Having a child is life-changing, but although babies bring tremendous fulfillment women are often dismayed at the physical changes in their bodies.
Post-baby breast lifts and augmentations are more popular than ever among mothers, especially in the "yummy mummy" era.
Breast augmentation, also known as an augmentation mammaplasty, breast enlargement or colloquially as a "boob job", is the most commonly requested surgical procedure, with an extremely high overall satisfaction rate.
"The hormones associated with pregnancy and the physical effects of breast-feeding, cause breasts to lose volume, soften and sag. Breast augmentation after childbirth is most often more about restoring shape and proportion than enlargement,” explains Cape Town cosmetic surgeon, Dr Stuart Geldenhuys.
It's about feeling good – increased self-confidence and sensuality. Women today are more conscious about restoring their figures and looking good after having children.
"Essentially it’s about how you feel about your body – if you are comfortable with your shape, no matter what type of breasts you have then plastic surgery is not for you, but if the size and shape of your breasts are negatively impacting on your self esteem, then plastic surgery can make a major difference."
“We live in an era of medical and technological advancements that allow us to optimize and remedy aspects of ourselves we are uncomfortable with."
Whether women are looking to restore their breasts to what they were prior to surgery, or decide to use the opportunity to get implants, Geldenhuys says that it's always important to keep things looking as natural as possible.
"We always aim for a natural result - proportional, with a gradual slope to the upper half of the breast, full rounded lower pole with focus and projection of the nipple areola complex, noticeable cleavage with soft transitions between the breast and chest wall."
What about women who have breast augmentation done before having children?
Many women who are unhappy about the shape or size of their breasts don't want to wait until they have had children to improve their breasts.
Women who have breast augmentation before having children are most concerned about how pregnancy will affect their breasts and if they will be able to breast feed or not. So, is it wise to reshape your breasts if childbirth and breast feeding are just going to undo everything?
"The ideal is to perform the procedure after a woman has had her children, but you can't tell a 25-year-old who is extremely unhappy with her breasts to wait until after she has children to feel good about her body," says Geldenhuys.
"So unless a woman plans to have children in the short term, we can do a sensible augmentation that will minimise any post-pregnancy sagging and volume loss."
Thankfully, breast augmentation techniques have become more sophisticated since the first implants were done and now long term results are taken into consideration when deciding on surgery.
When it comes to breastfeeding, in most cases, the ability to breastfeed or not is more likely to be based on the inherent breast tissue than on the augmentation.
"Good choices and surgery are really the foundations. Adequate soft tissue cover, dual plane, sub-muscular pockets and the use of anatomical shaped implants provide durable and natural results and minimize sagging and volume loss.
"Adequate tissue cover will ensure that neither the implant margins nor rippling will be visible and along with an appropriate sized implant will limit any long term breast tissue thinning or sagging."
Geldenhuys believes that in many instances, women who have implants removed or redone after childbirth may have made bad or uninformed choices - either having chosen breast implants disproportionately large in relation to their frames or they have experienced capsular contracture or visible rippling.
How have technological and medical developments improved breast augmentation?
Refinements in surgical and anaesthetic techniques along with major advances in breast implant technology have and will continue to impact favourably on the safety and reliability of the procedure.
The quality of silicone implants has significantly reduced the risk of leakage, rippling and capsular contracture.
Anatomical implants have been developed to create a more natural silhouette - A smooth, sloping upper breast pole without excessive roundness, and generous fullness of the lower pole providing nipple projection. In addition, anatomical implants come in a wide variety of heights, widths and projections allowing custom tailoring to a patient’s body proportions.
In Europe there has been a marked increase in the use of anatomical implants compared to round. Over the last three to five years, a leading manufacturer indicated a 10 percent increase in the use of anatomical implants, from 35 percent to approximately 45 percent in 2010. This shows the trend towards using more naturally shaped implants, to create a more natural breast shape.
However in South Africa, anatomical implants are used in less than 15 percent of all primary breast augmentations. Geldenhuys attributes this to the fact that anatomical implants are more expensive and require a more systematic approach to breast augmentation: “Breast and chest wall measurements define choices rather than just an artistic eye, and the surgery requires more precise execution.”
What can be done about breasts that sag massively?
"Sagging or Ptosis requires a breast lift and most often augmentation. It is a more complex procedure than a standard augmentation, requiring removing and repositioning the nipple, but the satisfaction rates are very high."
Geldenhuys emphasizes that there is a direct correlation between the satisfaction rate for breast augmentations and a patient having realistic expectations and a positive attitude to life.