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Dr. Bora OK MD.
Breast Augmentation Surgery
Breast augmentation surgery involves surgical interventions to achieve a better and symmetrical breast structure and to have a more fuller breast structure in some cases. This augmentation can be achieved by silicone or saline (filled with serum) breast implants and fat injections.
We Use FDA Approved Breast Implants
Not an Obstacle For Breastfeeding
LENGTH OF SURGERY: 2 to several hours
ANESTHESIA: Usually General
STAY IN HOSPITAL: A Night
STAY IN ISTANBUL: 6 Days
NUMBER OF POSTOP CONTROLS: 2 Postop Controls
What do we decide before breast surgery?
1-Desired breast cup size: The cup is an important criteria for breast size selection. It takes place in a different order for each country, ranging from small to large and from A to F. 2-Placement of the Implant: Silicone implants can be placed under the breast, the nipple or the armpit. I prefer to place implants under the nipple area and I usually recommend it to the patients. Patients with wide nipple width, it is possible to implant under the nipple area. 3-Implantaion method: It is possible to place the breast implants under the muscle,fascia or breast tissue considering the thickness of the breast tissue.
Should the breast implants be placed under the muscle, the breast, under the breast tissue?
Breast implants can be placed just below the breast tissue, under the pectoral muscle (pectoral muscle) or under the pectoral muscle fascia. Of course, these techniques also have their own details. At the same time, every plastic surgeon will have different approaches and experiences. Submuscular placement I place the breast implants mostly under the muscles in the breast implant surgeries. Because of people who want this surgery and having a small amount of breast tissue in other words an insufficient thickness to cover the upper part of the implant. When patients have a wide body and a correspondingly large muscle settlement and a small volume change is desired most of the breast implant can be placed completely under the pectoral muscle in submuscular implants placement. But in reality, often the desired or appropriate volume of breast implants do not allow the silicone implants to be completely immersed in the muscle.Therefore, in the majority of cases where we placed submuscular breast implants ,this muscle covers the central and upper part of the breast implants. The lower part of the virtual breast implants is not covered with muscle. The goal in here is not to completely cover the implants with muscle tissue, that is to cover definite part of implant which is upper part with muscle layer. A barrier is created between the breast tissue and the implants with this closing .This leads to a smoother breast transit and it is done in order to prevent the implant in this area which is seen from the outside clearly not to be obvious in later periods. However, when relatively large implants are placed on a person with a thin muscle tissue,there is a possibility of obviousness in this region. When we refer to submuscular breast implant placement in the breast augmentation, we usually mean to place an implant under the large pectoral muscle. Here, in recent years, techniques have been shown in which the implant is partially placed under the muscle using various technical differences and their advantages in breast augmentation surgeries have begun to be used all over the world. In generally ,aim is to keep the protectiveness of the muscle tissue on the breast implant at the maximum level in the required situations and at the same time to push the breast tissue up with the implant, it means to lift the nipple. Again with using the advantage of covering implant by muscle tissue,techniques for minimizing some problems related to submuscular implant placement are applied with minimizing tissue trauma . The approach I often encounter at pre-operative interviews is ‘we have placed a submuscular breast implant , so this muscle tissue holds the breast implant and there willbe no sagging in the posterior period’ is not true. Here, the pectoral muscle is attached to the bones in the body in a constant way except the movements of the arms and idea of this making breast tissue constant causes the patients think about that way. However, the breast tissue takes a large space. With gravity and loss of tissue and elasticity on the skin,the breast moves the down by seperating from the muscle tissue in time.This is also one of the reasons for the sagging in the weight-fluctuation periods. Therefore, when submuscular implant is placed, it does not have an effect to keep the breast tissue here. Conversely, muscle tissue adheres to the implant very much and the breast tissue moves downward on it in time rarely the implant is adhered to the upper side, and results in the image of breast moving downward on it . Although this possibility can be minimized by some approaches to be performed during surgery, postoperative healing and replacement of breast tissue of each individual is quite different. In that case as a treatment by opening a capsule