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BREAST AUGMENTATION SURGERY, BREAST AESTHETICS
Istanbul breast augmentation surgery is typically performed to enlarge underdeveloped breasts or breasts that have shrunk after childbirth, with reduced volume. It is also used to correct the obvious size difference between the two breasts or to eliminate congenital breast development disorders.
The most healthy and successful method of breast augmentation today is silicone prostheses. Breast augmentation surgery with silicone prosthesis is one of the most performed surgeries all over the world and pleases patients the most.
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A frequently asked question is medications used for breast augmentation. But Breast Augmentation is not a question of any non-hormonal drug. Such drugs are either money traps that don’t work at all, or they contain hormones. Uncontrolled use of hormones can lead to many health problems, especially cancers.
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Again, serum or fat injection is also one of the questions asked for Breast augmentation. If you want a one-day Breast Augmentation, it is possible to enlarge the Breast with a serum, but there is no permanent one yet. Fat injections may be limited in some cases, but they cannot be said to be as controlled, effective and safe as a prosthesis. In short, the most effective and safe way of Breast Augmentation in Istanbul JCI hospital is through silicone prostheses.
There are many types of silicone prostheses available. As a structure, they are in the form of bags containing silicone gel or serum with a fluid or non-fluid density in terms of their consistency inside a 1 mm silicone case.
Silicone prostheses are in shape; round, drop-shaped, anatomical or asymmetric shapes.
The outer surface of the silicone prosthesis can be flat or rough, the risk of contracture of the rough surface is less. It is necessary to prefer silicone prostheses with a smooth surface for over-muscle placements, while flat-surface prostheses are suitable for under-muscle, the advantage of flat-surface prostheses is that they can be manipulated after surgery and are 10-20% cheaper. Novotel prostheses are suitable for over-muscle placement.
By putting silicone prostheses filled with serum under the armpit, it is possible not to create any marks on the breast, but it can only be placed under the muscle.
Dentures filled with silicone Gel inside are closer to the breast tissue in consistency and the feeling of touch is more natural, but they can only be placed under the breast and around the nipple. New generation silicone prostheses have silicone gel in a non-fluid and non-distorted style.
It can’t be said that this kind of prosthesis is better. Each of them is suitable for different situations and all of them are up-to-date. Success in Breast augmentation surgeries depends on how natural the breast looks after surgery and how long-lasting the results will be. When choosing a prosthesis, the breast sizes that you want are taken into account, the structure and proportions of your breast and rib cage are also taken into account, and the prosthesis is calculated in the most appropriate size and shape for you.
Surgical technique
If you want to have breast augmentation surgery, you read different articles in various places about the type of silicone prostheses, types of surgery, and I’m sure you’re very confused. Each doctor provides information that highlights the type of prosthesis he finds superior to himself, the operation he performs or the prosthesis he uses. In practice, no technique or prosthesis has an absolute superiority over each other, and it can’t be said that this is better. Each technique has advantages and disadvantages compared to each other. The technique to be used, the patient’s wishes and the patient’s anatomical structure are based on the preference of your doctor depending on the condition of the breast. Below I will try to give you as much unbiased and categorical information as possible on these issues.
Surgical techniques in breast augmentation surgery vary depending on the place where the prosthesis will be placed and the place of entry.
Silicone Prosthesis;
1- under the breast tissue (subglandular)
2- under the membrane of the chest muscle (subfascial)
3- it can be placed under the chest muscle (submuscular or subpectoral)
The most commonly used input cuts are;
1- An incision under the breast made from the area where the lower part of the breast meets the rib cage, or
2- Semicircular incision around the areola, made along the lower border of the dark skin (areola) around the nipple.
3- The one that is used more rarely is the axilla incision made under the armpit.
Incision under the breast,
A prosthesis can be placed above the muscle, or below the muscle, or under the muscle, without touching the breast tissue at all. It reduces the risk of capsular contracture due to infection due to the fact that the breast tissue and milk ducts are not touched. The biggest disadvantage is that it is a permanent scar, although it does not remain very obvious over time.
