Breast Augmentation: Implants, Plastic Surgery, Results

Breast augmentation is a surgical procedure for women who wish to increase their breast size or improve their breast shape.

Αυξητική στήθους

Η αυξητική στήθους , είναι μια από τις πιο συχνά πραγματοποιούμενες χειρουργικές επεμβάσεις, που αφορά γυναίκες που επιθυμούν να αυξήσουν το μέγεθος του στήθους τους, ή να βελτιώσουν το σχήμα του. Επίσης αφορά γυναίκες των οποίων οι μαστοί έχουν άνισο μέγεθος μεταξύ τους, γεγονός που επηρεάζει την αυτοπεποίθησή και ψυχολογία τους. Στην αυξητική στήθους, χρησιμοποιούνται ενθέματα σιλικόνης υψηλής ποιότητας τα οποία είναι εγκεκριμένα από τον Αμερικανικό Οργανισμό Τροφίμων και Φαρμάκων ( FDA ).

Τύποι ενθέματος Τα ενθέματα σιλικόνης μπορεί να περιέχουν τζέλ σιλικόνης ή φυσιολογικόορό, και απο πλευράς σχήματος διακρίνονται σε δύο κατηγορίες: 1. Ανατομικά ενθέματα (σαν σταγόνα ή δάκρυ) Τα ανατομικά ενθέματα μοιάζουν με σταγόνες δηλαδή o κάτω πόλος τους προβάλει περισσότερο από τον πάνω. Η επιφάνεια τους μπορεί να είναι λεία, τραχεία ή και να έχει επίστρωση πολυουρεθάνης, ενός υλικού που μοιάζει στη σύσταση του με σπόγγο. Πολλοί πλαστικοί χειρουργοί θεωρούν πως είναι καλύτερη επιλογή γιατί μοιάζουν περισσότερο με το σχήμα του μαστού, δίνοντας ένα πιο φυσικό αποτέλεσμα. Ωστόσο, υπάρχουν και πλαστικοί χειρουργοί που υποστηρίζουν πως το σχήμα του ενθέματος δεν παίζει καθοριστικό ρόλο για το το τελικό σχήμα που θα έχει το στήθος. Και αυτό γιατί, η βαρύτητα, η πίεση των μυών και των ιστών γενικότερα, θα επηρεάσουν το σχήμα του στήθους με την πάροδο του χρόνου. Επιπλέον τα ανατομικά ενθέματα, πρέπει να τοποθετούνται πάντα με την πλευρά που έχει μεγαλύτερο όγκο χαμηλά, δηλαδή αν τα ενθέματα αναποδογυρίσουν, μπορεί να δημιουργηθεί κάποια ασυμμετρία μεταξύ των μαστών. Τέλος, τα ανατομικά ενθέματα, έχουν μεγαλύτερο κόστος από τα στρογγυλά, όχι λόγω ποιότητας, αλλά λόγω του τρόπου κατασκευής τους. 2. Στρογγυλά ενθέματα Τα στρογγυλά ενθέματα , μπορεί να έχουν λείο ή τραχύ περίβλημα και όπως λέει και το όνομά τους, έχουν στρογγυλό σχήμα. Επιπλέον, το πλεονέκτημα με τα στρογγυλά ενθέματα, είναι πως ακόμα και αν “στρίψουν”, δεν θα δημιουργηθεί κάποια δυσμορφία στο σχήμα του μαστού. Πρόκειται για τα πρώτα ενθέματα που κατασκευάστηκαν και αποτελούν διαχρονική αξία στην αυξητική μαστών, απο πλαστικούς χειρουργούς σε όλο τον κόσμο.

Size Selection The size of the silicone implant to be placed is something that will likely concern you greatly, and quite rightly so, in our opinion. There are two decisions regarding the suitability of the implant that need to be made. In one of these, you can and should participate , and it concerns the volume in cc/ml . The other decision is solely your doctor's, based on the measurements they will take of your chest and breast, and the aesthetic result you wish to achieve.

There are high, moderate, and low profile implants. The appropriate implant type for each case is selected based on breast size, implant projection, and the desired outcome, naturally after extensive discussion with the interested individual. . Breast augmentation is a procedure that combines art with science. You can find the implant size that suits you on your own. Do the rice test!

Placement Position During the first visit, after the necessary measurements, the incision point and the implant placement position will be chosen.

The incision can be made in the: inframammary fold nipple area (periareolar incision) armpit (less common) The incision is quite small, approximately 4cm , and the sutures used are absorbable, meaning they do not need to be removed. Many women prefer the periareolar incision upon hearing about it, thinking the scar will be well hidden there, and request it from their doctor. However, the inframammary incision is also well hidden, in the fold created by the breast with the chest wall, and moreover, according to literature, it is the safest method for capsule formation.

