breast pain, altered sensation, impeded breastfeeding function, visible wrinkling, asymmetry, thinning of the breast tissue. The suspected mechanisms of breast implant rupture are:
- Damage during implantation
- Damage during (other) surgical procedures
- Chemical degradation of the breast implant shell
- Trauma (blunt trauma, penetrating trauma, blast trauma)
- Mechanical pressure of traditional mammographic breast examination
In the study Long term Health Status of Danish Women with Silicone Breast Implants (2004), the national healthcare system of Denmark reported that women with implants did not risk a greater incidence and diagnosis of autoimmune disease, when compared to same age women in the general population; that the incidence of musculoskeletal disease was lower among women with breast implants than among women who had undergone other types of cosmetic surgery and that they had a lower incidence rate than like women in the general population.