Under the breast (inframammary incision)
The inframammary incision is placed in the proximity of the crease where the breast and chest come together. This crease is called the inframammary fold.
To perform the inframammary incision, the surgeon selects the optimum location to place the incision—under the breast and close to the inframammary fold. The surgeon makes the incision and creates a pocket in which to place the breast implant. The implant is slid upward through the incision, then centered behind the nipple.
The incision is located to secure proper placement of the implant, but also to reduce scar visibility. Scarring from properly located inframammary incisions should be easily hidden under a swimsuit top. The advantages of this incision type is that implants may be placed in all three locations – above, partially behind or completely behind the pectoral muscle.
Around the nipple (peri-areolar incision)
To perform the peri-areolar incision, the surgeon makes an incision at the edge of the areola. The goal of the incision is to place it in the transition area between the dark areola and surrounding breast skin where it can be hidden.
After the incision, the surgeon creates a pocket for the breast implant and then slides the implant through the incision into the breast pocket. Once inserted, the implant is then centered behind the nipple.
One possible advantage of the peri-areola surgery is that there may be no visible scar, because of the color and texture characteristics of the areola border. In some cases, a scar may be visible. Another advantage, as with the inframammary incision, this incision allows the implant to be placed in precise pocket formation and provides for absolute controlled bleeding.
In the arm pit (transaxillary incision)
The transaxillary incision is made in the natural folds of the armpit tissue, then a channel is created up to the breast. This procedure is sometimes performed with an endoscope, or a small tube with a surgical light and camera embedded in the end, to provide visibility through the channel. The implant is inserted and moved through the channel, then positioned and centered behind the nipple.
The biggest advantage of this incision type is that the scar is not at the breast, and can accommodate all three types of implant placement.
In the navel area (trans-umbilical or TUBA incision)
The TUBA incision is made on the rim of the navel. A tunnel is then made under the skin through the subcutaneous fat layer. An endoscope can be used to create the tunnel and to provide visibility to the surgeon. An endoscope is a thin tube with a camera and surgical light embedded on the end. The tunnel reaches all the way behind the breast into the layer of loose tissue between the breast and pectoral muscles. After a pocket is created in the breast, the implant is inserted through the incision and moved up into the breast area. The implant is then centered behind the nipple. Like the transaxillary incision, the TUBA incision does not leave any scars on the breast; and supports all three implant placement positions.
Implant Placement Positions
Above the pectoral muscles (sub-glandular)
This position places the implant behind the breast, but in front of the muscles and tissues that line the front of the ribs and chest wall. The fatty tissue in the breast is what gives the breast a soft consistency. This tissue extends throughout the breasts, surrounding the glands and fibrous tissues.
Partially behind the muscles (partial sub-muscular)
In partial sub-muscular implant placement, the implant is placed behind the breast tissue and partially under the pectoral and other chest muscles. During the procedure, the lowest part of the Pectoralis Major muscle is cut so that the upper part of the implant sits deeply beneath the muscle, but the lower part sits beneath the breast (subglandular).
Completely behind the muscles (complete sub-muscular)
In full sub-muscular implant placement, the implant is placed completely under the pectoral muscles. Some surgeons believe that this position reduces the potential of capsular contracture, and may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue. Placement behind the muscle however, may be more painful for a few days after surgery than placement directly under the breast tissue.
The most popular implants are silicone, which have been successfully used in many types of implants for many decades. The advantage of silicone is that they feel more natural, and have a lower tendency to ripple. Fears that people had about silicone leading to breast cancer and connective diseases has been disproved. Silicone has developed a great deal to be completely safe, and The European Committee on Quality Assurance and Medical Devices in Plastic Surgery (EQUAM) published the research results and stated that there is no proof that silicone implants cause any diseases. In fact, women get more silicone from their lipstick or daily beauty creams than their breast implants.
Saline implants comprise of weak salt solution similar to body fluids. The advantage is that they can fit through a smaller incision, but the disadvantage is – because they are made of water – they can ripple and feel ‘squishy’.
