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W. Bushong, Ph.D., LMFT Richard A. Martin, Jr., M.D., FACEP Kimberly L. Westwood, CPE, CCE et al. |
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Specialists in the Medical & Psychological Aspects of Transgender Health Care |
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Breast Augmentation
The location of the incision depends on the surgeon's preferred method, your body type, and your personal preference. The most commonly used incision for augmentation is in the crease under the breast because the scar is easily hidden and is closest to the blood supply. However, the scar it leaves tends to be wide and dark in color. An incision may be made around the areola: this tends to result in a thinner, lighter scar that is concealed by the color of the areola, but when this scar heals poorly, it is quite visible. The third possibility, an incision under the arm, leaves the breast completely unscarred, but creates a scar under the arm, which may be prominent. This approach is also more difficult surgically and may lead to bleeding and improper placement of the implant, or other complications. Whatever incision location is chosen, the surgeon should assure that the incision is placed so resulting scars will be as inconspicuous as possible. Working through the incision, the surgeon will lift your breast tissue and skin to create a pocket. The implants are then centered beneath your nipples. Some surgeons believe that putting the implants behind your chest muscle may reduce the potential for capsular contracture. Drainage tubes may be used for several days following the surgery. This placement 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. Also behind the muscle placement of the implant may make some breast movement seem less natural. As an example, when raising one's arms upward, the implant will be more likely to shift unduly upward as it is carried with the muscle. Judging purely from aesthetic consideration, many surgeons indicate silicone gel implants placed between the breast and the chest muscle provide the optimum result. The surgery usually takes one to two hours to complete. Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to help with healing. Within several days, the gauze dressings, if you have them, will be removed, and you may be given a surgical bra. You should wear it as directed by your surgeon. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades. Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear. Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely. Routine mammograms should be carried out after breast augmentation for those who are in the appropriate age group, although the mammographic technician should use a special technique to assure that you get a reliable reading. At TGIP, we often suggest breast augmentation, if desired, be scheduled at the time of the second genital surgery (Z-plasty). This second phase is less traumatic, and the added discomfort of the augmentation usually can be better managed by the patient.
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Care Health Information Archive
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Implant
surgery for breast augmentation, known as augmentation mammoplasty,
involves making a single incision in or near the breast and inserting
the implant either between the breast and the chest muscle (pectoralis
major) or behind the muscle itself. The implant is most often
placed behind the muscle.
