Breast Augmentation Surgery or augmentation mammoplasty
The feminine breast represents one of the most important symbols of feminism and its aesthetic appearance, in relation to shape and size, can affect the self-esteem of a woman. The perfect breast does not exist, but if it’s too small or has suffered a sudden change after a pregnancy, the prosthesis implant can redesign this with an excellent and NATURAL result.
The prosthesis’s that can be used are different in shapes and dimensions, and it will be necessary to choose the most adequate for each individual patient and situation. All of them are presented in a silicone wrapping filled with cohesive silicone gel and they have a feel very similar to a mammary gland. These materials have been developing since 1962 and nowadays they are extremely safe and reliable.
The new cohesive gels are safer because if the prosthesis´s were to break, the silicone will not exit, and it will maintain the shape and the encapsulated or harden phenomena’s have been reduced to the minimum.
Implant technique. Access points:
There exists three access points to put a mammary prosthesis and each one has its advantages and disadvantages. Its election depends on various factors such as the anatomy of the patient, the type of prosthesis, etc.
Sub-mammary access: the incision and the following scar will be made in the fold under the breast. It is a safe and easy access but the scar can be visible.
Armpit access: the incision is done in the armpit with a very aesthetic scar and with no relation to the breast, but the recovery process is more painful and complicated.
Areola access: the scar will remain in the inferior border of the areola and, in a couple of months, it is almost invisible. It is a very safe and reliable access and its aesthetic result is very good.
Implant position: the prosthesis´s can be positioned in front or behind the pectoral muscle and in this case it is also convenient to adapt the position to the anatomic characteristics of the patient. Both positions can present specific problems and it is necessary to evaluate every pros and contras.
Retro-pectoral: The implant is position in a “pocket” that is done between the pectoralis major, the minor and the ribs. This position has its advantages when the patient is extremely thin and needs to cover the superior part of the prosthesis to reduce the chance that the superior border of the implant is seen. It has to be mentioned that this is less logical and natural and that the muscle has to be cut. Additionally, non-aesthetical effects can appear with the contraction of the muscle. This position is very advantageous to hide the effects of encapsulation that the old prosthesis used to present.
Retro-fascia: The implant is put behind the fascia that covers the pectoral muscle. It achieves a better result than putting the prosthesis behind the muscle, but there are more risks of bleeding and pain. It is not frequent.
Retro-gland: The pocket is done between the mammary gland and the pectoral muscle in a more logical and natural position. The risks are minimum; the results perfect and there will be no pain in the recovery process.
Types of Implants:
The actual implants are very good and, regardless of the brand, they present very similar aspects. The major differences are found in the models and shapes, each manufacturer has an enormous catalogue and the election has to adapt to the patient´s thorax and is the surgeon’s responsibility.
With the goal of reaching a natural result, it is vital to pay attention to the aesthetic lines of the breast. The most important one is the line which, seen from a profile, goes from the collarbone to the nipple. This line has to be straight, because in nature bulkiness in the superior area creating an aspect of a ball does not exist. For this line to be straight the shape of the prosthesis is not relevant, what is, is that the vertical diameter of the implant does not go beyond certain point and does not stand out. This calculation, very simple for an expert surgeon, allows affirming that there are some implants that are adequate for each patient and that their volume and/or weight are not relevant. What matters are the diameters, and if calculated correctly, more or less volume can be added depending on each model of prosthesis.
These implants simulate the shape of a mammary gland in a stood up position. They were born as implants for a mammary reconstruction and have the advantage that they simulate better the shape of the thinner patient´s breast.
- They are harder to tact
- Bulkiness appears in the superior part of the breast
- They have a limited mobility
- They need a sub-mammary scar (low aesthetic appearance) to be placed correctly.
There exists many models and they allow a much more natural result.
The gel, softer, acquires its natural shape depending on each patient. In drop shape if you´re standing up, or round if you are laying down. They change depending on the patient´s movements, just like a natural breast. They are softer to feel and can be placed by any access. The high variety of models allows adapting it perfectly to each patient.
The safest way is to use general anesthesia. It is a smooth and fast anesthesia (1hour). Sometimes it is convenient, to avoid hematomas, to put two thin drainages during the first hours. The patient will remain hospitalized 24 hours and the next morning the drainages will be removed and the patient discharged. The initial aspect of the breast is not final, due to the inflammation and swelling.
During the first days the normal situation is to present slight troubles that are due to itchiness, dry skin sensation and weight of the implants. There is no pain. In 48 hours the first revision will take place and from that moment on the patient will be able to shower and use hydrating lotions. This eliminates almost all the troubles and the patient can recover a normal life. The only exceptions are: using braw during the first 24 hours and avoiding arm efforts during the next 2 weeks. During the first month, direct sun on the scars has to be avoided. In a month the breast will be soft and with a good appearance, but small inflammation can still remain. This makes the result not considered final until a period of 4-6 months.
The results of a breast augment are totally natural and aesthetically perfect if certain measures are followed and the final volume is adequate to the thorax and the whole body of the patient. These results are complete and definite in 4 to 6 months.
Like in every other operation there can exist: infection, hematoma, seroma, etc. In every case this is prevented and these complications are very rare, however cero risk does not exist in any surgery. The capsulation or rejection is, primary, a normal phenomenon and only in extreme conditions it can be a complication and require treatment. With the cohesive gel prosthesis the incidence rate is inferior to 1%.
Can I get a mammography done? Yes. You only have to warn that you have implants. Sometimes the ultrasound scan is more convenient.
Does there exist any risk of cancer or mammary disease? Emphatically no. Every study demonstrates the opposite.
Can I breast feed? Yes. The prosthesis does not affect the normal function of the mammary gland at all. In case of pregnancy and lactation the aesthetic changes are the usual, and have nothing to do with the prosthesis.
Will I loose sensibility? No. During the first months there can appear alterations in sensibility, and they are transitory because they are due to the post operatory inflammation.
Will it be noticed? The people more close to you will notice the change but the important fact is that no one will know that the breast is operated. The result is totally natural and it integrates completely in the physical structure of each patient.
Will the prosthesis explode? No. During the first month it is convenient to avoid trips of more than 2-3 hours by plane, because the pressure can increase the inflammation. The prosthesis´s do not explode: they were tested in NASA laboratories.
Do they have to be changed periodically? No. The mammary implants have to be controlled once a year but they don’t have to be changed unless a problem is found. A manufacturer guarantee exists. It last certain number of years, but this does not mean that they have to be changed.