The surgery aims to improve the projection, contour and proportions of the breasts, enabling the use of clothes with a cleavage and the end of the need to “hide” the body or use resources such as
bras with padding.
The breasts are seen by many as a fundamental indicator of femininity or a sexual attraction and are increasingly valued in Western culture.
The silicone breast implant is indicated most of the time for patients who have small breasts or who somehow want to breast augmentation. Widely studied, implants do not interfere with breastfeeding, let alone have any relationship with cancer, studies have shown that those who have breast implants when affected by cancer, these are diagnosed earlier because they are examined with greater frequency.
The clinical evaluation
Sometimes treated as a simple surgery, because in most cases the technique used provides safety, fast recovery and great results, one must be very careful in indicating the implant and the technique, whether in the format, type of implant capsule, location of the incision, position of inclusion of the subglandular, subfascial or retromuscular implants and mainly in the size.
In the evaluation by the surgeon, the characteristics of the breast tissue will be observed, as well as the dimensions and formats that the breast presents before surgery to indicate the best technique to be used and the most suitable prosthesis for each case.
Choice of Implants
The choice of implants (prostheses) is the main point, among the various brands available on the market today, more than 500 different sizes and formats, the choice takes into account the various factors to achieve the result as close to what is expected and as possible.
The greatest care is with patients who seek sizes far beyond what is indicated by the individual parameters, every patient is evaluated for chest width, breast base width, distance from the nipple to the shoulders and midline, volume and distribution of previous breast tissue, presence of previous surgeries and lastly, we must listen and advise on personal wishes.
The parameters evaluated in the lead to an implant close to the ideal, which we can change within some safety limits depending on the patient’s desire, but always informing what this change entails.
The location of the incision and the placement of subglandular or retromuscular implants are choices that depend on personal physical characteristics and the desired result.
Anesthesia is an association of sedation and local anesthesia, that is, the patient sleeps during the entire procedure, as is currently done in endoscopy exams, excluding the risks of general or epidural anesthesia.
Surgery and Immediate Postoperative
The procedure takes around 60 minutes, after which the patient will remain for 3 or 4 hours in the recovery room when she is discharged from the hospital and if she needs any other guidance after discharge, a telephone contact line is maintained 24 hours a day.
There is usually no placement of drains or the need to remove stitches.
On the following day, the patient can take a shower and wear a post-operative mesh suitable for the first 3 weeks, after this period she goes back to wearing the bras of her choice.
The patient returns postoperatively days later to observe the evolution of scarring, edema (swelling) and result.
Need for Exchanges
Breast implants do not necessarily last for a lifetime, and it is sometimes necessary to exchange the implant for others, but currently we do not indicate the exchange every 10 years as recommended a few years ago, today we indicate complementary imaging exams annually and a probable exchange only if there are changes that justify it, a fact that happens in 1 to 2% of cases when the implant and the technique used were correctly indicated.
One of the reasons to change the prosthesis is if it breaks, rupture of the implants is very rare, there are usually no symptoms and the diagnosis is a finding during imaging exams, it requires surgical replacement of the implant in an elective, programmed way, because the principle the only harm that can come is aesthetic, which may go unnoticed.
The other reason to recommend replacement of the prosthesis or prostheses is that the scar tissue that normally forms around the implant can squeeze and squeeze the implant. This can cause hardening of the breast, pain and, in severe cases, damage to the aesthetic appearance of the breast. Prostheses and techniques, when correctly indicated, rarely present these changes.