surronding to breast implant depending on the desire of the patient, the current breast implant, or a larger volume implant is pulled to the down on the breast and providing fullness in the lower region of the breast and / or necessary breast lift can be applied. Subpectoral Placement (Fascia ) Facia has a structure that covers not only the pectoral but all muscles in the body , and it’s thickness varies in the individuals and their muscle structure .Although Fascia itself is a thin structure compared to the muscle , it has some protective barrier feature by functionally covering the implants .How protective is this will be related to the thickness of the person's breast tissue, the fascia, and the volume of the implant. Since a more painless postoperative procedure reduces the possibility of displacing the breast implant in arm movements depending on muscular overactivity that may occur after sub-muscle placement,as I mentioned above, it helps to solve the problems that implant creates which is kept by muscle tightly in submuscular placement it can be preferred because it is thought to provide protection with an extra layer compared the subglandular breast implant placement. It should not be forgotten that the thickness of the breast tissue, the size of the implant volume and the healing process play an important role in this issue as well as the careful attention to protect its integrity by separating it very carefully during surgery in order to benefit from the most efficient amount of this thin membrane structure on the muscle. Subglandular Placement The breast is made up of breast tissue, fat ,skin and connective tissues. In patients with adequate amount of breast tissue, the implant can be placed under the breast tissue. This adequacy differs for each individual according to both the thickness of the breast tissue of the individual and the size of the implant planned to be placed. Here, It is required to plan surgery by foreseeing both the thickness of the skin and the amount of fat level and changes that may occur in the future (for example, weight loss) and the thickness of the breast tissue. It can be taken advantages of of less postoperative pain compared to submuscular and subpectoral placement , direct breast augmentation and pushing it more forward . When we place the breast implants under the breast tissue, the breast is completely separated from the underlying muscle and fascia and there is no intervention for the breast tissue in this surgery. Placing the breast implant under the breast tissue does not harm the milk ducts like other methods!
Do you have pain after breast augmentation surgery with breast implants?
In case of placing the breast implant under the muscles, there will be some pain depending on the weight. This pain is getting lower after a while, and usually after 5 days, goes down to a very low level. We see that some edema and pain during sleeping at night in the sub-muscular implant placement, and increasing in the mornings due to the immobility and starting to decrease in the afternoon. This pain is decreasing every morning from 2nd day after an operation in comparison with the previous day. Therefore, pain control can be provided by using painkillers before bedtime and after breakfast regarding our recommendations.
What are our recommendations for wound care after breast augmentation surgery?
At the end of the operation, I close the surgical incision site with protective tape that does not expand. I keep these tapes for 3-4 days. After that I propose to be kept in this region without changing very often. Daily incision cleaning can be provided over this tape. The dry and clean protection of the incision site will be sufficient for the maintanence. With this care varying according to the person, you can keep this care for 2-3 weeks. In this period, I also suggest that you consult your doctor and act in accordance with his/ her recommendations.
When can I have a bath after breast augmentation surgery?
The next day after surgery, there is a no harm to take a shower with waterproof tapes. But I suggest that the shower time is short, so be careful not to cause accidents when going into or out of the bathroom and if it is necessary after bathing, you should dry it using a non- warm hair drier.
How long can the breast implant (silicone) be used ?
Breast silicones can be used for a lifetime if there is no deformation in the silicone which is low possibility. Firms usually give a warranty period of 10 years.
In what conditions do our patients contact us for this operation?
1- Those who do not have congenital breast tissue or adequate development 2- Those who want a bigger and larger breasts to be proportionate to their bodies even if they have breast development and tissue 3- Those who want to regain volume because the volume of the breast decreases after periods of weight fluctuations 4- Patients with deficiency in breast tissue in consequence of breast asymmetry , congenital deformities, tuberous breast appearance or breast cancer surgery or trauma.
What are the differences between teardrop (anatomic) or round shaped breast implants ?