The implant placement can be: Under the muscle Placing the implant under the muscle is chosen primarily for breasts that do not have enough fat to cover the implant, with the advantage of having a lower chance of capsule formation. However, it usually involves a longer post-operative recovery time and a need for more analgesics (painkillers). Above the muscle and under the mammary gland (breast) In contrast, placement above the muscle is primarily done in breasts that have a sufficient amount of fat and cover the implant, thus providing a more natural visual and palpable result. Dual plane (half of the implant above the muscle and half below) In the third placement technique ( dual plane ), the implant is placed under the muscle on one side and above the muscle on the other side, thus combining the advantages of both aforementioned implant placement methods, and therefore is chosen more frequently .

The surgery in brief Breast augmentation surgery is performed under general anesthesia and lasts approximately 60 minutes . An incision is made at the chosen location mentioned above (inframammary fold, nipple area, armpit) to create the implant “ pocket ” at the selected placement site. After careful hemostasis and inspection of the area, the implants are placed. They have a unique barcode marking that you will receive with your discharge papers and should keep. Skin and muscle suturing, if placement under the muscle was chosen, is performed with absorbable stitches. Drain placement is not necessary and is performed only in cases where the surgeon deems it essential . Hospital stay after the surgery can range from a few hours to an overnight stay . A compressive bandage (sports bra) is applied, while any pain can be managed with analgesics. In the following days, some doctor's appointments are scheduled to monitor the postoperative course and check the incisions.

Durability of silicone implants Due to their excellent quality, silicone implants can remain without any problem for decades. However, after a few years from their placement, it is advisable to check them with ultrasound or MRI , and if a problem arises, they may need to be replaced.

Post-operative instructions For the first 2-3 days , rest is recommended, while gentle athletic activity such as walking is permitted 1 week later . Furthermore, immediately after the surgery and for one month , a compressive bandage (sports bra) is worn, while strenuous physical exertion is forbidden for the same period .

Bibliography Grabb and Smith's Plastic Surgery, 8th edition, Kevin C. Chung Manual of Aesthetic Surgery Vol. 2, 2005, Werner L. Mang Özalp B, Aydinol M. Breast Augmentation Combining Fat Injection and Breast Implants in Patients With Atrophied Breasts. Ann Plast Surg . 2017;78(6):623–628. doi:10.1097/SAP.0000000000000935 Cheng F, Cen Y, Liu C, Liu R, Pan C, Dai S. Round versus Anatomical Implants in Primary Cosmetic Breast Augmentation: A Meta-Analysis and Systematic Review. Plast Reconstr Surg . 2019;143(3):711–721. doi:10.1097/PRS.0000000000005371 Tebbetts JB. Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg . 2001;107(5):1255–1272. doi:10.1097/00006534-200104150-00027 Atiyeh B, Chahine FM. Design for Natural Breast Augmentation: The ICE Principle. Plast Reconstr Surg . 2017;139(2):568e–569e. doi:10.1097/PRS.0000000000003002

How long will I have to be away from work?

Time off work does not exceed 1 week, while driving should be avoided for 2 weeks, or until any discomfort subsides.

Does breast augmentation affect breastfeeding?

No, silicone implants do not affect breastfeeding, except in less than 2% of cases.

Are there complications?

Breast augmentation is a safe procedure with an excellent postoperative course in most cases. However, as with any other surgery, there are potential complications, such as: Capsular Contracture This is a natural process of the body to create a membrane that surrounds any foreign object placed in our body. However, if this membrane is too hard, it can press on the implant, deforming the shape of the breast, which is called a capsular contracture. In such a case, a procedure called capsulectomy and implant replacement may be performed. Implant Rupture Implant rupture is a complication that can be due to material failure, surgical error, or injury to the implant. Confirmation of rupture is done by MRI, and treatment is surgical with implant replacement. Most major companies offer a lifetime warranty for their prostheses and provide new implants free of charge to replace ruptured ones, unless it is proven to be a consequence of an accident or iatrogenic injury. Loss of Nipple Sensation A common, but almost always temporary, complication is a change in nipple sensation. Patience is needed as sensation may fully return after 6 or even 12 months. Asymmetry Something that naturally occurs in all women is breast asymmetry, and this is one reason why a woman may undergo breast augmentation. However, slight asymmetry may still be observed post-surgically. Incision Dehiscence - Hypertrophic Scars Scar healing varies for each patient. Rarely, and especially in smokers, there may be a small dehiscence of the incision. Hematoma Accumulation of a small or larger amount of blood in the breast. This is an extremely rare complication. Infection This is not a common complication, as the surgical conditions strictly follow all antiseptic rules. However, if it occurs, it is treated with antibiotic therapy, or in the worst case, with implant removal.