All About This Plastic Surgery Procedure
The breast augmentation surgery is used to increase the size (cup) and improve the size of the breasts. Your decision is very important and must be done together with a plastic surgeon based on their needs, desires, individual expectations and individual real medical alternatives.
The breast consists of ducts and glandular lobes surrounded by fatty tissue which provides the shape and texture.
Factors such as pregnancy, rapid weight loss, and effects of gravity (laxity of tissues) associated with aging, which cause the skin to stretch, which can cause the breast to hang or “fall.” In such cases, the placement of breast implants can help lift sagging breasts. Sometimes it is not sufficient only to lift the bust implant and must be done simultaneously an operation to lift the nipple areola complex and breast, known as mastopexy.
All women have asymmetry in the size or shape of a breast on the other from the female character development in adolescence. In cases where the asymmetry is very evident implants can be placed in shape and sizes for each breast. This achieves a more symmetrical result.
Commonly, there are four places where you can make the incisions: around the areola (periareolar), the lower breast folds (inframammary) or under the armpit (axillary) and umbilical / endoscopic: This incision site has not been well studied and is not recommended by manufacturers of breast implants. By this approach only saline implants can be used.
The breast implant can be placed either below the pectoralis major muscle (submuscular) or on the muscle and under the breast (subglandular). There are other places like the subfascial and dual plane.
The submuscular placement may cause the surgery take longer, recovery may be longer, and the patient may experience more discomfort when compared with subglandular placement. The potential benefits of submuscular placement is that it can result in less palpable implants, less incidence of capsular contracture, or hardening of the breast, and allow a better picture of the breast when performing imaging studies such as ultrasound or mammography.
The Subglandular placement allows surgery and recovery shorter, may be less painful and allows better access in case you need another operation, this surgery compared with submuscular. However, subglandular surgery may result in more palpable implants, as they will be less covered, higher incidence of capsular contracture, or hardening of the breast and can be difficult to obtain the image of the breast when performing imaging studies such as ultrasound or mammography.
Breast Implants: Saline or Silicone?
A saline breast implant is a silicone covering or bag filled with saline solution. The implant is filled with saline, also known as “salt”, through a small hose or connection, during surgery. These breast implants were developed in 1964 by a French company called Laboratoires Arion.
Is less natural and may result in more palpable implants compared to silicone breast implants. As the content is liquid, it will move by gravity, depending on the position of women, causing wrinkling of the top which can be visible or palpable.
Saline implants deflate when either saline drips through a valve poorly sealed or damaged, or by a break in the implant shell. Some implants deflate (or rupture) in the first months after being placed and others deflated after many years. You should be aware that the implant can be spent over time and will deflate or suffer ruptures.
In 1961, plastic surgeons Thomas Cronin and Frank Gerow developed the first breast implant silicone. One of the most important advances in implant technology was the introduction of high cohesiveness gel implants by Mcghan (Inamed Aesthetics) in 1993. These have the advantage that, not being liquid content, the implant maintains its shape; lowering the risk of wrinkles or irregularities like traditional silicone or saline implants. In case of rupture, the consistency of the gel prevents the silicone to migrate to other neighboring areas. The form is also easier to control with this material, so implants look and feel more natural and offer the best results.
Despite the misconceptions related to breast implants with breast cancer, there is no evidence to suggest that they are indeed related.
Although breast cancer incidence is not higher in women with silicone implants, the presence of implants makes cancer detection via mammography difficult, especially when the implants are placed in a subglandular or above the muscle.
There are two types of implants that can be used: the anatomical or round. The anatomical shaped like a drop, while the rounds are as the name suggests, and leads to a rounder shape. Both types are available in a range of sizes and profiles. Dr. Badilla will recommend that the implant is considered better for you and help you choose the size that fits your body better after listening carefully to your desires and expectations.
Anatomic implant or round implant
The main difference is that the round implant will give more lump or volume at the top of the bust. In contrast, the anatomic implant will give a decline in the top of the breast. Round implants have a more round and globular appearance than that anatomical implants. Contoured implants mimic the naturalshape of the breast more accurately.
Advantages anatomical implants:
- Almost total absence of wrinkles or irregularities on the implant.
- Do not deflate as saline implants.
- Allows greater control over the width of avoiding excessive breast lump at the top.
