feature BREAST SURGERY in 2015 42 www.cosbeauty.com.au
feature THE NUMBER OF OPTIONS IN BREAST ENHANCEMENT SURGERY TODAY MEANS THERE’S A PROCEDURE TO SUIT EVERY PATIENT’S NEEDS. CAITLIN BISHOP REPORTS. Breast surgery is more customisable than ever before. Research spanning decades has helped formulate surgical <strong>and</strong> aesthetic techniques that have placed breast surgery at the forefront of today’s plastic <strong>and</strong> reconstructive arena. The expertise garnered through years of investigation from leading aesthetic surgeons around the globe means breast surgery today offers more individualised results, with less scarring <strong>and</strong> reduced downtime following surgery. The implants used in breast augmentation have been improved <strong>and</strong> refi ned through both design <strong>and</strong> manufacturing. Features to reduce the risk of capsular contracture <strong>and</strong> prevent implant rotation, gel diffusion <strong>and</strong> implant rupture help achieve superior results with fewer incidences of complication. Surgical techniques have also changed. Different implant placement <strong>and</strong> incision sites afford breast augmentation patients more options in scar placement <strong>and</strong> aesthetic outcomes. Surgical advances in breast reduction have led to improved results, with less downtime. And a greater underst<strong>and</strong>ing of breast anatomy <strong>and</strong> aesthetics has made correcting deformities, such as tuberous breasts <strong>and</strong> asymmetry, more effective than ever before. Breast surgery in 2015 encompasses a range of procedures to suit the functional <strong>and</strong> aesthetic concerns of most women. Here, we outline the most common procedures performed today <strong>and</strong> how the surgical approach can be tailored to meet each patient’s needs, concerns <strong>and</strong> expectations. Breast augmentation When considering implant shape, texture <strong>and</strong> size in breast augmentation, a decision is made with reference to a woman’s individual body type <strong>and</strong> aesthetic goals. During the consultation process, measurements are taken to determine the anatomical limitations <strong>and</strong> allowances of the breasts, chest <strong>and</strong> soft tissue, <strong>and</strong> patients are able to express their motivations, concerns <strong>and</strong> expectations going into surgery. The choice of projection is a very personal one. A woman who is happy with her shape <strong>and</strong> has suffi cient breast tissue may opt for a low-profi le implant that will simply increase the size of her breasts. Another patient may favour a high-profi le implant to reduce sag <strong>and</strong> generate cleavage. Ultimately, a thorough underst<strong>and</strong>ing of the implants, their shapes, fi lls <strong>and</strong> placement will help ensure a satisfactory outcome. Implant fill There are two types of implant fi lling: silicone gel <strong>and</strong> saline solution. Both are encased within an outer shell of silicone. Silicone gel implants are touted to have a more natural feel than their saline-fi lled counterparts, <strong>and</strong> the gel’s cohesive consistency helps retain implant shape following insertion. In comparison, saline-fi lled implants are fi rmer to touch, <strong>and</strong> have a greater chance of rippling after insertion. If implant rupture occurs with saline-fi lled implants, the saline solution will be absorbed into the body <strong>and</strong> the rupture will be immediately noticeable to the patient. When using silicone gel fi lled implants, rupture is less noticeable <strong>and</strong> can remain undetected for longer periods of time, which is cause for concern to some doctors <strong>and</strong> patients. Although the length of incision will depend on the size of the implant, there are slight differences between saline <strong>and</strong> silicone gel fi lled implants. Because silicone gel is manufactured into the implant before surgery, the incision sites must be slightly longer than those required for saline implants, which can be fi lled through valves once inside the breast pocket. Implant shape Implants come in round, teardrop (anatomical) <strong>and</strong> conical shapes. The round <strong>and</strong> teardrop options are the most popular in modern-day breast surgery. Round implants come in smooth <strong>and</strong> textured shells, <strong>and</strong> will usually lend more upper pole fullness than anatomically shaped implants. When the patient is upright, a round implant can assume a defi ned, round shape or a teardroplike contour, depending on its fi ll. Anatomical (teardrop) implants have a fuller lower pole, <strong>and</strong> the shape more closely resembles that of the natural breast. Their design gives them greater projection in relation to the size of the base, making them particularly suitable for women with little breast tissue. A precise degree of accuracy is needed when positioning anatomical implants, because if they shift after surgery the shape of the breast may be noticeably distorted. To reduce this risk, anatomical implants will always have a textured surface to enable adherence to surrounding tissue. www.cosbeauty.com.au 43