Incision around the nipple,
Compared to the incision under the breast, the permission is much less likely to be obvious, and the scars here are not noticeable due to the thin and colored skin. The most important disadvantage is that the bacteria living here are likely to infect the prosthesis at a low level due to the interruption of the milk glands and ducts, and increase the likelihood of capsular contracture due to infection. An incision around the nipple does not create a permanent sensation disorder in the nipple, affects up to 20% of the milk glands and milk ducts, and does not prevent postpartum milk delivery. It is recommended for those who are sensitive about scars and want a gel-filled silicone prosthesis.
Underarm incision,
It is the ideal incision place for those who do not want any marks on their breasts. A 1.5 cmm incision made in the armpit crease does not leave any marks over time. The disadvantage is that only serum-filled prostheses can be used and can only be placed under.
Round silicone prostheses: are more suitable for under muscle and are ideal for those who want fullness in the upper breast. It can be flat surface or lumpy, it can also be full of serum or full of gel.
Shaped (drop) silicone prostheses: on the other hand, are suitable for upper muscle placement and the lower part is ideal for a fuller and more natural appearance. Again, in cases where there is a narrow rib cage, asymmetrically shaped silicone prostheses give better results.
Serum prostheses: are ideal for those who do not want any marks on the breast or around it, they can be placed through a 1.5 cm incision under the armpit or through the belly button (not used very often). It gives quite good results, except that the sense of touch is not as good as gel prostheses. It is the type of prosthesis with the least risk of capsular contracture.
Over-Muscle placement Plan (subglandular): The silicone prosthesis to be placed in this area, that is, immediately under the breast tissue, must necessarily be a prosthesis that we define as anatomical or drop. Round prostheses will not look natural. Advantages;
1- The prosthesis fits very quickly and the natural appearance is achieved in a very short time,
2- A larger image can be obtained by placing a smaller prosthesis under the muscle,
3- The pain becomes less after surgery and the painful period lasts shorter,
Disadvantages;
1- Since the prosthesis behaves like breast tissue, sagging occurs in the breast over time.
2- In those with little breast tissue, the prosthesis is felt over time, its edges become obvious, it becomes visible.
3- The reaction that develops against the silicone prosthesis, which we call capsular contracture, is seen more often.
4- Access to this plan is only by an incision made under the nipple or breast.
Under layout plans of the Muscle Membrane;
This plan has both some advantages of a sub Novum placement plan and advantages of a sub mammary tissue placement plan. Although the muscle membrane is a thin membrane, it is a muscle structure that is quite hard and does not expand easily. For this reason, it prevents the prosthesis from being noticed, as well as does not cause the breast to sag. In order for the prosthesis to contribute to sagging to be minimal, the best placement area in supramuscular prostheses is below the muscle fascia, that is, the membrane covering the muscle. The incidence of capsular contracture is also less in prostheses placed under muscle.
The disadvantage of this plan is that the silicone prostheses to be placed here can only be placed with a nipple or under-breast incision.
Subcutaneous (subpectoral) Novation plan;
Advantages;
1- It is difficult to notice the prosthesis even in those who have almost no breast tissue at all,
2- It is the layout plan with the least probability of capsular contracture.
3- Does not cause sagging of the breast,
3- It is possible to put a prosthesis on this plan from a 1.5 cm incision made under the armpit and not to create any marks on the breast.
Disadvantages;
1- It is more painful after the operation and the painful period is longer,
2- Arm movements affect the appearance of the breast more,
3- A certain period of time must elapse for the silicone prosthesis and breast to sit and form a natural image.
Recently, the layout plan, which we call the dual plan or under muscle plan, has come to the fore more. This layout plan covers the prosthesis better, while at the same time reducing the impact of the breast from arm movements. Again, it takes less time for the breast to regain its natural appearance.
