The breast augmentation is one of the most demanded cosmetic surgeries nowadays, with more than 300,000 proceduresmore than 300,000 procedures are performed each year in the United States alone.
The breast is an ectodermal gland whose function is the secretion of milk to nourish babies during lactation. On the other hand, it has great erotic and aesthetic importance.
The basic components of the breast are glandular tissue and adipose tissue, their composition being variable and determined by external and internal factors such as age, genetics, weight, pregnancy, lactation, hormonal changes, etc.
In young people, the skin is usually smoother and more compact, with good parenchymal and fat support. With age, it loses firmness, becomes thinner and loses support, especially around the areola.
The first steps before having a breast augmentation.
The breast augmentation is a procedure that has to be individually planned and considered.The procedure is performed according to the individual characteristics of each patient (anatomy of the breast and thorax, quality of breast tissue, type of breast, skin condition, patient preferences, etc.), also involving the patient in the decision making process.
The patient’s height, complexion, chest and hip width, existence of thoracic asymmetries, pectus excavatum, pectus carinatum, scoliosis, etc. should be evaluated. All these pathologies influence the result of our intervention, and therefore a thorough analysis and a great planning of the surgery must be done. The type of breast parenchyma, the quality of the tissues, the elasticity of the skin, whether the patient has been breastfeeding, etc., must be evaluated. Finally, the position of the submammary fold must be analyzed, to see if it is defined or not, and the position and shape of the areola, to see if it is hypertrophic, hypotrophic, symmetrical, and located at an adequate height, or on the contrary “ptosic” or drooping.
In the preoperative preoperative interview DraVillaverde will explain several fundamental aspects of breast augmentation and will advise you taking into account your individual particularities in order to establish the surgical plan that meets your expectations without putting your health at risk.
How is the breast augmentation operation and its postoperative period?
As for the is performed under general anesthesia and always in an operating room.. Asepsis and antisepsis precautions must be taken because in this procedure prostheses, which are after all a foreign material, are implanted in the patient’s body. The intervention has a The patient generally remains in the hospital until the following day..
It is necessary to wear a sports bra for the first few weeks after surgery, even when sleeping.. Efforts with the arms should be avoided during the first two weeks and the patient should take the painkillers needed during the postoperative period.
In the revisions after the intervention, you will be given the management guidelines that you will have to follow.
The breast prostheses do not interfere or pose a difficulty in the detection of breast cancer.In addition, mammography screening can be performed following the screening guidelines proposed for all women between 45 and 50 (depending on the autonomous community) up to 70 years of age. In certain population groups at risk (BRCA+ gene, family history, etc.) it is recommended to start screening earlier.
Before and after photos of breast augmentation surgery
What is considered when performing a breast augmentation?
Specifically, the elements to take into account in a breast augmentation operation are:
- Implant size
- Prosthetic and flat pocket
- Type of implant
- Position of the submammary fold
- Incision for surgical approach
Implant size
It will depend on the individual characteristics of each patient (width of the breast base, symmetry between the breasts, sternal fork-nipple distance, amount of breast tissue available…). It is important when selecting the size of the implant, that the size is not excessive in relation to the characteristics of the fabricIf the size is excessive, the mammary glandular parenchyma will become thinner, the skin will stretch… all of which could cause the appearance of depressions and deformities in the thoracic wall. Sometimes the edge of the implants can even be seen, becoming visible, a deformity called “rippling”, in cases where breast tissue coverage is deficient.
Prosthetic and flat pocket
Depending on the position where the prosthesis is placed, it can be a subpectoral pocket (under the pectoral muscle), subglandular (under the mammary gland, just above the pectoral muscle), subfascial (the prosthesis would be covered by the fascia of the pectoral muscle and the gland), or in dual plane (the prosthesis is covered in its upper part by the pectoral muscle, and in the lower area by the gland). The plane that offers the greatest advantages and quality of long-term coverage is generally the dual plane, since it provides good coverage of the prosthesis, without problems of contour and visibility of the prosthesis, with low incidence of contracture and without distortions due to pectoral contraction.
However, the surgeon will advise each patient according to his or her characteristics as to which plane is indicated or most advisable in his or her particular case.
Type of implant
There are several options on the market: with smooth or rough coating, round or anatomical shape, and made with cohesive gel or serum fillers. Each implant has advantages and disadvantages depending on the case in which they are used.
⇒Coverage: Textured prostheses tend to make a more robust capsule and prevent rotation of the prosthesis. The rate of capsular contracture is similar for both types of prostheses in the dual and subpectoral plane, while smooth prostheses have a higher rate of capsular contracture in the subglandular plane.
