- Breast Augmentation
- Who is candidate for breast augmenation ?
- The first consultation
- About the implants
- Review about the breast augmentation
- Breast augmentation risks and complications
Plastic surgical procedures have to be done by plastic surgeons !
The breast enlargement is one of the most popular aesthetic procedures. The breast augmentation helps to fulfill your desire for fuller, tighter breasts and make them more favourable shape. The breast enlargement makes the women more assertive and gives them back their self-confidence.
The breast enlargement is mostly suggested after the full development of the breasts. Weight-loss, after pregnancy and with aging the breasts can vary in size and/or shape. Every women has assimetric breasts. It is a natural expectation that the women want to have feminine-shape breasts and have balance between the upper and the lower body. The augmentation –with implantation- enlarges the size of the breast and enhances its shape as a result of beautiful and more youthful breasts.
In Europe the plastic surgeons mostly use implants filled with silicone gel. The most modern silicone gel is stable in its structure and has high cohesivity, that’s why it is stable in shape. According to the implant shape we can distinguish between round or shaped (anatomical). The anatomical implants give much more natural result, than the round implants. Instead of the previously used smooth-surface implants, nowadays we use the textured surface implants, which can reduce significantly the chance of capsular contraction. The augmentation is almost always performed with general anaesthesia with hospital background. After the procedures which were performed with general anaesthesia it is adviced to spend one night in the hospital.
The implantation does not influence the further pregnancy and the capability of breast-feeding. After the augmentation self-examination of the breasts is as necessary is it was before the mammaplasty.
WHO IS CANDIDATE FOR BREAST AUGMENTATION ?
- Sometimes the breasts are not developed enough in size as the women want.
- The development of the two breasts is not the same, thus one of the breasts will be smaller than the other. This assimetry can be so much, that even with clothing it is not possible to hide. In the case of asymmetric breasts it can be considered to place different implants in size and shape for the correction of the symmetry.
- After pregnancy, breast-feeding or weight-loss the breasts will lose volume and shape.
- The clothes which are well-fit in other parts of the body can be loose or floppy.
The breast enlargement can not correct all the expectations -sometimes unreal-, which were dreamt by the patients. We can not resolve everything with the operation. On the one hand it has limits by the technics of the operation, on the other hand just only those corrections can be performed which are fit to the harmony of the chest and the breasts.
THE FIRST CONSULTATION
At the consultation we will discuss Your problems, expectations and desired outcome. We will talk about everything which is in connection with the mammaplasty and important in the aspect of the breast enlargement procedure. We will examine the chest and the breasts and their proportion to each other. We will draw attention to the asymmetry of the breasts, which can manifest in the difference of the breasts in size and/or shape. The placement, the size and the shape of the nipples can be different as well. We will check the quality of the skin and the connective tissue as well. There is asymmetry which even can not be corrected with augmentation. Certain asymmetries can become more expressed after the breast enlargement procedure. The mammaplasty does not enhance on striae of pregnancy or growing striae.
We will take some photographs –from different directions- about the present condition. The photographs allow the patients to examine and evaluate their breasts from different directions. If the breasts are strongly sagged and simply the breast enlargement surgery is not enough, breast lift may be required in conjunction with breast augmentation. The necessity of this is determined by the placement of the nipples.
You will be asked about Your medical conditions, medical treatment, drug allergies, use of current medications and previous surgeries, procedures. It is very important to get accurate information about every medical conditions to plan the procedure with the best thoughtfulness. After the proper information the well-planned breast enlargement procedure will ensure You the biggest satisfaction.
Weight-loss, pregnancy and breast-feeding after the implantation can influence the further result of the mammaplasty.
ABOUT THE IMPLANTS
According to the implant filler we can divide the implants as saline-filled or silicone gel-filled. In Europe the plastic surgeons mainly use the silicone gel-filled implants. The most modern silicone gel is stable in its structure and has high cohesivity, that’s why it is stable in shape. With the silicone gel we can achieve a more beautiful shape, and after the implantation the touch of the breasts are much more flexible and soft than in the saline-filled implants. The motion of the silicone gel implants are more natural and their weights are lighter. The silicone is widely used in the medicine: in cardiac surgery, in urology, in neurosurgery, in otolaryngology and plastic surgery. Several oral medications, cosmetics, surgical stitches, injections and lubricants include silicone. The silicone gel implants – in the contrast of all other information – do not have any health-damaging effects ( carcinogenic effect, autoimmune effect or connective tissue disease-causing effect ). There is no scientific evidence about the health-damaging effects of the implants in the body. (link to the EQUAM )
We can sort the implants according to the shape as well. We can distinguish round or shaped (anatomical) implants. The anatomical implants give more natural result than the round implants. Instead of the previously used smooth-surface implants, nowadays we use the textured surface implants, which can reduce significantly the chance of capsular contraction.
REVIEW ABOUT THE BREAST AUGMENTATION
THINGS TO DO BEFORE THE OPERATION
Before the implantation some examinations are necessary to make: blood test, ECG, chest X-ray and baseline mammogram. With these data the operation will be performed in the best security. If You smoke, take aspirin or other blood thinner medications, or any anti-inflammatory drugs or other medications, please let us know! This drugs can increase bleeding or can cause other interactions during the general anaesthesia.
The augmentation is always almost performed in general anaesthesia ( in some assorted cases it can be performed in intravenous sedation and local anaesthesia ) with hospital background. For Your security during the surgical procedure which is performed with general anaesthesia we check Your heart rate, heart beat, blood pressure and blood oxygen level with monitors. For Your bigger security antibiotics are administerd during the breast augmentation.
