Boob jobs - it seems like anyone and everyone is getting them, including: celebrities, the girl-next-door and your average suburban mom. There is even an increasing demand from men who want to improve shape and (percieved) muscle tone in this area! Breast implants have become extremely pervasive in North American culture, despite the concerns about hazards to health. Aren’t you curious to find out what makes so many women (and some men) willing to put themselves at such a potential risk? Here are the latest statistics, facts and opinions about breast augmentation…
According to a recent cosmetic surgery statistical report by the American Society for Aesthetic Plastic Surgery (ASAPS), breast augmentation is the most popular procedure performed on women in America. In 2007 almost 400,000 surgeries of this type were performed, up from more than 329,000 the year before. There are a number of procedures available to change the way the breast appears (such as a breast lift), however this article will focus on breast enlargement - the procedure that utilizes an implant to increase the volume of the breast.
Why is it so prevalent?
Powerful marketing has been linked as one of the major contributing factors to the overwhelming number of breast surgeries. A Newsweek article titled ‘Mommy Makeover’ cited that last year 1/3 of the breast augmentations being done were for women over 40. Social pressure, the desire to fit in, as well as the desire to appear youthful and full of life can feel overpowering. However, another major reason to have the procedure is to revise the results of an existing breast augmentation!
Advancements in technology continue to fine-tune the surgery, thus improving it and making it a safer and less expensive procedure. With these advancements will bring greater accessibility for average Americans, particularly those who previously may not have been able to afford it. The cost of the procedure typically ranges between $4000 and $5000. One must also consider time spent away from work, cost of follow-up medication and consultation, as well as the potential cost to correct if something goes awry.
Breast implant surgeries are also often performed after mastectomies and sex reassignment surgeries: both procedures are life-changing and psychologically impactful. Losing one or two breasts to a life threatening disease such as cancer is emotionally scarring: for some women, the opportunity to get her breasts back may be worth taking some risks. For those who are undergoing gender reassignment, female breasts can help her to assume the identity that she’s always felt on the inside.
In some cases women feel that their breasts just aren’t the same as they used to be. Let’s examine the physical circumstances that make the breast change shape over time. Physiological transformations occur as a result of aging that affect breast shape, as skin loses its elasticity due to the weakening & stretching of ligaments that attach the breast to the chest. Other factors that cause the size and shape of the breast to change are genetics, pregnancy, hormone variability, breast-feeding, weight fluctuation and gravity.
If you are considering having breast enlargement, have a discussion with your surgeon regarding how many follow up surgeries are likely, how they will change over time - and how your body could potentially react if they must be removed and cannot be replaced.
Saline versus Silicone
Breast augmentation surgery is a cosmetic procedure that employs the use of a medical device to augment the size of a woman’s breast. The device is a silicone bag that is filled with forms of saline, silicone or the new form of silicone - the cohesive gel implant. There has been controversy over the last two decades regarding the safety of silicone, so much so that implants for cosmetic purposes became suspended in the U.S. and Canada in 1992. Their availability for aesthetic use didn’t reappear until 2006 and continues to be subject to scrutiny by researchers and health professionals.
Saline implants come in a variety of shapes, textures and include a large range of sizes to which they can be filled. Saline sacs are implanted empty and filled with sterile saline fluid once in place; this helps ensure that incisions remain small. A disadvantage is that once filled, the sac may reveal a ‘rippling’ effect; however, the incidence of this is lower when positioned underneath the muscle.
Silicone implants also have a range of shapes, projections and textures. The silicone sacs are filled with silicone gel; the advantage of the newer generation of silicone is that it sustains a more viscous cohesive consistency, which allows for a softer, more natural feel. Moreover, there is less of a chance for rippling to occur. The downside is that the sacs are pre-filled and must be inserted through a larger insertion point. This limits the silicone procedure options to inframammary and possibly periareolar.
A type of implant rarely seen other than in the adult entertainment industry is called polypropylene, which expand by absorbing fluid from inside the body. This type has been banned in numerous countries due to a numerous complications but has found popularity among extremely big busted performers.
