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Breast Augmentation

Breast Augmentation

Many meanings – both functionally and socially – have been attributed to the breast tissue by human beings since history. In mythology, breasts represent abundance and plenty. Breast tissue has been the symbol of motherhood because of nursing and it has been mentioned together with maternal love and compassion. Apart from these, as the nipple-areola complex (nipple and the circular dark coloured area around it) is an erogenous tissue, it also reminds charm, erotism, and sexuality. Besides, as there is not another protruding area on the frontside of the body other than breasts, they directly draw attention; and they also contribute to the aesthetic look of the body by softening the transition from shoulders to hips. In a study made in America, it has been found that the breast sizes of the business women directly affect their professional appreciation by male colleagues. I guess these all can explain why women consider their breasts important - even in subconscious.

 What should the ideal measure and shape of a breast be in order to look beautiful?

It will be wrong to consider the breast tissue apart from the other parts of the body. It should be evaluated together with height, weight, and width of hips and shoulders. Even if the breasts are perfect in shape and size, it will not look beautiful if it is not in harmony with other parts of the body. For example, when a clothing wrapping the waist and hips are worn, it should neither be loose nor tight over the breasts. Breasts shouldn’t need any supports when decollete clothes or swimwear are worn. In thsi way, the person will feel herself happy, comfortable, and beautiful. This will be reflected onto the people around her as self-esteem, which is very important at first glance. It is not possible to describe the shape of the breast mathematically, but the breast looking as a cone when looked from the frontside, the breast which does not extend beyond the fold under it, the breast having a vivid apperance, and the breast looking as drop-shaped when looked from the sides are defined as aesthetic and beautiful breasts. That’s why, in the breast surgeries, the plastic surgeon should use not only his knowledge and experience, but also his imagination, vision, and artistic aspect as a sculptor.

  How is the bra size can be measured?

Measurement of the thorax perimeter passing under the breasts gives the numeric value of the bra size (75, 80, etc.). When the measurement is done through the nipples, this will be higher than the normal. If the difference is smaller than 6.5 cm, it is accepted as A and it changes as B, C, D, or DD in every 6.5 cm increase. In this way the cup size of the bra is found and is written near the numeric value (as 75B, 80A).

Is there a certain age group with better results after the aesthetic breast operations and are there any age limitations?

For the breast development to be completed, we should wait until 18 years of age. The operation can be planned anytime after this age. If the situation affects the person’s mental condition; renders her to teasings; exposes her to unwanted looks and making her introverted and shy; causing neck, back and shoulder pain, paresthesias in arms, limitation in activities, abrasions in bra margins, fungal infections and rash under the breasts and bad smell; and limits breathing, the operation ahould not be postponed.

 How is the decision of the technique to be applied in these operations made?

Principally, the aesthetic operations have only one aim: to remove the mental, social, or physical distress originating from the organ to be operated and making the person to regain happiness and self-esteem. Many techniques have been developed in breast operations to be able to provide this. Every day, newer techniques with higher patient satisfaction come along. In the decision of the technique to be used, the expectations of the patient, breast size, and the personal choice of the surgeon play a role. Every surgeon has a favorite technique and the patient should know the reults of this particular technique before the surgery. Similarly, the expectations of the patient must be clarified to the surgeon.

 How is breast enlargement (augmentation mammoplasty) operations performed?

Breast enlargement operations can be performed by both the patient’s own tissue and breast protheses.

 How is breast enlargement with fat injection performed?

Fat tissue injections are made into the patient’s breasts and the breasts are enlarged. This is not a preferred technique by many surgeons because of the long term aesthetic results and the decrease it causes in the accuracy of some diagnostic tests related to the breasts.

 How is breast prothesis performed?

Breast enlargement (prothesis) operations are performed through one of the incisions made from the inferior part of the areola (the dark area surrounding the nipple), inferior fold of the breast, the armpit, or rarely from he umbilicus.
The prothesis is put under the breast tissue or under both the breast tissue and the thorax muscle. Every technique has its own advantages and disadvantages. For example, only the protheses which are inflated following the placement into the breast can be used through the umbilicus.

 What are the types of breast protheses?

Almost every prothesis has a silicone sheath. The surface of this silicone sheath may be smooth or rough. The material put in under the sheath can be oil, serum, or silicone gel. In some protheses, both silicone gel and serum are present in two different compartments. Some protheses can be inflated and some have fixed volumes. The most commonly used prothesis type is the silicone gel filled breast prothesis, because these protheses have better results compared to others. According to their shapes, there are round and anatomical (drop-shaped) protheses. Round shaped protheses have low, middle, and high profiled subgroups.

 How are the decisions of the prothesis type and the location of the prothesis (under the breast or under the muscle) made?

This is an issue to be decided by the patient and the surgeon together. After the patient declares what kind of a breast she wants – a natural appearing breast, a breast with prominent upper portion, a breast which is evident that it is a prothesis, a breast which will protrude under the clothes, a breast with minimal changes that it is not evident that it has undergone an operation, etc., the examination of the patient’s body and breast mesurements are done. After this examination, the aesthetic surgeon evaluates the concordance between the patient’s requests and her body, and makes some suggestions in the light of his aesthetic vision and experience for a better result. Later, the decision of the prothesis to be used is made. If the patient is not insistent on a particular prothesis as silicone gel or serum, the surgeon will use the prothesis in which he trusts. In some special conditions, the surgeon should tell without hesitation that the requests of the patient will not end up with good reults. For example, it will not be appropriate to place protheses under the thorax muscle of a swimmer.

 Do breast protheses have effects on pregnancy or lactation?

Breast protheses have no negative effects on pregnancy or lactation (especially if put under the muscle).

 Do breast augmentation operations affect the sensation?

Generally, the sensation of the breast are not expected to be affected after breast augmentation (prothesis) operations.

 Do breast protheses operations have a relation with breast cancer?

There is no evidence of breast cancer developing due to the silicone used in breast augmentation procedures, even in the latest studies it has been found that in the women with breast protheses breast cancer is seen 30% less frequently compared to the women without breast protheses.

 One of the reasons of unhappiness after the breast operations is the operation scars. Do all techniques have the same degree of scars or are there any techniques causing less scars?
If the wound healing of the patient is normal, the scar which will remain after a successful breast augmentation operation is almost non-visible, and it will disappear after some time. 
In breast reduction operations, there will certainly be some scars. The important things are; how small and visible this scar is, whether it extends from the bra and clothes, and whether it affects her private life. In the classical inverse “T” techniques, there is a scar beginning from the line around the areola (the dark area around the nipple), going downwards to the fold under the breast, and then extending to the both sides from this fold; that is an inverse “T” shaped scar with vertical and horizontal arms. 
In the “vertical mammoplasty” technique, which has first been proposed in 1970, but has got the ultimate form with liposuction and become popular ten years ago, there is not a horizontal scar remaining in the fold under the breast. The scar after this operation is not an inverse “T”, but an “I”, which is a vertical line. This scar heals well, and it is a barely visible scar which will not bother the patient in her private relationships.


 


International Society of Aesthetic Plastic Surgery
Türk Plastik Rekonstrüktif ve Estetik Cerrahi Derneği
Estetik Plastik Cerrahi Derneği