Breast Augmentation

Breast Augmentation (Augmentation Mammoplasty)
For a natural, beautiful, safe and painless effect on breast augmentation, we need three things:
1. Top material (i.e. implants of the highest quality). Over the last 15 years, we have been using solid silicone implants of American origin (Mc Ghan, Mentor) as well as English implants (Nagor) with a lifetime warranty.
2. Atraumatic surgery. We use highly technological tools with bright light, which allow surgeon to make the operation with absolute precision and economy of movements. At the same time, using special diathermy, the procedure is carried out bloodless with millimeter precision.
3. Proper medical education and training as well as many years of experience

What is The Ideal Age For a Breast Augmentation?
Since the development of the patient has been completed (over the age of 18) and in rare cases of amastia with the assent of endocrinologist, psychologist and gynecologist at the age of 16.

What Type of Anesthesia is Used for a Breast Augmentation?
A breast augmentation surgery is performed under light general anesthesia.

How Long Does a Breast Augmentation Surgery Last?
About 1 hour

How Long Will The Patient Need to Stay in the Hospital After a Breast Augmentation?
The patient returns home at the same evening after surgery.

Are There Incisions After a Breast Augmentation?
The incisions are individualized in every patient. In most of the cases, the incisions is made under the breast fold (with length about 4 cm. that depends on the size of prosthesis) and is hidden by the breast. The incision gives direct visibility of pocket creation and implant positioning. For a few months, the incision is a little red and hard and gradually in depth of one year it becomes a very thin, white line. In the case of hypertrophic scar, it is better to be under the breast fold in order to be hidden by the breast. If the patient has large areola, the incision may be peripapillary. The disadvantages are the following:
- the scar is not hidden by some fold
- it is created a scar in the mammary gland that can affect lactation and breastfeeding and prevent the detection of tumors in mammography.

Where The Incisions Are Emplaced?
The breast incisions are emplaced:
• To the retromammary space, between the breast tissue (the mammary gland) and the pectoralis major muscle (major muscle of the chest) (subglandular)
• Beneath the pectoralis major muscle (submuscular)
• Beneath the fascia of the pectoralis major muscle (subfacial)

1. In two levels, partially beneath the pectoralis major muscle (submuscular) and partially beneath the fascia of the pectoralis major muscle (subfascial). In the vast majority of patients the solid silicone implants emplaced under the fascia of the pectoralis major muscle (subfacial).
The advantages are the following:
1. Less or no pain
2. The breast is softer to the touch
3. There is minimal mobility of prosthesis during the contraction of the muscle
4. There is a more beautiful and natural aesthetic result in breasts that have been emptied after 
    pregnancy or weight loss
Necessary requirement is the use of solid silicone implants (round or teardrop shaped) that don’t create folds and maintain a stable shape.

Is There Postoperative Pain After a Breast Augmentation Surgery?
With the atraumatic technique that we use there is not any postoperative pain but only a minimal discomfort (such as when we have been exercised and the next day we may feel a muscle injury). Usually, there is a slight numbness of the nipple (hypoesthesia) or/and hyperesthesia for a few days. Most of the patients (about 60%) take mild pain medications for 1-2 days, while others leave the hospital without needing any treatment.

When Will The Patient Be Able to Return to Work – Everyday Activities?
If she works in an office, she may return in 48 hours while in a manual work in one week.

 When May The Patient Resume Physical Activities?
Immediately after surgery, the patient can move her arms without problem but aerobics is allowed after 1 month following breast augmentation surgery. Driving is permitted 2 days following surgery.

 When Sexual Intercourse is allowed?
It’s recommended to avoid the vigorous handling of the breasts for 3-4 weeks.

 What Is The Right Place For Sleeping After a Breast Augmentation Surgery?
The patient must avoid sleeping on her tummy or her chest after surgery.

 Is Breastfeeding Allowed After a Breast Augmentation Surgery?
Yes. There is no problem with breastfeeding.

 Are There Used Any Postoperative Bandages?
No. There aren’t used any bandages or/and gauzes, but only waterproof pads over the incision. The patient has to wear a sports bra immediately after surgery for one month.

How Can We Find The Right Size of Solid Silicone Implants?
The solid silicone implants come in different shapes and sizes. At the first appointment, the surgeon will measure the breast and the chest and will propose to the patient what it can be used in her own case in order to have a natural and not a flashy result. A big breast implant seems not to be real as a result and increases the risk of complications. The patient will see various sizes which will be tried in her bra but the final decision will be made by the doctor in the operating room, which are used various trial sizes and is selected the one that gives the most beautiful aesthetic results in the specific patient taking into account her preferences in relation with the size and shape. The same solid silicone implant to 10 different individuals will have 10 different results.

Do Silicone Implants Cause Any Disease?
There is no medical evidence to show that silicone implants cause breast cancer or connective tissue diseases.

What Types Of Silicone Implants Do We Use?
Over the last 15 years, we have been using solid silicone implants of American & English origin (Mc Ghan, Mentor, Nagor) with a lifetime warranty for material failure (0% in our cases).

What is Better to Use: Round or Teardrop Shaped Breast Implants?
In theory, it is believed that the teardrop shaped breast implant has more natural shape. In fact, the vast majority of women have excellent aesthetic-natural result with the round shaped breast implants. Nevertheless, in special cases we prefer to emplace the teardrop shaped ones.
The disadvantages of teardrop shaped breast implants are the following:
1. At a rate of 8-10% the teardrop shaped breast implants are rotated within the breast, resulting in an unnatural shape that needs reoperation (3 cases in our patients) by placement of round shaped breast implants with excellent results.
2. They are quite expensive

Is It Necessary to Perform Mammography Postoperatively?
Mammography is performed normally if prosthesis is positioned under the fascia of the pectoralis major (subfascial). It may need to be combined with an ultrasound or some extra shots.
What Are The Most Possible Complications?
1. Inflammation (0% in our cases)
2. Bleeding (1 case, in which is needed drainage of hematoma with excellent results)
3. Formation of tight scar tissue around the implant (capsular contracture)
Capsule is scar tissue that is formed naturally around any foreign object in our body. In some cases, the scar tissue hardens and shrinks having as a result to change the shape of the breast. For its formation, it’s very important how traumatic is the surgery (hematoma, tissue maltreatment) as well as the type of prosthesis (implant). In our cases, the rate is 0%. The treatment consists of surgical removal of the capsule and repositioning of the prosthesis (implant).