Breast Augmentation | mehmethasimguner

Augmentation Mamoplasty

We can perform breast augmentation surgeries in patients with breast volume deficiency and breast asymmetry.

The most preferred method in breast augmentation surgeries in recent years is augmentation with breast implants.

INSTRUCTIONS IN BREAST IMPLANT

According to the preference of the physician, armpit, nipple or under the breast are preferred as the entry site. I prefer the under-breast plan. The most preferred plan is under the breast.

The biggest advantage of this incision site is that the breast tissue can be isolated very easily and this makes surgery very easy. It does not create any incision marks on the front view of the breast tissue. The risk of loss of sensation of the nipple is less than the incision made from the nipple. In addition, I do not like the surgical scar left by the entrance from the nipple area, which is an incision site I have experienced.

The advantage of underarm entry is that it does not create incision marks in any part of the breast tissue. However, there is a risk of scarring in the armpit area, and the surgery is more difficult and risky.

PLAN PREFERENCE IN BREAST IMPLANT

Today, we have 3 standardized plans. The most well-known of them are; submuscular and supramuscular planes. In addition, it is very preferred in the semi-muscle sub-semi-supermuscular plan, which is also called 'dual plane'. There is also the so-called subfascial plan, in which the bottom of the membrane of the pectoral muscle is used.

Each plan has its own advantages and disadvantages.

Submuscular plan: The risk of infection is less, the situation we call capsular contracture occurs less frequently. It is the most painful plan in terms of pain.

Supramuscular plan: It is the plan with the least amount of pain. The risk of infection and capsular contracture is higher than the submuscular plan. In sagging breasts, it straightens the tissue better than the submuscular plan and also recovers it. In order to use this plan, the breast tissue must have a thickness of at least 2 cm, but in practice, I think that this thickness should be greater.

Dual plane plan: It includes some of the advantages of both plans. The most distinctive feature is that the décolleté part is fuller. It is similar to the submuscular plan in terms of pain. It is close to the supramuscular plan in terms of the erecting effect. It is one of the most frequently used plans in my own practice.

Subfascial plan: It is a supramuscular plan, in essence, it is more protected against the risk of infection since the prosthesis is surrounded only by muscle fascia. Since the surgery is very difficult and it is very difficult to create the plan without breaking the integrity of the disaster, I also do not prefer it in my own practice when I think it is more bleeding.

BREAST IMPLANT SELECTION

In the selection of breast implants, we have round type, or drop (other name, anatomical) prosthesis shape options. Round breast prostheses provide a better decollete effect, while drop breast prostheses provide a better lifting effect. I discuss which one will be the best and which one will be used by discussing examples with my patients.

In terms of prosthetic surface, there are 2 different options. A rough surface or flat surface. While the situation we call capsular contracture is less in rough dentures, the risk of prosthesis staying up is less in flat-surfaced dentures. In my own practice, I prefer rough prostheses more.

HOW MANY CC SHOULD IT BE?

The volume can vary from person to person according to taste, as well as to provide symmetry between the breasts. However, it should be known that there is a minimum and maximum range of prostheses that can be placed on each patient's breast. This range may vary according to the person's height, shoulder width and skin elasticity. While 350 cc prosthesis may be too big for a woman who is 150 cm tall, 450 cc prosthesis may seem too small for a 180 cm tall woman with broad shoulders. While planning the volume, I think that it is necessary to talk to the patient at length and discuss them over examples. While we, as physicians, can predict the outcome, this can be more difficult for patients. That's why I try to better analyze what our patient might like by making mutual evaluations on photographs with lots of examples.

LIFETIME?

It is one of the most frequently asked questions. I have seen a patient who has carried it for 20 years, and those who have to change it in 3-4 years. Frankly, when we look at it from a scientific point of view; If the capsule reaction has not developed, if it does not cause pain or deformity, there is no harm in keeping it in the body.

But there is a situation that has been detected in recent years. Although the exact cause is not known, a type of lymphoma that can develop in the prosthesis capsule, which we call ALCL, may occur. ALCL (anaplastic large cell lymphoma), which is a different type of cancer from breast cancer, can manifest itself in the form of pain, redness and tenderness years after surgery. As a treatment, it may be sufficient to remove the prosthesis and its capsule if it is detected in the early period, and if necessary, radiation therapy can be given. Since it is a condition that can be detected by MRI examination and the shooting costs are low in our country, I recommend my patients to have an annual breast MRI, especially after the 5th year, to be followed up in terms of this condition. Our country is in a lucky position in this respect, as it is difficult to have these examinations done abroad.

CAPSULE CONTRACTION

Due to the working mechanism of our body's defense system, a slightly hard shield in the form of a membrane is formed around the material that we call any foreign name, whether it is breast implants, screws, plates, knee prostheses placed in our body. We call it a capsule in medical language. This formation is completed in the first 3 months and the circumference of the breast prostheses is surrounded by a capsule. This is expected.

If it is undesirable; Over time, this membrane structure somehow thickens, hardens and compresses it in the prosthesis, which can even cause pain in this breast deformity. When the patient causes pain, asymmetry and severe deformity, replacement of the prosthesis and cleaning of the capsule are applied as treatment.

Theoretically, thickened capsule formation occurs more in flat-surfaced prostheses and in the supramuscular plane.