Breast Augmentation to Treat Hypoplasia

Contrary to popular belief, breast augmentation surgery is not only used to improve the figure; for some women, this procedure is needed to address deformities such as hypoplasia in which one or both breasts never mature properly.

Many women with this condition suffer from emotional pain because the breasts have always been associated with femininity and sensuality.  Fortunately though, most cases can be corrected by breast implant surgery; and because it is performed as a reconstructive procedure, insurance reimbursement is often possible. 

There are many factors which can lead to breast hypoplasia including hormone abnormalities.  If this is the problem, hormone therapy might resolve the condition and allow the breast tissue to develop normally. 

Hypoplasia can also be the result of systemic disorders, which must be addressed immediately while the patient is still young to increase the success rate of the treatment.  And for some, the problem may have originated from the damaged or injured undeveloped breast bud.

In some cases, underdeveloped breasts are caused by anorexia.  By simply addressing this underlying problem, most patients can develop normal breasts right after they regain their normal weight.

As much as possible, doctors treat the underlying problem before they even consider breast augmentation surgery.  However, there are cases in which the patients show no particular reason why their breasts never developed normally; in general, these women are good candidates for plastic surgery.

But even if the underlying problem has been resolved, some patients with hypoplasia will not be able to form a normal breast unless they will undergo breast augmentation.  This is because the delicate breast bud, once damaged at an early age, may never recover and lead to underdeveloped bosom. 

Patients with breast hypoplasia have a chest with a juvenile appearance.  And because of lack of anatomical maturity, the condition will often affect the breastfeeding, although some women have normal or limited mammary function.    

While breast augmentation surgery can correct the aesthetic problem caused by hypoplasia, it cannot help women who have no breastfeeding ability and those who lack sensory responses in their breasts.  But at least the look and feel of their breasts will be normal, helping them to overcome emotional and psychological issues caused by aesthetically immature breasts.  

Because hypoplasia patients lack breast tissue, silicone breast implant is more ideal than the saline version because it can mimic the feel and look of natural breasts.  In addition, choosing this type of implant can reduce the risk of palpable and visible rippling.

Effects of Saline Breast Implants Depend on the Amount of Tissue

As its name suggests, saline breast implant is filled with sterile saltwater; for this reason it provides a less favorable cosmetic outcome for women with little breast tissue and fat.  By contrast, patients with an ample amount of tissue will usually enjoy a more natural result because of the “thicker coverage.”

The reason why women with almost no breast tissue will have unnatural result with saline implants is that there is little coverage.  In fact, the implants will be easily felt through the skin, regardless if these are positioned under or over the muscle, particularly in the lateral side and bottom of the breasts.

And instead of having a teardrop-shaped breast, it would end up being unnaturally round.  So for women with little amount of tissue, silicone breast implants, which are filled with a cohesive gel that mimics the feel of glandular tissue and fat, are the best options for them. 

(However, using teardrop-shaped implants, which are always available in textured surface to prevent them from flipping over, are not advisable for women with a very small breast because of the higher risk of rippling.)

Another concern of using saline implants on women with limited breast tissue is the higher risk of rippling and wrinkling of the shell, which is caused by “lack of coverage.”  This problem may be even aggravated with the use of textured implants with large “graininess.”

On the other hand, patients with moderate to significant amount of glandular tissue—particularly those with firm breasts—will likely enjoy a more natural result with saline implants.  In fact, regardless of the type of implants they would use, it is easier for them to achieve a favorable cosmetic result.

But despite having more amounts of tissue and fat, women should still limit themselves from using large saline implants (filled with more than 500 cubic centimeter or cc) because it can lead to a higher risk of downward displacement than silicone implants with the same size.

Meanwhile, women with a modest amount of tissue will achieve a result somewhere in-between.  They will most likely feel the implant shell through their skin with saline implants, although the shape of their breasts will appear natural as if they have used the silicone version. 

In general, silicone breast implants are still the best option for these patients to achieve a more natural feel.  (When plastic surgeons mention the word “feel,” they are talking about the sensation of the breast as it is being touched by fingers.)

FAQs About Breast Implant Surgery

1.     Question: What kind of implants is used during breast augmentation?

Answer:  Currently, the US Food and Drug Administration only allows silicone- and saline-filled breast implants.  However, there is some speculation that the gummy bear implants (these are filled with a more cohesive type of silicone gel) which are under clinical trial, will be made available to the public in the next few years.

2.     Q:  Which can provide a more natural result?

A: Siliconeimplants are designed to mimic the feel of breast tissue, making them a more popular choice of women these days.

3.     Q:  Any benefits in choosing saline implants over silicone version?

A: Yes.  Patients are not required to undergo MRI screening, a test necessary for those with silicone implants because they are at risk of having silent leak (no visible manifestation that the shell has already ruptured),And in case of rupture, patients with saline implants can immediately see the problem because their breasts will become deflated within hours.

