Breast Augmentation

Since the past, when women are mentioned all over the world, motherhood and fertility come to mind. The organs that are the most prominent symbols of these features are the breasts. Ideally sized breasts also make women look attractive, beautiful and self-confident, and many women with small breasts have told their spouses, friends, family or doctor that they do not feel adequate as a woman because of their small breasts, and that they experience psychological problems due to loss of self-confidence. In addition to the fact that the breasts can be unilateral or bilaterally underdeveloped from adolescence, there are cases of losing their size and firmness due to weight gain and loss, pregnancy, asymmetrical or malformed “tuberous breasts”.

Every woman wants to feel beautiful, and throughout history, they have tried to use all kinds of substances, from glass beads to animal cartilage, rubber and liquid silicones, to enlarge and beautify their breasts, even if it ended in frustration. The first silicone-containing breast prostheses (implants) with healthy results, Dr. Frank Gerow and Dr. It was developed by Dow Corning company in 1961 with the help of Thomas Cronin and the first breast prosthesis was placed in America in 1962. Since then, silicone breast prostheses have also changed to look and feel more natural by keeping up with technological developments, and breast prosthesis surgeries have become one of the most applied surgeries. Another method that has recently been used to increase breast volume is the method of taking fat from other parts of the body and injecting it into the breast. You should discuss the advantages, disadvantages and applicability of this method with a plastic surgeon. Every surgical method you read on the internet may not be suitable for you.

Today, the most applied method to add volume to the breasts is the placement of a breast prosthesis. Although the concept of ideal breast and some numbers are determined by plastic surgeons, not everyone’s understanding of beauty may be the same and it should be accepted that patients may not be happy with the same size and model prosthesis depending on their age, height, weight, chest circumference, hip width, skin condition and expectations. Due to this need for diversity, silicone prostheses are designed in two ways: drop (anatomical) and round. Hundreds of different types of silicon have been produced, differing in surface, diameter, size, and projection (height). While round silicones cause a fuller appearance in the decollete area, drop silicones create a softer and more natural transition result. A woman who thinks that her breast is smaller than the size she wants or is asymmetrical and has decided to have surgery should definitely consult with a plastic surgeon and decide together with her doctor what size and shape will suit her, from which area the incision will be made, and in which area the prosthesis will be placed.

Silicone prostheses; It can be placed under the breast tissue and fascia, under the breast tissue, on the fascia, under the muscle (pectoral muscle) under the breast tissue, or in 4 different planes, the upper part of which is under the muscle and the lower part is above the muscle, which has recently been called the dual plane. Each plan has its own advantages or disadvantages. It is necessary to decide on which plan the prosthesis will be placed, according to the patient’s examination and wishes, and the surgeon’s knowledge, experience and preference.

Prostheses are most often placed through an incision of 4-5 cm from the nipple and inframammary fold (inframammarian sulcus). It is also possible to insert the prostheses by entering from the armpit and the navel, but this requires an endoscopic approach and with this method, the sheath of the silkons, which can be inflated with serum, can be placed. Silicones that can be inflated with serum afterward also have some disadvantages. The scars on the nipple or inframammary fold usually fade over time and can only be seen when viewed very carefully.

Since breast prostheses are placed under the breast tissue and do not damage the breast tissue, they do not interfere with lactation. If you have a pregnancy plan after the surgery, your surgeon may recommend postponing this surgery for a while, as the pregnancy process can unpredictably change the shape and volume of the breast and affect the results of the breast augmentation surgery. Likewise, I believe that the operation should be performed about 1 year after the end of the breastfeeding period, since the mammary glands of a woman who has just finished postpartum breastfeeding period do not become smaller and this may cause various complications after the operation.

To date, silicone prostheses have not been found to cause any carcinogenic, immunological or rheumatic diseases. It is used safely today. The presence of a breast prosthesis usually does not prevent mammography, and additional imaging methods can be used at the slightest hesitation. Before breast surgery, whether you have breast cancer in your family or not; If your age is under 40, you should have a breast ultrasound, and if you are over 40, you should have a breast ultrasound and mammography.

Breast augmentation surgery is an operation that can be performed in 1-1.5 hours under general anesthesia. If the prosthesis is placed in the submuscular plane, more pain is felt than in the supramuscular plane. Therefore, you may need to stay in the hospital for 1 night. If the supramuscular plan is preferred, you can be discharged on the same day as the pain will be very low. The placement of the drain (silicone tube that carries the accumulated blood out) depends on your surgeon’s preference and the course of the surgery. If a drain is placed, it is usually removed within 1-2 days. Since the pain is more when the prosthesis is placed in the submuscular plane, arm movements may be a little more painful in these patients and may cause movement restriction for 4-5 days. Since the stitches are dissolving stitches, they do not need to be removed. It is recommended to use a sports bra-like bra for 1 month after the surgery.

Depending on the place where the prosthesis is placed and personal characteristics, it is possible to return to work in 3-7 days. Heavy sports using the arms can be started after 2 months, and lighter sports can be started after 3-4 weeks.

The risks that may be encountered in the early period can be summarized as bleeding, infection and wound dehiscence, which are the problems that may be encountered in any surgical procedure. The most unpleasant reaction that can occur in the late period is the development of a capsule around the prosthesis. In fact, this reaction is a normal response of the body to any foreign object. Since the prosthesis is a foreign body, the body forms a membrane (capsule) of connective tissue around this prosthesis. This capsule is usually not a problem as it is thin. Rarely, it can thicken and cause stiffness and sometimes pain. Thanks to the developing technology, with the introduction of rough-surfaced silicones and the placement of prostheses behind the muscle or in the dual plane, the rate of capsule formation, which is a problem, has decreased to 5 percent. In order to prevent this situation, various massages may be recommended to the patient after the surgery. If a hard capsule that causes deformity in the breast has formed despite all precautions, this capsule may need to be surgically intervened.