Breast augmentation is one of the most applied aesthetic surgeries all over the world. The most commonly used method is augmentation with an implant (breast prosthesis).In addition,there are other methods called fat injection, BRAVA,which are used alone or together with fat injection.While fat injection can be used alone,it can also be used together with the implant in the last period.
Breasts are extremely important for women’s self-confidence. Being small and also being big can cause anxiety in the social field.
Breast augmentation;
women who have small sizes and do not find these sizes aesthetically suitable for themselves,
in women with congenital breast deformities,
It is made to reach the eye-pleasing and ideal breast sizes,shape and fullness.
In this way;
- breast size increases,
- desired fullness and projection is achieved,
- symmetry is achieved,
- anxiety in the social environment disappears.
Women with naturally small breasts, breasts that have lost their volume due to weight loss or breastfeeding, patients who need to re-establish their symmetry due to cancer surgery or from birth are good candidates for breast augmentation surgery.
The most used method is with breast prosthesis. The prosthesis is made of a silicone sheath filled with silicone gel or saline. It is available in two main shapes (anatomical-drop-shaped,round) and a wide variety of sizes.
The prosthesis can be placed in four different places. Each region has its own advantages and disadvantages.The most used area is the inframammary fold. A 4 cm long incision is made. Since the scar is under the breast, it is very little obvious. After a few months, the pink mark fades and turns into skin color. The second most frequently used entry site is the nipple. The scar remains on the line between the areola and the skin. However, it is not useful if a small nipple is present. The prosthesis can be placed using the axillary (armpit) region. Prosthesis placement is relatively difficult. Only a prosthesis filled with serum can be inserted through the navel with a special tool.
The prosthesis can be placed in different planes. It is placed mainly under the muscle and under the breast tissue. Modifications are available. Subfascial insertion involves placing under the very thin layer of fascia above the muscle. Plan selection is made according to the thickness of the breast tissue, the fullness of the upper region, and the desired projection.
The operation takes 1-1.5 hours. Photographing, planning and evaluation are done before the operation. In the evaluation, the patient’s wishes, anatomy and tissue characteristics are revealed and what can be done is determined. The patient’s request for the size gives a rough idea about the dimensions of the prosthesis.
At this stage, answers are sought to some questions;
Is only augmentation with breast prosthesis sufficient or will additional breast lift be required?
In answering the question of breast size, whether there is sagging or not, its degree, the distance between the nipple and the inframammary fold (if this distance is more than 9 cm, breast lift should be added), the amount of breast tissue, skin quality should be added prosthesis alone or breast lift. are auxiliary parameters.
Does the patient have any sine qua non for scars?
Some patients may not prefer the scar under the breast or around the nipple. Which method is considered should be shared with the patient. On the other hand, since the milk channels are cut in prostheses placed with nipple incision, the possibility of the leaking bacteria-carrying fluid being plastered around the prosthesis and increasing the risk of capsular contracture should be mentioned.
What is the patient’s preference for size?
Some patients may request a particularly large or a particularly small request. The general request is dimensions that will not spoil the natural look and do not go overboard. Size is related to breast sizes. The measurement of the base of the breast, the amount of projection created by pulling the nipple forward and the distance between the nipple and inframammary folds are actually the factors that significantly determine the size. Some congenital deformities (shoemaker’s chest, pigeon’s chest) will also affect the choice of prosthesis.
If there is asymmetry, it is very important to detect, document and make the patient aware of it before the surgery. It should be reminded that symmetry may not be fully achieved in the postoperative period as well. Especially mild forms of tuberous breast (congenital breast deformity – lumpy breast) can be augmented without diagnosis. In the presence of this deformity, it will be necessary to perform some additional operations on the breast tissue. It requires much more complicated planning than a simple breast augmentation surgery, and if this is not done, the result will not be satisfactory.
Before the operation, drugs such as aspirin, pain relievers, vitamin E must be reported and discontinued 1 week in advance with the advice of the doctor who started the drug.
In the postoperative period, pain is controlled with painkillers. Rarely, a hematoma (bleeding) problem may occur. The problem is resolved with the appropriate approach to the amount of bleeding. It would be appropriate to avoid heavy exercise for a few months. Stitches are usually placed under the skin and do not require removal. You can take a bath after 48 hours. A film (mammogram) can be taken for cancer screening after breast augmentation surgery. It does not create a weakness in this regard+.
Although longer lasting prostheses have been reported in the literature, the average lifespan is 15 years.
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