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Breast Augmentation · Mammoplasty

Breast augmentation (mammoplasty) is to correct the breast volume which is small and insufficient with an implant of prosthesis. It gives beauty and harmony to the female torso.

Breast augmentation (mammoplasty) improves the size and shape of the female breast. It is the perfect intervention for women with breasts which are too small or to correct a difference of breast size between breasts or sagging breasts to reaffirm the the breasts months after breastfeeding. With this surgery you can obtain increase one or more of the breast sizes.There are different surgical techniques, and the surgeon will advise the patient about the most suitable based on the shape of the breast, anatomy and skin quality.

+ About Breast Augmentation

What is breast hypoplasia?

Mammary hypoplasia is defined as breast volume in underdeveloped regarding the general morphology of the patient. Hypoplasia can be primary (small breasts after puberty) or occur secondarily, after a significant weight loss or a pregnancy followed by lactation. Can be isolated or associated with ptosis, ie which is the falling of the gland and to the loosening of the skin.

Objectives

The breast augmentation surgery aims to correct the size and shape of the breast, restore their beauty, harmony and naturalness.

Principles

All currently used breast implants are composed of a coating and a filler. The coating is always made of silicone rubber (elastomer Silicone). It can be smooth or rough (textured). The most used fillers is the silicone gel, which has completed 50 years. The silicone gel is incorporated into the prosthesis by the factory, so that the range of different volumes are set by the manufacturer.

Advantages and disadvantages

Silicone Gel: gelatinous substance is more or less smooth (cohesiveness). It can be:

  • Soft
  • Sign (cohesive gel) Limits the appearance of wrinkles. Eliminates the risk of deflation. consistency approximate to that of a normal breast. Does not expand into the tissues surrounding them in case of rupture. Product not absorbable by the body in case of rupture of the coating. risk of retracting (hardening) is a little higher than with saline. It can be extended in the tissue around them in case of breakage. The consistance is much firmer and heavier.

 
The serum Physiological: is of water and salt solution at a concentration similar to that of the body. It can be filled at the factory or at the time of the intervention (until snug). Natural absorption by the body in case of rupture of the coating. Index less retractable capsule (hardening) Possibility of appearance of folds. Deflation of the prosthesis so gradually or abruptly

Before the intervention

The location of the scar, the position of the prosthesis relative to the muscle, the type and size of the prosthesis have been decided in consultation, depending on the anatomical context and desires expressed by the patient. The surgeon will tell you which is best for your case. the analytical Preoperative run as usual prescriptions. May be useful to verify studies existing images (ultrasound and mammography). Any medication containing aspirin should not be consumed at least ten days preceding the intervention, and it is very important to reduce or to discontinue smoking.

Anesthesia and Hospitalization

  • Type of Anesthesia: Usually general anesthesia is classical, the patient is totally asleep.
  • Forms of hospitalization: It is sufficient one day of hospitalization.

Intervention

Each surgeon has a unique technique that adapts to each case to obtain the best results. Any of the techniques have steps in common:
 
Skin incision:
The implant is inserted through a short incision located: in the areola, in the axillary region or in the crease submammary.
 
Location of the Implant:
The pocket realized in which the implant of the prosthesis is located: Behind the mammary gland and muscle before pectoralis major, or behind the gland and behind the pectoralis major muscle.
 
Associated Acts:
In case of breast ptosis (sagging breasts, areolas low), it is preferable to associate a reduction act skin coating which implies a significant scar (periareolar, vertical).
Likely a drainage is left for 24 hours after the operation so that the blood or fluid which can be accumulated are eliminated. At the end of the operation bandages are placed to perform bandage Modelling in the shape of an elastic bra.
The intervention will last from one to two hours depending on the actions associated surgical and surgical skills

Post-operative

The post-operative can be painful the first few days, especially when the implant is behind the pectoralis major muscle, so it resorts to analgesic treatment. in some cases, the patient will feel a strong sense of tension.
Edema (swelling) and ecchymosis (bruising), breasts, and trouble in lifting their arms are a frequent principle.
The first dressing is removed after 24 to 48 hours and is replaced by a bandage which is lighter, making a sort of elestic bra made to your size.
The discharge is given after 24 or 48 hours after surgery and the patient is reviewed in consultation two or three days later: from this moment on the patient then puts on a bra that provides good containment.
This bra is recommended to be used for a month during the day and at night. If the sutures are not absorbable, they are removed between 8 and 15 days post-op.
Arrange an convalescence and light work about is advised during 8 to 10 days. It is advisable to wait one or two months to take up any type of sport.

Outcome of Breast augmentation (mammoplasty)

It can be appreciated from the third month, a period which is required for the softening of the breast and stabilization of the prosthesis. In addition to the improved aesthetics, the psychological benefit is very important.

Imperfections of the results

Scaring may have an abnormal evolution, thickening or retranyéndose. Some breast pain and changes in the sensation of the nipples are possible. On the other hand, the aesthetic result dissatisfaction can motivate secondary reintervention or surgery.

Duration of life of the implant

A prosthesis, either filled with silicone gel or saline has a duration of life undetermined not possible to estimate a priori since it depends on the complications potential. So that the life of the implant can not be guaranteed. a woman implant carrier is exposed to the risk of a complementary intervention to replace the prosthesis so that the beneficial effect is maintained. However, we must know that an implant Good quality does not have a finite lifespan: there is no time limit after which it has necessarily change the prosthesis. It is advisable to replace breast implants every 10 years.

