Breast augmentation, or augmentation mammoplasty, is a procedure aimed to increase the volume and improve the shape of the breasts. It can be carried out by placing implants or with fat from the own patient.
Mammoplasty is one of the most common procedures in plastic surgery nowadays, for aesthetic purposes or as reparative surgery such as post-cancer breast reconstruction or congenital abnormalities.
In this section, we will consider the breast augmentation with implants. This procedure helps to increase or balance the size of a small breast (hypoplastic one), or to recover the volume or shape after a partial or total loss (pregnancy, weight loss, aging…).
In consultations prior to the surgery, patients should indicate sincerely their expectations, in order to allow the plastic surgeon to show them the available options, risks, and limitations of each one of them. Moreover, the specialist will explain you what type of anaesthesia will be used, and if hospitalization is needed.
The procedure can be performed with different types of incisions, aimed at minimizing or hiding the scar.
- Periareolar: the incision is made in the lower border of the areola, in the transition between the skin of the areola and the breast. The healing is good, producing a scar that is almost imperceptible.
- Inframammary: the incision is made in the infra-mammary fold, a natural shaded and little exposed area; therefore, it is practically imperceptible. The key of this approach is to leave the scar exactly on the fold, neither on the skin of the breast nor on the skin of the abdomen.
- Transaxillary: the incision is made in a natural fold of the armpit, avoiding a scar on the breast. This incision is particularly advantageous in patients with small breasts and with a barely marked inframammary fold.
Dr. Tarragona will explain you the pros and cons of each type of incision, and which one will be the optimal for your specific case.
The implant can be placed in different planes depending on the patient:
- Subglandular: the implant is placed under the mammary gland. It is recommended in patients with a certain amount of breast tissue and subcutaneous fat (positive pinch test).
- Subfascial: the implant is placed under the fascia of pectoralis major muscle, being completely separated from the breast.
- Submuscular: the implant is placed under the pectoral muscle. It is the best option for reducing the visibility and palpability of the implant in the upper pole, presenting certain advantages in comparison to other planes, such as less capsular contracture and better visualization of the mammary gland in mammograms.
- Dual plane: the upper part of the implant is placed below the muscle and the lower part below the gland. It has been developed as a variation of the submuscular technique to minimize the risk of breast deformations, considering the different degrees of breast ptosis.
The choice of the most appropriate implant will be made based on the desired results and the characteristics of the patient. Your surgeon will advise you of the characteristics of the implant:
- filing (saline, silicone, glass bead)
- shape (round or anatomical)
- coating (silicone or micro-polyurethane)
- surface texture (smooth or rough)
Postoperative evolution and recovery
The surgery is performed under general anesthesia, thus the patient remains asleep throughout the surgical procedure. The duration of the procedure ranges between 1 and 2 hours, depending on each case.
Patients are usually discharged the day after the surgery, requiring a week of relative rest, after which the first treatment will be made, and the stitches removed. Depending on each case, the result will be perceived sooner or later. The final result is considered one year after the surgery.
Patients should wear a special design bra and a chest band during the first weeks.