Breast augmentation

Procedure is performed on patients with small breasts, asymmetrical breasts and on women who lost the firmness of their mammary glands due to aging. Procedure is performed in general anesthesia. Standard duration is maximal 1,5h.

Augmentation is performed with the use of silicone implants in various sizes and shapes, produced by various companies. Implantation could be performed with the use of various incisions – just below the inframammary fold, on the dermo-epidermal and nipple-areola junction or in the armpit. Implants could be placed in three different locations - directly underneath the mammary gland, under the pectoral fascia and under the pectoral muscle. All those details and matters are discussed with the surgeon before the procedure. Thickness of the subcutaneous fat tissue is a crucial issue.

Size of the implant is chosen based on individual features of each patient and on the grounds of performed measurements. Each treatment is preceded by appropriate planning of skin cuts.

• Standard procedure starts with the incision of patient’s skin around 5 cm and subcutaneous tissue followed by the preparation of the compartment for the implant and implantation of the previously chosen type and large of implant.
• The wound is being stitched up by dissolvable stitches and drains are being left in the compartment surrounding the implant.
• Finally, the wound is covered with a special surgical dressing and the bra is putted on which shall be worn for at least 6-8 weeks after the procedure.
• Until the drains are removed, the patient is asked for daily check-ups at the doctor's office.

Swelling and individually intensified pain (possible to be relieved with painkillers) are both normal effects of the procedure - they will subside eventually in the course of time. Sometimes patients observe bruising, which is also a normal post-op effect. Nipples may be ultra-sensitive to the touch and breasts may cramp periodically - both are also normal effects and will subside in the course of time. For 4 weeks after the procedure patient should avoid extensive manual effort, especially activities engaging the movement of shoulders (for example hefting, lifting, raising arms). Patient can get back to work (if it does not require manual effort) in 1-2 weeks after the procedure.

Consequences and possible complications after breast augmentation with implants:

1. Swelling and bruising - this is a consequence, not a complication.
2. Pain of varying intensity depends on the level of the patient's pain threshold.
3. Asymmetry, we are not symmetrical although it seems to the layman that our body is symmetrical. Therefore, it is impossible to achieve perfect symmetry despite all efforts.
4. Hematoma, requiring surgical intervention
5. Infection around the implant, forcing the implant to be removed.
6. Wound infection with wound dehiscence following a wide scar or
7. Extrusion of an implant requiring removal of it and healing at least 3 months to next surgery.
8. Lymph cyst (seroma) usually requires implant removal too.
9. Implant rotation and breast distortion.
10. ALCL lymphoma, a malignant tumor, in the bag around the implant
11. Folding of the thick capsule around the implant (rippling)
12. Clamping bag around the implant causing pain and distortion of the breast.
13. Pain, periodic, lasting without distortion.
14. Periodic or persistent nipple sensation
15. Allergies to medications used
16. Venous thrombosis with pulmonary embolism and death
17. Breast drooping. The effect of the treatment is not forever and will change from month to month and year to year.
18. Unsatisfactory aesthetic effect or lack of the expected effect, which is only a subjective assessment of the patient. You will miss the patient's expectations with the possibilities of the expected result obtained by the surgeon.