4.     Q:  What is capsular contracture?

A:  This happens when the scar tissue—which naturally forms around any implant—becomes extraordinarily dense that it ends up squeezing the implants.  Fortunately, there are many surgical techniques and post-operative treatments that can minimize the risk of capsular contracture.

5.     Q:  What is the difference between smooth and textured implants?

A:  Smooth implants have a balloon-like surface while textured implants have a rough, somewhat “grainy” exterior.

All teardrop-shaped (or anatomical) implants come in textured surface to prevent it from rotating inside the breast pocket, something which may lead to visible distortion.  On the other hand, round implants often come with smooth exterior because they can rotate without causing any problem.

However, some round implants have rough surface which is said to minimize the risk of capsular contracture.  But this claim has not yet been proven.

6.     Q:  Which can provide more natural breast contour, round or teardrop implants?

A:  Both implants can provide natural appearance as long as with the proper placement.  And contrary to popular belief, round implants do not automatically lead to a dome-shaped, unnatural-looking breast because their shape turn into a teardrop once inside the breast pocket (due to the pull of gravity).

      7.  Q:  How long do breast implants last?

A:  According to a study conducted by the Institute of Medicine, breast implants last an average of 16 years, although their lifespan still depends on many factors such as the patient’s lifestyle, certain features of the body, and type of implant used during the procedure.

Breastfeeding After Augmentation Mammaplasty

One of the most common concerns of patients considering breast augmentation is its effect on breastfeeding.  However, many studies have suggested the surgery does not prevent women from producing milk.

Is It Possible to Breastfeed After Breast Augmentation?

Breast augmentation patients will most likely be able to breastfeed their babies following the surgery, particularly if the incision is made along the breast crease and armpit.  However, a U-shaped incision around the edge of areola may increase the risk of having breastfeeding problems because the technique causes more trauma to the glands, nerves, and ducts.

Can Silicone Implants Contaminate the Milk?

Breast implants do not pose contamination risk to babies; in fact, the milk produced by a woman with siliconeimplants has a significantly less amount of silicone than formula milk.

Potential Problem

Patients should know that breast augmentation does not prevent them from producing milk, although there is a risk of having less sensitive nipples, which in turn may lead to difficulty in breastfeeding.  Fortunately, a study has suggested that five years after breast surgery, most of the damaged nerves have already been repaired by the body, significantly improving the ability to breastfeed.

Why Some Patients Can’t Nurse Their Babies

It’s not about inability to breastfeed, but more on the unwillingness of some women to nurse their babies.  According to a recent study conducted by the American Society of Plastic Surgeons (ASPS), women with breast implants who think that breastfeeding can lead to sagging breasts are less likely to do this successfully.

However, the ASPS said that breastfeeding does not affect the result of breast implant surgery and even highlighted the significant health advantages for both baby and mother.

Solution for Those Experiencing Difficulty in Breastfeeding

Women with breast implants should tell her child’s pediatrician about the surgery; in this way, the doctor can keep a close eye on the baby’s weight and make sure he or she is getting enough milk.

But for patients who had breast augmentation to address hypoplasia or underdeveloped breasts, they may experience trouble producing enough milk.  For these mothers, they are often advised to use pump after each nursing session to stimulate production.  But if this is not enough, they should use formula milk or donor milk.

Should Breast Augmentation Be Postponed?

Some plastic surgeons recommend postponing breast implant surgery for women who are considering having babies since pregnancy may change the appearance of their breasts.

Liposuction for Breast Reduction

Liposuction surgery is often used to remove the fats in the abdominal area, however, what many people don’t know is that the procedure can also serve as a replacement for traditional breast reduction.  When given to the right patient, it can reduce the size of female breasts by more than 50 percent.

In many cases, liposuction can also have a slight to moderate lifting effect because it can remove the weight of the excess fats.

Compared to the traditional breast reduction in which the excess fats, glandular tissue, and skin are removed, liposuction is less invasive; in fact, most patients can resume to most of their daily activities two to three days after the procedure.

But perhaps the most notable advantage of liposuction over traditional breast reduction surgery is that the risk of scar is almost eliminated.  This is possible because plastic surgeons only use a few small round incisions where they insert a pen-like device that suctions out the fats.

Some women achieve better results than others after breast reduction via liposuction, especially those whose breast enlargement is primarily caused by excess fats rather than tissue.  Many doctors have noticed that patients who have passed through their menopause tend to have more glandular fats than teenagers, making them a great candidate for this procedure.

