Breast Implant Incision Sites
Areola
The most common breast implant method of insert is through a small 2 to 3 cm incision at the areola border. The transition in skin color between regular breast skin and the darker areola skin color is the perfect place to hide a small scar.
Under the breast
Another common site to insert breast implants is the fold under the breasts. As the breasts enlarge, the breast tissue will typically fold over at the bottom, thereby covering any visible scars in the standing position. When a patient lies down the scars may be visible.
Underarm
Using modern endoscopic equipment, which involves pencil thin lenses and camera systems, a doctor can place implants through an incision under the arms, which hides the scar in the natural folds of the underarm creases. The advantage of the underarm approach is the absence of any scars on the breasts. Since it is currently not easy to revise or re-operate on the breast through the same underarm incision, the disadvantage to this approach is the need for another incision site and scar on the breast, should another surgery be necessary in the future.
Breast Implant
Breast implants alter the size and shape of the breasts. There are two primary types of breast implants: saline-filled and silicone gel-filled implants. Saline implants have a silicone elastomer shell filled with sterile saline liquid. Silicone gel implants have a silicone shell filled with a viscous silicone gel.
Breast augmentation surgery involves using breast implants to achieve fuller breasts. Some women have breast augmentation surgery to improve their self-image. Some feel dissatisfied because the size of their breasts do not meet expectations. Others want to bring balance to a breast that is somewhat smaller than the other is. Often women want the procedure to restore their natural breast volume, which may have decreased because of pregnancy, weight loss, aging or even breast cancer surgery.
A surgeon performs the procedure in a surgical facility under a light where an anesthesiologist administers a general and local anesthetic for the surgery, which lasts from one to two hours. The surgeon enlarges the breasts by placing soft implants through a small incision, either though the armpit, from around the nipple or under the breast. Both saline and silicone implants are now available.
Endoscopic
Endoscopic is the most modern technique for breast enlargement surgery. A surgeon makes a small incision in the axilla (underarm) and uses an endoscope to introduce the implant, either under the pectoralis muscle or the breast tissue. The doctor employs absorbable sutures throughout the procedure to assure the comfort of the patient. The unique features of this technique are the small incisions used to perform the procedure and the location of the incisions in the axilla or armpit. Therefore, no scars are visible on the breast or at the breast crease, which lead to excellent aesthetic results. It is an ideal procedure for those patients with smaller breasts where the scars on the breast would be visible, and for those who have a predisposition to abnormal scarring.
Axillary
Doctors use an axillary approach when the breasts of the patient are small, in good position and are relatively symmetrical. Cosmetic surgeons introduce the implant through a 1- to 1 1/2-inch incision in the center of the axilla and generally place the implant under the muscle mass. In patients who are extremely muscular, this placement may show movement of the implant; in such cases, the doctor puts the implant over the muscle tissue. To finish the procedure the doctor uses absorbable stitches at underarm area and uses a small tubular drain to collect fluid for a day or two in order to decrease swelling.
Nipple
This commonly used approach involves a 1- to 1 1/2-inch incision on the lower border of the pigmented areola and allows some correction of shape and position discrepancies of the breasts. The incision generally heals well with minimal scarring. Although blockage of nipple ducts is a theoretical problem, it rarely occurs. Most women are able to breast feed after this procedure.
Inframammary Incision
In a small number of cases where the areola is very small, the doctor makes an incision at the crease below the breast. This approach may be suitable with the most complicated breast augmentations or for women who had previous breast surgery.
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Personalized Medicine
Personalized medicine is a medical model emphasizing the systematic use of information about an individual patient to select or optimize that patient's preventative and therapeutic care. Personalized medicine is the products and services that leverage the science of genomics and proteomics and capitalize on the trends toward wellness and consumerism to enable tailored approaches to prevention and care. Over the past century, medical care has centered on standards of care based on epidemiological studies of large cohorts. Personalized medicine seeks to provide an objective basis for consideration of such individual differences. Traditionally, personalized medicine has been limited to the consideration of a patient's family history, social circumstances, environment, and behaviors in tailoring individual care. Personalized medicine uses new methods of molecular analysis to manage a patient’s disease or predisposition toward a disease. It aims to achieve optimal medical outcomes by helping physicians and patients choose the disease management approaches likely to work best in the context of a patient’s genetic and environmental profile. Such approaches may include genetic screening programs that more precisely diagnose diseases and their sub-types, or help physicians select the type and dose of medication best suited to a certain group of patients. Personalized medicine is an extension of traditional approaches to understanding and treating illness. Since the beginning of the study of medicine, physicians have employed evidence found through observation to make a diagnosis or to prescribe treatment. In the modern concept of personalized medicine, the tools provided to the physician are more precise, probing not just the obvious, such as a tumor on a mammogram or cells under a microscope, but the very molecular makeup of each patient. Looking at the patient on this level helps the physician get a profile of the patient’s genetic distinction, or mapping. By investigating this genetic mapping, medical professionals are then able to profile patients, and use the found information to plan a course of treatment that is much more in step with the way their body works. Genomic medicine and personalized medicine use genetic information to prevent or treat disease in adults or their children. Having a genetic map or a profile of a patient’s genetic variation can then guide the selection of drugs or treatment processes. This can minimize side effects or to create a strategy for a more successful outcome from the medical treatment. Helping the physician cover all the bases is imperative. Genetic mapping can also indicate the propensity to contract certain diseases before the patient actually shows recognizable symptoms, allowing the physician and patient to put together a plan for observation and prevention. Personalized medicine, when coupled with personal pharmacogenetics, is a unique approach that may be well suited for the health challenges we face in the new millennium. Although the medical and scientific communities, through research and discovery, got the upper hand over many of the diseases we have encountered since the advent of advanced medicine, many diseases that are more complicated. Diseases like diabetes, heart disease, cancer, and Alzheimer’s are caused by a combination of genetic and other factors. Coupled with the fact that they tend to be chronic, they place a significant burden on not only the patient, but on the healthcare system as a whole. Personalized medicine aims to provide the tools and knowledge to fight chronic diseases and treat them more effectively than ever before. Genetic profiles can help physicians to better discern subgroups of patients with various forms of cancer, in addition to other complex diseases, helping to guide doctors with accurate forms of predictive medicine and preventative medicine. With personalized medicine, the physician is intending to select the best treatment protocol or even, in many cases, avoid passing the expense and risks of unnecessary medical treatments on to the patient altogether. In addition, personalized medicine, when used correctly, aims to guide tests that detect variation in the way individual patients metabolize various pharmaceuticals. Personalized medicine is working to help determine the right dose for a patient, helping to avoid hazards based on familial history, environmental influences, and genetic variation.
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