Augmentation Mammoplasty
In the breast tissue, there may be development deficiency, along with after giving birth and losing excess weight. Esthetic augmentation mammoplasty can be performed with fat tissue injections, hyoluronic acid injections (Macrolane) and with the placement of silicon prosthesis’s.
Fat Injection: Tissues which are removed from the areas possible, mainly from the belly area is prepared and injected into the breast area under general anesthesia or deep sedation + local anesthesia. Operation can take anywhere between 1-1.5 hours. Swelling and light bruising may be seen in the first few days. With fat injection, a partial enlargement of the breast can be achieved. It is a technique that can be used in patients that don’t have breast deformations and enlarging the breasts a little is enough. 2-3 sessions can be performed if needed.
Hyoluronic acid: Hyoluronic acid, which is also used in face esthetics, is longer lasting in the breast augmentation mammoplasty (two years). It is injected into the breast area under general anesthesia. It is preferred to be used in patients who don’t have breast deformations and enlarging the breasts a little is enough.
Silicon Prosthesis: This technique is used worldwide and is mostly preferred in our country as well. All of the prosthesis’s are formed from silicon. The outer protection is made with silicon and the inside can include serum physiologic, liquid silicon, and silicon that is not fluid. Silicon prosthesis’s was first used in the augmentation mammoplasty operation in 1962. In the following years, silicon prosthesis’s have developed. In 1991, muscle and joint pains were seen in some patients, rheumatic diseases, and also breast cancers, and prosthesis’s were held responsible so their use was stopped in America under the Food and Drug Administration (FDA). The FDA asked the prosthesis producers to prove that prosthesis’s are not harmful. Although there was no incident, proof wasn’t made. In 2006, the FDA once again evaluated, and allowed the use of silicon prosthesis’s to be used in esthetic breast operations. In the years between 2001-2006, prosthesis’s where the outer layer was silicon and the inner layer was serum physiologic were used. Silicon prosthesis technology has shown high advance in present days.
Structure of Silicon Prosthesis: Nowadays, physiologic with the inside being liquid derum, liquid silicon prosthesis’s, dark consistency, non-fluid, prosthesis’s in droplet shapes are preferred. The prosthesis’s silicon structure and shape changes depending on the manufacturer firm. The surgeon’s preference should be the first plan but the patients preference should also be considered and the prosthesis brand should be chosen. The silicon’s prosthesis’s magnitude, shape, and structure is determined depending on the breasts necessity. If the breast tissue is little, big sized prosthesis’s and if the tissue is a lot, then small sized prosthesis’s are preferred. The prosthesis that will be used being in a circular or droplet shape form depends on the breasts natural structure. The fixing of breast sagging or tubular structure or other shape deformations need to be firstly evaluated and the shape of the prosthesis is determined.
The area where the prosthesis will be placed: The plans where the prosthesis will be placed can be under the breast muscle, under the half muscle, under the muscle membrane, and under the breast tissue. The placement of the prosthesis is planned based on the patient’s breast tissue and thickness of skin. Operation can be performed from entering under the breast, underarm, from the inside of the breasts colored portion, and from entering the belly.
Each technique has it’s own advantages and disadvantages. Operation performed from under the armpit can be hard to dominate and the operation’s security can lessen because it is far from the operation area. In women, the scars under the armpits can be shown because of the dresses they wear. The scar done under the breast can be uncomfortable. Operation performed from the belly is generally performed with placing prosthesis’s, which include isotonic solutions, and it is far from the operation area so domination may not be enough. The incision made from under the corner of the skin, which is attached to the breasts colored area should be done from the middle so that it can be dominated. Since the nipple will be closed, a scar will not be visible. Since the scar is in the colored area’s end, a scar will also not be visible there either. 3-4 weeks after the operation, feeling differences can be seen because of ecartation but this will not remain permanent if the operation has been performed carefully and with control. Breastfeeding is not affected because it is entered through the breasts gland and parallel from the ducts.
Operation: Is performed under general anesthesia and takes approximately 2 hours. The drains that will be placed in the operation area will remove the accumulated liquid. The liquid accumulated inside later on plays a big role in the capsule evolution. Drains are beneficial for the operations security. Generally, stitches that melt on their own are used so removal of stitches is not needed. Thick bandages that support the breasts are placed in the operation area. The patient will stay in the hospital for 1 day. Drains are removed in 1-2 days depending on the liquids color and amount. The adhesive bandages are removed after 1 week and sport bras are worn. The patient should not drive for 1-2 weeks. The most part of the swelling will get better in the first month but the breast to take its last shape will happen after 1 year.
