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10:00 - 17:00Breast augmentation is a surgical procedure aiming to increase the size and/or improve the shape of patient’s breast. During the procedure it is also possible to reduce a slight difference in breast size.
Surgical breast augmentation has underwent multiple modifications since 1961, when Cronin and Genowa performed the first breast augmentation surgery by filling breasts with fluid silicone. Not only the surgical technique has changed, but also the structure and shape of breast implants. Currently utilized 5th generation implants are filled with densified gel with solid, jelly consistency, which does not flow out even after the implant is damaged. Surface of implants is not smooth, only porous and covered with the so-called “texture”.
Implants offered by globally renowned companies are covered with a lifetime warranty and in case of their damage resulting from implant defects, regardless of the period of time that passed since the operation, the producer shall provide new implants within the scope of warranty, free of charge. All prerequisites essential to fulfil the warranty conditions can be found on websites of implant producers:
In AMC we offer You implants from:
Implant breast augmentation is performed because:
As far as this description is concerned, we shall describe breast augmentation related with aesthetic aspect.
Breast shape and symmetricity are influenced by structure of the chest in each aspect, location of the shoulder joint, spinal curvature, size of the breast muscle, location of areola of nipple and its direction, location of the fold under the breast, not to mention many other factors, not only limited to size and shape of the sole mammary gland. There are multiple factors posing influence on changes concerning the shape, firmness and location within the chest. Losing and gaining weight, increased breast volume during pregnancy and lactation, as well as the process of losing tissue elasticity during the ageing process, still influenced by gravity, deform female breast and cause their sagging (ptosis) and shape disorders. Only quite small group of patients meet the criteria of “perfect breast” with complete symmetry as far as anatomic structure is concerned (5-10%). Whilst in case of most patients we can observe a small or more significant asymmetry in their anatomical structure. Not all patients can be qualified to undergo the surgery aiming to change the shape of their breast only by means of breast implants, although that is what they expect. Depending on skills and experience of a plastic surgeon within the field of the latest operating techniques, chances to operate a larger number of patients, despite sagging and weak breast, are constantly growing. Nonetheless, there is a certain limit relating the possibility to obtain a good aesthetic effect resulting from the operation, despite the “grandness” of the surgeon and techniques he uses.
This limit can never be crossed, regardless what the patient expects, as it is the surgeon who is responsible for the final result of the procedure and hence the patient trusts the doctor and cannot be betrayed. What concerns aesthetic reasons, breast augmentation procedures can be divided into three main groups:
Depending on the local condition in case of each patient and taking into consideration her expectations, plastic surgeon selects the best method to be used in her case and clearly explains this decision to the patient.
What is extremely important is the initial consultation with experienced plastic surgeon, who has practiced within this field for many years and who has obtained a specialist degree after passing a state exam, and hence has adequate knowledge to properly qualify the patient, conduct the operation and manage the post-operative care, and to effectively treat possible undesired adverse events and complications. That is why procedures within the field of aesthetic surgery, which is an inseparable element of plastic surgery, can be performed solely by a plastic surgeon, and this is what our Clinic guarantees. Considerable number of patients has suffered from aftermaths of unsuccessful operations performed by general surgeons, gynaecologists, etc., and unfortunately even an outstanding plastic surgeon cannot overcome such consequences.
During initial consultation plastic surgeon will expect the patient to define her expectations as far as post-operative result is concerned. Plastic surgeon asks about the details of patient’s medical history concerning chronic diseases, administered medications and stimulants, as well as the current medical condition. He evaluates the anatomic structure of the patient to assess the chance to conduct breast augmentation procedure within the scope of size and symmetry.
During the examination he determines the reasons underlying unsatisfactory breast look taking into consideration developmental defects, posttraumatic deformations or the ones resulting from the natural ageing process. Thorough medical examination enables to determine all asymmetries and abnormalities within breast structure and chest structure. All information obtained during the examination and from medical history will enable plastic surgeon to better qualify the patient to undergo the most appropriate surgery and to perform the surgery, which will help the patient make the right decision.
What may also prove helpful in determining the patient’s condition during consultation and after performing proper tests is the complete medical documentation of the patient concerning chronic diseases. (Please bring such documents for consultation). After preliminary qualification to undergo breast augmentation with implants, we will undertake the proper selection, taking into consideration shape, size and type of implants. Significant diversity of breast implants makes it possible to achieve proper aesthetic effect by means of the operation in nearly all cases of disease inconveniences or anatomical deformations. During the consultation the surgeon and the patient agree on the place where the surgical incision is to be made in order to enable preparation of the breast implant pocket. The following three operational accesses are currently used:
All these places of surgical access are associated with certain advantages and disadvantages, which the plastic surgeon should discuss with the patient during consultation. Currently there are two types of breast implants that are utilised: round and anatomic with low, moderate and high projection. Anatomic implants are available in various proportions between the length and width and height, which give the opportunity to obtain a better result, despite anatomical differences of the patient’s body. During consultation the doctor should provide the patient with information on all possible dates of operation, taking into consideration schedule in the clinic and patient’s private plans. It is appropriate to set the date of the anticipated surgery within the first two weeks after menstrual bleeding, as this reduces the risk of post-operative complications.