In recent times, smooth prostheses are again being used as the first choice in simple augmentations, partly also because of the emergence of an extremely rare but serious disease: anaplastic giant cell lymphoma, which is associated with textured prostheses and whose incidence is about 1 case per million of patients operated on.
⇒Shape: as for the shape of the prosthesis, it can be round or anatomical. Round prostheses are generally the most commonly used option in simple breast augmentations, leaving anatomical prostheses for cases with some deformity, tuberous breasts, or other disorders that make it necessary to give shape to the breast, in addition to volume. Anatomical prostheses are generally the most commonly used for breast reconstruction.
⇒Filling: finally, the filling of the prostheses can be cohesive gel or simply saline.
- The saline solution allows the introduction of the prosthesis through remote approaches such as the axilla, navel, etc. A disadvantage of the prosthesis with saline filling is that the palpation of the breasts with this type of prosthesis is not so natural, and also have a higher incidence of rippling or appearance of wrinkles and folds especially at the neckline; on the other hand with this type of prosthesis there are higher rates of rupture (and as a consequence a sudden loss of the entire volume of serum contained in the prosthesis, serum that is reabsorbed by the body itself, and the consequent alteration of the shape of the breast).
- Cohesive gel prostheses are increasingly improved and the cover and components are subjected to several studies that guarantee their durability. In case of rupture the gel does not migrate out of the breast, it usually remains in the periprosthetic space and contained within the mammary capsule, without an evident alteration of the breast shape in most cases.
4. Position of the submammary fold
It is important to analyze the position of the submammary fold, sometimes it is necessary to readjust it to give a proper shape to the breast and avoid postoperative complications such as “double bubble” deformity.
5. Surgical approach (incisions)
The surgical approach or incision is the area through which the breast tissue is accessed and the prosthesis is introduced; precisely the area where the scar will remain. The approach can be inframammary (at the level of the submammary fold), periareolar, and less frequently, axillary, or transumbilical.
The inframammary approach is the one we prefer in cases where it is possible, since it does not distort the gland, it presents the least risk of prosthetic contamination by avoiding contact with the galactophores, and the scar is in an inconspicuous area with very good healing.
As with the previous items, each option has its advantages and/or disadvantages, as well as specific indications, so a thorough examination of the patient is necessary in order to make the best recommendation.
The operation and postoperative care
The procedure is performed under general anesthesia and always in an operating room. Asepsis and antisepsis precautions must be taken because in this procedure prostheses, which are after all a foreign material, are implanted in the patient’s body. The procedure lasts approximately 1 hour and a half, and the patient is usually admitted to the hospital until the following day.
A sports bra must be worn for the first few weeks after surgery, even when sleeping. Efforts with the arms should be avoided during the first two weeks and the patient should take the painkillers needed during the postoperative period.
In the revisions after the intervention, you will be given the management guidelines that you will have to follow.
Breast prostheses do not interfere or pose a difficulty for the detection of breast cancer, mammography controls can be performed following the screening guidelines proposed for all women between 45 or 50 (depending on the autonomous community) up to 70 years of age. In certain population groups at risk (BRCA+ gene, family history, etc.) it is recommended to start screening earlier.
How is a breast augmentation operation evaluated?
The breast augmentation is a procedure that has to be individually planned and considered.The procedure is performed according to the individual characteristics of each patient (anatomy of the breast and thorax, quality of breast tissue, type of breast, skin condition, patient preferences, etc.), also involving the patient in the decision making process.
The patient’s height, complexion, chest and hip width, existence of thoracic asymmetries, pectus excavatum, pectus carinatum, scoliosis, etc. should be evaluated. All these pathologies will influence the outcome of our intervention, and therefore an exhaustive analysis and a great planning of the surgery must be done. The type of breast parenchyma, the quality of the tissues, the elasticity of the skin, whether the patient has been breastfeeding, etc., must be evaluated. Finally, the position of the submammary fold must be analyzed, to see if it is defined or not, and the position and shape of the areola, to see if it is hypertrophic, hypotrophic, symmetrical, and located at an adequate height, or on the contrary “ptosic” or drooping.
In the preoperative interview the surgeon has to explain to the patient several fundamental aspects of breast augmentation, advise him/her taking into account his/her individual particularities, and establish the surgical plan together.
Virtual simulation of breast augmentation
With virtual simulation tools such as crisalix we can simulate the result of a breast augmentation, as follows: we make a scan of your torso to generate a virtual avatar to which different types of prostheses, sizes, shape, coverage, etc… can be applied, so you can get an idea of the expected result, try several prostheses to see the effect… and we will discuss it with you and advise you.
Free 3D simulation.
If you are interested in undergoing this type of surgery, do not hesitate to contact us, we will advise you and simulate with this virtual tool the result of this intervention … the result is amazing …!
Request a free virtual simulation and visualize your dream breasts.