Breast Augmentation

Brief Information Regarding Breast Augmentation:
There are two frequently asked questions:
'Is silicone causing cancer?' and 'Will I be able to breastfeed my child in the future?'
First we have to answer these mostly asked questions before we start to define the procedure.

Silicone Is Not Causing Any Cancer And Is Not An Obstacle For Breastfeeding!
There is a wide variety of methods and the appropriate one will be decided together with the patient according to (1) the way of insertion (2) the kind of the implant (3) the placement to choose.

(1) There are three incision types to insert the implant. These are applied to the breast crease, around the nipple, or to the armpit.
(2) The implants may be shaped round or anatomical, be filled with gel or saline, and may have a textured or smooth surface.
(3) The implant may be inserted in two different locations, which are over the muscle (subglandular) or under the muscle (subpectoral). After the operation you may stay for one night at the hospital or may immediately discharged. In 3-4 days after the operation the patient can go back to normal life. The patient is advised to avoid extreme arm movements for at least a month.

Detailed information;
Things to know about Breast Augmentation Surgery:
Women complaining from the small size of their breast due to developmental reasons, weight loss, or postnatal changes are good candidates for breast augmentation surgery. In case of an application for breast augmentation surgery a detailed interview and a complete physical examination is of great importance. 

The main purpose of this interview is to discuss in details about your expectations, things we can do to match your expectations, and to inform you about the advantages and disadvantages of different methods and implants. Your skin type, the recent conditions of your breast tissue, the shape and location of your nipples, the strength of your muscles, your general habits of life and sports are very important to specify the most appropriate procedure method for you.

Basically you have to discuss the following things:
What cup-size would mach your expectations?
The size, type, and form of the implant
Which procedure type you prefer
Whether the implant will be inserted over or under the muscle

Your body type, height, shoulder and chest size, and certainly your expectations will determine the size of your breasts. Your doctor will set you a range of various sizes according to your body style; from which you can choose the most satisfying size. We have to say that there are also some limits and to force these limits will result in an unnatural outcome and a capsular contracture possibility, which we will talk later. 

Your physical examination will show us which implant will be the most proper one for you; there are two widely used and reliable implants. The first one is an implant filled with silicon gel, and the other one is filled with a saline solution. Both of these implants have a silicon cover, but are filled with different liquid solutions. The differences between these implants are as follows: while Silicon gel filled implants are similar to real breast tissue with regard of appearance and consistence, saline solution filled implants are more diluted and loose. This disadvantage of saline implants is partly covered when inserted under the chest muscle. We prefer to insert saline filled implants under instead of over the muscle layer. The continuity of both implants is protected unless they are bruised by a sharp object. Some investigations claim that 10% of the volume of saline filled implants get lost within the first 6 months after the surgery. Besides the content of the implant you can also choose the shape of it. We can decide between round and anatomic shaped implants according to the shape of your chest and your expectations. The only difference between these two shapes is that anatomic shaped implants are giving a little less filling effect to the upper part of the chest.

There are three basic insertion locations for the implants. Although there is a fourth way of insertion described in the medical literature, which is performed through an incision at the umbilicus, this method is not noteworthy with regard to implementation and outcomes. Your doctor will describe the advantages and disadvantages of the three insertion points which are the breast crease, around the nipple, or to the armpit in detail and decide together with you which one to choose according to your bodily specifications.

There are two choices of insertion of the implant:
These are behind the breast tissue or behind the muscle layer under the breast tissue. In cases where the skin is very thin or the breast tissue is insufficient, the muscle layer is a good choice to cover the implant.  Furthermore, if the breast is slightly sagging and will be corrected without any additional method but the insertion of the implant, the more appropriate option is to place it behind the breast tissue. In excessive sport performers the insertion behind the breast tissue is preferred. But if a saline implant is chosen, the more correct insertion point will be under the muscle layer. Cases in which more than one factor has to be respected are quite frequent and decisions have to be made patient oriented.    

