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Breast Surgery-Augmentation

Augmentation is procedure to increase in size of breast.

This can be done with

1.Autologus tissue like fat grafting

2. Breast Implants.

Breast Implants:

All implants on the market today are made of two separate components, outer silicon shell and inner filling that can be of Saline or Silicone.

Surface Characteristics

The outer shell of breast implant are either smooth or textured .

Smooth                                                                                  Texured

1.Round                                                             1. Anatomic

2. Free rotation within the capsule              2. Tethered to capsule

3.May bottom out                                         3. More rippling

4.Loss of superior pole                                  4.Better retention of shape

5.Possibly higher contracture rate                5. Possibly low contracture rate

 

 What are shapes of Implant?

Breast implant may be round or anatomical shape.

 

The newest generation of implants –the cohesive silicon gel implant-promises increased gel integrity and a more natural appearance.

That are the approaches for breast agumentation?

There are four approaches

  1. Inframammary
  2. Sub-areolar (Trans-nipple)
  3. Transaxillary
  4. Periumbulical

 

Commonly dual plane breast augmentation is done in which implant is placed under both muscle and breast tissue.

Advantages of dual plane implant placement

1.Minimal capsular contracture

2.Implamt is not visible hence no rippling

3.No alteration in normal breast function as breast feeding

What are complication?

 

1 Most common complication is capsular contracture.

2. Implant malposition

3.Asymentry

4. Infection and implant removal.

Breast Augmentation with FAT GARAFTING

Fat grafting to enlarge the breast can be performed for cosmetic reasons, for correction of asymmetry ,and for reconstruction of deformity.

Advantages of fat grafting

  1. Absence of autoimmune response
  2. The ease in accessing donor fat
  3. Minimal complications.

 

Indications

  1. Augmentation of the breast in patients with small breast, tuberous breast, or Poland syndrome or the patient refuse silicone implants.
  2. Correction of contour breast deformity or asymmetrical after removal of breast implant or breast lumpectomy or after reconstructive surgery
  3. Creation of thick envelope of breast tissue after placement of silicon implant.

              Donor area for fat harvest

The most common donor site are

  1. Abdomen
  2. The thigh

 

Procedure:

Procedure is performed under general or regional anaesthesia.

Fat is aspitrated manualy with liposuction cannula attached to syringe or vaccume pump.

Lipospirated is washed with 0.9 % normal saline solution

Centrifugation is done at 1000 rpm for 2 minutes.

Then this purified fat is injected in to breast.

Postoperative Case

It is recoomonded that patient should wear a supportive bra day and night for 7 days after breast augmentation with fat grafting.

Oral antibiotics areadmistered for 3 days postoperatively.

Compression garments for donor area for 3 months.