Breast augmentation with implants
The strong points
- Breast augmentation with breast implants is the preferred method for increasing the volume and improving the shape of the breast.
- The majority of the interventions are done in ambulatory surgery (entry in the morning, exit in the evening at 7pm)
- Final result at 6 months
Description of the breast implants
Breast augmentation by prosthesis is intended to increase the volume of the breast and improve its shape.
It consists of creating a space in the patient's chest in order to place an inert implant made of a smooth silicone envelope. The filling of this implant with saline or silicone gel will provide additional volume to the breast gland.
There are 3 types of compartments in which the breast prosthesis can be inserted
- the retroglandular space (in front of the muscle): the breast implants are located between the gland and the pectoral muscle. It is a simple and not very painful procedure, but it leads to a high visibility of the implants and exposes to a higher rate of shells.
- the retro-fascial compartment: the breast implants are placed under the envelope of the pectoral muscle (or anterior fascia). This allows the upper edge of the implant to be better hidden. This is our preferred technique for patients with a normal thickness of fat on the chest. It limits the rate of this hull.
- the retro-muscular compartment (behind the muscle): the breast implants are placed under the pectoral muscle which is freed from its sternal attachments (Dual-Plane technique). This allows the upper edge of the implant to be perfectly hidden. We reserve this technique for lean patients with a low fat thickness because it is much more painful. It limits the rate of hulls.
There are 3 possible scars to create this lodge
- the submammary scar: We use it in 70% of our cases. It allows for the placement of large breast implants with good security, better preserves the sensitivity of the nipple and limits the occurrence of shells.
- The axillary scar: We use it in 25% of cases. It allows us to respect the breast perfectly and gives a very natural result. The scar is almost invisible even in the privacy of the patient. Its realization is more delicate and we systematically use a camera or endoscope in order to perfectly control our gestures.
- the areolar scar: We use it in less than 5% of our cases. The scar is often not very visible, however, access to the lodge requires the mammary gland to be cut in half with an increased risk of hulls due to bacterial contamination. Nevertheless, it allows the modification of the mammary gland and we use it in particular in cases of tuberous breasts or in cases of asymmetry with breast ptosis.
For a breast augmentation by prosthesis, the operation lasts between 1 and 2 hours.
Surgery is most often performed under general anesthesia. This requires a pre-anesthetic consultation at least 48 hours before the operation. In certain situations, a local anesthetic may be used. It will be reinforced by tranquilizers introduced by intravenous infusion (neurolepanalgesia).
In the majority of cases, the surgery is performed as an outpatient procedure (entry into the clinic at 7:30 a.m., exit the same day around 7:00 p.m.), but it can be considered during an overnight stay, especially if the prosthesis is placed behind the muscle (entry into the clinic at 1:00 p.m., exit the next day at 11:00 a.m.). The surgery is not very painful if the implant is placed in front of the muscle or under the fascia and work can be resumed after 4 days. If the implant is placed behind the muscle, strong painkillers are prescribed for 3 days and a 7-day work stoppage must be foreseen.
A support bra should be worn day and night for 15 to 30 days.
The aftermath of the operation
Pain is felt during the week following the operation. It can be significant when the breast implants are large or when they are placed behind the pectoral muscles. With the team of anesthesiologists at the Alma Clinic, we have set up a specific drug protocol to best treat this pain. It is associated with a specific loco-regional anesthesia (PECS Block) which blocks the pain sensation during the first 24 hours after the operation.
After the operation, the breasts swell because they become swollen with edema, and may rarely show bruising (skin with a dark blue color). These signs disappear quickly.
Care and precautions
We use Mepilex Border waterproof dressings that do not require any scar care for 3 days and allow you to take showers. You can change them every 3 days on your own or with the help of a nurse and they can be removed 9 days after the operation. The sutures are usually absorbable. To help your breasts adjust to their new shape, you will need to wear a special bra that will hold the implants in place. You will need to wear it continuously (day and night) for 2 to 4 weeks.
During the convalescence period, all sports activities will be forbidden. The same applies to handling heavy objects. You should also avoid sleeping on your stomach. The return to work can be considered between 3 and 7 days after the operation. The resumption of a light sport activity (fast walking, elliptical bike) is authorized at 45 days. All other sports can be resumed at 3 months.
The results of your breast augmentation can only be evaluated after 3 months.
Questions / Answers
Saline or silicone prostheses?
Breast augmentation can be done with different prostheses. Discover the advantages and disadvantages of saline and silicone implants. We will present you each type of prosthesis and the one we prefer. Read more ...
Round or anatomical prosthesis?
Anatomical breast implants were presented by the laboratories as a major evolution in breast augmentation, enabling a more "natural" result to be achieved. However, we've gone backwards and now only use smooth, round implants. Here's why Read more ...
What were the advantages of a polyurethane foam-covered breast prosthesis?
Here we'll explain why we used polyurethane foam-covered anatomical breast forms and why we stopped using them Read more ...
Which brand of prosthesis to choose?
There are many brands of breast implants, but the recent PIP and Allergan breast implant scandals have shown us how important the choice of implant brand is, both for the surgeon and the patient. We'll introduce you to the main laboratories and explain why we only choose certain types and brands of breast implants. Read more ...
How to choose your incision?
In this section we will present the different incisions possible during a breast augmentation by prosthesis and the scars left by them. Discover the different incisions and the ways we prefer. Read more ...
How to choose the right size of breast prosthesis?
During a breast augmentation by prostheses, the choice of the size of the prostheses is a very important step. Discover the simulation methods used to define the size of breast implants and reassure patients who are often worried. Read more ...
How much does a breast augmentation by prosthesis cost?
The price of aesthetic breast augmentation with silicone implants ranges from €5,000 to €8,000. Prices vary according to the type of implant, the technique used and the length of hospital stay. Read more ...
What are the complications of a breast augmentation with a prosthesis?
Fortunately, they are very rare, but this underlines the essential nature of the quality of the surgical procedure and the implant. Read more ...
Use of breast prostheses
Breast prostheses can be used in breast reconstruction after cancer, in the treatment of breast deformities or for purely cosmetic purposes. Read more ...
The different brands
There are many brands of breast implants available in France. They have all obtained the CE mark issued by the European Union. Some implants are approved by the American FDA following clinical trials on thousands of women. Read more ...
Breast implants and health insurance
In some cases, breast augmentation with implants can be reimbursed by health insurance. We explain what the necessary conditions are. Read more ...
The lifespan of a silicone gel-filled breast implant cannot be known in advance. Most clinical trials show an average lifespan of 11 years, but your implant may last 8 years or 25 years. Thus a close monitoring is necessary. Read more ...
Breast implants and pregnancy
The placement of breast implants does not indicate a subsequent pregnancy or breastfeeding. We recommend waiting 3 months after the end of breastfeeding before considering breast augmentation with implants. Read more ...
Breast implants and cancer
Numerous studies have shown that breast implants do not increase the risk of breast cancer. Recently, a rare immune cell cancer (anaplastic large cell lymphoma) has been described around some breast implants. We explain this risk in detail.
Have a question? Please contact us!
Docteur Yaël Berdah and Docteur Marc-David Benjoar
Plastic surgeons in Paris France