However, younger women may also enjoy the benefits of breast reduction via liposuction as long as the excess fat is one of the contributing factors of their breast enlargement.  To determine the amount of glandular fats, most doctors require their patients to undergo mammogram.

But still, not all women with exceedingly large breasts are a good candidate for liposuction.  Those with macromastia—a condition in which the breasts are extremely big due to abnormal development of the glandular tissue—will likely need the excision-based breast reduction surgery.

Thin women with excessively large breasts often have more glandular tissue and little fats, making them a bad candidate for liposuction.  For these patients, only the excision-based breast reduction can provide them good results.

After liposuction, the result is a smaller version of the breasts; however, patients should remember that the procedure cannot change the shape of the bosom. 

In many cases, it can also create a slight to moderate lifting effect because the weight of the excess fats is remove, though patients should remember that the final result also depends on the elasticity of their breast’s suspensory ligaments.

Because there is only minimal trauma to the glands and nerve, there is little chance that breast reduction via liposuction will affect breastfeeding.

Round Breast Implant and Its Benefits

In terms of shape, breast implants are available in two kinds: round and anatomical (or sometimes referred to as teardrop).  Patients should remember that the implant’s contour has a significant impact on the final result of their breast augmentation surgery.

To date, round implants are more commonly used than the anatomical versions because they come cheaper and are believed to last longer.  But still, the best option largely depends on the patients’ goals and expectations and certain features of the body.

However, anatomical implants are still popularly used on women who had mastectomy or cancer surgery, though plastic surgeons have started using them for cosmetic breast augmentation after realizing that they provide great aesthetic results.

But nowadays, round implants are more preferred by many doctors because they have a lower risk of implant wrinkling since they often come in smooth surface, which cannot pull the tissue.  By contrast, teardrop implants are always available in textured exterior because they are not supposed to rotate inside the breast pocket.

The anatomical implant’s textured surface will prevent it to flip over, which if occurs can lead to visible distortion.  But studies have suggested that this particular design can lead to higher risk of visible rippling, especially for implants that have large “graininess.”

The risk of visible and palpable rippling is particularly a concern for women with limited fat and tissue on their breasts.  For this reason, most plastic surgeons do not recommend teardrop implants for patients with little tissue coverage.

While round implant has all its sides equal, it does not mean the result is always a dome-shaped breast that looks unnatural.  Contrary to popular belief, its shape can still lead to natural appearance with a proper implant placement.

In fact, round implants can turn into a teardrop shape if held on one side and left suspended.

Another advantage of round implant over teardrop is that it comes at a lower price.  In addition, several studies suggested that it often lasts longer particularly those with smooth surface.

Because round smooth implants do not pull the tissue, they are less likely to wrinkle—one of the factors that can weaken the implant shell.

Also, patients who will choose round implants can either use saline (salt and water solution) or silicone filler.  By contrast, anatomical implants are only filled with saline because a cohesive gel like the silicone cannot be used.

Currently, silicone-filled implants are more popular than saline version because they provide a more natural result; this is not surprising because silicone gel is designed to mimic the suppleness of the breast tissue.

                                                  

Thinking of Breast Augmentation Surgery?

Breast augmentation has been one of the most sought-after cosmetic procedures in 2010.  During this period alone, about 296,000 US patients had the surgery, with the number expected to grow in the next few years.

If you are thinking of having breast augmentation surgery, these are the most common questions of patients you may also have in mind:

·         Is the safety of breast implants monitored by the FDA?

Both saline and siliconebreast implants are considered safe both for breast augmentation and reconstruction following cancer surgery.  Currently, the FDA only allows Mentor and Allergan-Mentor to sell their products in the country.

·         What is the advantage of saline breast implants over the silicone version?

Saline implants require smaller incisions because they are only filled once they are inside the breast pocket.  Take note that no FDA-approved prefilled saline implants are sold in the US.  Another advantage is that you are no longer required to undergo regular MRI screening because there is no risk of “silent leak.”

·         Which is more popular nowadays, silicone or saline implants?

Most doctors believe that silicone implants are more popular these days because they can simulate the natural feel of tissue unlike the saline version which is typically described as like having a water-balloon inside the breast.

But because a leak may not have any manifestation (e.g., deflated-looking breasts), it is recommended that you undergo MRI screening at least every two years.

·         Is there any option other than saline and silicone implants?

A new breast implant called “gummy bear” implant is used in Europe, though it is not yet available in the US market, unless you will enroll in nationwide clinical trials to test the product’s effectiveness and safety.

Gummy bear implant uses the silicone gel that is more cohesive than the one used by the currently available silicone implant.

·         Do patients need revisions in the future?

Because breast implants are not guaranteed to last a lifetime, you will likely need revision breast augmentation at some point in your life.  This is because the devices are still subjected to the natural wear and tear which can lead to rupture and leak.