Since the earliest times of history, the breast has been an important symbol of fertility and femininity. A proper shape, symmetry and full breast structure brings not only physical health but also happiness in social life for every woman. Psychological traumas such as embarrassment, social phobia or depression are inevitable for every woman who has an underdeveloped or underdeveloped breast tissue for various reasons. Thanks to the developing experience of plastic surgeons and the contributions of technology to medicine, eliminating the deficiencies in breast tissue is no longer a big problem today. For more than 50 years, millions of women around the world have had breast augmentation surgery and continue to do so. Of course, high patient satisfaction is what keeps breast augmentation surgeries among the most frequently applied interventions today.
Appropriate Patient Profile
Patients with underdeveloped or underdeveloped breast tissue, who have lost their volume at the end of pregnancy and breastfeeding, or who have significant asymmetries between both breasts are suitable for this surgery. Completing breast development physically and reaching sufficient maturity psychologically are important in determining the age limit. Therefore, this surgery is not recommended for women under the age of 18.
Prostheses, which have been used since 1963, have undergone a great evolution in terms of both diversity and reliability with the developing technology. Problems such as bursting and deterioration of prostheses are left behind. Today, prostheses are placed in 3 different planes: submuscular, submammary and dual plane (muscle and under the breast). Breast prostheses are divided into various classes such as content (silicone gel, saline), surface condition (flat, rough), shape structure (anatomical, round). In addition, there are different length, volume, projection, etc. values specific to each type of prosthesis. The patient’s wishes, breast structure and surgeon’s experience are the most important criteria in choosing the right prosthesis and determining the placement plan.
Two different options have come to the fore as an alternative to prostheses, which are the standard method for breast augmentation today. These are the options; Injection of adipose tissue obtained from the patient’s own body or fillers (hyaluronic acid) produced by different companies. Both methods have their own advantages and disadvantages. Although these techniques are developing, their usage areas are still limited.
After a suitable disease history and physical examination, a roadmap for surgery is drawn, such as the shape, volume, placement plan, operation process, and additional procedures of the prosthesis. Conditions that may pose an obstacle to the operation are inspected by the anesthesiologist, and necessary blood tests are performed. In case of chronic diseases that may affect the surgery, additional examinations or consultations may be requested. If any blood thinners are used, they should be discontinued at least 1 week in advance. Smoking may impair the wound healing process in some patients. There is no need to discontinue drugs used for other chronic diseases.
Breast augmentation surgery is performed in a hospital environment and under general anesthesia. It takes an average of 1- 1.5 hours. Prostheses can be placed in 3 different areas such as inframammary fold, nipple and armpit, depending on the frequency of preference. The most preferred method in terms of correct placement of the prosthesis, safety and long-term scar aesthetics is the inframammary fold. During the operation, thin tubes called drains can be placed temporarily to evacuate excess blood.
After the operation, food is eaten at the 4th hour and the patient gets up from the bed and starts walking. The patient is discharged on the same day or 1 day later. Pain is more prominent especially in prostheses placed under the muscle. The painkillers used provide sufficient help for the first 3 days when the pain may be most intense. The patient can be washed after 1-2 days. There may be some edema and a feeling of pressure in the breasts, it will pass in about 2 weeks. The patient can return to his daily life within the same week. Athlete style printed bras can be used for the first 2-3 weeks after the surgery. Light exercises can be done easily after the operation.
Of course, every surgical procedure has its own complications. Although these are rare, they should be explained to the patient by the physician for the purpose of informing the patient. There are alternative solution options for all of the early and late complications that may develop. Temporary problems; loss of sensation, tenderness, pain, early problems; bleeding, infection, delayed wound healing, long-term problems; capsule contracture, asymmetry and aesthetic problems.
The use of new generation prostheses used in recent years is life-long. You can use it without changing it, as long as psychological or physical reasons such as removing the prosthesis, replacing it with a larger or smaller prosthesis, and chronic complications do not occur.
Breast Augmentation and Pregnancy
Breast prosthesis does not affect pregnancy or breastfeeding function during pregnancy. It does not have any side effects on the baby. However, multiple pregnancy and breastfeeding processes may cause some sagging in the breast tissue due to hormonal irregularities.
Breast Augmentation and Cancer Risk
There was no significant difference in the lifetime risk of developing breast cancer in women who had breast prosthesis surgery compared to women who did not. Prostheses are therefore not a risk factor for the formation of breast cancer. Today, silicone breast prostheses are widely used in all countries of the world. However, all women, with or without a breast prosthesis, should have regular screenings for breast cancer. Prostheses do not constitute an obstacle for imaging such as mammography, ultrasonography and MR for breast cancer screening.