Breast Augmentation
The term hypoplastic breast refers to a breast with a volume that is smaller than the morphology of the body of the patient. It could refer to pre-existing hypoplasia from birth, but it could also arise later after a major weight loss and a pregnancy accompanied by breastfeeding. It can either exist alone or be accompanied by a breast drop, i.e. a downward retraction of the breast gland.
Purpose of the operation
The operation aims to increase the volume of the breast using silicone prostheses placed behind the mass gland or behind the pectoralis major muscle. All prostheses consist of an envelope with fluid inside. This envelope in most cases is made of silicone elastomer and may have a smooth and/or uneven texture. The liquid may be a silicone gel or even saline, in other words, water. These prostheses have been used for over 40 years in plastic surgery.
First appointmentin breast augmentation
Technical details such as the surgical incision, the type of prosthesis used, and whether it will be placed above or below the muscle, depending on the anatomy of the breast and the woman’s needs. After an extensive briefing and discussion, we arrive at the surgical technique that is appropriate for each case.
A mammogram and/or a breast ultrasound, depending on the age of the woman concerned, is necessary before surgery.
Type of anesthesia in breast augmentation
General anesthesia is usually chosen.
Hospital stay
Not necessary
Surgical techniquein breast augmentation
The surgical technique is simple. Incisions can be made:
- In the submammary fold, i.e. down and out of the breast
- In the contour of the nipple
- In the axillary region
The plastic surgeon prepares the “pocket” under the breast where the prosthesis will be implanted, which is placed in a position that highlights the shape of the breast, and then closes the incision. The point where the prosthesis is placed is either under the mass gland or the underlying muscle.
A drainage tube is placed in some cases to prevent fluids from accumulating around the prosthesis after surgery. This tube is usually removed the same day or the day after surgery.
At the end of the surgery, adhesive tapes and a bandage are applied to create a makeshift bra which is replaced with the normal bra 24 hours after surgery.
Duration of surgery
The duration of the surgery is approximately 2 hours.
The lifespan of silicone prostheses
A silicone prosthesis, either gel or saline, has a specific lifespan. The companies producing the prostheses estimate it at around 10 – 15 years. This does not mean that a prosthesis cannot be changed sooner or later. The fact is that there is no guarantee that they will never be changed. A woman with silicone prostheses should be aware that there is a risk at some point to undergo a prosthesis-changing surgery. Of course, if no problems have occurred, the prostheses can remain in the breast for as long as the woman wishes.
Combination surgeries:
During a breast augmentation, there are several cases where a breast lift or breast reduction is needed at the same time as the prosthesis.
Lipoplasty can improve any asymmetries.
Long-term complications of prostheses
- Creation of folds in the prosthesis.
This is more common in saline prostheses, but can also occur in silicone gel prostheses. In this case, the woman sees and feels the folds of the prosthesis, mainly under and outward of the breast. To avoid this, the doctor makes enough space for the prosthesis intraoperatively. If this still happens, there are surgical solutions to solve this problem. These are decided depending on the situation because each case is different. - Creating a capsule around the prosthesis.
The creation of a capsule around the prosthesis is unavoidable. It is a normal process of the body to isolate a foreign organ. In some cases, however, this capsule can become more prominent and thick and press on the prosthesis, causing pain and deformation of the breast. There are 4 stages of this condition. The likelihood of developing a problematic capsule cannot be measured because it depends on many factors, such as the type of prosthesis and the surgical technique. In case the capsule creates symptoms, such as pain and aesthetic deformity, it should be surgically corrected. - Opening of the prosthesis.
Such a phenomenon can occur after a severe injury in the chest area, less frequently due to a mistake in the construction of the prosthesis, or more often after years due to the age of the prosthesis. In cases of saline prostheses, it may be a valve problem. In cases of silicone gel prostheses, usually, the silicone stays inside the capsule and does not diffuse into the surrounding tissues. Of course, all of this is preventable with routine and systematic breast examinations, which all women should undergo.
Breast Augmentation – Postoperative instructions
- After surgery, the patient may have chest pain for 3-4 days if the prostheses have been placed under the pectoralis major muscle. The pain is adequately treated with oral painkillers. In the best of cases, the patient will feel a tightness in the chest for a few days.