What is more you should also obtain recommendations relating
Significant arrangements settled with the patient should be noted in medical documentation filled by the physician. On the set date of the surgery the patient shall have to undergo repeated medical consultation in order to verify her current medical condition once again. All ordered tests shall be evaluated, plastic surgeon and anaesthesiologist will conduct and interview with physical examination and will discuss all questions and doubts relating the scheduled procedure, which may change arrangements resulting from the initial consultation. During the second consultation with plastic surgeon and anaesthesiologist that takes place on the day of the operation, after clearing all doubts, after discussing the operating technique and possible complications for the second time, and after performing all measures and marking the scope within the breast (indicator – marker) the patient shall sign an informed consent to undergo surgical procedure. At this point photos constituting the element of a medical documentation will be taken.
Scheduled surgical operation shall not be performed when the patient’s medical condition on the day of the surgery shall not be satisfactory. All kinds of bacterial or viral infections, as well as unstable chronic diseases shall make the physician abandon the scheduled procedure until the condition of the patient improves or medical doubts are cleared. Tests ordered during the period preceding the surgery should help the physician to determine the patient’s medical condition and chances of improvement until the time of the scheduled operation.
Before admittance to the clinic the patient shall be asked to do laboratory tests, depending on her age and general condition – (blood type, morphology, APTT, glucose level, creatinine, sodium and potassium level, general urine analysis), chest X-ray, ECG and breast ultrasound, mammography or MRI, nasal and armpit swab. Additional tests may be ordered to determine the current condition of health, f. ex. in case of thyroid diseases it is required to have recent TSH, FT3 and FT4 tests. It may be also essential to consult another specialist, such as cardiologist in case of chronic cardiac diseases. When the patient reports in the clinic on the day of the surgery, she should have a complete set of ordered tests and her entire medical documentation.
If you smoke cigarettes, it is worth giving up smoking six weeks before the operation, as smoking decreases blood supply to tissues, respiratory capacity, which leads to increased operational risk and impaired healing.
After consulting patient’s physician in charge, it may prove necessary to discontinue using hormone replacement therapy or oral contraception 30 days before the scheduled procedure.
Avoid taking medications containing acetylsalicylic acid (such as Acard, Aesan, Aspirin, Polopiryna) and preparations with acenocumarol (Acenokumarol, Syncumar, Cintrom) 10 days before the surgery. Drugs from these groups increase the risk of excessive bleeding during the operation and during the post-operative period, which increases the number of possible complications. Do not use sunbeds and do not sunbathe during 14 days preceding the surgery, as this may cause dermal infections, superficial burns and increased susceptibility to infections.
Do not eat anything, do not drink anything and do not chew gum on the appointed date of the procedure 6 hours before the set hour when you should report to the clinic. When reporting to the surgical procedure, do not use make-up and do not put on any jewellery. Comfortable and casual clothing will ensure your comfort when coming back home after the surgery.
Before reporting to the clinic to undergo scheduled surgery make sure you will be transported home after the operation. Even after several days spent in the clinic it is required to have someone to help you with transport. You will not be able to drive a car on your own for the period of 14 days. Anticipated stay in the clinic – 3-5 days. Implants can last for life and do not require any exchange. However, with time, as patient’s weight changes, after pregnancies, skin and muscles lose their firmness, which leads to changes in breast shape. In such cases it is possible to exchange implants to improve the way breasts look.
Currently used implants have a lifetime warranty guaranteed by the producer and there is no need to exchange them solely because of the passing time. Guarantee covers material in the form of an implant and does not include the cost of the procedure.
Breast augmentation surgery is performed under general anaesthesia and it aims to increase breast size and improve breast shape. During the procedure it is also possible to reduce a slight difference in breast size. The surgery is performed in an operating room, under general anaesthesia, with anaesthesiologist and anaesthesiological nurse monitor the patient. Patient’s vital signs are being also continuously monitored. The procedure lasts between 1h and 1h 30min.
After making an incision in previously planned site, plastic surgeon creates an implant pocket under the breast muscle within the initially set range. He places breast implant in the pocket. Placing the implant under the muscle ensures a better long-lasting result and smaller possibility of post-operative complications. During the procedure the plastic surgeon introduces a drain (silicone tube) in order to evacuate tissue fluids. After suturing the wound the operator places a special dressing.
