The Procedure

What is the procedure ?

Breast augmentation is the most common cosmetic surgery procedure in this moment to enlarge, or change the shape of a woman’s breasts by inserting the implants (medical prosthesis) below or above the breast muscle. For the material of implant which are used for the breast augmentation surgery are produced from saline and silicone either. The shape of the silicone are include round and Tear drop shaped and the surface of the silicone are include 2 smooth and textured surface. These options can be selected by the patients and the surgeon either which can recommend you the best option which looks match with your body’s concern.
And the thing what the people will concern the most about breast augmentation is the new shape of the breast after the surgery. This will depend of the shape of silicone will be inserted inside which have 2 differently shapes,
1. Tear drop

This shape will be thinner at the top and gently slope to a fuller projection point near the implant’s bottom. This shape of silicone after inserted under the breast will make the patients have the natural looks and create a sloped shape when placed over the chest muscles. But the disadvantages of teardrop implant are if the pocket for the teardrop implant is not created correctly, there is a risk that the implant may flip over leaving the breast looking misshaped.

2. Round implant 

The round-shaped implant is the traditional breast implant design. This can make the patients have the soft but looks fuller, round and nicely proportioned breasts and become an attractive breast. But some people worry about the outcome will looks fake if the shape of the breast does not slope down as tear drop implant shaped. But actually, When a woman stands up, the saline goes to the bottom of the implants because of gravity, and the implants assume a natural teardrop shape anyway. 

The Method

How the procedure is performed?

The surgery will start with applying the general Anastasia to make the patient sleeping during the surgery. And the surgeon will make an incision under the basement of the breast, under the armpit(the most requested position from the patients, about 65%)or surrounding the areola either(depending where patient preferred is or the surgeon’s recommendation) to insert the implant into the breast. The position to inserting implant can be below muscle (85 % of the patients requested for this position) or above muscle either. But the patients who ask for inserting the implant below the muscle must have the adequate breast tissue to disguise the implant and assuming no rippling or contract. Otherwise, the women who have a little breast tissue must insert the implant above the muscle to avoid the “fake” look of implant that is apparent because they are closer to the surface.

And when the implant is placed on each side of the breast, the incision will be closed with the suture and the small tube will be inserted from inside each side of the breast to drain any liquids or bloods from inside the body to reduce the swelling and reduce the risk to have the blood clots inside. And the elastic plaster will be put over the incision in the final step of the operation.

What type of Anastasia is necessary for the procedure ?

General Anastasia

How will the incision look like ?

The incision of breast augmentation can be created in the differently 3 positions.

1. The incision under the armpit (Transaxillary incision )
The incision will be made under the armpit which is about 2-2.5 inches of the length. After the surgery, the scars will be less visible which often blends into skin crease well and is hard to detect. And moreover, no scars visible on the breast
2. The incision under the breast (Inframmammary incision )
The incision will be placed in the fold under the breast which is about 1-1.5 inches. This technique is suitable for the patients who need to have the big size of the implant because the scars will be hidden in the fold under the breast but it may be visible when you lay down flat

3. The incision surrounding the nipple(Periareolar incision ) 

The incision will be circle placed around the areola due to the areola area is the dark pigment area and the incision after the surgery will be very less visible. But this is high risk to loss the sensation of the nipple. So, just only a few specialists can propose to operate the surgery with this technique

Ideal Candidates

Is this procedure suitable for the candidate ?

  • The candidate can be both of the real woman and man (Transgender), but must be in good health which is not serious medication can’t have a surgery
  • The people who don’t have the cancer or any sys tissue insider the breasts 
  • For the transgender need to prepare the medical certificate from the physiologist to confirm that your mentality is stable enough to have the female body shape The Must over than 18 years old ofteh age , to be sure that your breasts stop developing already. Otherwise, the breast shape can change again after the surgery 
  • The peoples with the small or flat breasts and want to improve it 
  • The people who have loss the breast volume which may cause of the weight loss, pregnancy
  • The people, who don’t have the self-esteem to the body, can’t wear the open cloths or bikini
  • The people who have the different size of the breast between both sides
  • The people who have loss the breast volume which may cause of the weight loss, pregnancy
  • The woman who remove the breast because of the cancer decease 
  • For the new mother (just deliver baby) need to wait at least 1 year until the breast it lack of the milk or any liquid. Otherwise, the breast may get the infection from the operation and the material inserted
  • The stable mentality, since it will take a few months until you can get the final result of the surgery. And during this time if you don’t have the stable mentality, you can get depress of this 

What are the results the candidate can expect?

