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Breast Enlargement
Health Guide
Breast augmentation is a surgical procedure which involves the placement of an implant behind the breasts to enhance their size and shape. Breast augmentation is indicated for the following reasons:

- small breasts

-shrinkage of breast volume and sagging of the breasts after pregnancy

-asymmetry of breast size

-reconstruction of part or all of the breast following surgery

-gender reassignment surgery (male to female sex change)

This brochure will give you an overview of breast enlargement surgery and breast implants. After you have read the information please book an appointment to talk to one of our surgeons in greater detail. Write down any questions you wish to ask the surgeon. A separate information sheet is available with an estimate of the costs involved.

The Best Candidates For Breast Augmentation

Breast augmentation can enhance your appearance and your self confidence, but it wont necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

There is no one ideal breast shape and very few women have perfectly symmetrical breasts. The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you're physically healthy and realistic in your expectations, you may be a good candidate.

Type of Implants

Breast implants are available in an extensive range of sizes, shapes and types of fill. All implants have an outer silicon rubber layer, They are filled with either silicone gel, saline (salt water) a hydrogen or a soya bean oil derivative. There are round implants or anatomically (tear-drop) shaped implants. Your surgeon will give you more information so you can decide which implant best suits you.

Ask for a copy of the Department of Health booklet on Silicone Gel Implants whether or not you choose to have silicone because much of the information about potential complications is relevant to other types of implants.

Please bear in mind that breast implants are not guaranteed to last your lifetime. It is important for you to understand that you may require at least one operation in later life to remove or replace your implants.

A Warning About Fat Injection To Augment Breasts

This technique is unsafe and produces undesirable disfiguring long-term results. The transplanted fat will shrink and harden and may form lumps which are difficult to distinguish from breast cancer. Fat injection of breasts is not performed by any reputable surgeon in New Zealand. It is promoted as a cheap, "natural" method of breast augmentation by untrained "cosmetic surgeons" but the results are unsatisfactory and irreversible. This procedure is strongly condemned by the NZ Foundation of Cosmetic Plastic Surgery.

Risks and Complications

Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure.

The most common problem, capsular contracture, occurs if the scar or capsule around the implants begins to tighten. The incidence is approximately 8%. This squeezing of the soft implant can cause the breast to feel hard and may distort the shape. In severe cases it may also be painful It tends to occur within 6 - 12 months following surgery. Capsular contract can be treated in several ways, and sometimes requires either removal or "release" of the scar tissue or replacement of the implant. The chances of developing a capsular contracture depend on several factors and are not predictable.

Unsightly, thickened scars at the site of the skin incisions can occur in 2 - 5% of patients.

As with any surgical procedure, excessive bleeding following the operation may cause swelling and pain. If excessive bleeding continues, another ope
While there is no evidence that breast implants cause breast cancer, they may change the way mammography is done to detect cancer. When you request a routine mammogram, be sure to go to a radiology centre where radiographers are experienced in the special techniques required to get a reliable x-ray of a breast with an implant. Additional views will be required. Since the breast is compressed during mammography, it is possible for an implant, or the capsule around it, to rupture. An experienced radiographer should know how to push the implant away from the breast tissue to get the best possible views of the breast. Even when this special technique is used, some breast tissue may be missed. Ultrasound examinations may be of benefit in some women with implants to detect breast lumps or to evaluate the implant.

While the majority of women do not experience these complications, you should discuss each of them with your surgeon to make sure you understand the risks and consequences of breast augmentation.

Should complications occur that require early re operation the Breast Centre will not charge an additional surgical fee but you will be required to pay for the theatre, anaesthetic and hospital costs.

Planning Your Surgery

In your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor may also recommend a breast lift, (For more information on this procedure, ask your surgeon for the brochure on breast lift, also known as mastopexy).

Be sure to discuss your expectations frankly with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each. You may want to ask your surgeon for a copy of the manufacturer's insert that comes with the implant he or she will use - just so you are fully informed about this. And, be sure to tell your surgeon if you smoke, and if you're taking any medications or other drugs.

Your surgeon should also explain the type of anaesthesia to be used, the type of facility where the surgeon will be performed, and the costs involved. Because insurance companies do not consider breast augmentation to be medically necessary, they do not cover the cost of this procedure.

Preparing For Your Surgery

Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications.

While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for several days, if needed. One to two weeks convalescence at home may be necessary.

Where Your Surgery Will Be Performed

Breast augmentation surgery is best performed at an accredited hospital with in-patient facilities. It is recommended that you stay overnight following surgery although the procedure may be done as a day case in selected patients.

Types of Anaesthesia

Breast augmentation is best performed with a general anaesthesia, so you are fully asleep during the entire operation. If you prefer to have the operation under a combination of local anaesthesia and intravenous sedation an anaesthetist is still required to be present to administer the sedation and monitor your vital signs.

The Surgery

The method of inserting and positioning your implant will depend on your anatomy and your surgeon's recommendations. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple) or in the armpit. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible. Endoscopic techniques permit the surgeon to operate with great accuracy through small incisions.

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