Augmentation Mammoplasty
Under this title, we will provide you with information on breast augmentation with prosthesis. Breasts play an important role in our lives not only aesthetically, but also physically, sexually and psychologically. Breast augmentation surgeries are operations that aim at both volumetric increase and contouring. The patients’ problem could be related to sudden and/or excessive weight loss or it may relate either to volume defects and/or physical deformities
Breast augmentation surgeries are among common aesthetic operations that could be made starting from adolescence and that could have significant positive affect on patientsˊ self-confidence and socialization. The reliability of the silicon prosthesis used in this operations and the developments in surgical techniques, which enable quick recovery and return to daily life are among main factors that cause an ever increase in the level of preference for such operations. These are surgical interventions that have quick recovery process, satisfactory results, improving patientsˊ self-confidence.
Choosing the brand, content and size of the implant and determining the location of the incision, of the anatomic area where the prosthesis will be placed are the most critical questions that should be answered before the operation. The shape, size and place of the implant shall be decided after a detailed evaluation following a face-to-face examination. After choosing the type of the prosthesis (round, smooth or textured) the anatomic location of the implant shall be decided taking into account the implications and the patient’s expectations. There are different advantages of sub-muscular or sub-glandular positioning, which is often determined according to the characteristics of the body and nipples. For the patients who want to have a baby and breastfeed in the future and who do not want the implants taken out later, the sub-muscular positioning shall be preferred while for women who want to have a significant decollate after the operation, sub-glandular implants are more appropriate. For women who have already breastfed a baby and whose upper quadrant has been emptied, anatomic and sub-muscular implants supporting the nipple area are more appropriate.
For young persons who has not yet given birth and who has a flat breast and tight skin structures, flat surfaced and anatomic implants that are placed under the muscles in line with the diameter of the body and the condition of the nipples.
The points to consider in choosing the implant: the age, general health condition, body characteristics, profession of the patient, the characteristics of the nipple- areola region, structure of the pectoral muscles, whether the patient already has a child or will be an expectant mother in the near future, whether she has deformities in the skeleton structure such as asymmetries and congenital anomalies, the thickness of the skin, the structure and width of the shoulders, personal preferences and aesthetic expectations of the patient. The successful augmentation surgeries are carried out with a meticulous planning made by the surgeon based on his wide experience and taking into account all the factors mentioned above.
Breast Augmentation Techniques
Breast Augmentation operations are made in general hospitals under general anesthesia and they last approximately 2 hours. Generally, they are carried out with an incision of 3 cm in inframammary line or in the nipple area if its diameter is longer than 4 cm. After the preparation of the pockets under or above the muscles, the implants are placed inside these pockets. And the surgery is finalized with the closure of incision in suture lines in tissue and skin. Depending on the preference of the surgeon, drain is seldom used if necessary. If used drains are removed after w4 hours at most.
Recovery in Breast Augmentation
After the surgery, patient is taken to the bed with pressure bandage or corset. The patient is discharged in the same day. The first control is made on the second day after patient takes her shower. In general, medical dressing is not required as dissolvable stitches are utilized. On the third day, patients can start daily exercises and lights sports and they could start working. They could travel with car or by plane. It is possible to start heavy sports like swimming at the beginning of the third week. We suggest that patients use the corsets for up to 10 days. The final result of the breast enlargement operations could be stabilized after 2-3 menstrual periods. During this time, in order to prevent muscle spasm and to support the recovery, some doctors may suggest massage.
Frequently Asked Questions about Breast Augmentation Surgery
- Is it necessary to renew breast implants in time? If they are not damaged during the implantation, they have such durability and reliability that you can use them for a life time. There are some surgeons suggesting that it is necessary to change implants once in 10-12 years-period as they may wear down and be subject to “surface fatigue.
- Would breast implants cause breast cancer? This is one of the false-facts about breast implants. The implants placed in the breast are recognized by the body as foreign objects. Hence, they are covered by a thin membrane and they are more often checked by the immunity cells. Thanks to this control and early warning system, the problems, if there is any, in breasts with implants could be diagnosed much earlier compared to the breasts without implants.
- What happens if the breast implants are refused by the body? This problem, which is known as capsule contracture, is an exceptional situation and it is treated by removing the plants from the breasts without any damage and medical sequel in the patient’s body. After the necessary tests and evaluation, and following a certain period of recovery, the alternatives for breast augmentation are reviewed and the problem is solved with an alternative technique.
- Is it true that a certain type of lymphoma cancer, ALCL, develops after breast enlargement operations? ALCL is a type of lymphoma and certainly it is not cancer. This clinical situation, which is characterized by thickening of the capsule surrounding the implant and lymphedema, is rarely observed and its treatment is completely ensured just with the removal of the capsule and the implant. If there are, in time, symptoms of asymmetry pain, shrinkage, for diagnostic purposes, it would be sufficient to have an MR; if such symptoms do not exist, it is not necessary to remove the implants.
- Could the sagging nipples be corrected with breast augmentation? In some cases, sagging tits could be corrected by choosing appropriate implants. However, in other cases, it may be necessary to remove the excess skin from the breasts with operations called “Mastopexy”. This operation can be done with or without implants depending on the expectations of the patient as well as the degree of the sagging. The title “Mastopexy” is given to breast lifting operations and it is not an augmentation surgery.
- Could breast asymmetry be corrected with breast augmentation surgery? Yes, depending on the surgical techniques, the size of the prosthesis, the height of the nipple and inframammarial fold can be determined. In this way, 1-3 cm of nipple height asymmetries can be eliminated. And nipple asymmetries caused by nipple deformities could be corrected with small surgical intervention during the same session.
- Which aesthetic procedures can be combined together with breast augmentation? The most common procedures accompanying these surgeries are correction of breast and nipple asymmetries, treatment of deformations in the chest (pectus carinatum and pectus excavatum) through fat transfer.
- Would patients experience heavy pain after breast augmentation operations? Although pain is a subjective (personal) feeling, the pain felt after breast enlargement surgeries is responsive to medication and decreases in time together with mobility. While our experiences suggest that early mobility and involvement in daily routine enable a quick and comfortable recovery process, we also observe that the pain problem is most commonly experienced due to the smoking related coughing.
- Is it necessary to have “Breast USG” for every patient before surgery? During the recovery period, fibrotic changes could occur. Besides, changes in the location of the tissues could naturally take place due to the size of the breast implant. In order to prevent the confusion and to enable the comparison of postoperative changes in the tissues wit tumors or other cystic changes that may occur, I advise the patients to have “breast USG” in order to photograph the situation of their breasts.
10 How the breast implant rupture could be recognized? If asymmetry deformities take place in breasts in time, the possible implant rupture and leakage of silicone can be detected with “breast MR”. It should also be kept in mind that the asymmetry and deformities could be observed due to the turn-about of the implants in the location where they are placed. This rare situation is caused by mistaken surgical technique.
