Breast Augmentation: Procedure, Complications & Treatment.

Abstract

Breast Augmentation is one of the most common aesthetic procedures performed with a very high satisfaction
rate. After the description of first report of implant placement in 1964 by Cronin and Gerow, the popularity of the
procedure is on the rise. The complications are few but require thorough understanding of each one of them for
their prompt management and treatment. The procedure is generally performed by a prosthesis or implant.
These implants are available in different sizes, shapes and profile and the surface of implant shell can be textured, micro textured or smooth with advantages to each type.
Procedure can be performed through submammary, intra-areolar, axillary or transumblical approach. These implants can be placed in partial submuscular, dual plane, muscle splitting biplane, subfascial and subglandular
pockets with advantages to each.
In this chapter, over 1700 breast augmentations performed by the author were reviewed. All procedures were
performed under general anaesthetic. Textured and smooth surface implants were used and using intra-areolar
or submammary incisions, the devices were placed in partial submuscular, subglandular and muscle splitting biplane. All patients had at least single intravenous antibiotic and most of the procedures were performed as day
cases.
Complications following breast augmentation are few and may present early or late. Early common complications
are haematoma, seroma, infection and Mondors’ Disease. Late complications include capsular contracture, implant rupture, malplacement of implant, dynamic breasts, implant flipping and rippling of the implant etc.
The management and treatment of these complications were assessed and out come evaluated.
Synmastia, bottoming down, periprosthetic infection and dynamic deformities are revisited and their treatment
plans redefined. Mondors disease incidence, asymptomatic as well as symptomatic, was researched and its various presentations associated with breast augmentation described. Implant rupture, its association with quality
and handling was reviewed. Implant rupture, its presentation and treatment plan redefined. Relationship of infection to length of antibiotic is analysed and various treatment modalities of periprosthetic infection and their outcome was assessed and suggestions and strategies for their management outlined.
Breast augmentation is a procedure with a very high satisfaction rate however complications arising following
augmentations needs to be carefully evaluated and require a proactive and appropriate action plan. An informed
consent should ideally include information outlining benefits of breast augmentation, possible complications
along with the management plan of each one of them.