Breast augmentation
What is breast augmentation?
Breast augmentation is one of the most common surgeries performed on women who want to increase the size of their breasts, or improve its shape.
It also applies to women whose breasts are unequal in size, which affects their self-confidence and psychology.
High quality silicone implants approved by the US Food and Drug Administration (FDA) are used in breast augmentation.
Breast augmentation can improve breasts that have lost their volume due to pregnancy or weight loss.
Insert types
Silicone implants may contain silicone gel or saline, and are divided into two categories in terms of shape:
1. Anatomical implants (like a drop or a tear)
The anatomical implants look like drops, i.e. the lower pole, projects them more than the upper. Their surface can be smooth, rough or even coated with polyurethane, a material that resembles a sponge.
Many plastic surgeons consider it a better choice because they look more like the shape of the breast, giving a more natural result.
However, there are plastic surgeons who claim that the shape of the implant does not play a decisive role in the final shape of the breast.
This is because gravity, the pressure of muscles and tissues in general, will affect the shape of the breast over time.
In addition, the anatomical implants should always be placed on the side with the largest volume, i.e. if the implants are overturned, some asymmetry may be created between the breasts.
Finally, anatomical implants have a higher cost than round ones, not because of quality, but because of the way they are made.
2. Round implants
The round implants can have a smooth or rough shell and as their name suggests, they have a round shape.
In addition, the advantage with round implants is that even if they "twist", there will be no deformity in the shape of the breast.
These are the first implants made and are a timeless value in breast augmentation, by plastic surgeons around the world.
For women over 40, mammography precedes breast augmentation surgery, while for women under 40, breast ultrasound precedes.
Size Selection
The size of the silicone insert that will be placed is something that you will probably occupy very, very well in our opinion.
There are two decisions about the suitability of the implant that need to be made.
In one of them you can and should participate and it has to do with the volume in cc / ml and the other decision is purely of your doctor and results from measurements that he will make on your chest and breast, based on the aesthetic result you want to succeed.
The appropriate type of implant for each case is selected based on the size of the breasts, the projection of the implant and the desired result, of course after an extensive discussion with the person concerned..
Breast augmentation is an operation that combines art with science.
You can find the size of the insert that suits you.
Take the test with rice!
Mounting position
At the first visit, after the necessary measurements, the point of intersection and the location of the insert will be selected.
The incision can be made in:
- sub-aspect
- nipple area (Hypothalamic incision)
- in the armpit (rarely)
The incision is quite small, about 4cm and the sutures used are absorbable, so they do not need to be removed. Many women prefer to hear the peritoneal incision thinking that the mark will be well hidden there and ask their doctor. However, this incision is also well hidden, in the aspect created by the breast with the chest wall, and in addition, according to the literature, it is the safest method in terms of capsule formation.
The placement of the insert can be:
- Under the muscle
- Above the muscle and below the mammary gland (breast)
- Dual plane (half insert above the muscle and half below)
The placement of the insert under the muscle is chosen mainly for breasts that do not have enough fat to cover the insert, with the advantage being the least chance of creating a capsule. However, he usually has a longer postoperative recovery time and a need for more analgesics (painkillers).
On the contrary, the placement over the muscle is done mainly in breasts that have a sufficient amount of fat and cover the implant, thus giving visually and tactilely a more natural result.
In the third placement technique (dual plane), the insert is placed under the muscle on one side and above the muscle on the other side, thus combining the advantages of both of the above ways of placing the insert, so it is chosen more often.
During the physical examination, your doctor will evaluate your breasts for a possible degree of sagging that can be corrected either only with breast augmentation or may suggest a corrective surgery in the same surgery.
The operation
Breast augmentation surgery is performed under general anesthesia and its duration is about 60 minutes.
The incision is made at the selection point mentioned above (submandibular fold, nipple area, armpit), to create the "case" of the insert at the point chosen for its placement.
After careful hemostasis and control of the area, the implants are placed, which have a unique barcode marking that will be given to you with the discharge and you will have to keep it.
