Breast Augmentation

Chimera Cosmetic Clinic uses natural feeling, cohesive Silicon filled implants to augment breast size and enhance shape. The gain in self confidence is realised by placing the implant behind the breast, and sometimes also behind your muscle.

Commonly, Dr. Shaw makes a 4 centimetre cut in the fold under the breast, but this may vary depending on your preferences. A gain in size is obvious, though the principle challenge is improved shape. Any minor differences noted with your breasts may be minimised with a breast implant. Larger differences may need specific corrections such as different size breast implants or additional surgery to achieve your desired appearance.

Dr. Shaw operates under general anaesthetic with additional local anaesthetic for your recovery comfort, and you needn’t stay in hospital overnight as we are proactive with your pain control. Dr. Shaw insists that you wear our specially provided support bra’s after your augmentation, and that he manages your follow-up dressings until you are healed.
 To find out more, read our comprehensive explanation below, or call Lynn at 011 9076621 for a full assessment and explanation.

What is breast augmentation?

Breast enlargement surgery, correctly known as breast augmentation, remains one of the most frequently performed cosmetic procedures worldwide. This is hardly a surprise considering the link between breasts, femininity and motherhood. The first documented attempt at breast enlargement was by Dr. Czerny in 1895. Subsequent to this, many substances and techniques have been tried over the last century with somewhat unpredictable results. The modern era of breast enlargement surgically places a Silicon bag behind the breast to enhance the shape and size by stretching your existing breast over the bag. This basic method has remained the same since its introduction in 1964. What has changed are refinements with regards to position of skin cuts, positional depth of the implants, the anaesthetic techniques and massive advances in the quality of the Silicon breast augmentation implants themselves.

How do we cut?

The most popular cut used by Dr. Shaw remains a 4 to 5 centimetre cut under the breast in the fold. These cuts are generally well hidden by the slight droop that happens in most mature women with breasts larger than the smallest A-Cup. They also tend to heal very well as they lie in a natural fold. Alternatives used are cuts at the edge of the nipple, or in the armpits. The small bellybutton cut as seen in American movies is only possible for a saltwater bag, which in reality is used only in America, and has a far poorer cosmetic result than Silicon as used in the rest of the world.

Silicon vs Saline

The shell of all implants is made of a firm, cross-linked silicon polymer that should cause no reaction in your body. Nobody is allergic, and the results should remain soft and pliable to the touch. As with any product, a reputable company with impeccable track record maintained by consistent manufacturing checks is vital.

The big debate centred around the ideal filler material inside the breast implant.

The original, and still the most popular filler is liquid silicon. Media hype fueled by lawyers and other financialy interested groups has quickened the search for alternative fillers. This ongoing search is commendable, but pressure to rapidly produce an ideal substitute without adequete scientific trials and long term follow ups has led to some poor outcomes in Europe, the UK and USA.The most tolerated alternative filler, particularly in North America, is salt water otherwise known as Saline.

Saline is safe, and if any should escape from the shell it is merely absorbed by your body. These implants also have better mammogram characteristics. They are filled at surgery, with the possibility of using different amounts to adjust for small breast size differences. Lastly, they have valves with filler tubes, and the empty bags can be inserted from distant sites such as the belly button and filled once in the breast pocket.

Herein also lies the problem – they all slowly deflate. This leak used to occur from the valve, but this has been corrected and today’s implants gradually lose saline through the shell over time. When this happens, the underfilled prosthesis wrinkles and the saline causes visible skin ripples. The very firm feel of saline implants also contrasts with the natural feel of silicon filled implants. There are still both protaganists and detractors for both filler materials.

Suffice to say that the commonest filler in legally constrained North America was saline whilst the rest of the world enjoyed the superior feel, shape and look of silicon. With the relatively recent approval of certain silicone manufacturer’s prostheses in America by the FDA, these have again surpassed saline in usage in the States.

Silicon is by a great margin the preferred filler in use at present in South Africa.

Where do we place the implant?

The normal position of the implant behind the breast (retroglandular or prepectoral) can be modified by positioning the the upper half behind the chest muscle as well (retropectoral). This is often necessary in ladies with minimal fat or breast to cover the upper part of the implant. The added muscle layers ensures fullness (decollatage) but avoids visible edges. The disadvantage is temporary flattening of the implant by your strong muscle if you tense it to your maximum. Dr. Shaw places implants in either of these positions depending on your needs as discussed with you.

What is the best size?

This is certainly the most debated issue at consultation. Though Dr. Shaw concedes that bigger may initially look good, this can become a problem at a later stage when gravity causes gradual drooping of your breasts. The edges of a large implant are also easier to feel, and widened scars with stretch marks may even occur.

On the other hand, if the chosen implant is to small, the operation and financial outlay may seem to be wasted. It pays to observe the rest of your body, especially shoulder and hip width as well as bum size. Dr. Shaw emphasises balance and shape over size increases. Chimera Clinic specifically matches breast size to lifestyle. A sporty, active person would find overly large breasts an inconvenience and source of irritation rather than a delight.

Who do you trust?

The most important decision is probably your choice of Plastic Surgeon. Everybody loves a bargain, but as with most things in life, you generally get what you pay for. Check for qualifications, as most “cosmetic surgeons” have no training. The accepted qualification is that of Plastic and Reconstructive Surgeon. You must always feel comfortable with your doctor. Nobody likes everybody and if you don’t feel at ease, move on.

Get well informed

Arrive at your breast augmentation consultation well informed. A wealth of information can be gained from the media. This helps Dr. Shaw to understand your needs and expectations. Ensure that you understand the possible complications or adverse outcomes. A doctor who denies complication or less than perfect results is to be avoided. More important is honesty, and to determine how poor results will be managed. Ensure that a good follow-up plan exists.

And Lastly

Remember that it is up to you to explain your desires to Dr. Shaw as there are many different choices in breast augmentation. Stress what is important to you. Breast augmentation, as with all cosmetic operations, should be maintained and complemented with a healthy lifestyle to ensure durable results. Contact Lynn or Urzell at 0119076621 for an appointment.

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