Phuket and the Plastic Surgery Center, Thailand welcome you.

* * * * * Breast Augmentation * * * * *

* * * * * * * * Breast Lift * * * * * * * *

* * * * * * Breast Reduction * * * * * *

Breast Augmentation
( Augmentation Mammaplasty, Breast implants )

The surgery is aiming to help women whose breasts are small to have larger and proportional breasts. To make their dream come true, to be similar with others. Many time, it gives back confidence to the middle age women who had nice breasts when they were young or before they had children. This operation also fulfill many transgender who wish to have more feminine looking breasts.

Pre-operative consultation

The straightforward communication between a surgeon and a client will avoid most of the problems regarding the outcome. Some people is not a good candidate for breast augmentation such as a woman whose breasts are moderately or very droopy.

If the surgeon decide that the client will be beneficial from breast implants, he Will advise them to try several sizes of real implants until they find the proper ones. There are many other things to select before operation; Silicone or Saline implants, Low or High profile, Round or Teardrop , Smooth or Texture surface, Location of incision (armpits, nipples or breast folds ), Location of implant ( above or under chest muscle)

The surgeon normally need to take photos of clients’ breasts for comparison between before and after surgery.

Anesthetic Procedure

The client is subjected to have chest x-ray and routine complete blood count
Check on the surgery day. They have to stop eating and drinking at least 6 hours before surgery and inform their history of allergy or other health problem. Every cases
Of breast augmentation are performed under general anesthesia and undertaken at the hospital, not at the clinic.

Operative Procedure

     The surgery takes normally between one and a half and two hours depended on the location of incisions, how much bleeding , fresh or corrective cases.

     Drawing the extent of dissection may be done on the chest in sitting position before anesthesia or lying position after anesthesia depended on surgeon experience.The selected incision is done approximately 4 to 6 centimetres. The space will be created under or above chest muscle according to the agreement during consultation. Normally, the surgeon prefer to place implants under chest muscle if there is no disadvantage. Then, antibiotic solution will be used to irrigate inside those pockets. The most important step is to squeeze the breast implants until it sit on the right position. Finally, both incisions are closed.

     Normally, we will not put any drain except that there is a risk of bleeding or blood collection. Then we consider to put drain and retain for 1-2 days case by case.

Post-operative care

     The client will recuperate at the hospital for 1 night, or 2 nights if necessary. Then they can rest at the hotel until the follow up day, 5 days after surgery. During Hospitalization, they may request for Morphine or Pethidine injection to relieve pain.

     Also, anti swelling tablets and mild pain killer tablets are prescribed for a few More day after the client leave the hospital.

     Elastic bandage support is wrapped around the breasts for several days but if it Is not convenient, the client can use a sport brassiere (without wire) instead. After a few weeks, if they are getting better and have more comfort, they can start using the normal brassiere. The client whose breasts have tendency to sag in the near future, we recommend them to use brassiere supporting their breasts as much as possible. But for transgender or women whose previous breasts are quite flat, we encourage them to avoid brassiere to give chance for the implants to drop and stretch the skin faster.

     5-6 days after surgery, the client need to come back to see the surgeon for check up and have stitches removed. The surgeon will teach them to massage the breasts to reduce the risk of encapsulation (capsular contracture). If the clients have tear drop implants, they must not massage the breasts since it can misplace it and end up with breast deformity.

     The breast massage should be continued regularly for 6 months, 3 times a day. Each massage needs just several minutes a session.

     In many occasions, the new breasts will not look natural immediately because the skin over the breasts and implants has never been stretched before. A few weeks later, the breasts are going to look better and it may takes a few months before it look natural.

Activities

The client can have light activities during the first week but they may not be able to raise their arms higher than head. They should avoid lifting heavy luggage for a few weeks. They can start driving a car again a week after operation. It is a month after surgery before they can resume normal activities.

Complications

     Every surgery has a risk of complications. It is not common if the operation is performed by experience surgeons. Some complications are correctable, some are not and end up with removal of the implants. However, most of the clients still get chance to have breasts implants redone, normally 6 months later.

     Infection Approximately 1% of the cases, in most cases, implants must be taken out since antibiotic can not help clearing the infection. If the client need to have implants again, the surgeon will wait for at least 6 months before redo it.

     Bleeding and blood collection Approximately 1-2% of the cases. Normally found at the first 48 hours after surgery. The surgeon need to take the patient to an operation theatre to remove the blood clot out and stop the bleeding spot. A drain tube may be installed and retained for one or two days. However, implants need not to be removed.

     Seroma collection 5-10% of the cases, if the surgeon detect that there is fluid collected around implants, then he will consider either to leave it alone until fluid is reabsorbed into body or aspirate it out to speedy the healing process.

     Capsular contracture (encapsulation) Incidence is approximately 5-10% depended on the severity. It can happen any time after surgery, a month or many years later. Normally, when the foreign body is buried inside human body, the body will shell it with a tissue generally called a capsule. If the capsule around implant is thin and pliable, the breasts will look and feel realistic. If the capsule is a little bit thicker, the contour or feeling is still acceptable. But if the capsule is very thick and constricted, the breasts may be deformed and cause pain.

     There are many factors that can lead to capsular contracture and it is very hard to predict that it will happen in any case. The correction if considered, Capsulectomy, to repeat operation and remove the capsule. Replace the new implants. But it can not guarantee that it will not happen again.

     Numbness or reduced sensation at nipple and breasts Founded approximately 5-10%. It is not dangerous but may be concerned since it is annoying. In most cases, the feeling is coming back, completely or incompletely, 6 weeks to 6 months after surgery. In few cases, the feeling may not come back.

Cost of surgery

Augmentation Mammaplasty or breast enlargement costs 105,000 Thai Bahts (Approx. 3,400 US$, 2,200 Euro, 3,600AUS$, 1,700 Eng Pounds). Revision augmentation mammaplasty cost 3,800US$. This includes surgeon fee,anesthetist fee, Round mammary implants ( silicone or saline water ), room and meals at the hospital for 2 days, transportation between hospital and airport or hotel.