- Procedure Time
1-2 hours - Overnight stay
1 night - Anaesthesia
General - Recovery Time
4-6 weeks
Breast Implant
Breast augmentation surgeries with silicone implants are among the most common aesthetic operations all over the world. After the completion of puberty, the person's finding the breast volume insufficient, thinking that it is small compared to his body or congenital asymmetries can be considered sufficient reasons for this operation. Silicone breast prostheses are used not only for aesthetic purposes but also for breast reconstruction after breast cancer. The fact that foreign matter will be used in this operation naturally causes many question marks in the minds of people.
What is Breast Implant?
It is the process of enlarging the breast size, increasing its fullness and changing its shape by placing a silicone implant (prosthesis) under the breast tissue or chest muscle under operating room conditions.Breast implants are prostheses containing silicone, which are used to fill the breast after breast augmentation or mastectomy treatment. There are various types of these prostheses, which can be different types according to their content, and they can be different types according to their structure. The invariable part of these silicone prostheses are the outer layers, the silicone envelope layers. There may be silicone gel in it, or it may be medical water, which is called serum physiology.
What are the types of Breast Implants?
The structure of the most commonly used implants for breast augmentation are structures filled with silicone gel, which can have different consistencies, placed in a medical silicone sheath. There are also types filled with saline. Silicone implants come in two forms: “round” and “anatomical (tear drop)”.
When the horizontal and vertical diameters of the round implants are equal, even if they rotate in the body, they do not pose a problem. In round prostheses, the volume of silicone is evenly distributed everywhere, this type of prosthesis is more successful in filling the upper part of the breast. On the other hand, the vertical and horizontal diameters of the anatomical type implants used to shape the breasts, especially in zero size breasts, are different. They are made especially rough so that there is no rotational movement in the body.
The surface of the anatomical breast implants is designed rough to prevent rotational movement in the pocket where it is placed. Round-shaped implants can have a smooth or rough surface. In recent years, the use of flat-surfaced round implants has increased.
Who is suitable for Breast Implant?
Individuals who are over 18 years old, and whose thorax development completed.
Individuals who have good physical and psychologial health.
Individuals with a significant problem in their breasts; for example, small in size, asymmetrical, hollow and flattened or sagging.
Individuals who have realistic expectations.
Who is not suitable for Breast Implant?
Individuals who are younger than 18.
Individuals who have serious general health problems (such as infection, untreated cancer, immune system diseases) or have serious psychological problems
Individuals who are pregnant or breastfeeding.
Individuals who have untreated breast cancer.
Indiviudals who consume excessive alcohol, cigarettes or drugs.
How is the size of Implant determined?
First of all, it should be considered that it is not possible to use implants of the desired size for every person. The most basic measure that determines the size of the implant to be used is the breast base diameter of the person and this size varies from person to person. Another important factor that determines the size of the implant is the flexibility of the breast tissue and skin; The volume placed under the breast should allow the breast tissues to stretch sufficiently.
It is not possible to put a large implant on a size zero breast with very tight skin in the first time. On the other hand, implants to be placed under the muscle have to have a smaller base diameter and volume compared to the supramuscular implants. The volume of breast tissue present is another factor to consider. In short, there are some anatomical criteria that limit the size of the implant to be used, and attempting to place an implant larger than the optimal size by forcing these criteria leads to different deformations and complaints after the surgery, and the need to replace it with a smaller implant with a second surgery arises. With the effect of the first silicone implant placed in appropriate sizes, the breast tissue and skin on it loosen over time and adapt to its new condition like the belly of a pregnant woman.
After this stage, if desired, the old implant can be replaced with a larger volüme implant with the same base dimensions but with a higher projection. In this way, it is possible to reach larger breast sizes in a few surgeries gradually. However, it should not be forgotten that as the volume of the implant grows, its weight will increase and it will cause faster and more sagging of the breasts over time.
Where is the incision area to be made Breast Implant?
Which area is better?
Using a 3-4 cm incision made from one of the following areas, the under-breast is reached;
Inframammary fold (the line where the lower half of the breast meets the rib cage)
Lower half of the brown area around the nipple
Underarm area
Each cut has its own advantages and disadvantages. Case status and personal preferences of surgeons play a role in the selection.
Should the implant be placed under the muscle or over the muscle?