Preoperative Preparations, Operation Phase and Beyond
The basic outlines of what to do after the decision for the operation are as follows;
Avoid the use of Aspirin or Aspirin containing drugs at least a week before the procedure.
Don't eat anything at least six hours before the procedure.
Take a shower a night before the procedure or the same morning.
Prepare a comfortable and front buttoned clothing to wear after the procedure.
Prepare a sports bra in the size your doctor ordered.
Have your regular drugs present.
After all these preparations are done, appear at the hospital on the assented time, to undergo some laboratory investigations and anesthesia examination. As a last step a final planning and drawing in your room right prior to the operation will be made. At the same time photos from your breasts will be taken (your face will not appear) and inserted into your file to make some before-after comparisons.

The operation will be performed under general anesthesia. When you wake up, you'll wear a surgical bra over gauze dressing. A suction device called a drain catheter will be inserted at the operation into the area of the prosthesis, to remove small amounts of fluid collections after the operation, which will prevent a lot of postoperative complications. This device will be removed in 24-48 hours after the operation.

Your stay at the hospital is only a day. For operations performed in the morning you can be discharged the same day.

The first two days after the operation your breasts will be slightly swollen. We recommend getting some rest and recuperation throughout these two days. Reducing arm movements will help you to decrease the pain. From the third day on the swellings will start to reduce, your arm movements will be easier, and you can go back to daily life.

After the operation, you'll have to take antibiotics and a pain reliever (except Aspirin or Aspirin containing drugs) for 5 days.

On the 3rd or 4th day after the operation the bandage bra and other gauze dressings will be removed and you can start taking a shower only with a thin strip over the incision line. This strip and stitches, if there are any, will be removed on the 12th to 14th day. During this period you have to take 100 mg of vitamin E daily and to apply the prescribed massage.

You can start with heavy sportive activities after the 3rd week.

Complications and Frequently Asked Questions:
Every surgical intervention including anesthesia has various complications. We spend maximum effort to prevent these complications especially in aesthetic surgery. These operations are not obligatory. They are performed to improve the quality of life and the bodily image of the patient. Therefore, our main philosophy is to spend attention, caution and being selective as much as possible in every respect.

For patients older than 40 years a mammography is obligatory. If there is a diagnosis of a mass in the breast, the mammography is obligatory for any age. A blood count and coagulation tests are also obligatory and will be completed with an anesthesia examination.

Sterilization and preventive antibiotic therapy will be applied with extreme attention regarding the possibility of an infection.

Except the preoperative coagulation tests, a strict bleeding control are performed during the operation and a blood drain will be inserted for security reasons.

Besides the complications mentioned above, there are some special complications of breast augmentation operations:
Although all operational rules were obeyed there is a possibility of 3-5% of encountering a capsular contracture of the breast implant. This is easily explained a hypersensitivity reaction of the body against the implant. It is a scar tissue that forms around the implant which causes the breasts to harden (similar to what a contracted muscle feels like) as the naturally forming scar tissue around the implant tightens and squeezes it. This will lead to an unnatural appearance and partially to pain of the breast.

The most appropriate treatment for capsular contracture is complete capsulectomy, or removal of the entire thickened capsule surrounding the breast implant. This is the most likely procedure to prevent future recurrent capsular contractures from forming. While capsular contracture is an unpredictable complication, it is also the most common complication of breast augmentation. Even so it is a rare situation and usually seen in the first 6 months after the operation.

Numbness of the nipples is not frequent. Generally it is a temporary feeling, but it has been reported that in 5% of cases permanent numbness can occur.

A breast implant is not a contraindication for pregnancy or your ability to breast-feed, since milk ducts and nipples will be left intact. But it is recommended not to be pregnant at least for 6 months after the operation, because the recuperation period of the breast tissue will last. The pregnancy and postnatal period usually has a disfiguring effect on the breasts, and it is not predictable how much the breasts will be affected. The implant itself has neither a disfiguring nor a protective effect on the breasts during or after the pregnancy.

In conclusion breast augmentation is a dramatically effective method. All used materials are experienced for years in medicine and are usually adaptive to the body. Even so the patient has to know that there is a foreign body used to augment her breasts, and although not frequent complications can occur.

After the operation, you will receive a medical report including technical and medical details of the operation. It will be reasonable to hide this report for later consultations. For further questions please don't hesitate to contact our center. Aesthetic is both a scientific and artistic matter, and aims to protect your health and beauty together.