Above, I tried to give you information about surgery techniques, advantages and disadvantages. In all this, my preferences are;
1- If the patient is determined not to want any marks on the breast and the breast structure is also suitable; a serum prosthesis with an underarm entrance.
The satisfaction rate of this application is quite high, patients who want to grow more for the second time want it to be done with the same technique again. The impression I get during the ongoing checks and examinations is that an extremely natural image is obtained in shape, but the prosthetic gel is felt more than the prostheses.
2- The patient is sensitive about the scar on the breast, but he definitely wants the prosthesis not to be felt, if he wants a natural sense of touch, depending on the condition of the breast, I prefer the placement plan under muscle (dual plan) with an incision around the nipple under the muscle fascia. The type of prosthesis I choose is more drop prosthesis. Sometimes patients prefer a more rounded appearance, in this case, I put a round prosthesis in a semi-muscle layout.
The satisfaction rate from this application is also quite high, and this group is the largest group in terms of the number of operations performed. There are no complaints about the naturalness of the mark, shape or sense of touch.
3- If the patient does not show sensitivity about the scar, I prefer an under-breast incision. The biggest advantage of this entry is that the operation can be performed in the easiest and shortest time, providing more dominance. The absence of touching the breast tissues and the absence of the risk of contracture due to infection are also among the plus advantages. The easiest way to operate for all placement plans and all types of prostheses under the muscle, the entrance under the breast. The only disadvantage is that the mark will fade over time and appear as a thin crack.
My general impression during postoperative follow-ups is that there are no complaints about the scar at all and the satisfaction rating is high.
Depending on the scope of the surgery, the procedure takes about 1-1.5 hours. After the surgery, bandages are applied to the breasts or a bra can be used. Postoperative pain is easily controlled with medication and disappears on the first or second day. If you have undergone office surgery, you can be discharged within a few hours, if you have been admitted to the hospital, within a day.
Postoperative complications such as infection and limited blood accumulation are rare and treatable. Due to the formation of excessive scarring (decussation tissue), which is occasionally defined as capsular contracture, second operation may be required to soften very hardened breasts. Rarely, it may be necessary to remove the prosthesis. The risk of complications can be reduced by closely following the recommendations during your follow-up during the recovery period.
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AFTER BREAST AUGMENTATION SURGERY
If the dressing has been applied, it will be replaced with a special bra after a few days. Although efforts will be made to make it the least noticeable, scars are the inevitable result of surgery. In many cases, it will fade slowly and become difficult to notice over time.
The healing process on both sides may be different, and temporary breast asymmetry may occur due to this. Different degrees of hardening of the breast may occur in the weeks or even months following surgery. In some cases, breast massage may be recommended to increase softness. Following surgery, sensation may disappear in the nipples. But in most cases, the feeling will return.
Although you will get up on the first day after surgery, an appropriate program will be recommended for you to return to your normal routine. Although it varies from patient to patient, you will usually be able to return to work after 2-3 days.
Breast Augmentation Surgery:
– Operation time: 1-2 hours.
– Type of anesthesia: General or local sedation-assisted
– Duration of hospitalization: Discharged on the same day or 1 day
– Postoperative pain: Mild to moderate pain for a few days with painkillers.
– Swelling-bruising: Swelling for the first three days, bruising is rare
– Dressing: 3.-4. bandages are removed daily
– Bra: It takes 3-4 weeks.
– Stitches: There are no stitches that need to be removed
– Return to work: 3-4 days.
– Recovery: After 3-4 days, you can do all your routine tasks comfortably, and depending on the form of surgery, you can start working out within 4-6 weeks.
Stay with love,
Op. Dr.
Specialist in Aesthetic Plastic Surgery
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Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.
Physician's Resume:
Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.
Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.
In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.
Awards:
Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.
Certificates:
Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .
Professional Members:
American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.
Disclaimer:
Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.