Breast implants have many differences in terms of volume, width, height, content of the internal structure and placement , features of external structure and shape. The choice of alternatives can be made considering the body structure of the body, the characteristics of the breast tissue and the wishes. Round breast implants are round and symmetrical. Therefore, when placed in the breast, it will gain the same volume to the upper, side and lower regions of the breast tissue. It will provide enlarged shape as volume to every region of the body for people who have breast tissue . In the case of small amount breast tissue, the breast shape will be more round like the breast implant after an operation. Patient’s breast tissue size and the breast implant to be placed affect of how much the round shape can be. Upper region is less fuller than the lower region in teardrop or anatomically shaped breast implant ie, upper and lower regions are non-symmetrical in these breast implants. I use it when fullness is needed in the lower region, when the nozzle is in the higher position than the body. At the same time, because of the fact that sub-region fullness makes the nipple arise ; it can be used in situations where it is necessary, but at the same time it also requires a teardrop implant -specific surgery plan. Due to its asymmetrical structure, the surgery plan should be done well and the care after the operation must be taken carefully to keep the teardrop implants in place. Rarely, movements of the breast implants around itself may show a different placement from the shape of the implants to be placed and also cause the shape of the breast not to fit with planning.
What are the complaints of patients who request breast augmentation surgery?
1- Inadequate development of breast, almost having no fat and breast tissue. 2- Lack of upper region fullness in the breast 3- Lack of forward projection from the side angle 4- Disproportion with distance between hip and shoulders 5- No symmetry in breasts 6-Tubular shaped breast structure
When can I do sports after breast augmentation surgery?
Short term walking exercises can be performed in or around the house in the way that you will not be tired. I do not recommend long-term walking exercises until after the 4th week. I do not recommend heavy exercises until the end of 6-8th weeks. In such a case it is possible to get a better recommendation by consulting your doctor describing the exercise to be done.
Can I go swimming after breast augmentation surgery ?
There is no harm to have swimming in the sea or the pool from the 2nd week. In this case I suggest you to go into the water carefully and slowly, not to swim but to cool off.
Is sunbathing or solarium inconvenient after breast augmentation surgery?
Long-term sunbathing and solarium may damage the skin structure therefore is not recommended. After breast augmentation surgery, post-operative edema will occur in the breast. Due to this edema ,long-term exposure of the sun makes skin discoloration and irritation easier. For this reason, I do not recommend sunbathing for at least 6 weeks after surgery. Afterwards, I would recommend a sun cream with a minimum of 30 factors and to cover the incision site.
Is routine radiological breast control affected after breast augmentation with silicone implants?
Routine breast check ups include USG ( ultrasonography )and mammography controls. There is no disadvantage of breast augmentation surgeries in terms of these controls after the operation. You can do your routine breast check ups in the same way.
Is any restriction of movements necessary after breast augmentation surgery ?
We see that some of our patients have spontaneous restrictions, especially in their arm movements depending on sum of pain after breast augmentation surgery. There is no problem with slow and controlled movements after surgery to meet one's own needs. With these movements, pain due to inactivity in the shoulder joint can be prevented and it is possible to return to social life in an earlier period. As each operation is not the same and there may be differences in the operation period so ; you can ask questions about how you can move in this period after surgery. In general, our patients may have some edema in surgery region related to arm movements after long term walking. This is normal and will pass over time. So I do not recommend long walks in the early days. Especially during the first month, I would suggest that uncontrolled and sudden arm and shoulder movements should not be performed. Apart from this, we advise you to stay in touch and consult your specific situation and act accordingly.
Does breast augmentation provide breast lift?
If you have unwanted breast sagging , you need to know that breast augmentation surgery is not breast lift surgery. Breast augmentation surgery can fill the inner of the breast in case of 1-2 cm sagging to make it appear as if the breast is relatively more upright. In this case, if very small volume of breast is not desired , our patients can be satisfied with the look without the breast lift surgery. But if a steeper breast desired and having more sagging, breast augmentation surgery is needed. In such a case, I will inform and guide you with a preoperative consultation to make a definite decision about it.
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