Breast Implant
The most important sub-title in breast aesthetics is breast implants. Breast implant can be either applied alone or with a breast lift surgery. This definition is generally used for breast augmentation. Breast enlargment with implant is what meant.
Breast Augmentation
Breast Implant Types
Silicone Breast Implants
Form-stable implants are provide a more natural augmentation. They are shaped rather than round. They have more projection at the bottom and are tapered towards the top. Round breast implants have a tendency to make breasts appear fuller than form-stable implants. Higher profile options can achieve even more projection. Because round implants are the same shape all over, there is less concern about them rotating out of place.
The Duration of Silicone Breast Implants
The life of an implant is about 10 to 15 years, depending on different factors. You should have a consultion with Dr. Emre Gönen for further information.
About Breast Implant
About Breast Implant Procedure
If the patient is over 40 years old, mammography and ultrasonography tests are taken. Every procedure has general and spesific risks. Oedema and pain in breast area after procedure are common. Bleeding and infection after procedure are rarely observed. Some patients complain about the reducing or increasing sensitiveness around nipples or insensitivity around the cut area. These are generally temporary.
Vectra-Breast Analysis
Silicone Implants
The most common local complications and adverse outcomes associated with breast implants are capsular contracture, reoperation, implant removal, and rupture or deflation of the implant. Capsular contracture is the hardening of the breast area around the implant. It can occur in the tissue surrounding one or both implants. This hardening causes the tissue to tighten, which can be painful. If you have silicone gel-filled breast implants, you will need to undergo periodic MRI examinations in order to detect ruptures of the implant that do not cause symptoms .
There are several important things to consider before deciding to undergo breast implant surgery, including understanding your own personal expectations and reasons for having the surgery.
BREAST ENLARGEMENT
Breast enlargement is a very comfortable and safe surgery nowadays. Breasts complete a woman’s figure beautifully. Shoulder length, breast girt, waist and hip proportions are essentials of the ideal woman figure. Breasts may be small for various reasons. One may be smaller than the other, they can be asymmetrical. One may not even exist congenitally. To even the two breasts or to enlarge their volume we use silicone breast implants, fat injection and aquafilling materials.
Breast Enlargement with Breast Prosthesis
Breast prosthesis are materials that are semi fluid silicone gel filled medical supplies that are covered with steady silicone covers.
Breast Prosthesis Surgery
The surgery takes place in hospital environment with general anesthesia, it takes one hour.
Incision Options:
* Inframammary line (Submammarian)
* Lower nipple area (Periareolar)
* Under arm (Aksiller)
No matter the entry area the scars are significant at the beginning and insignificant in time. The prosthesis can be placed behind the breast tissue or behind the breast muscle (pectoral) according to the breast type of the patient. Each method has advantages and disadvantages.
The period after the breast prosthesis surgery
The patient is comfortable after the surgery. There’s not much pain. There may be some restriction to the movement of the arms if the prosthesis is placed behind the breast muscle. A bra or dressing is recommended to the patient. The absorbable sutures don’t need removal. There’s little swelling in the first days. The patient can go back to working in 3-4 days. The prosthesis is settled after the third week and the breast becomes normal again. The patient is advised to stay away from heavy exercise (jumping, running) for 2 months. Breast enlargement with prosthesis is generally a good surgery with permanent results.
Breast enlargement with fat injection
The recent studies showed that the most important stem cell reservoir is one’s own fat tissue and the fat in the abdominal are contained more stem cells than the bone marrow. The most suitable patients for breast enlargement with fat injection are the ones with much fat tissue. The procedure becomes easier if the patient has large areas to transfer fat from. This way fat reduction procedure is also done. The fat is gained more slowly compared to liposuction technique. Then the unwanted components of the fat are removed with centrifuge. The stem cell enriched fat tissue is prepared for transfer and put under the breast tissue. This enriched fat cells also help repairing and renewing the injection area.
Fat filling application
The surgery is performed with sedation or general anesthesia. The patient is discharged the same day. There will be a light pain in the chest and the in the area where the fat is taken. The swelling in the breasts will disappear in 15 days. the fat will be permanent %40-50. This procedure increases the breasts 1 size usually. If wanted the procedure can be repeated after 6 months.
Breast Enlargement with Aquafilling®
It’s a procedure with short postoperative period and minimal trauma for breast and hip enlargement. It changed the whole concept of implants. The results of Aquafilling are beyond expectation. Aquafilling is a hydrofilic gel that helps a nonsurgical procedure for breast and hip implants.
