Breast augmentation

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WHAT IS THE BREAST AUGMENTATION WITH IMPLANTS?

Breast augmentation with implants is a surgery aiming at the increase of breast’s size and/or the correction of its shape. During the surgery it is also possible to reduce small disparity of size between breasts.

WHAT DOES THE SURGERY CONSIST IN?

The breast implants may be inserted through the incision made to the inframammary fold, armpit, or along the lower periphery of the areola (the most frequently applied method in the Aesthetic Med clinic) The breast implants may be placed beneath or over the pectoral muscle.  At the Aesthetic Med clinic 95% of implants are placed beneath the muscle. This is because of the better aesthetic effect, increased patient's safety and less possibility of capsule creation around the implant (breast hardening).

Breast implants are not able to lift slack or significantly sagging breasts typical after the weight loss or pregnancy. If the breasts are too sagging (mastopexia), breast lift should be applied.

The surgery is perform in the operating room under general anaesthesia performed by an anaesthesiologist and an anaesthetic nurse.

The surgery takes about one hour and after the surgery you are likely to stay in the Aesthetic Med clinic for about 3 days. In some cases the stay may be prolonged.

Pain persists for a few days. The biggest discomfort may be expected within the first 72 hours. Usually basic painkillers are sufficient and at the Aesthetic Med clinic you will receive them on regular basis.

WHAT ARE THE TYPES OF BREAST IMPLANTS?

There are breast implants available in various types, with various shapes and sizes. At the Aesthetic Med clinic we are presently using oval and anatomic implants with various projections. Majority of implants have outer silicone or polyurethane cover and are filled with silicone gel.

The choice of the suitable implant size and shape will be discussed with you during your first visit. It is important that you have time to decide the shape and size you want. Of course your surgeon will help you make this decision. In some cases we can achieve a better shape using specific implant type advised by the surgeon during the consultations.

HOW LONG DO BREAST IMPLANTS LAST?

15 years.

WHAT ARE THE RISKS AND SIDE EFFECTS OF THE SURGERY?

Thinking about a plastic surgery we want it to be a very positive experience. Indeed, complications are rare and usually insignificant, but there is some risk related to every surgery depending on patient's individual features. Thus it is important to be aware of such possible problems.

The possible consequence of the breast augmentation surgery is that they may be harder than usually. Body always creates scars around foreign bodies and the breast implants are not an exception. After the breast augmentation a natural capsule of connective tissue is formed which in some cases may be thickened which gives the result of hard breast. (capsule). In that case breasts may be exceptionally hard and look more rounded or deformed. In such cases it may be necessary to undergo another surgery consisting in the incision, partial or complete removal of the capsule.

The implant infection is very rare and may occur as a result of major bleeding during the surgery and as a result of a post surgery blood tumor. In the rare cases when the infection occurs the breast implants may be removed. New implants may be placed after the remission of the infection.

Tear drop anatomic implants can rarely turn around or change position after the surgery.

There may also be problems with the breast and nipple, such as numbness, loss of sense or touch over-sensitivity. It is usually temporary, but these changes may persist to some extent. Quite rarely the scars may become red and wide, which may last for a few months.

“Bread loafing” implant or wrinkling may be a bigger problem with very slim persons or with those who do not have much breast tissue. However the risk of complications is significantly reduced if the implant is placed under the breast muscle.

Scarcely there are very weak implants that may break with the passage of time. That is why it is worth considering if you are ready for a possible surgery and related costs, especially for the more expensive implants of recognized companies that are used by the Aesthetic Med clinic.

A general risk related to every surgery may also occur, e.g. a blood clot in a leg, which would require treatment (so called deep vein thrombosis), however the risk of this complication is extremely low. Some of the clots may also travel to lungs, causing severe breathlessness and pain in the chest. These symptoms are known as pulmonary embolism, which occurs very rarely, by may threaten your life. A respiratory tract infection is also very rare and the possibility of this complication is increased with smokers.

There are no proofs of the relation between silicone implants and the occurrence of any form of illness. The breast augmentation definitely does not increase the chance of breast cancer. You will still be able to examine your breasts with implants. After the breast augmentation the breast ultrasound scanning is necessary at least once a year. Mammography is still possible after the breast augmentation, but you should first inform the radiology employees about the surgery.

