Aesthetic Plastic Surgery

Definition:

Breast hypoplasia is defined by a volume of breast underdeveloped compared to the morphology of the patient. It may exist at the outset (small breasts since puberty) or appear secondarily, as a result of weight loss or pregnancy followed by breast-feeding.

It can be isolated or associated with ptosis, ie a failure in the gland and distention of the skin. This aesthetic surgery but can not be covered by health insurance.
Objectives:

A mammoplasty increase is to correct the volume breast deemed insufficient by the development of implants (prosthetic) behind the mammary gland.
Principles:

All breast implants currently used are made of an envelope, and a filling. The envelope is always made of silicone rubber band (silicone elastomer). It can be smooth or rough (textured).

With regard to the filling product, only now are allowed in France on saline and silicone gel because they are known and used for nearly 40 years.

The implant is said pre-filled when the product has been incorporated filling factory (and silicone gel or saline). The range of volumes is determined by the manufacturer.

Inflatable implants to saline are completed by the surgeon who can adapt to some extent the volume of the prosthesis during surgery.
Before the speech:

The location of the scar, the location of the implant relative to muscle, the type and size of the prosthesis have been decided in consultation, depending on the context in particular anatomical and desires expressed by the patient. This way they come after a clear presentation of different methods to choose what is best in each case. A pre-operative assessment is normally conducted in accordance with the requirements. The anesthetist will be seen in consultation at least 48 hours before surgery.

In addition to the pre-operative examinations usual, it may be useful to check the breast imaging (mammography, ultrasound). Any medication containing aspirin should be taken within 10 days preceding the intervention.
Types of anesthesia and hospitalization:
Type of anesthesia:

It is usually a general anesthetic classic, when you sleep completely.
Terms of hospitalization:

A one-day hospitalization is usually sufficient.
Intervention

Each surgeon adopts a technique of his own and that adapts to each case to get the best results. However, it may hold common basic principles:

Skin incision

The implant is introduced by a short incision located:

* Or on the areola,
* Be in the region of the armpit,
* Either in the crease under breast.

Position of the implant

The lodge is built by décollement and in which the prosthesis is located is:

* Is behind the mammary gland and to the pectoralis major muscle,

* Is behind the gland and behind the pectoralis major muscle,
Gestures associated

In case of breast ptosis (droopy breasts, areola bass), it is desirable to involve a gesture of reducing the skin envelope which implies a larger ransom cicatricial (periareolar, vertical).

It is possible that a drain is left in place a few days after the operation so that the blood or liquid that can be collected are eliminated.

At the end of intervention, dressing models, with elastic in the shape of a bra is made.

Depending on the surgeon and the possible need for a complementary partner gesture, intervention can take 1 to 2 hours.

After intervention: follow procedures

FOLLOW-UPS can be painful the first few days, especially when the implant is placed behind the pectoralis major muscle. Then use a painkiller for a few days. In the best case, the patient felt a strong sense of tension.

Edema (swelling) and ecchymosis (blue) breast discomfort to the elevation of the arms are common at the beginning. The first dressing was removed after 24 to 48 hours and replaced with a lighter dressing, making a sort of elastic bustier made to measure. The release took place 24 to 48 hours after the operation, then the patient is reviewed in consultation two to three days later. We put in place a bra ensuring good contention.

Wearing this bra is recommended for about a month, day and night. If the son of suture are not absorbable, they are removed between the eighth and fifteenth days after surgery. Consideration should be given to recovery and a work stoppage for a period of 8 to 10 days.

It is advisable to wait one to two months to resume sporting activity.
The result

It can be appreciated from the third month, the time needed to easing breast and stabilization of prostheses. Beyond the aesthetic improvements, the psychological impact is most beneficial.
The result of imperfections

It is possible that the scar is an abnormal evolution in the form of thickening or retraction. Breast pain, disorders of the sensitivity mamelonnaire are also possible. On the other hand, a result of dissatisfaction aesthetics can motivate a reoperation after consulting the surgeon.
The question of the duration of the implant

A prosthesis, it is filled with silicone gel or saline for a period of uncertain life that we can not estimate a priori since it depends on the possible occurrence of complications. Thus, the life of the implant can not be guaranteed.

A woman with breast implants is at risk of using a complementary alternative to that effect is maintained. Nevertheless, there is basically an implant quality does not have a lifetime limited theoretically there is no deadline beyond which the change of implant is mandatory. Thus, in the absence of wear or complications, the implant can be kept as long as the patient wants.
The possible complications

The increase in breast prostheses, although carried out mainly for aesthetic reasons, remains a real surgery, which involves the risks associated with any medical however slight it.

We need to distinguish between complications related to anesthesia those relating to surgery.

* With regard to anesthesia, during the consultation, the doctor-anesthetist himself inform the patient of the risks anesthetics. You should know that anesthesia induced in the body sometimes unpredictable reactions, and more or less easy to control: the fact to use a perfectly competent Anesthésiste, engaged in a real fact that the surgical risks are now almost statistically insignificant. Be aware, in fact, that the technology, products and anesthesia monitoring methods have made tremendous progress over the past twenty years, providing security, especially when the intervention is conducted outside the emergency and in a healthy person.
* As regards the surgery: choosing a Plastic Surgeon qualified and competent, trained in this type of intervention, to minimize these risks, but not completely remove. The operating suites are generally simple setting of an increase in breast prostheses. However, complications can occur, some inherent in all breast surgery, others related to the establishment of a foreign body in the womb: the risks specific to breast implants.

