Breast Augmentation (with implants)

Breast augmentation is suitable for young mainly girls who have smaller than the desired breast size and would like to improve their image. Of course, breast augmentation is also applied to women who have undergone mastectomy for health reasons, for aesthetic, but also for psychological reasons.

 

Breast augmentation (with implants)

The most common method in breast augmentation is the placement of silicone implants, which have been selected to meet the requirements and wishes of the patient.

Preoperatively, in addition to the classic examination, the patient undergoes a mammogram to rule out any other breast pathology. Breast augmentation requires general anesthesia. Its duration is 1-2 hours.

In breast augmentation, depending on the technique to be chosen, incisions are made either in the submandibular groove or around the areola, so that they are indistinguishable.

In breast augmentation plastic surgery with silicone implants, the implants are placed either under the mammary gland, or under the pectoralis major muscle or even better under the muscle and the existing mass gland (dual plane).

Postoperatively, the patient is required to wear a special bra to properly support the breast. After breast augmentation, it is recommended to abstain from intense exercise for a month, while the return to work is estimated at 5 to 10 days, depending on the severity of the work. It can be performed regardless of the possibility of pregnancy, since the woman is perfectly capable of breastfeeding after such an operation.

Subfacial Fitting and Breast Augmentation

Specialized technique

In this technique the implants are placed under the fascia of the pectoralis muscle. The result is completely natural. During the surgery the plastic surgeon does not intervene in the anatomy of the mammary gland when he creates the “pocket” and the procedure is non-traumatic. It is a technique that combines the advantages of older techniques without any of their disadvantages. The result is very natural and almost no surgery seems to have been performed.

So:

  • The pain is minimized
  • Recovery is immediate
  • The shape of the breast is more natural since the fascia covers the insert
  • Because the implant does not come in contact with the breast, the possibility of a wrinkle capsule is reduced.

You ask, we answer …

There are four options for placing breast implants:

  • Above the muscles and below the existing breast
  • Under the muscles
  • Dual plane: half up and half down
  • Subfascial: under the fascia of the pectoralis muscle.

The latter two are the new techniques for breast augmentation with more advantages than the previous ones. In any case, the plastic surgeon must be fully familiar with the techniques to decide which technique to apply. An important factor for successful breast augmentation is the characteristics of the breast such as thickness, base, etc., which are taken into account to finally choose the type of implant and the level of placement.

Silicone implants are divided into anatomical and round. The round ones are distinguished in small, medium and large degree of projection. Anatomical implants, apart from this distinction, are also divided based on the different height, which can be smaller, the same or larger than their width.

Anatomical implants require special care when placing them because the “pocket” made by the surgeon is narrower to avoid possible rotation. The advantages of the newer implants (round and anatomical) include their technological construction and the density of the silicone.

Initially the size of the implants depends on the patient herself and her own desire. At the same time, for a successful breast augmentation, an important role is played by her body type, ie the already existing breast, her chest. These are points that are discussed at the first visit in order to make the right decision by the patient.

The incision can be made in the areola, in the armpit or in the armpit. If we want the incision to look minimal, then it is done in the subastina, an area that allows us not to cut the mass gland. The scar that eventually becomes is about 4 cm and after a few months is barely visible when the breast augmentation is done properly.

Silicone implants are completely safe and extremely durable. They do not cause allergies, and in no way are they related to the occurrence of breast cancer. We emphasize that they do not affect the mammary glands and do not alter the composition of milk in case a woman wants to breastfeed.

The implants do not need to be changed. The production companies give them a lifetime warranty. There are two reasons why a lady would change implants. Either because due to her choice she would like to change the size of her breasts, or because over the years and possibly some pregnancy she will change the size and shape of her breasts. Also in the extremely rare case of capsule formation or rupture of the implant.

There is no such restriction on breast augmentation. Breast augmentation can be done at any age after 18 years. How can the patient be sure that she has made the right decision about the size of the implant? Our main concern, apart from the successful outcome of the operation, is that the result of the augmentation is what the patient expected.

To be sure that she will make the right size choice, from the first visit, a thorough discussion takes place and we try different sizes of inserts under the bra so that the patient has a first image. When the patient asks for something very big then we have to see if this breast augmentation can be done based on the width of the breasts. Our goal is a natural and elegant result.

There is no such restriction on breast augmentation. Breast augmentation can be done at any age after 18 years. How can the patient be sure that she has made the right decision about the size of the implant?

Our main concern, apart from the successful outcome of the operation, is that the result of the augmentation is what the patient expected. To be sure that he will make the right size choice, from the first visit, a thorough discussion takes place and we try different sizes of inserts under the bra so that the patient has a first image. When the patient asks for something very big then we have to see if this breast augmentation can be done based on the width of the breasts. Our goal is a natural and elegant result.