Some women fear that the breast augmentation would influence their ability of breast feeding, but this is very unlikely. If the breast feeding is important to you, the best solution is to contact your surgeon to obtain additional information.

All these risks will be discussed with you in detail during the surgery consultation. However do not hesitate to discuss with your surgeon any questions or doubts you may have.

HOW DO I PREPARE FOR THE SURGERY?

The surgeon is going to suggest you the possible dates of the surgery and ask you to choose the most convenient one. When planning the surgery its date should be set for the time to two weeks after the last period, which reduces the possibility of complications after the surgery. Depending on your age and general health condition, prior to your admission you may be asked to make standard blood and heart tests (morphology, ionogram, APTT, ECG, chest RTG and breast ultrasound scanning). All the time you may also ask questions that have appeared to you during the process or in any way have raised your fear.

On the day of the surgery you will be admitted to the hospital. In case of the general anaesthesia you will be asked not to eat or drink within six hours prior to the surgery, which addresses also to the chewing gum.
If you smoke, it is advised to quit six weeks before the surgery. There is a rule: the longer you smoke and the earlier you quit, the better, because smoking reduces the quantity of the oxygen in blood and may significantly increase the risk of post surgery complications.

On the surgery date it is also important to inform the surgeon, anaesthesiologist and the nurse about all the taken Rx and OTC medications, as well as about any recreationally used drugs.

For 2 weeks before the surgery you should avoid medications with acetylsalicylic acid, since they increase the risk of bleeding during the surgery. For 30 days before the surgery you may also be asked to stop taking contraceptive pills or a hormone-replacement therapy. Your doctor will give you an appropriate advice in the scope.

After the surgery you should make sure someone takes you home, because you will certainly not be able to drive.

WHAT HAPPENS AFTER THE SURGERY?

You should expect feeling sleepy after the surgery, because probably you will keep awakening and falling asleep for the rest of the day. You may feel quite uneasy and feel pain in the chest area. Painkillers given continuously will minimize the pain.

Two small tubes (so called drainage) may be put on both sides of the wound in order to drain excess blood or body fluids. They are usually removed before you return home.

Initially your breasts may seem bigger than you have expected. It is normal and will last for a few months during the post surgery period until the swelling decreases and the implants settle in the new position.
Prior to your going home you will again be examined by a surgeon and/or a nurse. All the durable stitches should be removed 7 to 10 days after the surgery.

You will also receive an information leaflet and the details considering your implants. This includes the manufacturer, type, catalogue and lot / lot number. The information should be kept in a safe place.

Once again we would like to draw your attention to the fact that you will not be in condition enabling driving, so it would be better to have somebody with you at home for a few days. Having any doubts in that time, contact the Aesthetic Med team and ask for an advice.

WHAT IS THE ANTICIPATED TIME OF THE RECUPERATION, ABSENCE AT WORK AND THE RETURN TO NORMAL ACTIVITY?

The recuperation time and the time of the regaining health may vary depending on the patient’s individual features, so the below advices should be use as a suggestion only. Having any doubts in that time, contact the Aesthetic Med team and ask for an advice.

For the first week at home you should perform only simple activities. However in order to prevent complications you should stand up and walk every hour. Still you should avoid aggressive arm movements as well as any prolonged effort for six weeks after the surgery.

The good practice is to cease activity that appears painful. You should also wear an appropriately matched sport bra during the day and at night, for four to six weeks after the surgery.

BREAST AUGMENTATION AFTER THE SURGERY – STEP BY STEP

Day 1 to 4

You stay in the Aesthetic Med clinic under care of doctors and nurses and follow their recommendations.

5 - 14 days

You are wearing a bra night and day. Recommended stitch removal after 7 – 10 days. You may gradually increase your activity, but do not perform anything tiring.  Driving may be started after 14 days.

2 weeks

Bruising and swelling will continue to decrease. You may return to work two weeks after the surgery.

4 weeks

After four weeks you can start gentle exercises, but avoid heavy physical effort for the next two weeks. The appearance of the breasts continues to improve.

6 - 9 months

The changes regress, the scars start to soften and lighten. You may start to evaluate the final result.

The information included on the web site does not constitute a professional medical advice provided by doctors from the Aesthetic Med clinic.

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Consultation
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M.D. Ph.D. Andrzej Dmytrzak
Specialist in plastic and reconstructive surgery
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