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BREAST AUGMENTATION

How is it Performed?

 

Maripaz Duque, M.D.

 

 

  Center of Skin Laser Treatments

 
   
       

The surgery for the correction of small breasts is called Augmentation Mammaplasty. Throughout the years many materials have been used for the manufacture of breast implants. At the moment, most mammary implants are filled with silicone gel or saline solution.

   
       

Silicone implants are made of high cohesivity silicone gel within a silicone cover.  The external surface of the implant can be smooth or texturized.  Texturized surfaces allow for the capsule that the body normally surrounds the implant with, to be lax and to have less risk of contracture or hardening.

Saline filled implants have a silicone cover around them.  They tend to be more rigid and frequently lose volume with time, becoming wrinkled and changing their shape.

When you attend the plastic surgeonís office for your initial medical consultation, you will both determine which type of mammary implant will be used according to your needs, whether it will be placed behind the mammary glandular tissue or behind the pectoralis muscle, and the location of the skin access through which the implant will be inserted.

In most cases, surgery is undertaken under general anesthesia, which requires consultation with an anesthesiologist before surgery, and practicing routine laboratory exams according to the patientís age and coexisting medical conditions.

The clinic or hospital where the surgery will be scheduled must have every technical and scientific resource necessary to attend to any type of complication that appears during or after the surgery. This it is not an office procedure, because manipulation and insertion of mammary implants requires the strictest norms of asepsis, in order to prevent their infection and extrusion.  Also, excessive bleeding can occur during surgery, which may require the use of special instruments to control haemorrhage, or even use of blood transfusions in extreme cases.  Mammary implants are not re-usable, so always ask your surgeon to certify the type of implants used in your surgery by filling out a reference format which assures the implantís authenticity and quality.

Some marks are made on the patientís skin before starting surgery, to define the location of the wound through which the implant will be placed. In most cases it will be inserted through the areola. Marks are also made to determine margins of the pocket which will hold the implant.

 
     
 

                                                                        

In the operating room, the anesthesiologist prepares the patient for the administration of general anesthesia. Once the patient is asleep, the surgeon or the nurses wash the patientís chest with iodized solution or surgical soap.

Surgery begins with the incision of the inferior half of the areola margin. By advancing through the mammary glandular tissue, the surgeon creates a pocket for the implant to be placed, either behind the gland or behind the pectoral muscle.  The decision for pocket location depends mostly on the patientís physical features.

                                                                          

The implant is carefully introduced through areola until it is completely inserted and the surgeon makes sure it is adequately placed in the pocket he or she designed for it. 

                                                         

The surgeon closes the breast with several stitches, some of which are placed deeply within the breast and are absorbed by the patientís body. Then the skin is closed with a continuous nylon suture, which the surgeon pulls out 10 or 12 days after surgery.

Paper tape is then placed over the wound and around the breast to ďmoldĒ and fix the implant externally. 

                                                                    

Finally,   the surgeon fits the patient with a special bra which will have to be worn for the next six weeks. 

                                                                             

The patient is transferred to the recovery room where she remains for 1 or 2 hours.  If there are no complications or indications for hospitalization, she can then leave the hospital and go home.

Swelling and pain can be considerable, and they are handled with pain o anti-inflammatory medications administered by oral route.

The patient must keep moderate rest for 2 to 3 weeks. She must not drive motor vehicles nor exercise her arms for the same amount of time.

Definitive breast shaped can be appraised after 2 to 3 months. The permanent use of a supporting bra is advisable, even at night, because the weight of the implant and breast can cause stretching of the skin and gradual breast descent with time.

 
   
 

 

                       1 WEEK

                                2 WEEKS            2 MONTHS AFTER SURGERY
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The implant must be checked annually by your surgeon, by means of manual examination of the breast and ultrasound or mammography imaging to rule out implant rupture.

If the breast becomes hardened and painful, it is often due to "capsular retraction". This means that the tissue  that normally envelopes the implant has begun to begins a to contract and gradually compress the implant.  In early stages it is treated with specialized physical therapy. In late stages, or severe cases in which no improvement is seen with physical therapy, the implants must be either exchanged for new ones or permanently removed, according to the surgeonís criterion.

 
   
Maripaz Duque, M.D.  
Plastic Surgeon  

www.maripazduqueMD.com

 

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Read about:

FACELIFT  |  RHINOPLASTY  |  BLEPHAROPLASTY  |  OTOPLASTY  |  BREAST AUGMENTATION  |  BREAST LIFT
BREAST REDUCTION  |  LIPOSUCTION  |  TUMMY TUCK

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