The Procedure
It’s performed under sedation or local anesthesia. It takes less time than silicone implant. The procedure is complete in 45-60 minutes. The injection area is not related with lactation so breastfeeding will not be affected negatively.
After the Procedure
Aquafilling consists of %98 Sodium Chlorite, a substance that already exists in our body and has no side effects and %2 Copoliamid, a substance used for enhancing the persistency of the fluid and also has no side effect. This procedure is an alternative for patients who doesn’t prefer surgery, anesthesia or surgery scars. Its effect lasts for 3-5 years approximately.
Breast Enlargement Surgery
Breast enlargement surgery is a comfortable and safe procedure. It takes 1 our approximately. A breast implant is placed under the breast tissue to make the breast volume look bigger than it already is. There are a lot of variables for planning a breast enlargement surgery.
1- What kind of breast prosthesis / implant will be used? (water based, slicon based, round, water drop shaped, smooth surfaced, grainy surfaced)
2- Where the breast implant will be placed? (under muscle, under the breast tissue, under the muscle fascia)
Breast Prosthesis Used In Breast Enlargement Surgery
There are hundreds of different brands, structures, surfaces, and shapes for breast implants.
All the breast implant brands are over certain standards and they are safe. But some of them are more in the foreground and they have a higher trust index. Surgeons generally have a brand that they fell safe and they use that brand for long years.
The contents of breast implants
When we look at the contents of the breast implants we see that they are water based and silicone implants. Our choice is the silicone based ones. They are mostly preferred also around the world. The most important reason for that is the water based implants may leak in time, can lose their inner volume and the motion of the fluid can be felt by the patients.
The surface of the breast implants
The surfaces of the breast implants may differ. They can be smooth surfaced or grainy surfaced (textured, micro-textured). This is the surgeon’s choice. We usually prefer grainy surfaced implants. Their adherence quality is higher. They are durable about the dislocation or rotation movements. They are also known to reduce the capsule contracture formation in the tissues.
The shapes of the breast implants
The shapes of the breast implants vary. They can be fully round or tear drop (anatomic) shaped. This is again mainly the surgeons’ decision to help best fit the patient’s needs or about the different methods of surgery. Their qualities are the same. Our general choice is micro-textured surface, anatomic shape, form stable cohesive silicone breast implant.
Where to place the breast implant?
Silicone breast implants can be placed under the breast muscle or under the breast tissue. If the breast tissue layer is less than 2 cm. placing the implant under the muscle tissue is better for the noticeable and handled prosthesis. In most cases they are placed with double plan. This means that the top half is under the muscle and the bottom part is under the breast tissue. They are rarely placed totally under the muscle. This is not necessary. The most important problem about the under muscle placement is that the separated look occurring from the joints of the muscle and the implant’s motion with the muscle movement. These all cause an unnatural look. For thin patients with small breast tissue simple under breast tissue implants can become explicit with time. This situation is more defined when round shaped implants are used.
Our Choice
My personal choice is subfascial placed, anatomical shaped implants that are put in fascial area but not under the breast tissue. I believe that the under muscle placement is unnatural and we should let he implants move with the breasts simultaneously. For that reasons I find subglanduler / subfascial implants more naturalistic.
BREAST REDUCTION SURGERY
Breast reduction surgery looks like a cosmetic surgery that we prefer to change our looks but it’s in fact a necessity for most cases. Women with big breasts suffer from the pressure of the bra straps on their shoulders, and also severe vertebra, neck and back pain. Big breasts may limit the daily activities. They also affect our choice of clothing and may also have a negative effect on our social and psychological state. A breast reduction surgery can help us have more reasonable sized breasts.
BEFORE THE SURGERY
If you are considering a breast reduction surgery you can always consult Dr. Emre Gönen for information. You must openly tell the reasons why you are considering this surgery and the expectations you have. The size of your breasts, their shape, the condition of your skin, your age, marital status and plans about having children will be asked to you and evaluated during the examination. If your breast swell and become larger during menstruation the procedure should be done afterwards. Looking at the pictures of the patients that had the surgery before may help you decide easier.
There are some blood tests before the surgery and if Dr. Emre Gönen requires the should also be a mammogram and breast ultrasound. You’ll need someone to help you on the day of the surgery and the next couple of days. ıt’s a procedure that needs to be done in the hospital and you may need to stay for 1 night.
THE SURGERY
This surgery is performed at the hospital under general anesthesia. It takes 2,5-4 hours. In the cosmetic breast reduction surgery the big breast tissue is reconstructed in accordance with your body measurements. The excess breast tissue and the skin on it are removed. The nipple is carried back to its own place.
