Frequent questions and concerns about breast augmentation with silicone implants.
It is no coincidence that it is one of the most popular plastic surgery procedures. The breast is a reference point for the femininity of the female body and its size is genetically predetermined.
Many women are bothered and want to change their image because their breasts are small (micromastia) or there is asymmetry between the two breasts (anisomastia).
In other cases, the breast may have changed significantly in size and shape after major weight changes, pregnancy or breastfeeding, or in women who have undergone mastectomy and tend to develop an image with strong signs of inferiority of their personality due to this specific anatomical deformity.
A woman can undergo breast augmentation surgery after reaching adulthood, at the age of 18. There is no age limit for breast augmentation.
Silicone is a synthetic material that comes in the form of a viscous liquid (gel) or a solid with an elastic consistency. It is biologically inert and completely safe.
It has been used in medicine since the 1960s for the manufacture of many implantable medical materials and extensively in the cosmetics industry.
The silicone originally used to fill the implants was quite fluid, but now the implants contain a cohesive silicone gel – Cohesive gel.
There are 3 different degrees of cohesion, with grade 3 being the highest and most stable, helping to maintain shape. Anatomical silicone implants contain grade 3 cohesive gel – Cohesive gel 3.
Implants are distinguished according to their casing into silicone implants or polyurethane implants.
They differ in relation to their content in silicone implants and saline implants.
There are also permanent implants that combine silicone and a saline dilator on the surface (double lumen- Becker).
The main differences between silicone implants lie in their shape, texture, silicone gel composition, and projection (the projection profile) and not in relation to their degree of safety.
Silicone implants are distinguished according to their shape into round and anatomical (drop-shaped), according to their surface into smooth and rough surface, according to their material into soft and cohesive silicone, according to their profile into high, medium or low profile.
Those that have been approved by the US Health Agency (FDA approved breast implants) are considered safer. Manufacturing companies offer a lifetime guarantee for the latest generation implants.
The final choice of implants and surgical technique is made on a personal level and depends on the wishes and anatomical particularities of each patient.
In any case, women who have any type of implant should keep the label with the serial number of their implant as part of their medical record.
An important point of any preoperative assessment, in addition to the necessary examinations, is the performance of a mammogram or breast ultrasound.
This examination ensures the patient is free from any undiagnosed breast diseases, but also offers appropriate images for subsequent comparative study.
It is generally recommended to stop taking vitamin supplements, smoking and alcohol, and of course aspirin, 1-2 weeks before and immediately after surgery.
A healthy diet contributes to a better and faster recovery.
The access and consequently the incision, regardless of the location chosen (inframammary fold, areola, armpit), does not exceed 4cm in length.
The inframammary approach is generally preferred, because it achieves the most satisfactory aesthetic result, without interfering with the function of the mammary gland (breastfeeding).
The surgery is performed under general anesthesia or neuroleptic analgesia and lasts approximately 1 hour.
The main part of the surgery is the creation of a special pocket behind the breast where the implant will be placed.
This pouch can be created either directly behind the mammary gland or below the pectoral muscle, or under the fascia of the muscle, or even using the dual plane technique.
Choosing the most appropriate location for implant placement depends on many factors and is completely individualized.
Anatomical silicone implants follow the “golden ratio” of 45:55, 45% of the breast volume is above the nipple and 55% below it, thus giving a more natural result.
In patients when the skin envelope is thin and the chest is not covered by enough subcutaneous fat (small or “empty” breast), the use of anatomical implants beneath the pectoralis major muscle or its fascia or even the dual plane technique is indicated, because the coverage offered by the skin envelope is considered insufficient to cover the implant.
As already mentioned, the entire procedure takes approximately 1 hour and you can go home the same afternoon or the next day.
The sutures are internal and absorbable.
The first change will be made the day after the surgery.
The result is usually immediately visible, while the sensation and texture of the breast gradually improves within the first two months after the surgery.
Postoperatively, the use of a comfortable, underwired bra (sports or nursing bra) is required for approximately one month.
Initially, swelling is observed, which gradually subsides and the breast takes its final form after 2 months.
Serious complications are not common, but as with any surgery, breast augmentation does have its risks.
They are mainly associated with concomitant diseases such as diabetes, cardiovascular and respiratory problems, as well as with smoking or taking certain pharmaceutical substances.
The placement of the implants is done based on the new global guidelines regarding surgical technique (“14-point-plan”), with the aim of minimizing the possibility of complications related to the operation.
Breast Augmentation is a routine procedure and is completely successful for the vast majority of patients.
However, as with any surgical procedure, it is very important to understand that there is a possibility of complications.
The possible complications that may arise, fortunately rare:
In all patients who have a foreign body placed, such as a silicone implant, the body recognizes it and encases it by creating a membrane of fibrous tissue around it, called a “capsule”.
In the majority of patients, the capsule remains as a thin and soft layer.
In a small number of patients and for specific reasons, the capsule becomes thick and shrinks, resulting in the breast becoming hard.
This can lead to breast deformation as well as mild or severe discomfort and pain.
The treatment for the problem is surgical removal of the capsule and replacement of the implant.
The rickets capsule rarely occurs during the first years, but may affect 10% of patients after the first decade.
You can move around freely from the first day after the surgery.
Return to light work is recommended after 5-7 days.
You should not make any sudden movements, no weights, no driving for 2-3 weeks.
After the first three weeks, the patient can return to all her daily activities without any particular restrictions.
Sexual activity is also not allowed for at least a week.
There is no risk to a woman’s health after breast augmentation surgery associated with the use of silicone implants.
At times, silicone implants have been accused of causing various diseases, but extensive scientific studies conducted in recent years on hundreds of thousands of women have shown no association with any disease between silicone implants and autoimmune or other systemic diseases, neither for the women themselves who have silicone implants nor for their breastfed children.
The US Food and Drug Administration (FDA) has, in recent years, been investigating the association between certain types of breast implants and a rare form of non-Hodgkin lymphoma, anaplastic large cell lymphoma (ALCL).
Currently, the data is under evaluation with certified cases being very rare (approximately 1 in 30,000 operations) and the majority of them being curable.
Before you decide to have breast augmentation, you should think about exactly what your expectations are from the surgery and discuss with the plastic surgeon whether they are realistic or not.
You should also be informed about the implants that will be used and understand the benefits and risks of the procedure.
The incision is described as a thin red line under the breast or on the areola, and its quality depends on the skin type and proper adherence to postoperative instructions. It usually becomes inconspicuous over time.
Breast implants carry all certifications (FDA, CE), have no expiration date, and companies provide a lifetime guarantee on the breast implants they provide.
However, a woman may choose to change them after a few years, due to age or pregnancy.
A hospital stay is usually not required unless the doctor determines otherwise in each case.
The cost of breast augmentation surgery is determined by the type and quality of the implants.
During the medical visit, it is suggested, depending on the somatometric characteristics of the interested party (height, chest circumference, existing breast), her needs and expectations, whether the implant to be selected will be anatomical (“teardrop” shape) or round, with a rough or smooth surface.
The price of a breast augmentation, in addition to the above factors, also depends on whether a breast lift will be needed at the same time.
The final cost of breast augmentation surgery is determined during the medical visit, which covers all expenses (preoperative examination, doctor’s fee, operating room costs, hospitalization, postoperative care) except for the extension of hospitalization if the patient wishes.
