Thankfully the techniques of breast augmentation have advanced considerably since the days at the end of World War II when Japanese prostitutes used to inject silicone directly into the breasts to add to their ‘appeal’ to US servicemen. During the 1950s, the process advanced in as much as polyvinyl sponges were then used as primitive implants but, as they tended to both harden and shrink within a year, as well as frequently result in infection, it was not until the late 1980s that the procedure really became established and safe enough to start to attract women in the numbers it does today.
The process of breast enlargement, or augmentation, consists of the surgeon making an incision which will create a ‘pocket’ into which a breast implant can be accurately positioned. There are two basic options for the type of implant placed in the breast. Saline implants are filled with sterile water which will affect the shape and firmness of the breast. The alternative, silicone implants, are filled with a gel which feels and moves in a manner very similar to natural breast tissue.
Saline implants, should they leak, release a fluid which will be naturally absorbed and expelled by the body whereas silicone implants have raised more concerns over the years should they collapse or leak. Because of these concerns, there are different regulations in various countries about what can and cannot be used. Needless to say, you need to ensure that the clinic you select for any breast augmentation procedure is totally conversant with the laws that apply in your particular location. The best type of implant can also depend on the patient’s own particular requirements.
There are several different incision techniques used in breast enlargement procedures. The ‘Donut’ lift – sometimes referred to as the Peri-areolar incision or the Benelli lift – is an incision made solely around the perimeter of the areola and is considered especially suitable for women with a mild or pronounced degree of sagging. The so-called Crescent lift involves an incision along the upper side of the areola leading to the removal of a crescent-shaped piece of skin. This is usually thought best for patients with a very minimal amount of sagging as it cannot accomplish the same degree of lifting as the donut lift. Additionally, incisions can be made in the crease just below the breast, under the armpit or, occasionally, through the navel.
Breast reduction, or reduction mammoplasty, in order to allow women – and increasingly, men – to have smaller and better proportioned breasts also has a variety of techniques. The major advances in recent years have resulted in nipple sensitivity being maintained along with the ability to lactate, both of which were problematic just a few years ago.
A procedure using liposuction only has become increasingly common, especially with men, in which fat is simply removed from inside the breast. Other common procedures involve the Inferior Pedicle and the Vertical Scar techniques. The Inferior Pedicle technique – often known as keyhole surgery or the Weiss method – takes the form of an anchor-shaped incision around the areola, extending downwards along the breast’s natural line. Through this incision, excessive fat, glandular tissue and skin can be removed before the nipple and areola are ‘moved’ to their new, higher placement. This is often considered to be most suitable for women with extremely large breasts.
The Vertical Scar method – otherwise known as Short Scar breast reduction – is becoming more and more common, especially in the USA. Here, vertical incisions only are employed and, in comparison with the Inferior Pedicle method, there is much less resultant scarring.
The shape and size of the patient’s breasts, along with the desired amount of reduction, will help the surgeon decide which surgical method is going to be most suited in an individual case.