Breast Augmentation Surgery

Breast augmentation with prosthesis is one of the most frequently performed operations in plastic surgery today. Patients who do not have sufficient congenital breast development or who have an asymmetrical breast structure and patients with breast tissue loss and asymmetry after pregnancy / breastfeeding or after serious weight loss apply for breast augmentation surgery.

This situation, which is more noticeable with clothes, forces patients to wear supported bras. Breast augmentation surgery with Breast Prosthesis is an operation of approximately 2 hours. This surgery is usually performed under general anesthesia. Patients stay in the hospital on the day of surgery and are discharged the day after the surgery. After the operation, pain is expected during arm movements for 1 week, especially in patients in whom prostheses are placed under the muscle. During this period, patients are prescribed antibiotics and painkillers. The breast prosthesis is placed through 3 different incisions. These incisions are nipple, under-breast line and armpit line incisions.

It is the incision made from the outer borders of the brown area around the nipple expressed by the nipple. Since this incision is made at the border of the brown area and the normal skin area, the scar has the advantage of being minimally noticeable. Since some patients frequently require lifting surgery, we use the same area to place the prosthesis while the nipple area is lifted up. Again, in some patients, the brown area of ​​the nipple became irregular after pregnancy, enlarged in diameter and often acquired an asymmetrical appearance. Transforming this area into a more regular circle shape and reducing the arola (brown nipple area) already requires an incision in this area. One of the most frequently used incisions in patients is the under-breast line. This region is our choice for patients who do not need breast lift and whose nipple area called areola has not changed after previous pregnancies or weight gain. This region has two advantages. The first is that the contact with the breast tissue is minimal while reaching the area where the prosthesis will be placed, and this incision does not harm the breast anatomy and physiology at all. Second, the incision site uses an already anatomically existing crease. It is accepted that scarring will occur at a minimum level, as it will not be exposed to any tension, such as nipple incision after prosthesis placement. In some patients, often the brown area of ​​the nipple (areola) is quite small, consistent with a lack of breast development.

The semicircular nipple incision to be made in this group of patients makes the placement of the prosthesis very difficult. Therefore, incision under the breast is already a mandatory choice. Underarm incision; This area, which looks attractive due to its distance from the breast and its concealed location under the armpit, requires the use of special endoscopic instruments. Small silicone prostheses can be easily placed under the armpit. It may not be preferred for two reasons. The risk of bleeding afterward is higher than other methods. Since the pocket where the prosthesis will be placed is opened from a very small and distant area, it is often very difficult to open a pocket of the right size and placement. Breast augmentation surgery is a suitable pocket preparation surgery for prosthesis. Preparing a pocket of the right size and placement is much more important than where the incision is. In the long run, the scar of each incision site gains an acceptable appearance, with exceptions. The most important change that breast augmentation surgeries have undergone since their first application is related to the prosthesis used rather than surgery. Surgical principles, that is, where and how to open the prosthetic pocket, have not changed much. However, developments regarding the production of prostheses that create less reaction in the body and provide a more natural breast appearance and feel are still continuing.

Drop and round prostheses are used according to the patient's preference. A more natural breast is obtained with drop prostheses. With round prostheses, the décolleté area becomes more prominent. Rotation or displacement does not cause shape problems in round prostheses. If the drop prosthesis rotates, shape problems may occur due to the asymmetrical feature of the prosthesis. The process of inspection and testing of prostheses produced by prosthesis manufacturers before they are put on the market is most severely applied in the United States. For this reason, we use products that have received FDA approval in the USA. After the use of the prosthesis in the operation, we give our patients labels containing the basic information of these prostheses and bearing the production number. Except for special cases, our preference for prosthesis placement in both groups of patients is submuscular. In this method, also known as subpectoral, the upper ¾ part of the prosthesis is under the pectoral muscle on the anterior chest wall, and the lower ¼ part is under the breast tissue. The most important reason for this preference is that the physical contact of the prosthesis with the breast tissue is minimal and it is prevented from being noticed from the outside because the prosthesis is surrounded by the muscle layer. Placing the drop-shaped prosthesis under the muscle gives the breast the most natural appearance.

Since some patients have very little breast tissue before surgery, the task of hiding the prosthesis is given to the muscle tissue. In some patients, it is a very common problem to notice the upper part of the prosthesis placed on the muscle, since the breast tissue is mostly sagging. This problem manifests itself with an unnatural appearance in the form of double protrusions when viewed from the profile. In these patients, the prosthesis is placed under the muscle and provided with sufficient cover and muscle tissue on the upper part. In the early period after breast augmentation with a prosthesis placed under the muscle, arm movements are expected to be painful for 1 week. At the end of this period, the limitation of movements gradually decreases. In the early period, risks such as bleeding or infection are possible, although very small. The patient is usually seen on the 5th day and the use of supportive bras is started. The necessity and duration of bra use is different for each patient. It is recommended not to do sports activities for about 1 month. The shape of the breast takes place at the end of this period.