- Swelling is present for the first few days and gradually subsides without problems.
- A pressure bra is used for a period of 6 weeks. For the first 4 weeks, the patient has to wear the bra for 24h/24h and for the 2 final weeks for 12h/24h.
- The incision is red for the first 3 months and gradually turns white with the final result becoming visible in 1 to 3 years.
- The incision should not be exposed to the sun for the first 3 months.
- Progressive recovery of gymnastics in the breast area is allowed after the 8th week.
- The incision will not disappear completely. For the best course of the incision, massage with a cream every day. Silicone sheets locally on the incision are recommended until the desired aesthetic result is achieved.
- 4 days off work is recommended
- The final result starts to be visible 3 months after the surgery, as this time is necessary for the breast to soften and the prosthesis to take its final position.
Breast Augmentation – Frequently asked questions
Can I breastfeed after a breast prosthesis surgery?
Breast prosthesis placement does not seem to have any effect on breastfeeding.
Do breast prostheses increase the chance of breast cancer?
The relationship between breast prostheses and cancer has been analyzed. A recent article associates one type of breast prosthesis with a very rare type of lymphatic cancer. This percentage of women who became ill is very, very small compared to the general population carrying breast prostheses. It is information that every woman deserves to know everything before deciding to go through the process of this surgery. Of course, every woman has a chance of getting breast cancer, so frequent and systematic check-ups should be done regularly.
Can a breast X-ray examination be done regularly?
Before any mammogram or ultrasound, you should inform the radiologist that you are carrying breast prostheses because there are special techniques that are applied in these cases to perform a comprehensive examination
In conclusion, then, you should not overestimate the risks of a breast augmentation procedure, but simply realize that it is a relatively simple surgery but can have complications.
Breast Augmentation – Frequently asked questions
Can I breastfeed after a breast prosthesis surgery?
Breast prosthesis placement does not seem to have any effect on breastfeeding.
Do breast prostheses increase the chance of breast cancer?
The relationship between breast prostheses and cancer has been analyzed. A recent article associates one type of breast prosthesis with a very rare type of lymphatic cancer. This percentage of women who became ill is very, very small compared to the general population carrying breast prostheses. It is information that every woman deserves to know everything before deciding to go through the process of this surgery. Of course, every woman has a chance of getting breast cancer, so frequent and systematic check-ups should be done regularly.
Can a breast X-ray examination be done regularly?
Before any mammogram or ultrasound, you should inform the radiologist that you are carrying breast prostheses because there are special techniques that are applied in these cases to perform a comprehensive examination
In conclusion, then, you should not overestimate the risks of a breast augmentation procedure, but simply realize that it is a relatively simple surgery but can have complications.
Preparation before surgery
- Photographs of the area are taken.
- Classical preoperative check-up includes blood tests, chest X-ray, and cardiac evaluation.
- 12 hours before surgery do not eat anything.
- 6 hours before surgery do not drink anything.
- On the morning of the operation do not take any medication without the anesthesiologist's approval.
- Alcohol should be stopped 1 week before surgery.
- In the case of general anesthesia, it is necessary to meet with the anesthesiologist before the surgery.
- Report previous anesthetic experiences, either positive or negative and inform him/her of any health problems or medication you are taking.
- Do not take aspirin, anti-inflammatory drugs, or herbal supplements 10 days before the surgery, as they increase the possibility of bleeding during and after surgery.
- 3 days before the surgery and every day after washing your face or body with medicated soap, depending on the planned surgery.
General Complications after surgery
Complications in plastic surgery operations are not common but it is necessary to be aware of them at the first appointment.
- Hematoma: A hematoma is the accumulation of blood in the wound.
- Inflammation: To prevent inflammation, antibiotics are administered during surgery.
- Poor wound healing: If the incision in the operated site is more prominent than expected, it can be corrected 6 months to a year after surgery with local anesthesia. In some cases, the appearance of keloids is possible where specific treatment is needed.
- Skin necrosis: It is more likely in heavy smokers.
- Pulmonary embolism and thrombosis.
This text may give rise to new questions. We are at your disposal for any other information.