Breast Augmentation

1 – Breast Augmentation with Silicone Prosthesis

The first breast prostheses started with their use in the USA in 1963. After this date, the use of breast prosthesis has increased every year.

The aim of breast augmentation surgery is not only to enlarge the breast, but to shape it. In the selection of the prosthesis to be placed, factors such as body structure, condition of the rib cage, skin structure, as well as the wishes of the patient are taken into consideration.

Frequently Asked Questions About Breast Augmentation Surgery

Who is Suitable for Breast Augmentation Surgery?

People with small or medium-sized breasts and people whose breasts have been emptied after giving birth are ideal patients for breast augmentation surgeries.

At What Age Should Breast Augmentation Surgery Be Performed?

If the breasts have completed their growth, prosthesis surgeries can be performed after the age of 18. However, in special cases, prosthetic surgeries can be performed before the age of 18.

What Types of Prostheses Are Used in Breast Augmentation Procedures?

Silicone prostheses are often used in breast augmentation procedures. Silicone prostheses have undergone a great change since they were first produced. Fifth generation prostheses have been used since 1963. Problems such as gel leakage, bursting of the prosthesis, and deformation of the prosthesis, which are common in previous models, are not encountered in the last generation prostheses. Manufacturers give a lifetime warranty in this regard. Capsule contracture rates are minimized. The features of the fifth generation prostheses are cohesive, that is, they contain a gel with low fluidity, the prosthesis surfaces are rough, their shape is anatomical or round, and they can maintain their shape while in the body. Prostheses filled with salt water, which emerged for a period, are now gradually losing their validity.

Is it Possible to Use Non-Silicone Prosthesis?

Prostheses used other than silicone; They are prostheses filled with saline (saline). Their use has been declining in recent years. These prostheses are not used much anymore due to the lifting of the bans on silicone and the development of silicone technology.

Do Silicone Prostheses Cause Cancer?

In 1993, the Food and Drug Administration (FDA) stopped the use of silicone prostheses for 10 years. The reason for this was the uncertainty of its effect on breast cancer, the concern that it might disrupt mammographic examinations, and the suspicion that it might cause some joint diseases. Studies over these 10 years have proven all of these suspicions to be unfounded. It was re-released in the United States from 2003. With the available data, it can be said that silicone prostheses do not have any effect on breast cancer.

2 – Breast Augmentation with Fat Injection

Fat injections other than prostheses in breast augmentation are a topic that has come to the fore in recent years. In order to provide sufficient sizes, the procedure usually needs to be applied in 2 sessions. Thanks to advanced technologies in oil intake, its permanence increases to 80%. It is among the advantages that it can be obtained from the person’s own body, does not include complications secondary to surgery such as capsule contracture, hematoma, infection, as in prostheses, can be applied under local anesthesia, and there is no scar problem. It gives a more natural result compared to prostheses. In breast augmentation with fat injections, excess fat in every part of the body can be used. It may not be applied in very thin patients who do not have enough fat in their body. Calcifications that may occur may cause confusion in future control mammograms. However, injections made to the right plan reduce this risk. Therefore, having baseline mammography and breast USg results before the application in patients over 40 years of age will facilitate follow-up.

3 – Breast Augmentation with Fillers

Breast augmentation processes are performed with injections of fillers containing hydrophilic gel. However, the permanence of these procedures is lower than prosthesis and fat injection.

What should be done and what should not be done before the operation?

It is necessary to stop taking blood thinners such as aspirin and smoking 2~3 weeks before the operation.

Green tea, flax seeds, cherry stalk, tomato seeds have a blood-thinning effect when consumed heavily in herbal products.

Before all breast surgeries, mammography/breast USG is required for every patient over the age of 40. Breast USG is required for those under the age of 40. Having a radiological image before the breast procedure is very important for subsequent follow-ups. The examinations are repeated 1 year after the operation.