3. Shape and size
There are different types of implant – varying in shape and consistency. They can be rounded in shape or anatomical/tear-drop shape. The silicone can be softer or firmer according to your requirements. The surgeon will assess you and guide you as to which one is best for your requirements.
Recovery and Post-op care
How bruised, sore, and swollen your breasts are after surgery, depends on individual. You can expect to wear a surgical bra for several days, or until swelling has subsided. Rather than being a sharp pain, it is more like a dull ache. Your surgeon will prescribe a pain reliever or creams if necessary – however, do not take aspirin for 2 weeks after surgery as it can increase the risk of bleeding.
After about 2 days, the discomfort will subside, however the recovery time varies from person to person. The nursing team will observe you and be on call if you have any concerns and to make sure you are recovering well.
Ensure you drink plenty of fluids, and eat nourishing foods as this is also important.
Heavy lifting or straining should be avoided after surgery for at least a month because this can cause the breasts to swell and increase pressure. You can typically return to work within a week and to full activity within a few weeks. Sensation in your nipples may be reduced temporarily, but should return to normal as your breasts heal.
We provide excellent post-care support, with follow-up visits and programs to assist your recovery. If you have any questions or concerns, please let us know and we will schedule an appointment with the surgeon.
Recommended length of stay on holiday
Other recommended procedures with a breast enlargement
Many people who travel for Cosmetic surgery have more than one procedure because of the cost advantages and also for a more balanced look. Face treatments – the popular facelift, or eye lift – are popular with breast enlargements to freshen the face. Liposuction to the lower body is also very popular to give an overall better shape.
The “Ultimate Makeover” includes liposuction with a choice of other surgical and non-surgical procedures. Enquire for more information.
Your new look
Most people who undergo breast enlargement are thrilled with the results, making them feel more womanly, sexier and confident. As long as you remain realistic about the results, you will be pleased with the outcome.
Breast enlargement is permanent, however, breast size and shape will change during the normal stages of life – pregnancy, weight loss and gain and aging.
Preconditions and Risks
We minimize risks and complications by selecting patients carefully and always having the most skilled surgeons, physicians and nurses carry out procedures. However, despite the highest standards, complications can occur. They are rare, and most patients will not have complications,
but if you have concerns about possible complications, please discuss these with your doctor.
Please read the preconditions and risks page before embarking on any surgery. Please read the following list of possible complications/risks:
If infection occurs, it is usually within days or weeks of surgery. Though rare, infection can occur long after breast surgery when the incisions are completely healed. In rare cases, the implant is removed until the infection subsides, then replaced at a later date.
Nipple Sensitivity and Numbness
Some women report that their nipples become oversensitive, undersensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear within time, but may be permanent in some patients.
Bottoming out is a complication when the implant rides too low in the breast tissue and may cause the nipple to point upwards. Correction for bottoming out may be accomplished by re-entering the breast and re-creating the pocket.
Symmastia produces the appearance of breasts being too close to each other. To correct symmastia, a surgical procedure may be required. Larger implants may be exchanged for smaller implants. After corrective surgery, a special support bra and other supportive bandages may be needed to
provide the necessary cleavage support while the tissues heal.
The body’s natural healing process creates a capsule around the breast implant, just as it would any other foreign object. Capsular formation is normal and also occurs with other types of implant surgery including placement of pacemakers, artificial bones, or joints. In some cases, however, the capsule closes or contracts around the implant. This closure is called capsular contraction. Capsular contraction can occur at anytime after surgery—when it does occur, it is typically within a few months. Capsular contraction, however, is not common.
Capsular contraction compresses the implant, causing the implant to look distorted. In the most advanced cases, the implant can feel hard and misshapen. The implant has not changed or hardened, but the capsule squeezing the implant has caused it to feel hard. Treatment for capsular contraction requires surgery to remove or replace the implant.
Common Q & As
If you have questions other than those listed here, please view our complete page for Q & A.