  • The result is immediately visible and permanent 
  • The size of the breast is bigger and look fuller( depends on your preference size)
  • The shape of the breasts can be changed (depends on your preference shape)
  • The breasts looks more natural beautiful
  • Increasing the self-esteem and more enjoy in life 
  • Able to wear all trendy dresses you wish and including the bikini 
  • The surgery is quite safe and you still can breasts feeding after the surgery 
  • The results of the surgery is long last and the quality of the implant is lift time also , unless the gravity make your breast skin falling down, you may need to lift it up in the future ( but not happen with all peoples )
  • The transgender can have the feminine female shape and be able to go ahead to have another sex change surgery

Recover/Post-Operative

Length of stay at the hospital and in Thailand

1-2 nights stay in the hospital and recommends 9 days in Thailand

Pre-operative care

  • Before the surgery can happen, you need to have a consultation with the surgeon consultation with the surgeon and inform them all information about your medical problem, your allergies, medical you are taking and including
  • Inform them about the expected result of the surgery you are seeking for to see it’s realistic to make it happen or not, select the size or the type of implant. And the surgeon will clarify you all information about the surgery, technique to be used, the incision or including the complication
  • In some surgeon can show you the picture of the previous case to you and clarify all detail about the procedure, the complication and side-effect, the incision or scars and etc.
  • You will be asked to stop taking Aspirin, ibuprofen, and products containing aspirin and ibuprofen including anti-inflammatory medication, high dosing any multivitamins/herbal remedies/teas etc. before and surgery for 2 weeks, this may inhibit blood clotting and cause bleeding problems during and after surgery 
  • Some surgeons will recommend you to take multivitamin supplements which are including Vitamin A and C, this can help relieve swelling after surgery. But however, this must be the approval of your surgeon only.
  • Some surgeon will recommend you to have mammogram checking to be sure that you don’t have any breast disease before having a surgery 
  • Stop drinking alcohol or smoking before and after the surgery 2 weeks, this can result in prolonged wound healing, skin loss, infection, increased scarring. This is very important for the peoples who would like to undergo the major.
  • If you have over weight, the surgeon may recommend you to change the life style, control the weight, and regularly exercise. You have to follow the surgeon’s recommendation to archives the best result of the surgery and minimize the chance of complications
  • You should try to stool by drinking the prune juice and take them away because after the surgery, you may be taking pain medications which can cause constipation.
  • Try to drink water as much as you can, because hydration is very important both of before and after the surgery for safe recovery
  • Prepare the support bra for the recovery time after the surgery. Unless, you are informed that you find it in the hospital after the surgery

On the surgery date

  • And on the surgery date, you should stop eating and drinking 6 hours before the surgery
  • Take a bath and wash your hair wash your hair (because after a surgery, you maybe not confortable to do it for a few days) but without applying the lotion and cream on the body including no makeup
  • Take out all accessories, such as earring and also remove the nail polish before getting the operation room
  • Wear the loos cloths or the comfortable, especially on below part of your body 
  • Make a physical checking up to be sure that you have the normal level of your blood pressure or any disease come up which can’t undergo the surgery or not

