PLASTIC SURGERY
Operations

Breast Augmentation

Female breasts have always been one of the symbols of femininity and sexuality. Over time, the breasts change losing their youthful shape – firmness is reduced, the breasts sag and lose breast volume that results most frequently for women after breast-feeding. Breast augmentation is performed when a women desires larger breasts, to restore breast volume lost after pregnancy or to correct marked asymmetry due to different size of the breasts.

The first step towards a breast augmentation procedure is the consultation with a plastic surgeon. During the consultation, be honest and open with the surgeon about your wishes and expectations, as the final surgery result will depend on this.

The breasts are enlarged with implants. Implants are saline- or silicone gel-filled inert sacs. They vary in size, and the size is chosen during consultations.

During the consultation, clinical parameters will be evaluated, which directly influence the outcome of breast augmentation and natural shape of the breasts:

1) Body weight, body constitution and height of the patient;

2) Natural size, shape and symmetry of the breasts;

3) Location of the nipple;

4) quality of breast skin;

5) Shape and dimension of the chest wall;

6) What breast size is expected by the patient after surgery?

You will discuss the main surgical aspects of breast augmentation with your surgeon:

1. Incision placement: there are three opinions for incision placement during breast augmentation. They can be placed beneath the breast (in the inframammary line), around the areola of the nipple or in the armpit. Most patients choose the inframammary incision.

2. Options for breast implant shape. There is a wide spectrum of breast implants in order to achieve a more natural-looking breast. The majority of patients chose round-shaped implants. For women with good-shaped firm breasts wishing a simple breast enlargement, these implants are the ideal choice. Teardrop-shaped (anatomical) implants are placed when a patient desires the breasts of such shape. It can be the ideal choice for women who have the breasts of similar shape. In the presence of this shape breast, mild elevation of the nipple can be achieved without additional scars. In these cases, the implants are inserted into a subglandular pocket. In addition, these implants are suitable for patients wishing less fullness in the upper part of the breast. It is worth mentioning that sometimes teardrop-shaped implants can rotate slightly. This occurs in about 5% of cases. This problem can be corrected during an additional surgery. If the nipple of the breast points downward, a breast lift procedure would restore an aesthetic appearance.

3. The new-generation silicone gel breast implant is very safe and looks like a natural breast.

4. Size of the breast implant. The size of the breast implant is one of the most important aspects in a breast augmentation surgery. Therefore, the surgeon will offer several methods to help patients to take the best decision based on their anatomy, personal preferences and result they expect to achieve. In general, the enlarged breasts should be proportional to a woman’s body constitution. Patients are shown photos, thus a woman can chose the breast size according to her wishes. The surgeon will also measure the patient’s breast and chest shape in order the implant would help to achieve the breast size desired by patient. Choosing breast implants smaller than natural patient’s breasts similarly as choosing breast implants too large for natural patient’s chest shape can cause an unnatural appearance of the breasts.

5. Position of the breast implant: where to place the implant – above or behind the muscles? The breast implants placed behind the muscles are partially covered; therefore, this allows smooth transition from the chest wall and the breast looks more natural. If the breast implants are placed directly over the muscles, the upper pole of the breast can look more projected out over the chest wall. However, placing an implant directly behind the mammary gland yields more favourable outcome: after a few weeks the breast heals completely and achieves the shape needed. The size of the mammary gland in the breast is very important. If the mammary gland is small and the skin and subcutaneous layer are thin, the best results are achieved by placing the implant behind the pectoralis major muscle.

Surgery
The surgery is performed under general anaesthesia. Time in surgery is approximately 2 hours.

Postoperative period
Swelling in the breasts remains for 2–3 weeks. Sometimes the extent of swelling in both breasts can differ. These differences disappear with time. However, if there is a great difference between both sides, you must contact us. After a breast augmentation surgery, the breasts appear to be placed quite high up. It is normal. Within the first two months, the breast implants will gradually lower and settle into a more natural position. You should not be concerned if one implant settles quicker that the other one, as this sometimes occurs. Within the first weeks after surgery, you should avoid raising of the arms as it can cause repositioning of the implants from their location. You can return to work within a few days if your occupation does not require strenuous movements and hand raising.

You will have to wear a special surgical bra for 4 weeks after surgery, 24 hours per day. Avoid strenuous physical activities and exercising for 2 months after surgery.

Complications
Complications are rare. It can be bruising, which disappears within several days or weeks. Sensation in the nipples may be reduced, but later it returns to normal.
Breast augmentation plastic surgery does not alter any breast functions. After surgery, you can get pregnant, bear a healthy child and breast-feed. If you get pregnant, your existing breast tissue will be affected by normal hormonal changes of this period; therefore, your breasts will enlarge and the skin will stretch accordingly. Palpation of the breast implants is more likely to occur in thinner women. It has no any medical implication.
Capsular contracture. This is the most serious complication of breast implants. A capsule formation is a layer of scar tissue that naturally forms around any artificial material placed in the body. It is important to understand that it is a natural body response to foreign body in the body. Mostly this capsule is soft and even not palpable. Capsular contracture occurs when scar tissue tightens around the breast implant, squeezing it so that hardening of the breast is felt.

PLASTIC SURGERY Operations

Breast Augmentation

PLASTIC SURGERY
Operations