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    Breast Fat Grafting
    17 April, 2017

    Closeup portrait, plastic surgery doctor drawing line on patient breast augmentation implant

    Breast Augmentation with Implants


    If you're considering breast augmentation...

    Breast augmentation, technically known as augmentation mammaplasty, is a surgical procedure to enhance the size and shape of a woman's breast. By inserting an implant behind each breast, surgeons are able to increase a woman's bustline by one or more bra cup sizes.

    Introduction

    Breast augmentation (enlargement) is designed to increase the size of the breasts and also improve their shape by the insertion of an implant beneath the breast tissue. Breast augmentation is suitable for women who have naturally small breasts or where there has been shrinkage in size following a pregnancy or weight loss.
    This operation aims at producing a natural shape which enhances cleavage and will improve your figure by balancing the hips and therefore emphasizing your waist.

     

    Breast implants rely on a silicone shell (the outer part of the implant) and a filling which is usually silicone gel. Dr. Freschi only uses cohesive silicone gel filled implants which do not leak if. The size of your new breasts depends on your personal choice but it is always recommended to stay within reasonable limits for your height, build and body weight. The decision regarding size will be carefully considered when you visit Dr. Freschi for a consultation.

    How long do implants last?

    Recent developments in silicone technology have produced cohesive silicone gel which is the most advanced silicone implant available. Rather than being a liquid this is a solid gel which has the same consistency as jelly at a children's party. After many years of wear and tear should any cracks develop these implants would not leak as the silicone is in a solid form. The additional protection provided by the body's natural "biological bag" will prevent harmful leakage outside the implant.
    In order to have a proper assessment of the state of your implants it is advised to have your implants examined by a specialist on a regular basis from about 10 years after your operation.

    Where is the implant placed: In front of or behind the muscle?

    Breast implants can be placed in a pocket either in front of the chest muscle (referred to as the subglandular pocket as it lies directly under the breast itself) or behind the chest muscle (referred to as submuscular).

    However in some very thin women with little or no breast tissue if the implant is placed in front of the muscle it would only be covered by skin and not much else. In this instance to place the implant behind the muscle will look better as it will have a more natural slope in the upper pole. The exact placement of your implants will be carefully discussed with you at your consultation.

    Can breast enlargement help to lift breasts which have dropped?

    Although a degree of lifting can be achieved with implants alone, in the event that the skin of the breast has stretched to the point where the nipples have dropped significantly it may be necessary to reposition them upwards by means of an uplift or mastopexy. It is not often that this is required and most women achieve an excellent shape with just implants alone, however if Dr. Freschi feels that a natural shape can only be achieved with an uplift as well as an implant he will discuss this with you in detail.

    Will breast implants interfere with breast screening?

    Accurate mammograms can still be performed after breast enlargement even though implants are opaque to x rays. A special manoeuvre (Eklund) has been developed to allow the breast tissue to be x-rayed around the implant. This allows accurate mammography without loss of accuracy compared to women without implants so please inform the radiographer at the time of your x ray about your implants.

    What happens if I get pregnant after I have breast enlargement?

    Breast implants do not interfere with breast feeding but care should be taken to maintain the shape achieved by the surgery. If pregnancy should occur particular care should be taken in supporting the breasts in order to maintain the best possible shape subsequently. This is achieved by wearing a supportive bra day and night during pregnancy and also whilst breast feeding to provide constant support. If you can limit breast feeding to three months or less this will also reduce the stretching of your breasts and therefore preserve your shape.

    What happens at the consultation?

    At your initial consultation, Dr. Freschi will evaluate your general health and chest, and explain which surgical techniques are most appropriate for you. For instance, if your breasts are sagging, he may also recommend a breast lift although a degree of lifting is achieved by the insertion of a breast implant alone. After discussing the proposed surgery Dr. Freschi will give you an idea of your new look using sample implants which are helpful in deciding which size will suit you.

    How do I prepare for surgery?

    It is important to avoid taking any Aspirin or products containing Aspirin for 2 weeks either side of the operation since Aspirin has an adverse effect on bruising. While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days at home, if needed.
    If you are a smoker it is helpful to stop for two weeks before surgery and for a week afterwards so as not to restrict the circulation to the skin.

    Where will my surgery be performed?

    The surgery is usually performed at a clinic in the city of Buenos Aires where Dr. Freschi works with in Plastic and Aesthetic Surgery. You will usually be admitted on the day of surgery.
    You will need a friend or relative to accompany you home when you leave hospital after surgery.

    What type of anaesthetic will be used?

    Breast augmentation can be performed under a local plus sedation or general anaesthetic, so you'll sleep through the entire operation.

    What does the operation involve?

    The method of inserting your implant will depend on your anatomy and Dr. Freschi´s recommendation. The incision is usually made below the nipple where as it is well hidden.

    Following this the incisions are stitched in several layers to protect the implant and external strapping is applied which you will need to keep in place for two weeks as it provides extra support for the breasts during this period. The whole operation takes over two hours.

    What happens after the operation?

    After surgery the breasts will be tender and slightly swollen for a few days and it is advisable to limit arm movements and take the painkillers which you are prescribed. Most women can drive by the fourth or fifth day after surgery and return to work after a week to ten days.

    You will need to keep the strapping applied by Dr. Freschi during the surgery in place for 15 days and wear a supportive bra over this.

    There may be changes in the sensation of the nipple and breast which are temporary. It is fairly common for the skin above the incision to feel somewhat numb for 2-3 months but this improves spontaneously. Some patients describe increased sensation or sensitivity which again is a result of the stretching of the breast tissue and its nerves. If this occurs it may last for 2-3 months before returning to normal.

    What are the risks?

    It is important to stress the possibility of risks but in practice these are rare and breast enlargement is one of the most reliable of all cosmetic surgery operations.

    • Excessive internal bruising (haematoma) occasionally occurs and may require removing some stitches to wash out the bruising from beneath the skin. This has no effect on the long term outcome of surgery.

    • Infection is rare because routine antibiotics are given following surgery. If infection occurs despite this, then the implant may have to be removed although after the infection is treated a new breast implant can usually be put in.

    • Changes in the sensation of the nipple and the breast (either an increase or a decrease) can occur following breast augmentation, but these are usually temporary.

    • Occasionally hardening of the implant may develop due to scar formation.

    This problem occurs in about 3 - 4% of women undergoing breast. The exact cause of this problem is not fully understood but may be due to the body's sensitivity to the otherwise inert breast implant. This hardening can occur months or even years after surgery. If this condition is severe more surgery may be needed in the future to remove the capsule and replace the implants.

    Dr. Andrés Freschi