What you need to know about breast augmentation (enlargement)
Breast augmentation (enlargement) is a cosmetic surgery to enlarge your breasts that requires anywhere from one to two hours under full anesthesia. There are various ways of enlarging breasts. The two safest and most recommended by the Al-Khalidi Women’s Health and Breast Center are (i) implants, specifically silicone gel or saline, and (ii) fat transfer (the fat is transferred from your own body).
While some breast augmentation procedures can be done in some clinics, if you are considering breast augmentation, we advise you to go to a hospital with a fully equipped operating room. Any surgery carries risks, so having a multi-disciplinary team available immediately to handle any complications or special situations that arise will reduce your risk.
Breast augmentation using implants
Augmentation with implants involves placing an implant underneath the breast tissue or underneath the breast tissue and muscle in order to increase the overall size of the breasts and give them more fullness in areas they are deficient.
Your doctor will discuss with you the options of enlargement after a clinical examination, so you can make an informed decision. Performing a breast augmentation surgery requires detailed planning and discussions with your doctor.
Another consideration ahead of the operation is to discuss with your doctor the location of the incision (scar).
There are three different incisions for augmentation with implants:
- In the fold under your breasts.
- Around your nipple.
- In your armpit.
The type of incision your doctor will make takes into consideration the current shape of your breasts, the desired shape of your future breasts, whether or not you may breastfeed in the future, and whether you have had breast surgery before.
Most patients can go home on the same day. Some patients may feel they are too tired, so they may want to stay overnight at the Al-Khalidi Hospital and Medical Center for observation.
The Al-Khalidi Women’s Health and Breast Center advises their patients who live outside of Jordan to remain in Amman for a up to a week after the operation. As with most operations that require full anesthesia, your doctor needs to monitor you closely to make sure you are free from possible complications such as blood clots or infection.
Augmentation using fat transfer technique
Your doctor will transfer fat from your hips or abdomen to your breast area.
Transferring fat from your own body is a natural and minimally invasive operation. The result is a subtle enlargement that looks natural.
Fat transfer is ideal for you if you would like a slight adjustment only and have enough fat as determined by your doctor. This procedure is not ideal for women with a low body-mass index.
The operation lasts between one to two hours. Any surgery requires close monitoring by your doctor to make sure you are free from possible blood clots or infection. You may need to stay at least one day at the Al-Khalidi Hospital and Medical Center.
Other ways of enlarging breasts
There are other methods of enlarging the breasts, such as using artificial fillers; however, these other methods are not effective and not proven to be safe. Science is still uncertain about the long-term effects of these methods, so at the Al-Khalidi Women’s Health and Breast Center, we do not advise our patients to consider these yet.
Massage machines and certain creams are some of the other advertised ways of enlarging the breasts, but these are not effective.
Is breast augmentation right for you?
Many women have thought about having their breasts enlarged at one time or another. Deciding to go through with it requires you to explore thoroughly your thoughts and the process to make sure you are absolutely certain of your decision.
Breast enlargement is an elective and cosmetic surgery. Whatever your reason may be for enlarging your breasts, you need to discuss various options with your doctor and understand what to expect.
Pros and cons of implants and fat transfer
As was mentioned above, though there are several methods to enlarge the breasts, we recommend these two:
- Breast implants.
- Silicone gel implants: They are filled with silicone gel. They come in different sizes, shapes and texture (smooth or textured).
- Saline implants: They are filled with a sterile saline solution during surgery. They come in different sizes, shapes and texture (smooth or textured).
Pros Cons Safe and FDA approved. If a bad quality implant is chosen, you may experience problems with rupturing of the implant or with tissues hardening. This is known as capsular contracture. Implants don’t wrinkle. Long life: newer implants have a life guarantee. Implants give breasts a more natural feel. They are tested with considerable weight so they are guaranteed not to rupture.
Pros Cons If a saline solution ruptures, it is still safe because only water leaks. They feel harder than silicone implants. Safe. FDA approved. You can see rippling and wrinkling under the skin.
Even though silicone gel implants are safer than most other implants, there is still a very small chance that they rupture. If your silicone gel implant ruptures, you may not be aware of it as you might have no symptoms. Other times when your silicone gel ruptures, you might experience breast pain and a change of breast shape. Your doctor can tell through an MRI if indeed your implant has ruptured. Ruptured implants do not cause serious medical issues.
