Breasts are one of the most significant body parts that make women feel happy and self-confident about her own body perception. Every woman wishes to have aesthetically beautiful-looking breasts. In addition, breast tissue which loses its volume due to growth retardation or postnatal weight loss may gain a droopy-looking because the skin covering breast loosens or breasts may be small or asymmetrical from birth.

In these cases, plastic surgery of breast is applied. The patient decides with her physician about which type of operation or operations will be performed. In the table below, it is indicated which operation is helpful in solving which aesthetic problem/s.

  • Operations Performed for Aesthetic Problems of Breasts
  • Breast Augmentation for Small Breasts (silicone implant application)

Why is breast Augmentation Operation performed?

Breasts are organs that represent feminity. The fact that breasts are big, small or droopy, asymmetric or there are no breasts from birth or due to diseases women have later may cause serious psychological problems. Women whose breast volume is insufficient structurally, or due to weight loss or growth retardation are candidates for breast augmentation operation, one of the those breast surgeries.

How is it planned?

Your general health will be assessed when you first apply. It will be decided with you which surgical technique is the most suitable one for you considering your breast and skin tone. It may be recommended for you to undergo a mastopexy operation in the same session if you have lack of breast volume and droopy breasts.

You will be informed about choices of breast augmentation operation, risks and restrictions of each one. If you smoke or take any medication or supplementary food, notify your physician of these. Your physician will inform you about the type of anaesthesia, hospitals where the operation can be performed and the cost of operation.

You will evaluate the following four important topics while planning the operation with your physician;

1. Form  of implant

2. Operational incision location

3. Implantation location of the implant

4. Volume of the implant

How is it performed?

Breast augmentation operation is performed with a silicone implant. The location of incision where silicone implant will be placed, layer that the implant will be put (inframammary fold, under muscle or under sarcolemma, a recently most-prefered method – subfascial), the form, content and sizes of implant are determined with the patient considering the structure of breast and rib case  in course of examination. Since there is not a single method, anatomy, requests and priorities of the person is determinative.

Incision formed to place the implant in the body is approximately 4-5cm long as indicated below and it is opened over inframammary fold, in connection line of nipple and breast skin or under arm.

As shown in the left Picture below, the implant may be placed under the breast tissue or as shown in the right Picture below, it may be placed under the muscle which is under the breast tissue. Each method in breast surgeries has its own pros and cons. These advantages and disadvantages will be explained to you.

Outer Wall of all silicone breast implant is hard silicone and it has various types such as the ones whose inner part is swollen with serum or whose inner part is filled with cohesive gel silicone. It has two shapes: anatomical (tear dropped shaped) and round. In pre-operative negotiation, all these matters will be discussed with the patients in details and which type of implant will be used is concluded. The operation is performed under general anaesthesia. It takes nearly 1.5 hours. Duration of hospital stay is generally one day. In case implant is placed under muscle, pain can be taken under control thanks to painkillers even if pain is a bit more.

How is the post-operative period?

Putting on a bra day and night for 2-3 weeks following the operation will enable the individual to move more confidently and comfortably. Individuals may go back to work 5-7 days later.

Women with breast implant can become pregnant comfortably and breastfeed their babies. There is no scientific data about the fact that silicone implant cause breast cancer.

Complications (unfavourable situations) that might be encountered following the operation are bleeding, infection, capsular contracture, loss of sense.

FREQUENTLY ASKED QUESTIONS ABOUT BREAST AUGMENTATION OPERATION

  • What type of a material is silicone material?

Silicone is a synthetic polymer made up of silicone and was discovered in 1824. Silicone is naturally found in sand, opal and quartz Stones and made up of silica (silicondioxidesiO2). Silica turns into silicone material with high temperature and carbon. Silicone is among the most-found materials on Earth as well as oxygen and carbon. Silicone is in fact used in medicine as lubricant. It is a material which is commonly used in all branches of medicine and not giving any harm to body and also can remain in body for years. Hard silicone have been used for years in numerous forms such as facial implant (implant placed to augment cheekbones or jawbone), joint implant, balloons placed inside stomach, breast plants, testis implant. It is also commonly used in body lotions, soaps, processed food and medication.

  • Are silicone breast implants reliable?

Silicones used in breast augmentation operations are hard silicones. Hard silicone is also used in medicine for treatment purposes. Since hard silicone cannot disseminate to body contrary to liquid silicone, it has not been detected to be the cause of a major disease till now.

In scientific studies conducted on this topic, it has been determined that there is more silicone in cow’s milk and baby food in the market than the one found in human milk of women with breast implants.

  • It is said that silicones are not used in America and Europe anymore, is this true?

It is understood that there is a trace amount of free silicone in human body from the samples taken from autopsies in scope of a research. It has been proved that it is not harmful to use silicone in hard form and the use of hard silicone for medical purposes is approved by FDA (Food and Drug Administration), a universally accepted American institution. Thus, silicones have been commonly used in America, Europe and all around the world.

