Information about the breast augmentation procedure
The immaturity of the female breasts, assimetrics, and skin extension may often cause psychic problems, which leads to loss of self-confidence and problems with estabilishing relationships. These shape deviations of the female breasts can be easily corrected by the use of breast implants.
From the middle of the 1960s implants have been continuosly developed, they are in fact an elastic pouch filled with liquid silicone, high-density silicone-gel or saline solution. By shape they can be round or natural breast shape, resembeling the anatomical dimension of a female breast. By surface they can be plain or textured. The surface has a role of the formation of the tissue around the implant detailed below.
This procedure is performed under general anesthesia, rarely under local anesthesia. The chosen optimal size implant is placed under the glandular tissue or the pectoral muscle. Placement of the implant can be made by an incision in the hidden sub mammary line or through a 4 cm incision on the nipple or through the axillary's region. Incision closed with a plastical suture. For the opening made for the implant drain is used to help discharge of fluid, this is usualy removed next day.
Recovery, post-op care
After the operation elastic bandage is to be worn for a week. After the first week bandages are removed and suspension bra to be worn for 5 weeks to estabilish the right implant position. Stitches are removed after two weeks. Due to the intervention, tension and sensitivity disorder expected for 2-3 weeks which gradually disappears, and the patient gets used to the implant and it's weight. After the observation period (1 night after anesthesia) the patient can go home with a companion. Arranging home care, and comply with the instructions is the patient's responsibility. Patients are being controlled periodically after the operation. During the consultations we also discuss the post-op treatments like applying massage to prevent contracture, and remind our patients to inform the doctor about any incident regarding the brest and the implant, especially situations like accident, pressure on chest etc..
Possible post-op complications
Like in case of all surgical intervention, breast implants may have side effects that patients need to know and understand. We have to make it clear that implants are not for a lifetime, its duration depends on the type of implant, operation circumstances as well as the patien's tendency and lifestyle. There is no risk-free breast implant procedure. Although it is quite rare, the following complications may occur depending on the type of implantation..
1. Capsular contracture
The body creates a capsule around the entire surface of the new implant. This capsule around the implant may begin to tighten and squeezes down on the soft implant, causing the breast to feel hard. This could happen anytime after the operation even years later, however if it occurs it is usually occurs few months after the operation. This could effect both side, and rarer in case textured implants are used.
The reason of Capsular contracture is not known, preventing takes a lot of attention from both patient and doctor. For prevetion there is numerous theory and technique, however no 100% proven solution so far. In rare cases incision or surgical removal of the implant may be necessary. This is unpleasant, however most patients with this side effect would take the implant procedure again.
Like anything that is filled with a liquid-like material, an implant can also leak, however with a normal everyday lifestyle it is almost impossible, since modern implants are made of multiple layers. The reason for leaking in rare cases when itt happens is accident, old implant or mechanical impact. In case of the the new so-called cohesive gel-filled implants the gel does not get absorbed and can be easily surgically removed and replaced. In case of saline solution implants, the solution is absorbed, causing no harm to the body, and the implant can be surgically replaced.
In case of gel-filled implants it may occur that microscopic gel-drops leak through the layer. These drops can be found in the surrounding tissue, but sometimes can reach other parts of the body too. It is not proven that this would cause capsular contracture or any side effects. The possibility of gel-leaking is significally reduced by the use of modern high-density cohesive gel-filled implants used at our clinic.
In case infection happens the signs (irritation, tightness, pain, fever) are visible soon after the operation. Treatment include antibiotics, or rarely removing or replacing the implant. If the removal of the implant is necessary, a new implant procedure can only be performed after 6 months of recovery.
5. Other complications
• Hematoma or seroma: after the operation or later
• Skin dying:usually cased by intense internal pressure blocking circulation.
• Breast Asymmetry: all surgeon's main goal is to achieve the best symmetry possible, however circumstances like capsular contracture, shifting of implant or posture asymmetry of the patients can cause differences on either side.
• Temporary or permanent changes in the feeling of the nipple or breast
• Shifting of implants: shifting can be caused by mechanical impact or capsular contracture. In case this effects the shape of the breast, further surgery may be necessary .
• Wrinkling of the breast, tangible implant: these problems may occur depending on the type and size of implants, especially when loosing weight.
Other complications are rare but may occur like: silicone sensitivity, bleeding, hematoma, seroma formation, sometimes months after the operation.
Patients with tendency may experience keloid scars, this cannot be predicted before the procedure.
Before a mammography examination, the x-ray doctor has to be informed about the implant as it can be misleading.
Researches about the not known side effects: Besides the above mentioned side effects, there are researches whether a silicone implant can or cannot causebreast cancer or autoimmun illness, especially the mutation of the sorrounding tissues. Some patiens bring on relations between mutation of the sorrounding tissues and the silicone implants. Leading physicians , plastic surgeons, rheumatologists, as well as the American Medical Association emphasize, that there is no scientific proof in this matter. Reserches showed no relations between mutation of tissues and the silicone implants. Other questions include whether the children of mothers with silicone implants can have immunological problems. A recent article shows there may be a relation between childeren's stomach problems and mothers with silicon implants, however the adventages of breast feeding and the wide use of silicon products in pediatrics contradict this assumption. Women with silicone implants who are willing to breast feed should consult their doctor about the newest researches in this matter.
Implants are not for a lifetime, any of the above complications may require the removal of the implant. According to the manufacturers the implant need to be replaced in every 10 years even if no complication occurs, this is the period we guarantee the implant.
Things to avoid after the operation for a few months:
Direct sunlight, sunbed to avoid problems with the healing of the wounds.
Sport activities to avoid shifting of implants.
Effects of the implants has not been examined during pregnancy, in this case cunsult your physician.
The final shape will form only months after the operation , this period of time is needed for the body to sorround and fix the implant. Also this period of time is necessary for the patient to get used to the new situation. Unfortunately after many years a breast with an implant may also become flaccid just like a natural breast, this cannot be evaded. Important to know, that in case the implant getst removed, the breast will not recover its previous form. Meanwhile the tissue and the skin has changed, therefore further operation may be necessary, thet would cause more scars.