Breast augmentation
BREAST AUGMENTATION:
We define breast augmentation surgery. It is performed in young women with micromastia, amastia and/or breast asymmetry, while when, in older women, drooping is present, it must be combined with breast lift/mastopexy.
The size of the female breast is determined mainly by genetic factors such as: genes and sex hormones and to a lesser extent by acquired factors such as body weight and the intake of pharmaceutical substances. Breast development is complete shortly after puberty, so early in life women have the option of breast augmentation if it is necessary to improve their body symmetry, femininity and self-confidence.
TO WHOM THE INTERVENTION IS ADDRESSED
Surgery is indicated for women with small or no breasts, with medium breast size but little droop (especially after breastfeeding), with anisomastia, amastia, tubular breasts or Polland syndrome, as well as those undergoing reconstruction after mastectomy. The purpose of the surgery is to create symmetrical, normal shaped and sized breasts.
WHAT CAN HAPPEN
The operation is performed using pre-formed inserts, mainly silicone. In America, saline implants are used, which acquire their final volume after the surgery, where the doctor in consultation with the patient decides whether a volume needs to be added or removed. In the EU these inserts have not been approved.
The implants are placed through a small incision of up to 6 cm, which can be made in the inframammary groove (under the breast), around the nipple or in the armpit. The size of the implant is decided based on the anatomy of the patient's chest and her wishes. The plane where the insert is placed can be completely below the muscle (subpectoral) or partially below the muscle and partially below the breast (dual plane). In women who have normal breasts and desire further augmentation, the implants can be placed under the breast parenchyma (subgladular).
BREAST AUGMENTATION WITH FAT TRANSFER
Taking fat (in the form of lipoma) and transferring it to the breast was historically the first breast augmentation operation, performed by Czerny in 1895 with success! Nowadays there are indications that autologous fat grafts in the breasts can provide solutions to specific problems and it is a technique that is gaining ground among plastic surgeons.
WHAT IS THE TYPE OF ANESTHESIA IN BREAST AUGMENTATION
Breast augmentation is performed under general anesthesia in an organized clinic. The duration of the surgery is approximately 2 hours, while due to the reception of general anesthesia and the duration of the surgery, it is considered appropriate to stay in the clinic for a few hours and to mobilize immediately.
WHAT WILL THE SCARS BE LIKE AFTER BREAST AUGMENTATION
The type of scars depends on the surgery that will be chosen. The inframammary approach is usually chosen, so the incisions are very small up to 6 cm, are located below the breasts and are only visible when the arms are elevated. The incisions heal and mature over several months and the scar they leave is usually not easily noticeable and is always covered by the bra. For the majority of women, the existence of scars is negligible in front of the improvement in the shape and size of their breasts. It is worth noting that breast augmentation is one of the plastic surgery operations with the highest post-operative patient satisfaction indicators.
To avoid unsightly scars you will be given instructions immediately post-operatively and you will enter a follow-up program in case you have a history of cheloids.
WHAT WILL BE THE DURATION OF THE RESULTS
The results are permanent and will remain stable as long as the woman maintains a stable weight. During the period of pregnancy and breastfeeding, the normal breast is enlarged to meet the needs. Breastfeeding can be carried out unhindered.
Over time, augmented breasts will behave just like non-operated breasts, obeying the law of gravity and gradually becoming downward-sloping. However, this drop will be less compared to normal breasts of the same volume, because the implants are fully or partially held by the muscle. The fall can be limited by using special sports bras.
WHAT ARE THE LIMITATIONS OF THE SURGERY
Breast augmentation can be done in young women from the age of 22. Only patients with Polland syndrome, with anisomastia or tubular breasts, in whom breast size has been stable for at least 12 to 24 months, can be operated on earlier. Surgery is not performed during breastfeeding or during a period when family planning has not been completed. Patients with serious health problems, who cannot receive general anesthesia or those with dysmorphic syndrome should be prevented from this surgery.
WHAT ARE THE RISKS FROM THE INTERVENTION
The doctor will evaluate your general condition and your history and, if he decides that you are suitable for the surgery, he will inform you about the possible complications and what needs to be done to reduce the possibility of their occurrence. You will also be asked to stop using supplements and medications that affect blood clotting and to refrain from smoking. The anesthesiologist will then talk to you about the type of anesthesia you will receive and the possible complications.
WHAT YOU SHOULD DO BEFORE BREAST AUGMENTATION
Depending on your age, you will be given instructions on the medications you may be taking and should be stopped or replaced, as well as the additional check-up you may need to do with a mammogram and breast ultrasound. Usually a simple pre-operative check-up one day before surgery is enough.
The doctor will explain the effect of smoking on wound healing and ask you to stop. One week before the surgery you will need to take measurements to order a special bra, have your photo taken and sign the consent form.
WHAT TO DO AFTER BREAST AUGMENTATION
You stay in the clinic for a few hours up to the first 24 hours, but your time off work must have been calculated at 2 weeks. This does not mean that you will not be able to do light work much sooner, but in general you will feel overwhelmed and you will have to limit the movements of the upper limbs for the first 4-5 days.
Leaving the surgery you will wear a special bra which you will keep for 6 weeks. You will likely have a drain that will be removed in the first 24 hours, and you will need to be mobilized as soon as possible. Pain and swelling are treated with anti-inflammatories and painkillers. Because the sutures are intradermal there is no need to remove sutures. It is also recommended to refrain from sports for 1 month.
WHAT IS THE COST OF THE INTERVENTION
The cost of breast augmentation is calculated by adding up the fee of the clinic, where the patient is operated and treated, the Plastic Surgeon and the Anesthesiologist. The purchase of inserts and special bras must be included in the costs. Breast augmentation can be done in young women from the age of 22. Only patients with Polland syndrome, with anisomastia or tubular breasts, in whom breast size has been stable for at least 12 to 24 months, can be operated on earlier. Surgery is not performed during breastfeeding or during a period when family planning has not been completed. Patients with serious health problems, who cannot receive general anesthesia or those with dysmorphic syndrome should be prevented from this surgery.