Post-operative care

  • When you wake up from Anastasia, you will have the small tubes (can be 1 or 2 tubes) inserted to your each breast to drain out the fluid from your body. And the surgeon will take it out 1 -2 days after the surgery
  • And besides the tube on your breast, you will be wrapped with the elastic bandage to reduce bruising and swelling and you have to stay in the hospital to be sure that you are safe before discharge the hospital
  • The surgeon will recommend you to sleep with head of the bed elevated, no bending, lifting or straining or use two to three pillows for one week after surgery to reduce swelling and bruising 
  • You may need to sleep on your back for several weeks to avoid disturbing the wound and incision 
  • The painkiller pill and antibiotics medication is recommended if the pain is extremely and for preventing to get infection during the healing process and continue taking them until they are all gone 
  • You can take Vitamin C (ascorbic acid) that helps promote healing, for two weeks following surgery
  • 1-2 days after the surgery, the small tube will be taken out from your breasts and you should start walking as soon as you can to reduce the risk of blood clots 
  • The surgeon will let you use the support bra after the surgery to support the surgery area and help you about the healing process, minimal swelling, improving blood circulation and you can get back to the normal lift sooner 
  • Massaging the breast after the surgery is very important which the surgeon will advise you to do at least 2 times a day and 10-15 minutes each in order to avoid “Capsular contracture” or “Scar Contracture” or also “tissue capsule”
  • The cool pack is also recommended to reduce the swelling and bruising, apply on your surgery area (but not directly which your skin can be injured)especially in the week
  • Keep your incision clean and dry, clean your wound with hydrogen peroxide and then applying the antibiotic ointment (polysporin/bacitracin) twice a day is an essential part of the healing process and prevention infection
  • It’s common if there are bleeding or oozing come out from the wound during this time which will go sway in a few days, just use the button to clean it 
  • Avoid taking a bath in the first week after the surgery. If possible, you should take a bath after the suture is removed
  • 7 days after the surgery, you have to go back to see the surgeon again for post –operative checking up and remove the suture
  • Do not swim in the pool for 4-6 weeks, it’s very risky to get injection from the public pool during the recovery time
  • Avoid extreme activities or strenuous sport at least 3 weeks because of the rising high blood, this can cause of bleeding inside your breast 
  • Your incision maybe very dried, you can apply the moisturizer, oil cream or the vitamin E can help, this also can help to reduce the potential scarring after the surgery 
  • During the first 6 months , if you have wear the bikini or the suite which your incision can fade the sunshine, you must put the sunscreen with a skin- protection factor (SPF) all the time when you go out to prevent pigmentation of incision line

What are the possible risks and complications involved?

The common symptoms

When you wake up from the Anastasia, you may feel very tired, strong or normal pain, swelling or/and bruising, discomfort or a feeling of tightness in the breast area is very common (because your skin adjusts to your new breast size), these are very common after the surgery which will fade away in a few days after the surgery, and the oral pain medication that is given to you does help tremendously.

Infection

Normally, the surgeon will let you take the oral anti-biotic medicine both of before and after the surgery to avoid getting infection. But it’s still possible to occur may cause of the acidly food or you don’t clean the incision well or the bacteria are so strong either which you can notice from the pain surrounding the incision , the high heat from inside the wound, plenty of the bleeding and oozing come out from the wound. This you should go back to see the surgeon again as soon as you can to get the treatment in the correct way.

Capsular Contracture

This problem happened from the body reacts by forming a protective lining around it, the capsule is formed by your own living tissue which leads to change the shape of implant after they are inserted inside the breast. Only one thing can avoid this problem is regularly messaging your breast. However, some surgeons believes that using texture implant and insert under the muscle can be reduced the capsular contracture

Asymmetry

Normally, the original size of human breast between left and right side can be difference. And when the implants are inserted into the breast, this can make the both side of the breast looks more different. The solving way of this problem is the surgeon will consider the different size of implant to insert to each side of the breast, and the outcome will be symmetry.

Delayed Wound Healing

The peoples have a different kind of the skin, some of them are very fast to be healed, and some of them have a slow healing process. But just one important thing is not to increase the risky to delay the healing process by smoking or drinking alcohol as the surgeon always recommended you.

Scarring

After the wound dry, it will turn to be scaring. The degree of scaring varies from person to person. If scarring become irregular and raised. It can become Keloid which may leave the permanent scars. This you may need to get some skin treatment to heal or the scarring revision is recommended the people with very large keloid

Leaking or rupturing implant

This is very rare side-effect to happen since the quality of the implant material now is very good, less possible to be leaking (a tear or hole in the implant’s outer shell). But in case it occurs, in the silicone gel implant, we will call “quiet leaking”.  Because the material is very slowly to leak out from the shell until you feel nothing which is different from the saline implant that your breast will be flatted right away when it’s leaking.