The method of implantation will vary according to a combination of factors: desired shape and size; implant palpability (how easily it will be felt); surgeon specialty; implant material and surface. One of the other major considerations is whether or not a potential patient has enough breast tissue to cover the implant. A woman with enough tissue may have option to do a sub glandular placement, meaning that it is placed between the pectoralis muscle and the breast tissue.
The more common method is sub muscular implantation, meaning that all or part of the device is positioned under the pectoralis muscle. The reason for this is that people generally don’t have enough tissue to cover the device. Another reason for its popularity is that the imaging process during a mammography is easier.
You may be limited to a particular incision type based on a combination of preferences. The methods are:
1. Periareolar - an incision is made around the lower part of the nipple. This method can accommodate both silicone and saline implants, but some women are concerned that about damaging their sensory nerves as well as the milk ducts.
2. Transaxillary - the incision is made through the armpit and is associated with fewer complications related to breast feeding. This procedure can accommodate sub-muscular implantation.
3. Inframmamary - the opening is made in the round fold under the breast. This method is less disguised, but also carries less risk related to breast feeding. This is a common way to implant silicone and allows for either placement method. These incisions will generally be longer because they need to accommodate pre-filled silicone implants.
4. Transumbilical - the entry point is the belly button and the surgery utilizes a tiny scope to accurately place the saline sac. This method produces the most inconspicuous scars and is touted as being method with the least amount of complications and post-operative pain and recovery time. It also allows for both placements. Because this is a newer approach, make sure you find a surgeon that is very familiar with it!
One’s expectations should be realistic when undergoing a breast augmentation procedure; it may take up to one year before the final results become apparent and scarring fades. Some implants need time to settle into place and clients have the option to change the volume of their saline implants within a short period of time post-surgery.
Healing time will vary from individual to individual but it is estimated that a breast augmentation patient can be back to work within as little time as two weeks. Implant placement can affect the length of healing time; sub-muscular procedures are thought to prolong the recovery process. Post-operative life will likely involve a temporary decrease in vigorous physical activities, the requirement to wear compression bras, and possibly utilizing surgical drains. Patience with the process and open communication with your surgeon is important during this stage.
The risks associated with breast implants are significant and have continued to receive media attention. In an issue of ‘Us Weekly’, actress Tara Reid spoke out that she had to undergo reconstructive surgery in 2006 to repair the damage done by a breast implant procedure. It can happen to anyone - even a celebrity. What’s even more worrisome is that some American health insurance companies won't insure women who have implants, even if they have had them removed.
The FDA warns that capsular contracture and rupture are the most frequent complications. Capsular contracture is a tightening of the scar tissue that the body forms around the breast implants; the incidence can increase following infection or hematoma - and can be exacerbated by the type of placement, as well as the material inside the implant. There is also a chance that breast implants may rupture. It is easier to detect ruptures in saline-filled breast implants than in silicone gel-filled implants.
Saline deflation will be characterized by a reduction in shape and size immediately or within a few days. It may be difficult to ascertain whether a silicone implant has ruptured, even upon a doctor’s examination. Because ruptures can be asymptomatic, it is highly recommended that a patient receive MRI’s every couple of years to monitor the status of the device. Other concerns are: pain; rupture; decomposition & disfiguration; Toxic Shock Syndrome; breast and nipple numbing; inability to breastfeed; chest wall deformity.
Can a woman’s true sense of vitality and femininity be defined by her breasts? Studies have shown that body image concerns certainly impact women’s decisions to pursue surgery, but found that poor overall self-esteem was not the central motivation. In other words, a woman may feel that if she could just have this specific change done to her breasts, it would simply boost the existing self esteem that she already has. Despite socio-cultural and socioeconomic pressure, there is a powerful bond between a woman’s personal satisfaction and how she perceives her breasts.
Breast augmentation can have a lasting impact on the rest of your life, so do your research and carefully assess the risks. Be sincere about your motivations and evaluate the validity of the factors that are influencing your decision to operate on your breasts. Do you still want to have breast enlargement once you strip away all of the external motivating factors … in other words, are you doing it for you? Most importantly, ensure that general self esteem and self-confidence problems (that do not require surgery) are not the underlying issue - before you go under the knife!
Other Types of Alteration
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