What is breast augmentation aesthetics?
Breast augmentation is a group of operations that make up a significant portion of aesthetic surgeries in aesthetic surgery clinics. It is a common term for operations to increase the size of the breast using breast implants (silicone) or the patient’s own fat transfer to the breast. It can be easily and quickly performed today, requiring only 1 day of hospitalization. It is also performed to correct the loss of breast volume after pregnancy and weight loss or to correct the shape and structure of the breast.
Silicone breast implants have been further developed in recent years. There are now lighter forms available. Silicone implants are produced in a solid and durable structure that does not adhere to the body, is resistant to impacts, is non-allergic, does not cause cancer, so they have been used safely for many years. Additionally, these silicones should feel and have a texture similar to the breast when touched, should not give the person a very different foreign tissue feeling, and their borders should not be obvious.
Who is eligible for breast augmentation?
- Physically healthy individuals
- Not pregnant or breastfeeding
- Those who complain of both breasts being small or one being asymmetrical compared to the other
- Those with fully developed breasts
- Those who complain of sagging, loss of volume, or deformation of the breasts after pregnancy, weight loss, or aging
- Those who complain that the upper part of their breasts is empty
- Individuals who complain that one or both of their breasts are not fully developed or sagging are suitable for breast augmentation surgery.
What are the characteristics of implants used in breast augmentation aesthetics?
Silicone implants are used in breast augmentation surgeries. The structure of these implants consists of two layers. It consists of a harder, impact-resistant silicone layer on the outside and a fluid silicone structure on the inside.
There are two different types of silicone implants: anatomical and round. In round implants, the base is round and oval in shape. In anatomical implants, there is a drop-shaped structure. The projection distance of the implant is determined by measuring the distance between the base and the nipple. If a more upright and forward-looking appearance is desired, a high-projection implant is used. Additionally, there are different types of implants, smooth or textured. Capsule reaction is a bit higher in textured implants. There are also implants coated with a micro-polyurethane shell. The aim here is to reduce possible problems.
Before the operation, drawings are made to determine which type of implant will be preferred. The surgeon determines and applies whether the implant will be placed under the muscle, under the muscle fascia, or above the muscle according to the patient’s existing breast tissue, chest cage structure, breast shape, and structure, whether additional lifting is needed. The experience of the surgeon is very important in this regard.
Whether to choose round or drop implants is also somewhat related to the patient’s preference and the surgeon’s experience and patient experience in this regard. The risk of rotation is a disadvantage of drop implants. The rotation of the implant can occur over time. This is not observed in round ones.
There are different manufacturers for implants. There are manufacturers from the USA and Europe. We prefer the most widely used and reliable implants worldwide in our clinic.
Frequently Asked Questions
Silicone implants are placed through the following incisions, depending on the surgeon’s experience:
- Most commonly, from under the breast fold
- From the lower part of the areola (nipple) ring
- From the armpit
I prefer to place the silicone implant through a small incision under the breast fold. Healing is faster, and aesthetically, the incision scar is extremely small and hidden under the breast fold.
Another consideration is which layer the silicone will be placed in. When placing silicone, it can be placed in different layers. These are; above the muscle, under the muscle fascia, and on the muscle. The surgeon determines and applies this according to the patient’s breast and body characteristics during the operation.
Before the surgery, you will have been to the hospital, your preoperative tests will have been seen, and you will have been examined. You will not eat or drink anything after midnight. You will come to the hospital where the surgery will be performed in the morning on an empty stomach and will be taken to your room reserved for you. A vein will be opened, and a serum will be attached, and you will wait. The attendants will take you to the operating room, and you will be delivered to the safe hands of the anesthesiologist. The entire operation will be performed under general anesthesia, and you will not feel any pain.
The operation will last about 1 hour, and after a short recovery, you will be taken to your room. Although you will not have any pain at first, you may experience some pain as the effect of anesthesia wears off, so special pain relievers to prevent this will be given to you intravenously through special systems, ensuring a painless night for you. You will have a special surgical bra on you, which will be placed on you in the operating room. You should use this for the first month. You will not see any drains placed during the surgery. These drains will not be necessary in breast augmentation surgery. You can start taking liquid foods after 6-8 hours. You will be given painkillers and antibiotics through your vein since your vein is open. Necessary conditions will be provided for your comfort, and after spending one night as a guest in the hospital, you will be checked by me the next morning, your prescription will be arranged, and you will be informed about what to do and what not to do, and then you will go home or to the hotel where you stayed.
Breast augmentation surgery is a very comfortable operation in terms of the process. General anesthesia is preferred. The prosthesis is usually placed under the breast about 4 cm through a small incision. In some cases, it can be placed around the nipple or under the armpit. Since we prefer self-dissolving stitches after the operation, there is no need to remove the stitches after the operation.