Complications

Breast augmentation with implants is done but essentially anesthetic reasons, it is a real surgery, which involves the risks associated with all medical procedures for however small. Techniques, anesthetics and monitoring methods have immense progress in the last 20 years, offering optimal safety, especially when the operation is performed without urgency and a person completely sana.
Con relation to the act Surgical choosing a qualified and competent plastic surgeon, trained for this type of interventions limited to the maximum risk, without suppressing it completely.
The post-operative is generally simple, however complications may occur some inherent interventions linked to breast implants and other foreign body in the breast: the risks specific for mammary implants.
 
1 / complications inherent in the interventions
Breast Infections treated with antibiotics and sometimes surgical drainage. hematoma, may need to be evacuated. Alterations in sensitivity, essentially the nipple, but the normal sensitivity reappears in a period of 6 to 8 months. The evolution of scars always have to be favorable and there may be hypertrophic scars and even keloids, unpredictable onset and evolution that can compromise the aesthetic appearance of the result and requires specific local treatment periods.
 
2 / Specific risks of breast implants
They are of three types which vary depending on the nature of the filling of the implant. Is the formation of folds or waves, producing a capsular contraction of the implant and the risk of rupture or deflation:

  • Fold formation or appearance of waves. The implant to be smooth tension is never crowded. From this fact, the folds of the coating of the prosthesis may be visible under the skin, producing waves then look especially at the upper outer and lower breast. This in more noticeable in the upper part in the If the prosthesis is placed in position retromuscular. This phenomenon is more common when the prosthesis is filled with saline solution, even if it is textured. This exposes even greater risk of rupture and deflated by spending premature coating level crease.
  • Capsular contracture and fibrous capsule. Forming a fibrous capsule around the implantation always occur. Is a normal reaction of the organism that produces a kind of membrane around any foreign object to isolate and protect ("membrane or capsule exclusion "). In some cases, this membrane is comparable to an unfavorable Keloids skin: its thickness increases too, retracts and forms a true capsule fibrous around the implant. This is capsular contracture. There are four stages of hardness ranging from undetectable normal appearance to severe forms of capsule breast hard, round, fixed and sometimes painful. The frequency of this complication can not be estimated overall because it varies depending on the indication, the type of prostheses and the operative technique. This complication is most frequent in the case of gel-filled prostheses silicone. The capsule does not increase the risk of rupture but exposed to a complication of type aesthetic. Surgery can correct this complication sectioning the capsule (capsulotomy). Several authors have proposed technical solutions to limit the occurrence of this contract: - place the implant behind the pectoral muscle - making walls rough on the outside of the implant (textured prostheses) - the use of implants filled physiological serum.
  • Rupture and deflation. This type of accident occurs due to a change in the lining of the prosthesis is the continent (silicone elastomer). the phenomenon of porosity, or the opening punctiform or of an actual gap may cause and appear as a result of violent trauma, a manufacturing defect, but all due to the age of the prosthesis (effect of use). Deflation in the prosthesis containing physiological saline may be a problem of loss by the filling valve. Top of Form 1

This type prosthesis has a total or partial deflated quickly. If a prosthesis is filled with gel silicone, the gel remains in the fibrous coating surrounding the implant (leak intracapsular). The flight then has no clinical significance. However, the exudate intracapsular may promote the development of a capsule periprotética. Less often, in If significant gap in relation to a violent trauma or needle, the gel escapes beyond the fibrous capsule (extracapsular rupture). In small amounts, the gel can cause the appearance of a foreign body granuloma or in the form of nodules (siliconoma). in If capsular rupture important (trauma), the gel diffuses into surrounding tissue, breast takes a very soft consistency, and inflammatory reactions may occur: in these cases the surgical implant is necessary

Frequently asked questions about breast implants

Can you breastfeed?
Placing the implant behind the gland seems to have no influence on breastfeeding.
 
Does breast implants leed to the appearance of breast cancer?
The relationship between breast cancer and the prosthesis was investigated to reveal that there was not any link between the two and the mammary prosthesis implantation does not increase the risk at all to breast cancer. Surgeons frequently used anticancer centers prostheses breast reconstructive surgery.
 
Is the monitoring of the breasts possible?
Considering the prosthesis behind the breast, clinical monitoring is simple. The presence of an implant can alter the ability of X-rays to detect breast cancer. The patients with breast implants should let the radiologist know in order to use specific adapted methods (ultrasound, digital mammography).
 
Why were there so many controversial silicone implants a few years ago?
Breast prostheses filled with gel silicone were accused of triggering autoimmune diseases in some patients today These days, all scientists working in this area has produced evidence that there is no significantly increased risk of autoimmune disease in women carrying implant breast and particularly those filled with silicone gel.
 
Is there a surveillance after implantation of a breast prosthesis?
It is necessary to have in terms of postoperative visits surgeon's prescription. Subsequently, the presence of a breast prosthesis does not imply additional tests to routine medical surveillance but is essential to specify the doctor that you are carrying breast implant. It is imperative in case of changes in one breast (hardening or softening contrary) doctor (gynecologist, surgeon) who will judge whether it is necessary to use an X-ray or ultrasound. in summary, one should not exaggerate the risks, but just be aware that an intervention surgery, even seemingly simple, always implies a small random part. Resorting to a qualified plastic surgeon assures you that this has the training and competence required for avoid these complications, or otherwise treat them effectively.