The suturing of the skin and the muscle, if the placement under it has been chosen, is done with absorbable sutures.
Drainage placement is not necessary and is performed in cases where the surgeon deems it necessary.
The stay after the operation can be from a few hours up to one night in the hospital.
A pressure bandage (sports bra) is applied, while the existing pain can be treated with analgesics.
In the next few days, some visits to the doctor are planned to monitor the postoperative course and check the incisions.
Ask your doctor
Dr. Christoforos Haritos
Plastic Surgeon
210 69 29 999
Duration of silicone implants
Due to their excellent quality, silicone implants can remain without any problems for decades.
However, after a few years of their installation, it is advisable to check them with ultrasound or magnetic and if a problem arises, they may need to be replaced.
Most companies offer a lifetime warranty, in case of rupture of the implants, offering you a free replacement.
Instructions after the operation
For the first 2-3 days, rest is recommended while a mild sport activity such as walking is allowed 1 week later.
In addition, immediately after the operation and for a month, the pressure bandage (sports bra) is applied, while intense physical exertion is prohibited for the same period.
Frequently Asked Questions
How long should I be absent from work?
Abstinence from work does not exceed 1 week while driving should be avoided for 2 weeks, or until you get rid of any discomfort.
Does Breast Augmentation Affect Breastfeeding?
No, silicone implants do not affect breastfeeding, except in less than 2%
Are there any complications?
Breast augmentation is a safe procedure that has an excellent postoperative course in most cases. However, as with any surgery, there are possible complications, such as:
Capsule formation
A normal process of the body, to create a membrane that surrounds every foreign body that is placed in our body. However, if this membrane is too hard, it can press on the insert, thus deforming the shape of the breast, i.e. creating a moisturizing capsule.
In such a case, an operation called capsulectomy can be performed and a replacement of the implant.
Prosthetic burnImplant rupture
Rupture of the implant is a complication that can be due either to hardware failure, to some surgical mishandling, or to occur after injury and injury to the implant.
The rupture is confirmed by magnetic resonance imaging and the treatment is surgical with replacement of the implants.
Larger companies offer a lifetime warranty on their intentions and offer new implants free of charge to replace the rebates unless proven to be the result of an accident or iatrogenic injury.
Loss of feel in the nipple
A common complication, but almost always temporary, is the observation of a change in the aesthetics of the nipple. It takes patience as the aesthetics can be fully restored after 6 or even 12 months.
Asymmetry
Something that normally happens to all women is breast asymmetry and this is a reason for a woman to do breast augmentation.
However, a slight asymmetry can be observed even postoperatively.
Intersection splitting - Hypertrophic scars
Gum healing is different for each patient. Rarely and especially in smokers, there may be a small incision in the incision.
Hematoma
Concentration of a small or large amount of blood in the chest. It is an extremely rare complication.
Infection
It is not a common complication, since the conditions of the operation strictly follow all the rules of antiseptic. However, if it occurs, it is treated with antibiotics, or in the worst case with the removal of the implants.
Bibliography
- Grabb and Smith's Plastic Surgery, 8th edition, Kevin C. Chung
- Manual of Aesthetic Surgery Vol. 2, 2005, Werner L. Mang
- Özalp B, Aydinol M. Breast Augmentation Combining Fat Injection and Breast Implants in Patients With Atrophied Breasts. Ann Plast Surg. 2017;78(6):623–628. doi:10.1097/SAP.0000000000000935
- Cheng F, Cen Y, Liu C, Liu R, Pan C, Dai S. Round versus Anatomical Implants in Primary Cosmetic Breast Augmentation: A Meta-Analysis and Systematic Review. Plast Reconstr Surg. 2019;143(3):711–721. doi:10.1097/PRS.0000000000005371
- Tebbetts JB. Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg. 2001;107(5):1255–1272. doi:10.1097/00006534-200104150-00027
- Atiyeh B, Chahine FM. Design for Natural Breast Augmentation: The ICE Principle. Plast Reconstr Surg. 2017;139(2):568e–569e. doi:10.1097/PRS.0000000000003002