The purpose of breast augmentation by implant is to increase the volume of the breast and improve its shape.
It consists in creating a lodge (or space) in the patient’s chest in order to put in place an inert implant formed of a silicone envelope. The filling of this implant with physiological saline or the silicone gel will make it possible to bring extra volume to the mammary gland.
There are 3 possible types of lodges in which one can slide the breast prosthesis
1. The retro-glandular lodge: the breast implants are located between the gland and the pectoral muscle. It is a simple box to carry out and not very painful but which leads to an important visibility of the implants
2. The retro-fascial lodge: the breast implants are placed under the envelope of the pectoral muscle (or anterior fascia). This allows a better hiding of the upper edge of the implant, especially if it is a round implant. This is our preferred technique in patients with normal fat thickness on the chest
3. The retro-muscular lodge: the breast implants are placed under the pectoral muscle which is released from its sternal attachments (Dual-Plane technique). This allows the upper edge of the implant to be hidden perfectly. We reserve this technique for lean patients with a low thickness of fat because it is much more painful.
There are 3 possible scars to create this box
1. The sub mammary scar: We use it in 50% of our cases. It allows the placement of large breast implants with good safety
2. The axillary scar: We use it in 30% of cases. It allows respecting the breast and gives a very natural result. The scar is almost invisible even in privacy. Its completion is more delicate and we systematically use a camera or endoscope in order to control perfectly our gestures.
3. Areal scar: We use it in 20% of our cases. It is a good technique but leaves a scar on the breast and which requires cutting the gland in half in order to access the lodge with an increased risk of shells by bacterial contamination. It makes it possible to modify the mammary gland and we use it especially in cases of tuberous breasts or in cases of asymmetry with ptosis of the breast.
The procedure of the plastic surgeon lasts between 1 h and 2 h for a breast augmentation by prosthesis.
The procedure is usually performed under general anesthesia. This requires a pre-anesthetic consultation at least 48 hours before surgery. In exceptional situations, local anesthesia may be used. It will be reinforced by tranquilizers introduced by intravenous infusion (neurolepanalgesia).
In very few cases, the surgery is performed as part of an ambulatory hospitalization (admission to the clinic at 7:30 am and leaving on the same day at about 7:00 pm. But it may be considered during an overnight hospital stay, especially if The prosthesis is placed behind the muscle (entrance to the clinic at 1 pm, exit the next day at 11 am). The surgery is not very painful if the implant is placed in front of the muscle or under the fascia and the work can be resumed after 4 days. If the implant is placed behind the muscle, strong pain killers are prescribed for 3 days to 7 days work interruption must be planned.
A compression bra should be worn day and night for a period of 15 to 30 days.
You will feel a little bit of pain during the week following the operation. They can be important when the breast implants are bulky or when they are located behind the pectoral muscles. We have set up a specific medicinal protocol to treat the pain as well as possible with the anesthetist team. After the procedure, the breasts swell because they gorged themselves with edema, and can rarely present bruises (skin with a dark blue color). These signs disappear quickly.
We use Lumiderm band-aids that do not require any scar treatments for 5 days and allow you to take showers. It will be changed during your consultation on 5th day and may be withdrawn on 10th day. The sutures are most often resorbing. You will need to put a special bra that will hold the implants in place, to help your breasts adapt to their new shape. You will need to wear it uninterruptedly (day and night) for 4 weeks.
During the convalescent period, any sport activity will be prohibited. The same applies to the handling of heavy objects. It will also be necessary to avoid sleeping on flat belly. Return to work may be considered between 3 to 7 days after surgery. Returning to a moderate sport activity (fast walking, elliptical trainer) is allowed to 45 days. All other sports can be resumed at 3 months. The results of your breast augmentation can only be evaluated after 3 months.
Breast augmentation can be done with different prostheses. Discover the advantages and disadvantages of serum and silicone prostheses. We will present each type of prosthesis and the one we prefer.
The anatomical mammary prostheses have been presented by laboratories as a major evolution in breast augmentation to achieve a more “natural” result.
We will explain here why we use breast implants covered with polyurethane foam.These implants are a real revolution as they are developed by the German laboratory Polytech Health.
There are many brands of breast prostheses but the recent scandal of PIP breast prostheses has shown the importance of choosing the implant brand. We will introduce you to the main laboratories and explain why we choose only high-end prostheses.
In this section we will present the different incisions possible during a breast augmentation by prosthesis and the scars left by these. Discover the different incisions and paths we favor.
During prosthetic breast augmentation, the choice of prosthesis size is a very important step. Discover the simulation methods used to define the size of the breast prosthesis and reassure the often worried patients.
The price of an aesthetic breast augmentation with silicone implants varies from 3800 to 6000 €. Prices vary depending on the nature of the implant the technique used and the duration of the hospitalization.
They are fortunately very rare, but this highlights the importance of the quality of the surgical gesture and the implant.
Mammary prostheses can be used in breast reconstruction after cancer, in the treatment of breast malformations or for purely aesthetic purposes.
There are many brands of breast prostheses available in France. They all obtained the CE marking issued by the European Union. Some implants are approved by the US FDA following clinical trials on thousands of women.
In some cases, breast augmentation per implant can be reimbursed by health insurance. We explain to you what the conditions are.
The lifetime of a silicone gel breast implant cannot be known in advance. Most clinical trials show an average lifespan of 11 years but your implant can last 8 years or 25 years. Monitoring is therefore necessary.
The placement of breast implants does not indicate later pregnancy or breastfeeding. We advise to wait 3 months after the end of a breast feeding before considering a breast augmentation per implant
Breast prostheses and cancer
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