Beneath the breast tissue is the pectoral muscle, and below it are the ribs. The silicone implant can be placed on the supra-submammary plane or on the sub-muscular (dual plane) plane. Implants with wider bases can be placed on the supramuscular plan in a shorter time, but if the breast tissue covering the implant is not thick enough, which is the case in most patients, a clear border is formed around the implant, the breast-rib cage transition is not natural and gives the breast an artificial appearance.
Since the muscle tissue and breast tissue will cover the implants placed under the muscle, a more natural appearance is obtained when viewed from the outside. In addition, the possibility of capsular contracture is lower in implants placed under the muscle.
The most frequently preferred method in practice is the submuscular application technique called "dual plan". In this method, the implant part above the nipple level is under the muscle, and the part below the nipple level is in the submammary plane.
Before the Breast Implant Surgery
Before the Breast Implant surgery, the patient and the plastic surgeon who will perform the surgery should meet face to face and the whole process should be discussed in detail. In this interview, it is first evaluated whether the person is a suitable candidate for breast augmentation surgery.
Breast, rib cage and body measurements of suitable candidates are taken, photographs of the body part between the neck and belly button are taken from different angles, many features such as the structure of the rib cage, the shape of the breasts, and whether there is asymmetry are evaluated by the surgeon.
Later, details such as the shape and size of the implant to be applied, from which incision it will be placed and which plan (under or above the muscle) will be placed are discussed and decided. Information is given about the possible risks and complications of the method. All questions of the patient are answered.
In the preoperative period, a routine breast examination should be performed by a general surgeon to clarify the health status of the breasts, and any mass or pathology should be examined by ultrasound and other methods deemed necessary. These examinations should be performed even at very young ages and in completely normal-looking breasts, because even in these people, previously unrecognized problems can be detected.
In order to prepare for the surgery, the patient is given an information form that explains in detail what she should pay attention to, what she should consume and what she should not consume, and she is expected to strictly comply with all these recommendations.
Consumption of tea, vitamins, medicines and nutritional supplements such as green tea, which has blood thinning properties, should be stopped at least 15 days before the surgery. After the pre-operative meeting with the anesthesiologist and the necessary examinations, if no problem is detected that prevents the operation, the operation phase is started.
How is Breast Implant Surgery performed?
It is performed under general anesthesia in operating room conditions. A skin incision is made from the previously determined area and a pocket is created under the breast where the implant will be placed. A very meticulous control of bleeding is performed in this pocket, and the pocket is washed with solutions containing different antibiotics or antiseptics.
The original implants to be used are put in their places after the test prosthesis is placed in the created pocket for the appropriate size and shape of the implant. According to the preference of the plastic surgeon, a silicone tube called a “drain” is placed in the pocket and one end is pulled out so that the blood and tissue fluid that will accumulate around the implant can be taken out. The incision made at the beginning of the operation is sutured with “hidden and self-dissolving” sutures, a bandage is applied and the operation is terminated.
How long does the Breast Implant operation take?
Depending on the surgical technique used and the way the surgeon works, the operation time usually varies between 1-3 hours.
What should be considered after the Breast Implant surgery?
Oral feeding is started 2 hours after the operation, and after 4 hours, they can stand up and start walking. The bed is in a semi-sitting position. It is beneficial to spend the night of the operation in the hospital in order to be able to follow up and treat closely.
In this process, it is necessary to avoid compelling movements of the arms, raising the arms too much, excessive straining on the toilet and walking too much. Depending on the color and amount of the fluid coming from the drains within 24 hours, it is decided to draw it, which usually takes 2-3 days. In patients who move more and use their arms, there is more fluid flow and the drains are removed later. Special bra and corset are used in the postoperative period.
While being discharged from the hospital, the operation note explaining the details of the surgery performed and the implant identification document of the company containing the silicone implant information used should be requested and kept for use when necessary.
One week after the operation, it is possible to return to daily life gradually, provided that the arms are not too hard. Sports such as swimming or tennis, where the arms are used intensively, can be started after 6-8 weeks.
In particular, it is recommended that patients in whom the implant is placed under the muscle should avoid sports that force the chest muscles excessively, such as heavy lifting and pull-ups, because the silicone implant can be displaced downwards and outwards by the repulsive force of the muscles. During the first two months sauna, solarium or long-term active sunbathing should be avoided.
In the first 3 days after the operation, the breasts become very tight and swollen, after the 3rd day, the edema gradually regresses and the breasts begin to soften. The breast image observed in the first weeks is not the final aesthetic image. In the first weeks, the image that is tense, motionless, and the nipples protrude a lot begins to change from the 2nd month; The breasts become softer, more mobile, edema in the décolleté of the breasts recedes, the nipples turn a little higher, in short, in the 1-6 months following the breast surgery, it becomes even more natural and takes its real appearance.