The procedure of introducing breast implants does not make it possible to lift too slack with considerable degree of sagging, where breast lifting surgery shall be required.
Possible outcomes and complications related with breast augmentation surgery
When making a decision to undergo plastic surgery, we expect to fulfil our dreams, positive feeling and complete satisfaction after the operation. As a result of professional activities performed by a plastic surgeon in a properly adjusted place, all expectations of the patient shall be met. Complications are extremely rare, and plastic surgeon perfectly knows how to act in such situations, and this gives the patient a true feeling of safety. Nevertheless, every medical intervention, including surgical procedure, even the one performed in a perfectly healthy patient is associated with risk of adverse events and complications. Complications depend on multiple factors, concealed health issues of the patient, proper preparations and experience of the whole clinical staff, next to proper standards concerning care for the patient.
One of possible complications following breast implantation procedure is the fact that breasts after the surgery may be harder than breasts without implants, which results from implant consistency and is more frequently observed in very thin patients. After breast implantation, the organism creates a natural areola of scar tissue, which in some cases may be thickened, which gives the effect of hard breasts (capsule). In such case breasts may be extremely hard and seem more round or deformed. In such cases it may prove necessary to perform another operation during which an incision and partial or complete excision of the bag shall take place. Such situation occurs sporadically, in 1.5% - 3.5% of patients. Experienced plastic surgeon is skilful enough to minimize the risk of such situations. Infection of implants is an extremely rare situation, however, it may lead to the necessity to remove implants and implement new ones after 6 months.
Anatomic implants may be shifted or turned, which leads to changes in breast shape and makes it necessary to undergo repeated corrective operation. Frequent cause of implant shift is the fact that the patient does not observe physician’s recommendations as far as physical activity during post-operative treatment is concerned.
The patient may also suffer from breast and nipple ailments, such as paresthesia, limited sensation or palpable hypersensitivity. This is usually a temporary phenomenon, yet these changes may be maintained to a certain extent. Scars quite rarely become red and wide, although it may last for several months.
Breast implant rippling may become a more significant issue in very thin patients, who had a small mammary gland or small amount of fat tissue before the surgery. We can considerably limit the risk of such a possibility, if the implant is placed under the muscle. Implants produced by renowned companies extremely rarely face any damages. They are often very expensive, yet the price reflects their quality.
As in case of every operation, breast augmentation is related with general risk such as thrombosis, thromboembolism, haematoma within the wound, infection, impaired healing or hypertrophic scars. There are no proves indicating a relation between silicone gel implants and the occurrence of any form of disease. Breast enlargement certainly does not increase the risk of breast cancer. You will still be able to examine your breasts with implants. It is worth noticing that after breast augmentation surgery control breast ultrasound examination has to be performed at least once a year. It is also possible to undergo mammography after breast augmentation, yet it is essential to inform radiology employees that you had this particular surgery. In case of problems related with performing mammography, an MRI examination shall be performed.
Apprehensions associated with breast augmentation, namely fear that it will pose influence on breastfeeding ability, is of small probability, and placing the implant under the breast muscle significantly decreases such risk.
All the above-mentioned situations shall be discussed during consultation with plastic surgeon.
After the operation you will be sleepy, you will wake up and fall asleep for the rest of the day. You may feel discomfort in the operated site, yet the pain ailments shall not be significant. Analgesics shall be constantly administered and hence all discomfort is minimized.
Two small silicone tubes (the so-called drainage) may be introduced on both sides of the wound, to evacuate the excessive amount of blood or body fluids. They shall be painlessly removed before you are discharged.
Initially, your breasts will seem bigger than you expected. This is entirely normal and it will last for 3 to 5 weeks after the surgery.
On the day when you exit the clinic, you will undergo control and photos shall be taken.
You will also obtain a medical sheet and details concerning your implants. These include data on implants (producer, type, catalogue number).
The period of convalescence and complete recovery may vary, depending on individual features of each patient, and usually lasts between 6 and 9 weeks.
Days 1 to 3
You stay in the clinic under the care of physicians and nurses and you simply follow their recommendations. On the day when you area discharged, you will obtain detailed recommendations together with documents on implants and the surgery.
5 - 14 days
You need to wear your bra during the day and at night. It is recommended to remove sutures after 7-10 days. You can gradually increase your physical activity, yet do not perform any strenuous tasks. It is highly not recommended to drive a car within 14 days after the procedure.
2 weeks
Bruising and oedema will be still decreasing. You can return to work two weeks after the surgery. Use recommended scar ointments.
4 weeks
It is possible to undertake gentle physical exercises four weeks after the surgery, yet it is still essential to avoid considerable effort during the following two weeks.
8 weeks
The patient may perform all activities.
12 weeks
Control breast ultrasound examination.
6 - 9 months
Breasts are soft, scars are not really visible.
10:00 - 17:00