After the surgery, you will be taken to your room after a short recovery. You will not usually have pain after you wake up. There will be a vein access in your arm and a serum attached to it from the operation. You will be given appropriate protective antibiotics, painkillers, and edema-reducing drugs through your vein. You will be allowed to start taking water and liquid food 6 hours after the operation and stay in the hospital for 1 night. Your dressing and control will be done the next day, and you will be discharged with your prescription and instructions. Your control will be done at our clinic on the 3rd day. You will be informed when you can take a shower. You can return to your normal work within a week with caution. If your shoulder movements are limited in the first week, you will benefit in terms of pain. We also do not recommend lying on the breasts and side sleeping in the first weeks. You can fly after 1 week. You cannot swim for 1 month, and if you do sports, you can continue after 1.5 months. You should be careful about the prosthesis during sexual intercourse in the first month.
After breast implant surgery, we recommend using sports bras, which are non-supportive, have minimal stitching, and do not create any negative effects on the implants, for the first 6 weeks. Afterward, you can transition to bras with support, such as underwire bras. Your breast size, known as “cup size,” will change after surgery. This means that your bra size will not change, but you will move from an A or B cup to a C cup.
The implants we use do not contain liquid silicone and have a special non-allergenic structure. The silicone inside the implant is not fluid. It is cohesive, so even if the implant is cut or punctured, it does not leak. Our bodies form a capsule around the implant, which is an additional layer of tissue.
After breast augmentation surgery with an incision under the breast, if there are no additional conditions that could interfere with breastfeeding, breastfeeding will not be affected. This is because the breast tissue remains intact, and there is a capsule around the implant. Implants do not harm the milk ducts, and silicone never passes into the milk. However, if the implant is placed through an incision around the nipple, breastfeeding may be affected if the milk ducts are damaged.
In addition to risks related to anesthesia, hospitalization, and other general post-operative risks, there are specific risks associated with breast augmentation surgery:
- Allergies (to medications, blood products, suture materials, and other products used)
- Bleeding and hematoma (accumulation of blood)
- Breast asymmetry and shape irregularities
- Fluid accumulation (seroma)
- Infection
- Scar formation, hypertrophy, wound healing disorders
- Capsular contracture around the implant
- Numbness in the nipple
- Malposition of the implant
- Implant rupture
- Although rare and not fully proven, Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)
After the surgery, we recommend sleeping on your back to protect the implants. Patients can sleep on their side after 2 months.
In some cases, removal of the implant may be necessary. If the patient decides against having the implant anymore or wants a different size, at least 1 year should pass before re-implantation. Reasons for removal include the development of capsular contracture.
Capsular contracture occurs when a capsule forms around the implant, which is a natural response of the body to a foreign object like a silicone implant. If this capsule thickens and causes contraction, it can lead to a deformity in the breast. This typically occurs after the first year, with a frequency of 1-2%. The severity of this contraction can vary. In advanced stages, the implant may need to be removed.
- Careful selection of the implant size to reduce the risk
- Taking measures to reduce the risk of bleeding or infection during and after surgery. These include quitting or reducing smoking before the operation, stopping blood thinning medications, and performing the surgery with meticulous attention to bleeding control.
- There are also some factors that concern us as surgeons during the operation. These include using powder-free gloves, washing the silicone implant with antibiotic solution, minimizing the use of trial silicone implants (sizers), placing the implant under the muscle, and paying maximum attention to sterility and bleeding control. This highlights the importance of surgical experience, meticulousness, and knowledge.
Some patients already have sagging breasts before the surgery. In these cases, a breast lift should be added to the procedure. The surgeon’s use of appropriate techniques, experience, thorough evaluation of the patient before the surgery, correct markings, and selecting the right size of the implant to place it in the correct anatomical plane ensure minimal sagging. Achieving good results after implant surgery, patient satisfaction, and surgical success depend on many factors coming together in a process. The same implant use, performed in the same hospital, can yield different results in different hands.
In a breast augmentation surgery where a very small incision is made under the breast, scarring is generally not a significant issue. After a certain period, using scar creams or special silicone products can help reduce the appearance of the scar.
There hasn’t been a clear link found between breast implants and cancer. In recent years, the Food and Drug Administration (FDA) has reported a potential association between some implants and a very rare immune system cancer called anaplastic large cell lymphoma (ALCL). However, more studies are needed in this area, and it is not yet fully understood.
Enlargement using a person’s own fat tissue transferred to the breast area is safe. It is a method used with confidence. However, there are risks associated with using different synthetic filler materials for enlargement, such as reactions to the filler material, granuloma formation, infection, and other risks. When a problem occurs, it is not possible to remove, remove, or dissolve the filler material. It is a practice that we do not use and do not recommend.