- Fat transfer.Fat from your hips or abdomen is transferred by a lipo-modeling technique to your breast area to give it shape and volume in a natural-looking way. Not everyone is suited for this all-natural surgery. Talk to your doctor about your options for breast enlargement.
Fat transfer Pros Cons Minimally invasive. It increases your breast size only slightly. Ideal for women who wish to shape their body. You must have a normal body weight. The volume of your breast may be lost if you lose weight. The breast may droop with time as the fat droops with the breast tissue.
Your doctor will discuss with you the best options for you after a thorough examination in the clinic before your surgery.
Shapes of implants
Implants come as round or teardrop shape with low, moderate and high profile. You and your doctor will determine which shape is best for you after discussions in the clinic about your desires and measurements taken by your doctor.
Patients outside of Jordan
For patients outside of Jordan, the Al-Khalidi Women’s Health and Breast Center advises you to arrive a day before to undergo a full examination and consultation. Detailed planning and discussions with you is key to the success of the augmentation surgery. You are strongly advised to remain in the country one week after the operation so your doctor can monitor your recovery.
Please visit our website (www.khmc.jo) for more information and to make arrangements with your doctor.
Why do some implant operations go horribly wrong?
It is important to trust your doctor and to do your operation in a hospital with a multidisciplinary team on hand in case complications arise.
One of the main problems with breast augmentation is inadequate planning. Planning is critical to the surgery’s success and should last about an hour.
When your doctor plans your surgery, she examines you in the clinic. Depending on your age and situation, you might have to undergo a mammogram and other tests. Your doctor will take numerous measurements with lots of markings, especially of the breast footprint.
The footprint of the breast is the base of the breast. The implant should not exceed the footprint. Women have different breast footprints and this is why it is important for you and your doctor to have discussions about expectations and for your doctor to take measurements.
For example, a thin woman has narrow shoulders and a certain width of her original breasts. The implant should be in proportion because if it is bigger it will cause a distortion of the breast. It will look artificial and will be too heavy for the breasts. Your wound may not heal.
Poor planning prior to your operation results in incorrect outcomes. If a patient has the incision in the wrong place, the result will not be good.
Your doctor also uses planning time to gauge your expectations. Your doctor will check for size with breast implant sizers in the clinic. You can try on a size the doctor chooses for you to see what it might look like.
The words “small” and “big” are subjective; the preoperative consultation determines what you want to achieve, what kind of implant would suit you, how wide, how tall, and whether it should be shaped, round, under the muscle or over the muscle. All of these considerations will affect your final shape and your satisfaction.
Other potential problems in using implants
Newer implants are extremely safe; however, like any operation there are some risks:
- Infection. About 1 in 200 people risk developing an infected wound. This is treated with antibiotics, but the worry, however rare, is if the implant itself gets infected.
- Hematoma. This occurs if you develop bleeding after the operation and a blood clot collects around the implant. This is extremely rare and can happen in any operation. If this happens you will need corrective surgery and possibly another breast augmentation surgery.
- Rupture. Always ask your doctor what implant is being used. Always choose an implant that has been researched for years, that we know is safe with a good reputation and a good warranty. A company that gives a warranty for life is a good one to use. A company that gives a warranty for five years is perhaps not a good one to use. Implants are not supposed to rupture. There have been times when a needle was inserted for a biopsy and the implant ruptured, but it is not typical.
- Capsular contracture. This happens when tissues around your implant get hard and contract the implant. This happens years after your augmentation where you feel your implant may be painful or high or hard. This is because the capsule becomes hard. Most implant companies will have a warranty against this. If it happens you will need another operation.
Implants and cancer
Implants do not cause cancer and implants do not hide cancer. This has been thoroughly researched and there is no proven connection.
What if I change my mind after having implants?
It is easy to change implant size or remove implants altogether at a later time. You might want bigger ones later on, smaller ones, or simply change them because your breasts might become droopy. You might not want implants anymore. They can be removed very easily with a very simple operation.
This information was provided by Consultant Oncoplastic Breast & General Surgeon at Al-Khalidi Women’s Health and Breast Center, Dr Layal El-Asir.