  • Is it possible to have silicone allergy?

It is possible for every human to develop allergy to nearly all materials in the world. We all face silicone in our daily lives everyday. Silicone exists in many materials that we use in daily life such as polishes, sun and hand creams, anti-perspiring deodorants, soaps, processed food, waterproof coatings and chewing gums.

Silicone is one of the materials which can totally adapt to human body . Therefore, it is a rare situation to develop allergy to silicone.

  • Does breast implant cause breast cancer?

Research conducted with many people has proved that breast implants do not cause cancer. The reason why misinformation is provided is embedded in the fact that it was once banned in the USA. American Food and Drug Administration (FDA) banned such kind of implant on the grounds that they cause rheumatism-like disease in 1992. After a while, no scientific data were found to prove silicone implants caused this disease and the ban was removed. Today, silicone implants are commonly used worldwide.

  • Does the existence of silicone breast implant influence mammography results adversely?

There is no explicit consensus about this issue. Sensitivity of mammography decreases to some extent on people with silicone implant, but it does not have any effect on the accuracy of results when performed appropriately. For that reason before having a mammography screening, the person who operates this process should be notified of the existence of silicone breast implant. In addition, in terms of early diagnosis of cancer, since silicone pushes breast tissue forward, any fibrosis that might form on breast tissue can be more easily recognized.

  • What is the percentage of women getting a silicone breast implant placed?

There is unfortunately no statistical data about this issue in our country. However, more than 250 thousand people a year prefer breast augmentation operation in the USA. This statistical data indicate that one of 250-300 women,in a round sum, has silicone breast implant.

  • Who is appropriate for breast implant?

Breast implant operation can be primarily performed on women with small breasts. It is also possible to perform it on women whose breasts are originally normal but have got smaller or droopy due to such reasons as pregnancy or weight loss/gain etc.. The aim is to both augment the breasts and raise them. Women with small or droopy breasts generally use uplift bras. This need can completely be eliminated by using implants. Breast implants are placed under the breast tissue and provide a natural support to the breast, which makes the breast look raised and plump.

In addition, breast implants are used in different sizes in order to balance breasts for women with asymmetrical breast problem. In post-operative breast cancer operation, silicone breast implant is used in order to reform the breast removed.

  • Before having a breast augmentation operation, is it necessary to be at an ideal weight?

It is important to be at an ideal weight and close to the fixed weight especially for plastic surgeries of body in terms of persistency of the operational result. An explicit weight loss after breast augmentation operation may result in unfavourable droop and smaller size of breast. A meaningful important weight gain may cause the breasts to reach at an unfavourable bigger sizes.

  • Can the difference between two breast be balanced?

Asymmetry can be balanced by choosing the correct implants in suitable size. However, this recovery may vary to existing breast tissue. As known, there might exist an asymmetry in sizes of breasts of a women seeming normal. The difference (if there is too much difference) is minimized to an extent that will not be visible.

  • Is it possible to have a natural appearance as a result of breast augmentation operation?

Natural appearance in these operations depend on the operation technique, shape of the implan, flexibility of the person’s breast skin, and the location where the implant will be placed. If the flexibility of skin is appropriate, then it will give a more natural appearance. Also, it is necessary not to force a bigger implant than the person’s skin can cover. Implanting by forcing the skin may cause a fake appearance and complications (especially capsular contracture).

  • Will bra size of 75 change into 90 after the operation?

Two measurements in breast size are important. One of them is rib cage (below the breast) and the second is measurement on the breast. The first measurement tells us the length of bra (70-75-80-85-90-95-100.etc). The difference between two measurements shows us the breast size. This difference is defined as B, C, D and A, which is the smallest one. For example, difference between two measurements is 2.5 cm, then breast size is (Cup Size) “A”. The number of bra (length) will be same which is 75. However, cup size will get bigger. Consequently, body does not go bigger but cup size does.

  • To what extent is breast augmented with silicone implant?

What the patient wishes about this is important in determining the size, but still restricted. Such elements as rib cage, skin elasticity influence the size of augmentation. To use a bigger implant than recommended is inconvenient in terms of droop and skin cracks in the long run and other complications.

  • How is the size of implant used in breast augmentation determined?

What the patient wishes about this is important in determining the size, but still restricted. An appropriate implant should be selected considering height, weight of the person, rib cage width, existing size of the breast tissue, position of the nipple, base sizes of breast tissue. The size of implant should be both small enough not to cause any complications and big enough to satisfy the patient. It should be considered that an inappropriate implant will both prove an unaesthetic appearance and also the result of the operation may be adversely influenced in time.

  • What are the disadvantages of using a bigger implant than recommended?

Breast skin gets older and springs with increasing age  and even skin with no implant gets thinner. Aesthetical appearance of implant in the breast depends on elasticity of skin.

Volume and weight of breast increases when the implant is placed. This situation causes the skin to spring irreversibly. Big implant means putting redundant weight in breast, which guarantees a bad aesthetical appearance by causing the increase of flexibility and droop of  breast. However, it is impossible to foresee to what extent and when it will happen.

