Breast enlargement or augmentation is the most common aesthetic surgery. The enlargement is done with the insertion of prosthesis that is filled with a silicone gel.
A lot has been written about silicone prosthesis. Most researches were made in the USA, where in 1991 FDA forbade the use of prosthesis, due to the increasing pressure from the media, regarding the possible harmful effects. After fifteen years of researches the prohibition was canceled, because no harmfulness was found concerning silicone prosthesis. They have, however, found that there is a lower incidence of breast cancer, that the silicone content in breast milk is lower than in cow’s milk or milk powder and that it does not interfere with preventive breast examinations.
There is a common fear of bursting prosthesis, which is redundant, since implants are in fact extremely resistant, the crack is rare. Newer implants are filled with a gel so that the silicone does not “spill”, nor does it change the shape of the breast.
Breast enlargement is carried out after preliminary examination with the surgeon about the size and shape.
Namely, there are two types of prosthesis; round and teardrop/anatomical. Each of the two has its advantages and disadvantages.
The procedure is done under narcosis and lasts about an hour.
Most commonly used incision is the one under the breast. Although when there is a simultaneous breast required, I perform the cut around the ring. I personally like to avoid the cut in the armpit area, due to various complications. Further on a subcutaneous pocket is formed, that usually continues under the big breast muscle in order to cover the upper and outer part of the implant. That gives the breast a more natural look and it is necessary with skinny patients. If the ribs are visible above the breast, the prosthesis will also show unless we cover it with breast muscle.
After the procedure
I advice against all major physical activities for at least three weeks after the operation. During this period it is necessary to wear a sports bra. The pain after the surgery is tolerable with the assistance of mild analgesics (Nalgesin, Lekadol) and cold compresses.
You are not allowed to take aspirin or aspirin-like products at least 14 days before surgery. After a week you can return to work (however it is not recommended to lift heavy loads for at least two weeks).
The implants cannot make the breasts natural. They can make them appear more natural (so they do not look like playboy breasts), but never completely natural.
A few months after the operation connective capsule might form around the prosthesis. The capsule can be completely gentle, or it can be stronger, causing pain or in worst cases deformity of the breast.
If that happens, the operation has to be done anew. Removal or at least partial removal of the membrane is required and also an insertion of an implant under the muscle.
Fortunately, the emergence of such capsule is extremely rare, especially with newer, textured breast implants.