Augmentation Mammoplasty

Breast Implant

In this video, I explain some specific points about this surgery; I answer frequent questions generated in the consultation (Spanish version). Watch this short video and contact me to clarify other concerns.

It is a procedure that aims to improve the appearance of the breasts through silicone implants.

Some patients genetically have small breasts and even an alteration in their shape due to a high inframammary fold and a very wide areola called tuberous breasts. In other patients, the volume decreases after lactation or due to massive weight loss. On the other hand, this surgery is helpful in patients who require breast reconstruction due to congenital defects such as Polland’s Syndrome, mastectomies, or gender changes.

Surgery aims to increase the size of the breasts and improve their shape through cohesive silicone gel implants, saline solution, polyurethane or other materials specially designed for this purpose.

AM I A CANDIDATE FOR A BREAST AUGMENTATION?

Candidates are dissatisfied with the size or shape of their breasts or breasts, especially in volume, shape, and symmetry.

HOW IS THE SURGERY PERFORMED?

There are several approaches to the placement of prostheses. These can be placed through the peri-areolar approach, through the lower edge of the areola, by an inframammary incision in which the incision is in the lower fold of the breast and, finally, by axillary in which the prosthesis is inserted through the fold of the armpit. The periumbilical approach has been described, requiring an inflatable prosthesis in saline solution.
Regarding the plane in which the pocket where the prosthesis will be located is made, it can be retro glandular, that is, precisely behind the breast; retro pectoral or submuscular, that is, behind the pectoral muscle; and finally, retro fascial, which places the prosthesis behind the gland, but below the muscle envelope called the fascia. The dual-plane combines these pockets where part of the implant is below the muscle, and another is below the gland. The decision of where the implant will be placed is made according to the quantity and quality of the patient’s tissue after the physical examination and the size of the selected implant.

The surgery takes approximately one to two hours and is usually done under general anesthesia. Pain is controllable with medication, but patients usually complain of engorgement or tightness in the breasts that subsides quickly in the first weeks after surgery.

RECOVERY

  • The patient is discharged on the same day of the procedure and returns home. You must always wear the indicated postoperative bra, only removing it when bathing.
  • Keep relative rest for 48 hours; you must walk and move several times a day to promote blood circulation in the legs and avoid thrombi.
  • Sleep with your head elevated for the first few days to minimize swelling; place 2-3 pillows behind you to help you stay in this position.
  • Avoid lifting heavy objects or carrying small children.
  • Eat a soft diet, mainly broths, fruits, liquids, and light foods, to promote intestinal transit since anesthesia and some prescribed pain medications slow down this process.
  • During the postoperative period, you can perform a rotary massage on your breasts, moisturizing the skin with creams; the way to do it will be explained during the review appointment.
  • It is recommended not to drive a car or a motorcycle during the first week to avoid complications and, above all, the risk of accidents when maneuvering the vehicle.
  • You should avoid strenuous exercise for the first three weeks, including sexual activity. Subsequently, you can progressively start cardiovascular exercise, walking, jogging, bicycling, etc. After six weeks, you can increase the exercise to a higher intensity, such as weight lifting or contact sports involving greater upper limb mobility.

RESULTS

They are visible immediately after surgery; the result is achieved after six months; when the tissues have finished reducing inflammation, the skin adheres to its new position, and the implant is properly positioned in the space created.

FREQUENT QUESTIONS Q&A.

  • Pain: There is tolerable and easily controllable pain by medication, which will gradually decrease.
  • Inflammation: During the first days after surgery, your breasts may feel somewhat inflamed; they will appear purple to a lesser or greater degree depending on the characteristics of your skin, constituting a regular event of surgery due to tissue manipulation. Over the days and weeks, the inflammation will decrease.
  • Return to activities: After the first week, the patient can gradually return to their daily activities.
  • Exercise: Wait three weeks to perform cardiovascular physical activity and six weeks for a more intense workout.
  • Prostheses or implants: They are supplied by the manufacturing or distributing companies; the selection of these is made by the patient and is based on the existing recognition in the market and compliance with the national INVIMA and international standards such as the FDA (Food Drug Administration) or Canadian regulatory agencies. The marketing company or manufacturer guarantees the prostheses and is not the direct responsibility of the surgeon.
    • If you can feel the ribs with your finger, under the breast or on the side of your chest, you can feel the edge of the implant under your breast and on the side of your chest.
    • Currently manufactured implants strive for durability from the outer shell, which has been designed much thicker to prolong the life of your implant. A thicker cover may be more accessible to feel above your skin.
    • If feeling an edge of the implant shell might be a problem, breast augmentation with implants is not recommended.
    • We cannot change the quality or thickness of the fabrics. You will be more likely to feel the implant if you are thin or have very little breast tissue.
    • The larger the size of your implant, the more noticeable the changes in your breast will be over time. A large implant will stretch the tissues over time and may cause thinning and sagging. Your tissues do not improve with age; on the contrary, they will be less able to support the weight of any implant, especially a large implant.
    • Any implant is filled correctly to avoid collapse and possible folding of the outer shell when standing up, which will feel firmer than a normal breast. If the external cover folds, it may fail early and require a new surgery and replacement of the implant.
    • If you want a completely natural chest, it is not advisable to have a breast augmentation with implants.
  • Risks: Review and read the Surgical Risks section in detail, where the most frequent dangers and complications are described in detail in all surgeries and those associated with implants or medical devices.