AFTER THE SURGERY
It’s usually comfortable after the surgery. A bra or medical dressing is used for the breasts. Usually a drain is placed in both of the breast. These are removed in 24-72 hours. It may be hard for the patient to use her arm for a couple of days. If there are sutures they are removed after 10-12 days. there may be some swelling in the early days. the patient can go back to work in 2-3 days. ıt’s recommended not to heavily work-out for 3 months. Cosmetic breast reduction surgeries usually have good and permanent results that make the patient’s life much easier. It has a positive effect on the psychology of the patient and her partner. Make’s one happier with her life. It’s a big help for our choice of clothing. A newly shaped breast is durable for long years.
WHAT IS MASTOPEXY?
It means to hanger the breasts. There is no actual hanging. There is procedure applied to the skin of the mammary gland to shape it, but the breast looks like it’s taken up and hanged. This definition describes the procedure of reconstruction of the sagging breast tissue. It’s commonly called “Breast reconstruction” or “Breast lift”. The mammal structure can sag in time because of giving birth, breastfeeding, lactation and weight gain or weight loss. There’s loosening in the breast tissue and in the skin. The breasts have this condition by default sometimes. The breasts may sag because of these changes in their shapes or they may sag because they are too large and heavy. All of these structural deformities don’t affect the function of the breasts, the only concern here is aesthetical. All of these deformities can only be fixed by MASTOPEXY. The breast lift surgery can also fix the size differences and symmetry problems of the breasts.
What is sagging (ptosis) of the breast?
Ptosis (sagging) breast is a surgical classification.
They are basically divided into 2:
1-Real surgical ptosis
2-Fake sagging (pseudo-ptosis)
Real surgical ptosis classification is made according to the level of the nipple. The nipple should be 19-22 cm. away from the collarbone, this considered normal. The height of the patient is also important for this decision. 22-23 cm. can be evaluated fit for ptosis surgery for a short patient. Hence, the position of the nipple is also important for deciding the phase of the problem. If the nipple is over the inframammary trough it’s phase 1, if the nipple is level with the inframammary trough it’s phase 2, if it’s under the inframammary trough and facing the ground then it’s phase 3 ptosis. If there’s pseudo-ptosis it’s usually phase 1 but the bigger part of the breast is under the nipple as if only the mammal gland is pouched downwards.
Before the Surgery
The patient’s complaints care taken into consideration before the surgery. She’s questioned about former/other health problems. Medical history information is collected, pregnancy, breastfeeding, menstrual cycle, former operations are noted. The breast pictures are analyzed with Vectra XT 3D. Mastopexy surgery is virtually performed and showed to the patient. It’s decided if there will be an implant procedure with the surgery. The findings of the Vectra analysis are discussed, the possible outcomes are taken into consideration and a date for the surgery is set. The procedures before the surgery are told to the patient. I strictly advise the patient to come for a final interview the day before the surgery. The consent forms are signed and the drawing for the surgery is made.
Mastopexy Surgery
The surgery is performed at a hospital under general anesthesia, and takes 3-4 hours. It follows the sketches made the day before the surgery. The incisions are either only on or around the nipple or maybe even a vertical incision is made and a short T shaped incision is added under the inframammary tough. The goal is to take the nipple up, remove the excessive breast skin and make the breast tissue rounder, tighter and fresh.
After the Mastopexy Surgery
It’s usually comfortable after the surgery. A bra that pressures the breast is put on to the patient. Drains are placed into the breasts, usually both of them. They are removed in 24 hours. This is to avoid blood piling up in that area. Arm movements are limited for a couple of days. there’s no need to remove the melting sutures. There may be swelling in the early days. The patient can go back to work in 2-3 days. Heavy exercise is not recommended for 6 months. This surgery usually has good results, helps the patients psychological state. The satisfaction rate is really high. The pro-op period is a comfortable, mild one. The only complaint is dizziness for a couple of days. there’s no pain usually. Recovery period is short.
Gynecomastia
Weight gain or some hormonal problems can cause an increase in the breasts’ fat volume. This condition can cause the growth of breasts in men. If it’s cause by the increase in fat liposuction is performed. Sometimes the mammal gland overgrows, when it should be very little in a man’s body. This condition usually appears during adolescent era or old age. Gynecomastia seen during adolescent era disappear in time. The patient should wait for 2 years to see that. Gynecomastia in men can also occur because of liver diseases, excessive alcohol consumption or some certain medications.