Tissues get thinner by loading the weight mentioned above on the breast skin, which increases the risk of surgical complication and recovery problems. In terms of usage, implant and its details can be easily felt in the breast tissue, which may even be visible at times. Aesthetical deformities such as ripple and lap might be recognized visibly.

When putting excessive weight on the breast, scar of operation becomes more apparent, which necessitates another scar correction operation (a second operation means another cost, loss of manpower, risk and additional difficulties).

If other complications develop due to excessive load (which are impossible to predict)in this case it may be necessary to remove the implants and additionally perform a breast lifting operation.

  • Can droopy breasts be raised with implant?

It depends on the level of droop. If there is a little droop in breasts, it can be corrected by using an implant which is big enough to fill the breast volume. If there is too much droop in breasts, a lifting operation might be necessary while placing the implant. However, nursing women have loss of tissue in their breasts, which is called atrophy, and breasts droop as if they are not emptied. It may not be possible to correct this at all time with breast implant. In cases where there is a little droop or breast tissue is minimized, it may yield very favourable results to place implants. But if there is also droop in breast skin, breast lifting operation should be performed as well as implant operation.

  • How are people with silicone breast implants influenced by pregnancy?

Breast will get bigger during pregnancy and experience all natural changes due to pregnancy. The amount of augmentation will vary to women and size of silicone implants will take role in this augmentation.

  • How does breast implant affect breastfeeding?

The implant is placed under breast tissue in breast augmentation operation; thus, it does not harm implanted breast tissue or mammary ducts. However, it should be kept in mind that a woman who has not undergone any operation might yield no milk.

However, special studies regarding the involvement of silicone in milk have been made and in these studies it is detected that the amount of silicone in cow’s milk and baby food in the market is more than the one in milk of women with breast implant.

  • Can I go to the tanning booth or suntan after breast augmentation operation?

Tanning booth or sunbathing do not harm the silicone. However, it may have adverse effects of operational scars. Since tanning booth or sunbeams will darken operational scars permanently, you should avoid sun and tanning booth for a year. In case you don’t, protect the scars with gih-factor sunscreens.

  • What type of implants are used?

Implants including physiological saline solution and gel implants are used. Gel implants give a more natural appearance and sense.

  • Does silicone breast implant to be used in breast augmentation operation have an expiry date, does it need to change?

New-tech implants can be used for lifetime. (Persistence warranty of implants are described by the manufacturer companies and it is written at the rear part of implant). However, pregnancy and normal aging process impact the operational results adversely. Breasts which continue to age may go droopy even in their implanted situations after a while and lose their aesthetic appearance. In those cases it may be decided to perform just a breast lifting operation without touching the implant following the assessment of the physician.

  • Can we sense silicone implants by hand and does it change form or explode due to pressure?

Latest generation implants manufactured with new technology are not sensed. Especially when they are implanted under the muscle, it is highly difficult to sense them. It is nearly impossible that they explode unless there is a very severe impact such as traffic accident.

  • Does silicone implant application result in cracks on breast?

It is risky when generally implants bigger than what the physician recommends are placed. When an implant in recommended sizes is placed, it is a rare situation.

  • How long does the operation take, when can I be released from hospital?

Depending on the technique preferred, it varies from 30 minutes to 1.5 hours. The individual may go back to her daily life leaving the hospital the next day or same day.

  • Is post-operative period really uneasy?

You may feel some pain with arm movements for the next three-four days following the operation. This situation may last longer when especially the implant is placed under the muscle. However, this pain can be controlled by painkiller. Breast region is covered in bandage for nearly a week. There might be some mild bruising on breasts. As blind stitch technique is applied, there will be no stitches to be removed on the skin. It is recommended to avoid lifting heavy things and exercises that you use arms for a time period your physician advises and to support your breasts with sports bra. You can go back to your daily life within maximum a week.

  • When can I swim in sea or pool after breast augmentation operation?

You can swim in sea or pool  15-20  days later. However, it is recommended not to force your arms while swimming.

  • When does stiffness in breasts occurring after the operation go off and when can I see the result of the operation exactly?

Within 3- 6 months, stiffness in breasts will go off and it will take its shape by getting more natural.

  • Does smoking affect recovery process?

Smoking causes narrowing of blood vessels, therefore it reduces oxygen and nutrition transferred to the operated region through blood. Tissues need this blood and substances it transfers in order to recover. For that reason, smoking cigarette or similar type of things impact the scar recovery adversely. Smoking should be quit for a while before the operation.

  • What is under-muscle placement?

Breast consists of skin, the top layer, breast tissue and muscular layers at the bottom. This is called under-muscle placement to place the implant under muscle which is the bottom layer.

  • What is over-muscle placement?

Breast consists of skin, the top layer, breast tissue and muscular layers at the bottom. This is called over-muscle placement to place the implant between the bottom layer, muscle layer, and breast tissue, layer in the middle.