Wellness & Fitness

I want breast implants

implant

Contrary to popular belief, breast implants won’t stop your breasts from sagging. PHOTO | COURTESY

Q : I am 39- years- old and thinking of getting breast implants. My body has undergone lots of changes over the past 15 years – I’ve had three babies (all of whom I breastfed until the age of 2) and I recently lost a lot of weight and although I am happy with my overall look, my breasts make me unhappy. They sag and have stretch marks and I feel that they are not attractive any more. I would like to get some breast implants but I am not sure how to go about it. I hope to get one more child in the next five years. Where can I get implant surgery in Kenya? Will my insurance pay for it? What are the risks involved?

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Breast implants don’t prevent sagging

Contrary to popular belief, breast implants won’t stop your breasts from sagging. To reduce the saggy look of your breasts, you will likely need a breast lift in addition to the implants. You also need to realise that as you age (or if you undergo significant weight changes again), your breast may sag again even with the implants in place. Lastly, you need to understand that implants will not get rid of your stretch marks.

You can’t always get the breast size you want

Some women with very small cup sizes may wish to get much bigger breasts, for example a lady with an A cup size may wish to increase her size to DD cups. This is not always possible. Several factors need to be considered when deciding what is the best size of implant for you – especially if you wish to keep a natural look. Your surgeon needs to establish how ‘loose’ or ‘elastic’ your skin is, the size of the base of your current breasts, the natural distance between your breasts and how broad your chest is. If you wish to get a size that is bigger than what is feasible with one operation, your doctor may suggest that you have several operations to achieve your desired size.

Should you get silicone or saline implants?

For a long time, there was great concern about silicone implants due to cases of leakage and its harmful effects on the body. This has led to improvement in the quality of implants used and most of the ones available are of high quality and rarely leak. Saline refers to salt water solution so if it leaks, it is usually not harmful to the body. Although they have similar cosmetic effects, most people find that silicone implants feel more ‘natural’ than saline ones. Saline implants, however, can be inserted through smaller incisions (skin/tissue cuts) than silicone ones.

Breast implants don’t all look and feel the same

Breast implants come in either round or ‘teardrop’ shapes. The ‘teardrop’ shape is designed to look a little more like the normal form of the breast. Some breast implants are also smooth whilst others have a rippled surface. These differences can all contribute to how your breast looks shortly after surgery and in 10 years to come. The best thing is to show your doctor a picture of what you would like your breasts to look like after your procedure – this way your doctor can decide if it is both feasible and which implants would be best for you.

Putting in breast implants is major surgery

Reality television has made it appear as though putting in breast implants is as easy as going to have your teeth cleaned. Unfortunately, it is not that simple. Usually, it needs to be done in theatre under general anaesthesia with all the risks that such procedures entail. Your surgeon and your anaesthetist need to determine that you are a good candidate for general anaesthesia. All your chronic (long term) medical conditions must be under control e.g. diabetes or hypertension. Certain physical attributes and lifestyle habits may make you a poor surgical candidate. For example, if you are morbidly obese, your surgeon may not be able (or willing) to put in implants. There is also great hesitance to put in implants in very heavy smokers.

How are breast implants put in?

Your implant can be inserted through an incision just under the nipple (peri-areolar) or in the fold under the breast (inframammary) or in the armpit (Axillary) or through a belly button incision. The implants may either be inserted under the breast tissue or behind the breast muscle. After the implants are placed, the incision sites will be stitched closed, and your surgeon may put in drainage tubes to remove any fluid that may collect around the surgical site. The drains are removed a few days after surgery.

What are the complications of implant surgery?

Most cases are uncomplicated but like with every surgical procedure, there can be problems during and after the surgery. During the surgery, most complications are related to the general anaesthesia. After surgery, some women report excess pain, bruising and swelling of the breast. This is often short-lived and resolves within a few weeks of surgery. Some women get blood clots (haematoma) or excessive fluid collection at the surgical site. This can easily be drained by your doctor. The wounds can also get infected. The wound could also heal with excess scar tissue causing the breast to look deformed. Some women report reduced sensation around their breast. The implant may also get displaced with time. although rare, implant rupture can occur.

Can you breast feed with implants?

Most surgeons place the implants under the muscle so you should be able to breast feed even after surgery. That said, some women, find it very difficult to breast feed after getting implants. This is a concern for women who have had a breast lift when the implants were being put in. During breast lifts, the areolar/nipple may have to be moved up. This may lead to a nipple that has no (or very little) sensation. This will interfere with the body’s ‘milk let down reflex’ (normally, when a baby latches onto a nipple, the brain sends a signal to the breast to release milk. This reflex is dependent on intact sensation at the nipple). Some women are concerned that silicone or saline particles may ‘mix’ with the breast milk. This usually does not happen. The contents of the implant are sealed off from the breast tissue. Always inform your doctor if you wish to continue having children after your breast implants.

Breast cancer and implants
You need to get screened for breast cancer before and after you get your implants. Although, breast implants generally do not increase your risk of getting most breast cancers, there is a very rare form of lymphoma that is thought to be associated with breast implants (further research needs to go into this). After you get your implants, you need to continue going for regular screening for cancer (you can continue getting mammograms even with breast implants. Some doctors, however, recommend using an MRI scan for screening instead of a mammogram).

Are these procedures done in Kenya?

Cosmetic breast surgery is available in Kenya – but only in the private sector. There are several internationally recognised plastic surgeons located in Nairobi. In the public sector, breast reconstructive surgery is only done for cancer and trauma patients. Health insurance plans usually do not cover cosmetic breast procedures.

Breast implants may not last a lifetime

If you wish to keep your breasts looking the same for many years, you will probably need repeat surgery to change your implant. Most implants are good for about 10 or so years after which you may need to have them replaced. The need for repeat surgery is more common for women who plan to continue having babies after getting their implants. Pregnancy and lactation increase the size of the breast and once you stop breast feeding you will notice that your breasts will change shape again. The same applies to breast changes that occur around menopause (the breast tissue thins out).