Breast, the main function of which is breastfeeding, has been a complementary element of the female sex outside the reproductive system throughout human history. Each race has a unique breast shape, the width, color and size of the nipples differ from each other. Sometimes developmental and sometimes familial characteristics do not develop sufficiently at the end of adolescence and normally may remain smaller. After breastfeeding, breasts may shrink or breast tissue may decrease and cause a hollow appearance. In people with obesity problems, it may become deformed and sag in the breasts after diet or stomach reduction surgery.

There are two safe surgical procedures for women with such problems; Breast augmentation with silicone prosthesis and breast augmentation with oil graft injection.

Breast augmentation with silicone prosthesis

Silicone prostheses consist of hard silicone on the outside and dense fluid silicone on the inside. Although different brand prostheses are offered in our country, I use products with FDA and CE certificates for my patients.
Silicone prostheses are divided into 2 according to their shape;

Damla (Anatomical) prosthesis; It has a flat bottom and has an upper surface that increases from top to bottom. It has a more dense hard structure compared to round prosthesis. In the decollete part, it is not as prominent as a round prosthesis. It is more suitable for natural breast image.

Round prosthesis; It has a hemispherical shape and has a softer consistency. It is more useful in defining the decollete area.

Location of the prosthesis:

Nipple, nipple lower fold, underarm areas can be preferred for implantation. Each region has its own advantages and disadvantages.
The nipple cut is advantageous in terms of trace, and the seam line is hidden within the colored area of ??the nipple. The disadvantage is that milk channels in the place where the incision is cut may cause a decrease in the amount of milk in breastfeeding. In addition, the body´s reaction to prosthesis, which we call capsule reaction, was more common in prostheses placed at the nipple.
The incision made for armpit placement does not require any incision in the breast. However, postoperative pain may take longer and may cause chronic muscle pain. Also, it is not a preferred place for high volume dentures.

The nozzle lower fold is the region where the breast meets the body. The prosthesis is placed through a 5 cm incision. If the sewing line is planned to coincide with the full fold, the scar visible in the early period will be hidden, which will disappear almost completely after 1 year.

Insertion level of the prosthesis

Silicone prosthesis can be placed under the muscle, under the breast tissue and under the muscular membrane. If there is no breast tissue, it may be preferred under the muscle to prevent the prosthesis from touching. If there is a certain thickness of breast, a prosthesis is placed under the breast tissue. The under-muscular membrane technique can also be considered as a combination of the other 2 techniques. After the examination, the surgeon decides which level of prosthesis will be placed and will explain the reason for preference in this regard.

Which shape and size?

Factors such as the shape of the breast, the structure of the rib cage, body length, height and weight are evaluated by examining. By making measurements, the current bra size and the desired size are determined by learning the patient´s desired size.
If the patient wants a natural appearance, more anatomical prosthesis, and a pronounced whamp appearance from the décolleté, a round prosthesis can be preferred. The surgeon´s knowledge and experience will tell you the appropriate prosthesis after the examination. During the operation, trial prostheses are placed, and when the proper size is obtained, after permanent dentures are removed from their boxes and washed with antibiotic solutions, placement is performed.

Pre-surgery preparation;

If you have previous surgery, high blood pressure, diabetes, chronic diseases such as goiter, allergy to any medicine or food, you should definitely inform if you have medications you have to use.
If you have breast cancer or diseases in your family, make sure to mention it.
I recommend that patients who undergo breast surgery have a breast Usg before surgery and mammography if age is appropriate. Such imaging reports will be required to detect breast masses and to follow up postoperatively.

Hospital and Operating Room process

Preoperative examinations are prepared on the same day or 1 day before. You should not eat or drink anything 8 hours before the surgery. If the results are evaluated by the anesthesiologist and there is no obstacle, your surgery can be performed. The patient will not feel any pain during the procedure as it is performed under general anesthesia. The average operation time is 1 hour and the time spent in the operating room will be longer after the patient is put to sleep and awakened.

Is the surgery risky?

In operations performed under general anesthesia, risks can be divided into 2 depending on anesthesia and surgery. Considering the developing anesthetic equipment and technology, procedures are performed much more safely than in the past. Laboratory tests performed before surgery are checked and if necessary, consultation is requested from other branches. If you have a chronic illness, an allergy to any medication, a problem you have had in your previous surgery, you should definitely tell. You should not eat or drink anything 8 hours before the surgery. You should follow this rule to prevent any food in your stomach from leaking into your lungs during surgery and experiencing major problems.
Since new generation silicone prostheses are resistant to high pressure, the risk of bursting and tearing in the breast is very low. Antibiotic treatment is given after surgery to prevent infection. Sometimes drains are placed in the breast to remove fluid and accumulated blood in the early period and drains are removed on the 3rd day. The patient should use a medical gathering bra for at least 1 month according to the physician´s instructions and should not raise the arms higher than the shoulder level for at least 2 weeks in those who have a prosthesis placed under the muscle.

What is a capsule reaction?

It is a reaction of the body against silicon prosthesis. This may be due to the patient´s tissue sensitivity, prosthetic surface, lack of sterility during the procedure, and bacterial causes. A certain thickness of capsule structure is formed around each prosthesis, but in some cases, it turns into a thicker and harder structure and complaints such as tenderness, pain and redness occur in the person. Antibiotics, painkillers or steroids are treated early. If improvement is not observed, the silicone prosthesis may need to be removed with the capsule structure.

When does the breast shape occur?

In the first days after the surgery, the silicone prosthesis will appear above the decollete area higher than normal due to skin and muscle tension. The prosthesis adapts to its normal position with the recommended massages and relaxation of the skin muscle tissue after approximately 3-4 weeks. The size of the prosthesis inserted in this process may be shorter or longer than the body structure of the person.

Will the nozzles be equal?

Almost all women have more or less difference in size and shape in their breasts. Synchronization can be achieved by installing different size prostheses in the surgery.

Is there a lot of pain after surgery?

When the prosthesis is placed under the breast tissue, there is almost no pain, but the prosthesis placed under the muscle may cause pain in the first days. To prevent this, discomfort is reduced to a minimum by making narcotic pain relievers during surgery and in the service.

Is there a breastfeeding problem?

Breast augmentation surgery with silicone prosthesis does not cause any damage to the milk glands and ducts. It does not create breastfeeding problems after surgery.

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