Breasts have an essential role in woman’s metal and physical identity. Besides the biological function, they play a vital role as a symbol of beauty and femininity. The appearance of breasts is determined by hereditary factors, breast feeding, age and the content of the mammal gland. Before the size and shape of breasts is changed, physical and aesthetical aspects have to be considered. Sometimes breasts are not of the same size or shape. Before breast enlargement several measuring procedures have to be carried out to design the size and shape of breasts according to the client’s wish. Breasts have to look beautiful and natural under any angle. The goal is a perfect result. Breast enlargement operations are performed on women of full age.
We use different breast prostheses of which the patient chooses the most suitable one. The most widely used are Nagori (http://www.nagor.com) and Natrelle (http://www.allergan.com) prostheses.
The patient’s expectations and the possibility to achieve them are discussed. Patient’s health, primarily diseases related to breasts, and used medication are discussed. The need for pre-surgery breast examination (mammography) is decided individually.
The patient’s examination includes the x-ray of the chest and the mammal gland (asymmetries, sagging of breasts, placement of the nipple area), and the evaluation of skin quality. Photos of the patient’s breasts are made and included in the medical history. Finally measuring of breasts is carried out in order to choose the proper implants for the patient; also the location of the incision (later the place of the scar) and the placement of the prostheses in relation to the mammal gland are planned.
How is the operation performed?
When the patient arrives in hospital, she is guided to the ward. Before the operation the surgeon describes the operation and the expected final result. The locations of incisions are drawn on the patient’s skin. During the breast enlargement operation the incision is made in the tuck so that the scar is less visible. The incision may be performed also in the area of the breast areole or under the armpit. The chosen implant is inserted into the breast through the incision. The wound is stitched in three layers; the stitches of the skin in the upper layer are removed later. The wound is covered by plaster and bandages. The operation is performed under general anaesthesia supervised by the anaesthesiologist. The procedure lasts for about two hours. After the operation the patient wakes up and is supervised by the anaesthesiologist and a nurse. If necessary, painkillers are applied. The patient remains in hospital for the first 24 hours under the supervision of the nurse. Pain experienced after the operation is not unusual. It may occur in the operated area, be short-term and easily alleviated by painkillers. During the first day wide bandages support the breast, after that the wound is covered by plasters. Next day after the operation the surgeon examines the patient and gives recommendations for the further care of breasts and wounds. 7-10 days after the operation stitches are removed from the wound. The procedure is fast and painless. For a month the patient has to wear a supporting bra for day and night.
Depending on the nature of work, a 1-2 weeks’ recovery period is required after the operation. The family doctor issues the sick list to the patient. Gym, aerobics and other sport events, which may affect the recuperation of breast, should be avoided for about a month. Lifting heavy weights and hard physical work, the sauna and the solarium should be avoided. Swelling and haemorrhages may occur after the operation but they disappear within three months. The wounds heal within six months.
The main reason for the replacement of implants used for breast enlargement is the encapsulation of the prostheses. Transplants are replaced also when the exterior appearance of the breast changes. Breasts may sag and lose the shape due to aging, pregnancy and breast feeding. After the operation folds may appear on the breast, the shifted transplant may cause asymmetry, the size and shape of the breasts do not correspond to the patient’s expectations, the implant may be palpable through the breast, the scar may be deformed and scarring may be uneven. It is always not possible to avoid risks even if the surgery technique is perfect. The majority of changes, which accompany implantation, are irreversible. If the patient wants to have the transplant removed and not replaced by a new one, breasts may become sagging, wrinkled, folded and pleated. Infections after the operation may occur within a couple of days or a week. Infections may occur at any other time after the surgery as well. If antibiotics used for the treatment are not effective, it is probable that the implant has to be removed. Very seldom the toxic shock syndrome, including symptoms like fever, nausea, diarrhoea, fainting, dizziness or rush resembling sun burn, is also possible. In such case immediate medical attention is required. Haematoma/seroma is a complex of blood/body fluids around the implant. They may cause inflammation and /or hardening of connective tissue around the transplant. Swelling and painfulness may also occur. Haematoma is usually visible right after the operation, but sometimes may develop also later as trauma consequence. Later prostheses may hinder the results of mammography required for diagnosing breast cancer. Transplants filled with isotonic solution may leak due to an open or damaged flap or shell. The implant filled with silicone gel is solid and does not leak that easily.