Breast Augmentation

What is breast augmentation?

The breast has a particularly important role in everything to do with beauty, femininity and sexuality.Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to improve the size and shape of the breast of the woman and find the proportionwith the rest of the physiognomy of the patient, increasing the confidence in herself.

Therefore, the breast augmentation will be useful in the following situations:

-To enhance the silhouette of the woman whose breasts are too small.

-To correct the decrease of the size of the breast that occurs after pregnancy.

-To correct a size difference between both breasts (breast asymmetry) and as a reconstructive procedure after a chest operation…

We will make also an exploration of your breast and in some cases a mammography will be requested. We will explain to you the different surgical techniques for breast augmentation mammoplasty, we will discuss the size and shape your breasts and options or a combination of procedures that will be better for you.

You must expose your expectations in a sincere and honest way, Dr. Garcia-Guilarte will show you the available alternatives for your problem, with the risks and limitations of each one of them. Also it will explain to you which is the type of anesthesia that will be used, the need or not of hospitalizing in the clinic where the surgery will be made.

At the end of the consultation, you will receive instructions on how to prepare for surgery, including rules on food and liquids, tobacco or outlet socket or suppression of medicines, vitamins and iron supplements, preoperative issues… Be sure, also, that a relative or companion can take you home when you discharge after your breast augmentation surgery.

Surgery and Anesthetics

The breast operation is performed in the operating room, in a clinic or hospital. The hospitalization is necessary; we give you the discharge the sameday of the intervention or the next day. The breast augmentation surgery is performed under general anesthesia, remaining the patient asleep during the breast operation.

The breast augmentation is performed through a small incision that is placed, depending on the anatomy of the patient and preferences of you and the doctor, around the areola, in the furrow under the breast or under the arm. The incision is designed so that the resulting scar is almost invisible. For this reason, the doctor will perform the necessary preoperative markings in your room for your best result.

This procedure lasts between 1 and 2 hours.

Implant position

The situation of the implant depends basically on the preoperative characteristics. That is to say, depending on the thickness of the breast tissue will indicate the position of the implant under the pre-pectoral fascia (subfascial) or underneath the pectoral muscle (submuscular), but never subglandular, this latter is accompanied by a higher incidence of capsular contracture.

If the thickness of the breast is enough, the prosthetic outline will not be perceptible and we will be in favour of subfascial position. In case of not being enough we will decide by the submuscular position, our objective will always be to obtain greater naturalness despite the increased breast volume.

After surgery

After breast augmentation surgery, it is normal to find yourself tired a few days, but you can do almost normal life at 24-48 hours.

Most of the discomforts are better controlled with prescribed medication, although the sensation of mammary tension can be kept one week. However, the postoperative period is currently painless and even a normal working life can resume within 3-5 days of the intervention.

The morning after your breast augmentation procedure, drainage will be removed. The bandage or dressing will be also removed the next day of the intervention, being replaced by a special bra. The stitches are removed between 7 and 14 days; oedema does not yield up to 3 or 6 weeks.

Breast implant of cohesive gel of silicone ANTOMICAL type

Breast implant of cohesive gel of silicone ROUND type

Follow the instructions of the doctor and your physical therapist about what exercises can be performed. During the first few days you should take an antibiotic to prevent infections and capsular contractures.

Your breasts will be more sensitive than normal during 2-3 weeks. At the beginning the scars will be rosy, aspect that will continuously improve since 6 weeks. The mammographic controls appropriate for each woman according to his age can continue; although it should be noted the existence of the mammary prosthesis.

BREAST AUGMENTATION WITH FAT

The breast augmentation procedure will not limit its ability to breast-feed if you become pregnant.

During years, the injection of fat in the breasts has had bad reputation or opinion because it may mask or impede a possible breast cancer diagnosis. At present, this procedure has been earning gap and is used more often after having proved that there is not interference with the diagnosis and/or treatment of any breast pathology.

Grafts of fat (lipostructure, etc.) have helped us to refine the results because with very little we can improve certain aspects of our surgeries thus improving its result.

The major drawback of this technique is that the patient must have enough body fat to be able to extract the amount of graft fat as a liposuction and its subsequent injection into breast. The fat in one or more areas (abdomen, flanks, and face inner and outer thighs) will be sucked through specific technical and instrumental. This fat will be subsequently processed properly by centrifugation and/or filtration to be injected into the breast.

This injection is done through 3-4 points of puncture to introduce the cannula and then crossing over different levels. The distribution of fat in each breast, and each patient can be customized the most by placing the quantities needed in the places where they are most interested. Something also very important to highlight is that two repetitions of the procedure are normally necessary, or even three given that a part of the injected fat is reabsorbed.

The volume used behind the gland will provide an increasing size and a slight breast lift; the volume used beneath the skin will “tense” and give a more turgid aspect. However, the limitation of the breast graft is based on the use of restricted amounts of grafting of fat and, therefore, a limitation on the final size that you can get. The amount of fat that can be grafted on each breast is limited by “what fits”,and must not exceed in no way this restriction to ensure the proper engraftment and the absence of side effects.

Therefore, a mammary lipo-implant rarely can achieve more than one cup or more than one size. However, this limitation can be overcome by performing more than one graft, so that amounts will be added.

The operation can be done under local anesthesia with sedation or better, with general anesthesia. Its duration is significantly greater than the increase with prosthesis due to fat extraction and the precise work technique that should be used in the implantation-injection of fat. Thus, it will take around two hours.

As in any breast surgery procedure, the post-operative controls are very important. You must perform controls mammographic and even resonances for supervising the status of fat and its mammary gland (the same that you should do to supervise the status of the prosthesis). Your Gynecologist may make appropriate checkups as usual.

To date, calcifications that appear after a breast augmentation by lipo-implant can be distinguished easily from the typical microcalcifications from breast cancer. A very high percentage of other breast surgeries (gain reduction or Mastopexy) also present calcifications in the postoperative period. Even patients without previous breast surgery may present calcifications. However, if a mammogram or magnetic resonance imaging is detected calcifications or suspicious signs of breast cancer would enter the appropriate protocol to perform more tests or even biopsies being able to carry out the above without any problems.

Since breast augmentation is performed with patient’s own tissues, the process of breast aging will be totally natural.Google