In this process, changes in the sensation of the nipples, electric shock in the breast, different pains such as burning, swelling compatible with menstrual periods are normal to experience. Some scar reducing creams are used for the surgical scar on the breast, it takes 2 years for the scar to take its final form.
How should you sleep after the Breast Implant?
It is important to lie in a supine and semi-sitting position for the first 2 weeks following the surgery in order to avoid complications such as bleeding and not slipping of silicone prostheses. You should continue to use the bra and corset given to you while you are lying down. While you are sleeping, you may have turned to one side without realizing it, short turns may not cause serious problems, but if you put pillow supports under your arms on both sides, you will both prevent these involuntary turns and provide support to your arms.
When can I sleep on my side or back?
2 weeks after breast augmentation surgery, you can sleep on your side, provided that you use the bra and corset given to you. If you feel a pain or discomfort in your breasts when you lie on your side, it is useful to extend this period. Since there is a direct pressure on the silicone prosthesis in the prone position, there is a risk of slipping of the prosthesis to the side and down, and therefore, the patient should not be lying face down until the wound healing around the prosthesis reaches a certain stage, which according to research is at least 3 months.
Is the Aesthetic result obtained with Breast Implant permanent?
The breast is not a static organ, the aesthetic appearance obtained after the surgery will not be permanent for life. The shape of the breasts constantly changes over time due to aging, gravity, weight gain and pregnancy.
Considering the weight of the implants, sagging and loosening of the breasts is inevitable over time. This process will be faster in some and slower in some, depending on the tightness of the breast skin and the environmental conditions to which the person is exposed.
In the long term, reoperation may be required for reasons such as leakage or bursting of the silicone implant, inversion, excessive capsule formation around the implant, tumoral mass development in the capsule or breast tissue, fluid collection in the breast, and development of deformity.
Potential Risks and Complications of Breast Implant Surgery
As with any surgery, breast augmentation surgery has risks and complications, and surgery candidates should be adequately informed about this issue. It is possible to prevent most of these complications in people who take their doctor's recommendations seriously and apply them before and after the surgery.
Bleeding: In the early postoperative period, especially in the first 15 days, there may be blood accumulation (hematoma) in the pocket where the silicone implant is placed. The breast suddenly begins to swell, enlarge and hurt. In operating room conditions, the implant is removed, bleeding is controlled and the implant is put back in place. To avoid such complications, blood thinners and foods should be avoided at least 15 days before the surgery. In the postoperative period, it is necessary to avoid movements that increase blood pressure and force the chest muscle.
Infection: Infection may develop at the surgical site; symptoms such as redness, pain, discharge, high fever in the breast are observed. The implant is removed, the surgical area is cleaned, and the infection is controlled with antibiotics. A new implant can be placed in the same area a few months later.
Wound healing problems at the incision site: The incision made in the skin for implant placement may not heal normally; Problems such as redness, swelling, stiffness, healing in a different color from the surrounding skin may be seen.
Loss of sensation in the nipple and skin: A decrease or complete loss of sensation can be observed on the nipple and in the entire breast skin, especially in the first weeks after the operation. This condition, which usually resolves within months, may rarely be permanent.
Seroma: Excessive fluid accumulation and swelling in the breast may develop due to trauma, excessive exercise or tumoral mass formation around the silicone implant. If this condition, which can sometimes be relieved by rest, continues, additional surgical procedures may be required for sampling and drainage for fluid examination.
How long do the implants last?
The life of the silicone implant may vary depending on the technology used by the manufacturer. In practice, people who have breast augmentation surgery with silicone implants are not given a specific date for the replacement or removal of the implants. The implants are kept in place if the person does not have problems with breast aesthetics or general health and if there are no problems with the implant during routine controls.
Will the result be natural?
From the outside, it is possible to achieve natural results that cannot be understood the person has breast implants. If very large implants are placed just below the already thin breast tissue, it will look artificial, but if an implant of a size compatible with the body dimensions is placed under the muscle, or if it is placed on the muscle, but there is enough breast tissue to cover and camouflage it, they will look like natural breasts.
Will the implants be recognized when touched?
Whether or not the breast prosthesis can be understood or not depends on the softness of the implant and whether a prominent capsule is formed around it.