- The form can be adjusted to the thorax of each individual case.
- The feeling and form is very natural.
- Do not irrigate or spread if the implant ruptures
- Do not exert much pressure on the lower pole of the breast making it less likely that over the years fall or pull the lower pole.
- Also, it is assumed that the duration of these implants is greater.
Advantages of Implants round:
- With round implants, upper breast is going to look more rounded and full. Some women prefer a more rounded in their breasts, in these cases; round implants are a good alternative. Another aspect to consider is that round implants are less expensive than anatomical cohesive gel implants.
Surgical technique and anesthesia
Augmentation surgery performed in Costa Rica, usually on an outpatient basis. I.e., the patient leaves the same day of the operation.
Typically, general anesthesia is used, however, local anesthesia with sedation also an option. The surgery takes 1 to 2 hours. The doctor makes an incision and creates a pocket for the breast implant. The implant is placed and positioned within the pocket or space created. Finally, the incision is closed, usually with absorbable sutures and will place a special adhesive tape to provide added support. You can put gauze over the wound to promote healing.
It is usually not a painful procedure. The patient should rest two days and in a week you can make normal life, without making a lot of activity with your arms. Most patients at 3 or 4 weeks can initiate strenuous exercise or sports.
In any operation, no matter how small, it leads to inflammation. The degree of this varies from person to person and is very difficult to predict. This is a natural reaction of the organism. In this type of surgery, the first few weeks, the breasts are deformed and flattened appearance. This is because the rearrangement has been made of breast tissue, and inflammatory process is never symmetrical. Around the third week, they take a more natural and are hiding the scars, but the entire process takes 6 months or more. Once finish the healing process, the full process of inflammation dissipates.
- The sitting or standing position favors her to decrease the inflammatory process.
- It is recommended that you sleep on your back during the first ten days.
- A special bra or bandage, should be worn day and night the first 2 weeks postoperatively, and then only during the day for a month.
- You must use micropore ® for no rubbing or friction points directly to the wound with dressing while protecting the wound.
- Always shower every day, washing the wound with soap and water to which must be removed the bra and tap to wash it.
- If the wound crusts or grains, should be cleaned gently with hydrogen peroxide after bathing.
- The wound dressing should remain the same unless you have some kind of secretion, in which case we recommend covering it with gauze.
- Do not make an effort with your arms as heavy lifting, exercise, etc.., or lifting arms above the shoulders during the first 2 weeks. From the third week, you must start with moderate exercise and movement arms, little by little until you get to normal in one or two weeks.
The risks of breast augmentation:
Any surgical procedure produces a certain degree of risk. Although most patients experience no complications, it is important to understand the risks, potential complications and consequences of breast augmentation.
Bleeding (hematoma) – Although the risk is minimal bleeding into the space around the implant may occur after the operation. If this occurs, the patient will be taken back to the operating room to control bleeding. Keep in mind that this could produce an abnormal form of the breast and potentially lead to hardening of the breasts.
Infection – Some of the breast tissue normally contain bacteria and is likely to come into contact with the implant during breast surgery augmentation. For this reason, all patients are placed antibiotics before surgery and for several days after. The risk of infection is less than 1%.
The loss of nipple sensation – Some patients notice a change in nipple sensation after breast augmentation surgery. The change may result in an increase or a decrease in sensation and may last several weeks. However, the change is temporary. Permanent loss of sensation is very unusual.
Possible long-term complications:
Capsular contracture (hardening of the breasts due to the presence or contracted scar capsule that compresses the implant) – Each individual makes a scar around the implant. This is a normal response of the immune system to a foreign body. For unknown reasons, some people form thicker scars than others. A thick scar can distort and even cause chest discomfort. This problem has decreased since the use of silicone implants and submuscular placement, however, if warranted additional treatment, the scar is incised or is removed and the implant will be replaced.
Graft rejection – If the implant is rejected, a surgical procedure is relatively short and simple required removing the old implant and replacing it with a new one.
The ripple visible (rippling) – People with small breasts who have had a large increase may be at risk of having a visible rippling of the skin that covers it. This problem is more common with saline implants, and can be avoided by placing the implants under the pectoral muscle.
Interference with mammography – Implants can do technically difficult to conduct and read mammograms. Implants placed behind the pectoral muscle allow the breasts are observed more effectively through a method called Eklund technique.