Is Anesthesia Necessary in Breast Augmentation Surgery?

Prosthetic surgeries are performed under general anesthesia.

Breast augmentation procedures with fat injection and fillers can be performed under local anesthesia or sedation anesthesia.

Is There Any Scar After Breast Augmentation Surgery?

A 4-5 cm incision is made to place the silicone prosthesis. Prostheses can be placed under the breast, nipple or armpit. A very rare application is the placement of a prosthesis through the navel. Since only prostheses inflated with serum can be placed under the belly button and armpit, they are no longer preferred applications. Although it seems like less scarring is left in nipple applications, submammary incisions are now more preferred due to the fact that the breast tissue is cut and the rates of capsular contracture are higher. In addition, in patients with small nipples, prostheses cannot be placed through nipple incisions. Recently, inframammary incisions are the most common choice all over the world and are accepted as the safest approach.

Fat injection and filler injections are made through a 2-3 mm incision. Scars are much less than prosthetic surgeries.

Is the prosthesis placed under or over the muscle?

Prostheses are placed under the muscle in patients who are weak and have insufficient breast tissue. The upper part of the prosthesis is under the muscle and the lower part is under the breast. This method is called “dual-plan” and this technique is mostly preferred. In patients whose subcutaneous tissue is thick enough, a prosthesis can be placed under the breast tissue or muscle membrane (fascia).

What Happens After Breast Augmentation Surgery?

You can take a bath three days after the operation. After the control, the patient can return to work and start normal daily activities, drive a car. In the first 3 weeks, he should not do sports other than walking. Again, for the first 3 weeks, a sports bra should be worn day and night. After the third week, he can do all sports activities except arm and chest movements. After the sixth week, all kinds of sports activities are free. The prostheses stay higher than normal for the first 3 weeks and their appearance will not be natural. After the third week, they begin to soften and descend to their normal places. The breasts take their full shape only in the 3rd month. Subsequent checks are made at the end of the 3rd week, 3rd month, 6th month and first year unless there is a special situation. Control mammography/USG is taken when one year has passed since the operation.

What are the Problems That May Be Encountered After Breast Augmentation Surgery?

In the early period, problems such as bleeding, infection, wound healing may occur. However, these are rare problems. The most common long-term problems in breast prostheses are aesthetic problems such as capsular contracture and symmetry disorders. Prosthetic leaks and bursts are no longer observed in good brand prostheses, brands such as Allergan and Mentor give lifetime product guarantees in this regard. Capsule contracture is when the body perceives the prosthesis as a foreign body, surrounds it with a hard capsule and pushes it to one side. When capsule contracture develops, it causes hardening of the breast, asymmetry and visual disturbance depending on its severity. Its incidence varies between 1 and 5%. If it occurs, the patient should be operated again, the capsule should be removed and the prosthesis should be replaced. If it repeats, it can be operated once more, but when it repeats for the third time, the prosthesis procedure is canceled. Stubborn capsules are not very common. Capsule development rates are low in new generation prostheses. In addition, the capsule develops less in submammary incisions, submuscular applications and prostheses with rough surface. Using a meticulous technique in the surgery and not applying excessively sized prostheses also reduce the risk of capsules. Other problems that may be encountered after prosthesis include asymmetries, appearance of the prosthesis from the outside, fluctuations on the prosthesis, the patient’s dissatisfaction with the size of the prosthesis, and the unnatural appearance of the breasts. All of these problems can be reduced by not using oversized prostheses, using fifth-generation form-stable prostheses, placing prostheses under the muscle in weak patients, and meticulous surgery.

Is There a Loss of Sensation in Breast Augmentation Surgery?

Sometimes there may be temporary loss of sensation or hypersensitivity in the nipples. These complaints usually resolve completely within a few months. Permanent loss of sensation is very rare. The most important reason for loss of feeling is the use of oversized prostheses. In addition, patients with capsular contracture may experience loss of sensation and pain.

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