The incision can be placed into the inframammary, the periareolar or the axillary region. The incision of the mammaplasty is always chosen individually. Not everybody is candidate for any type of the incisions. To minimize visible scarring the best option is the inframammary incision. From this incision the inserting of the implant is the most easiest and saftiest. After the implantation the natural shape of the breast will hide the scar.
To insert the silicone implant there are different methods. The traditional methods are directly behind the breast tissue (between the glandular tissue and the muscle) or under the pectoral muscle (between the muscles and the ribs). In the case of submuscular placement the post-surgical period is more painful and uncomfortable.
In the case of anatomical implants there is a new technique, called „dual plane” technique, which gives a very natural result. In this method the upper pole of the implant – approx. the upper 1/3 part – is placed under the pectoral muscle, and the lower approx. 2/3 part under the breast tissue. With this procedure we can achieve maximal shape-correction with natural effect. With the augmentation as the result of the different inserting techniques, we can achieve slightly different breast-shape. The round implant is more conspicious, and the anatomical implant gives more natural shape to the breasts.
After the mammaplasty there are always a little amount of leaking blood and swelling, which are eliminated by a drain from the cavity. With this the recovery will be faster and saftier and the post-operational pain will decrease. The drain will be removed the following day of the operation.
At the end of the augmentation we cover the wounds with bandages and help the patient to take on a special bra.
THINGS TO DO AFTER THE OPERATION
In the case of the operation, which was performed with general anaesthesia, it is practical to spend one night in the hospital. If the operation was performed in intravenous sedation or local anaesthesia, after the surgical procedure it is allowed to go home. After the breast enlargement operation it is suggested to relax and spare Your breasts with due foresight. Sleep on Your back and avoid pushing the breasts! Between the first and the third days after the operation You can feel more discomfort, but this is just a temporary problem, which is caused by the stretching effect of the implants. The initial decoloration and swelling are just temporary symptoms and disappaer fast. These are natural consequences of the operation. The stitches will be removed after 2 weeks, when the tension is significantly decreased.
It is recommended to wear a special bra in the first 6 weeks. Two weeks after the implantation do not drive car and for six weeks avoid any stiff sports and physical activity! During this period You have to avoid sunbathing and going to the solarium! After the sparing period You have to cover the scar with sun protection cream for a long time!
After the augmentation self-examination of the breasts is as important as it was before the operation. If You are recommended to go for baseline mammogram because of Your age You have to do it independently the implantation!
After every plastic surgical procedures You have to return for follow-up care regularly, thus after the implantation as well. The regularity of this depends on the type of the procedure and other personal feautures of the patient. At the previously discussed follow-up cares we will examine the operational area and discuss about the things to do in the future. Please remember that if You have any questions or problems, please do not hesitate to contact us independently the appointment!
BREAST AUGMENTATION RISKS AND COMPLICATIONS
If the operation is performed by a qualified plastic surgeon, the operation and the post-surgical recovery period will be without any unexpected episodes. The breast enlargement as all other surgical procedures can have complications, even ideally. Besides the generally presented complications ( bleeding, infection, poor healing of incisions and thrombosis ) – which are very rare -, can occur some special complications because of the implants.
Changes in nipple or breast sensation can occur temporary. This will cease in a few days and become normal again.
The implanted silicone is totally tissue friendly, but it is still a foreign material for the body. Around the implant a thin, connective tissue- pod will develop, which is a natural consequence of the recovery period. In normal case this connective tissue scar around the implant is the same in thickness. In one part of the cases ( according to statistics, in the 5-15 % of the implants which were inserted by us ) this pod will become more thick, will thighten and can malform the breasts. This can happen months or years later, after the implantation. This is called capsular contracture. Till today we do not know the reason of this, but there are a lot of different assumptions. This is a special firm scar tissue, and to its effect the shape of the silicone implant will change and the breasts malform.
The breasts can become firm, and wrinckles can develop on them. Because of the contracture a stretching feeling will develop in the breast, and possibly some pain will be presented. In this case a little correction is necessary. In the correction procedure the firm scar tissue will be cut or eliminated. With this procedure the implant will be free again and the breast will have its natural shape. After the operation the problems will cease and the breast will get back its beautiful and attractive shape. Unfortunately those people who are liable to this kind of scar formations, this mutation can happen several times. To decrease the possibility of the capsular contracture we prefer to use the textured surface implants.
With the most modern devices, materials and stitches which were inserted by the most friendliest techniques it can happen that the colour of the scar will be brisk and red, thick in touch and a little bit widened. This depends on mostly personal liability, thus it can have significant differences. This malformation decreases by the time, thus the scar will be thinner and its colour will lighten. If this does not occur, we remove the scar and treat the new scar with other special scar-treating methods.
In a very exceptional case the infection after the implantation needs the temporary elimination of the implant. After the total cessation of the inflammation we insert back the implant to reconstruct the beauty of the breast.
The complications can be vanquished or revised with the appropriate treatments and procedures, thus they do not effect the final result of the operation or slightly influence it.
The breast augmentation helps to fulfill your desire for fuller, tighter breasts and make them more favourable shape. The breast enlargement surgery makes the women more assertive and gives them back their self-confidence.The operational scars will pale by the time and fade into its environment. But You have to notice that they will never be invisible.
The result of the implantation is long-lasting but does not take forever. The gravitation and the change in the flexibility and water-content of the tissues, the other alterations with aging have effect on the size and shape of the breast. If the breasts change with aging, it can be necessity to perform breast lift or reimplantation with bigger implants.