1 / The complications inherent in all breast surgery:

- The occurrence of an infection requires antibiotic treatment and sometimes surgical drainage.

- Hematoma may require an act of evacuation.

- Changes in the sensitivity, especially mamelonnaire can be observed, but the sensitivity appears normal in most cases within 6 to 18 months.

- Especially the development of scars can be detrimental to the development of hypertrophic scars or keloids, creation and evolution unpredictable, which can compromise the aesthetic outcome of treatment and require specific local often long.
2 / The risks specific to breast implants:

They fall into three categories, which vary depending on the nature of the filling of the implant (see table). This is the formation of wrinkles or waves, the occurrence of capsular contracture peri-prosthetic and the risk of rupture or deflation.
Formation of wrinkles or aspect of “waves”:

The implant, to remain flexible, never filled with tension. As a result, the folds of the envelope of the prosthesis can be visible under the skin, while giving an aspect of “vague” especially in the upper, outer and lower breast. This is limited at the top when implemented in retro-muscular position. This phenomenon is much more common when the prosthesis is filled with saline solution, especially if its wall is textured. It exposes women at greater risk of rupture and deflation by premature aging of the envelope at a trick.
Capsular contracture and fibrous hull

The formation of a fibrous capsule around the implant is required. It is a normal reaction of the body that form a sort of fibrous membrane around any foreign body in order to isolate and protect themselves (or membrane capsule exclusion “). In some cases, this membrane is the seat of an adverse trend similar to keloid scars skin thickens it, shrinks and forms a real fibrous hull around the implant. This is the capsular contracture. There are four stages of firmness ranging from normal, undetectable to severe forms of shells with within hard, round, set and sometimes painful.

The frequency of this complication can not be estimated because it generally depends on the indication of the type of prosthesis and the operative technique. This complication is more common in cases of implant filled with silicone gel. The hull does not increase the risk of rupture but sets a complication aesthetic. Surgery can correct this by section contracture of the capsule (capsulotomy).

Several authors have proposed technical solutions to reduce the appearance of this contracture:

* The position of the implant behind the pectoral muscle,
* Manufacture of rough walls on the outside surface of the implant (textured prostheses)
* The use of implants filled with saline.

Rupture and deflation

Such an incident occurs as a result of an alteration of the envelope of the prosthesis, ie the container (silicone elastomer). Phenomena of porosity, open or puncture real gap may be involved and appear as a result of violent trauma, sometimes of a manufacturing defect, but especially because of the length of the prosthesis (phenomena wear).

For a prosthesis with saline solution, it can also be a problem sealing the filling valve. This type of prosthesis deflation suffered partial or total, fast or slow. If this is a prosthesis pre-filled with silicone gel, the gel is still mostly in the fibrous envelope surrounding the implant (intra-capsular leakage). The leak was then no clinical. However, this seepage intracapsular can promote the development of peri-prosthetic shell.

Much more rarely, in cases of breach in relation to significant trauma or violent to the needle puncture, freezing escapes beyond the fibrous envelope (extracapsular rupture). In small amounts, it can cause the appearance of a foreign body granuloma as a nodule (siliconome). In case of extra-capsular rupture important (trauma), the gel diffuses into surrounding tissues, breast takes a very soft consistency, inflammatory reactions may occur: the explantation surgery is necessary.
Questions: What you should know about breast implants
Is it possible to breastfeed?

The introduction of breast implants behind the mammary gland appears to have no impact on breastfeeding.
The breast protèses they promote the emergence of breast cancer?

The relationship between breast cancer and implant was searched but no link between the two has been highlighted and the establishment of a breast does not the risk of breast cancer. Surgeons of cancer centers regularly use for breast reconstructive surgery.
The monitoring of the breast is possible?

The prosthesis was behind the mammary gland, clinical monitoring is simple. The presence of an implant can affect the ability of X-rays to detect breast cancer. The patients carrying a breast implant should be made clear that the radiologist can use specific methods and adapted (ultrasound, digital mammography).
What about the controversy over silicone gel?

Breast implants filled with silicone gel have been accused of being responsible for the onset of autoimmune diseases in some patients. Today, all the scientific work on this issue has demonstrated that there was no significantly increased risk of autoimmune disease among women with breast implants and in particular those filled silicone gel.
Is there surveillance after the establishment of an implanted breast?

It is necessary to undergo post-operative visits, depending on the request of the surgeon. Subsequently, the presence of a breast implant does not need to conduct reviews in addition to the usual medical surveillance, but it is essential to clarify the doctor that you are carrying a breast implant. It is imperative for a variation of a breast (hardening or softening the contrary) to consult a doctor (family physician, gynecologist, surgeon) who will judge whether it is necessary to use an X-ray or ultrasound.

These are the information that we can now scientifically and honestly you make in the field of surgery by increasing breast prostheses. In total, we should not overstate the risks, but just be aware that surgery, even seemingly simple, always has a small share of hazards.

The use of a qualified Plastic Surgeon assure you that it has the training and expertise to know to avoid these complications, or treat them effectively if necessary.

This information brought to you in addition to consultation, we advise you to keep this document to read it again after the consultation and reflection “at their leisure.” This reflection may raise new questions for you wait for additional information. We’re here to talk at a future consultation, either by phone or on the day of intervention where we will in any case before anesthesia.

Filed under: Aesthetic Surgery, Cosmetic Surgery, Plastic Surgery, Reconstructive Surgery

Tags: breast augmentation, breast augmentation before after pictures, breast pictures