The answer will be given by the shape we want the curve of the upper pole to have and how tight the skin is. When the choice is anatomical implants we also consider the somatometric criteria. All this process helps the woman to make the right decision so that after the operation she feels refreshed and completely satisfied with the result.

In the case of small weight loss, the result of the operation is not affected. But when the weight loss is great things change. That is why it is good to have reached your goal before the operation, even if there is the possibility of weight change.

As with all surgeries, the woman may feel pain in the first few days after breast augmentation surgery. This pain can be treated with simple painkillers. Women with small breasts that undergo this operation often feel a feeling of heaviness in the first weeks, but it is mild.

In most cases the patient stays in the clinic for one night. No longer stay is required and essentially follow-up is necessary in the first postoperative hours. In the first weeks after the operation, the breast will be more sensitive for 2-4 weeks. It is advisable to avoid sexual intercourse during this period. The woman can return to work after a few days. If the work requires physical exercise, another week of recovery is recommended.

The scars are initially slightly red but gradually their appearance improves and as time goes by they become indistinguishable.

Improve your appearance if you think your breasts are too small or you have an unevenness (that one is smaller than the other)

  • If you need a small erection if the breasts have lost their density and have a slight fall either due to weight fluctuations or due to pregnancy
  • For correction after breast surgery for another cause
  • Improve your self-confidence

Discuss your goals with your surgeon so that you can be realistic about what breast augmentation can do for you.

Breast augmentation involves several risks, such as:

  • The development of scar tissue that deforms the shape of the prosthesis (scalp capsule)
  • Pain
  • Contamination
  • Changes in the sensation of the nipple and breast
  • Implant leakage or rupture

Correcting these complications may require a second operation, either to remove or replace the prostheses.

The US Food and Drug Administration (FDA) has identified a possible link between breast implants and the development of breast implant-associated large cell regenerative lymphoma (ALCL), a rare cancer of the immune system. The FDA believes that women with breast implants may have a very low but increased risk of developing ALCL compared to the general population. The incidence of the tumor is small.

This problem is treated by removing the implant and resecting the capsule. However, further research is needed to fully understand the relationship between ALCL and breast implants

Breast augmentation is done in a hospital. You will probably go home the same day. Sometimes you need to stay in the hospital overnight.

During the process

I will make a 4 cm incision in one of the three points:

  • In the fold below your chest (optimal)
  • In the armpit
  • Around your nipple in the halo

This is followed by the separation of the breast tissue from the muscles and connective tissue of your breast. This creates a pocket behind or in front of the outer muscle of the chest wall (chest muscle).

Then insert the implant into this pocket and place it behind your nipple.

The saline implants are inserted empty and then filled with sterile water as soon as they are in place. The silicone implants are pre-filled with silicone gel.

When the implant is in place, the incision is sutured, followed by bandaging and closure with skin adhesive tape.

After the procedure

Some pain and swelling may be present for a few days to a few weeks respectively after surgery. Expect the scars to become indistinguishable over time, but they will not disappear completely. Especially you who know where they were will see them.

You will wear a compression bra or sports bra for extra support. If you do not have a physically demanding job, you may be able to return to work within a few days. Avoid strenuous activity – anything that can increase your pulse or blood pressure – for at least two weeks.

If you notice heat and redness in your chest or have a fever, you may have an infection. It is the only complication that the Plastic Surgeon is afraid of because he is often forced to remove the implant.

You need to tell me your preferences for the size, feel and appearance of your breasts. This will be followed by a discussion of the types of implants – smooth or rough surface, round or anatomical (tear), with saline or silicone – as well as options for surgical techniques.

Before deciding to have surgery, consider the following:

  • Breast implants will not prevent your breasts from changing over the years. To correct a sagging breast, you may need breast augmentation (mastoplasty) in addition to breast augmentation.
  • Implants are not guaranteed to last a lifetime. The average lifespan of an implant is 10 years. Rupture of the implant is possible. Also, your breasts will continue to age and factors such as weight gain or weight loss may change the way your breasts look.
  • Mammograms can become more complicated. If you have implants, you will need specialized mammography screenings that are no longer a problem for many radiologists.
  • Breast implants may interfere with breastfeeding. Some women are able to breastfeed successfully after breast augmentation. For others, however, breastfeeding is a challenge.
  • The FDA recommends regular MRI scans three years after breast augmentation. However, recent studies show that there is little evidence to support the screening unless you have symptoms.

You may need a basic mammogram before surgery. If you smoke, I will ask you to quit smoking at least shortly before surgery. Make sure you have a companion to take you home after the surgery and stay with you for at least the first night.

Breast augmentation can change the size and shape of your breast. Surgery can improve your body image and self-esteem. But keep your expectations realistic and do not expect what you see in magazines. It will remain just your breasts increased in size.

Also, your breasts will continue to be affected for years after the augmentation. Weight gain or weight loss can change the way your breasts look.

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Duration
1-2 hours

Recovery time
10-30 days