Breast augmentation (Mammaplasty)

Breast present from ancient times a symbol of woman’s beauty. For many women too small breast can be an origin of significant psychic problems. Breast augmentation via plastic surgery can serve as a solution.

Breast augmentation, also known as mammaplasty, involves surgical placement of an implant behind each breast to increase its volume and enhance the breasts shape. Breast augmentation is requested by women who perceive their breasts as too small or sagging.

Types of implants

Basic types are by shape:

  • round
  • anatomic – teardrop
  • asymmetric (different implant for each breast)

Basic types by filler:

  • silicone cohesive (silicone gel, filler for anatomic implants)
  • silicone liquid
  • saline (minimum use in the Czech republic)
  • polyurethane

Basic types by the surface of implant:

  • smooth (as a rule they are not imported to the Czech republic)
  • textured (the implant has a “velvet surface” with the aim to grow into the breast and not to move inside the breast)

Basic types by profile:

  • moderate
  • high

The size of the implants is indicated in mililitres. The choice doesn’t depend on the size but on the dimension. The selection depends on following factors: figure, height, width of the chest, figure proportion, size of pelvis, size of mammary gland and of course on the wish of the patient. Mostly used sizes in the Czech Republic are 200 – 300ml. (Implants from about 100ml to 1000ml are produced).

For imagination a plastic cover (bag etc.) can be filled with liquid, friable or boiled rice and put into the bra when choosing the size of an implant.

Most commonly used implants by producers in the Czech Republic are:

  • McGhan
  • Mentor
  • Polytech
  • Eurosilicon

Price of breasts implants

Price of breasts implants range from about 18 to 50 thousand CZK according to the type of implant and the producer. From 18 to 28 thousand CZK for round and from 40 to 50 thousand CZK for anatomic shape. Prices are independent on size.

Surgical procedures of breast augmentation

When choosing a surgical procedure following aspects are considered.

The placement of the incision:

  • below the breast in the infra-mammary fold
  • through areola
  • in the armpit

The choice depends on the wish and disposition of the patient and on the practice of the clinic.

The placement of the implant:

  • under the mammary gland
  • under the muscle
  • partlially under the muscle

Both methods (under the muscle and under the mammary gland) have their advantages and disadvantages. The choice depends on the quality and the size of the gland, the quality of the skin and the subcutis and the power and quality of the muscle. The implant coverage has to be sufficient. If it is not sufficient, the implant can be visible and it does not look aesthetically. The consultation is intended to harmonize the patient’s ideas with the real possibilities, body proportion and with the opinion of the surgeon.

The process of augmentation

Breast augmentation will be performed with a general anesthesia in most cases.Typically, people are requested not to drink, eat and smoke for about 6 hours before the surgery. The surgery usually takesone to two hours and one to two days stay in hospital may be needed.

The surgery

The method of inserting and positioning your implant will depend on your anatomy and your surgeon’s recommendation.
The 3- 4 cm long incision can be made either in the crease where the breast meets the chest, through the dark skin surrounding the nipple or in the armpit. Every incision is made carefully so resulting scars will be as inconspicuous as possible.

A pocket to which an implant is inserted is created by blunt tissue preparation.

The pocket will be filled with the implant either directly behind the breast tissue or underneath the chest wall muscle.

The size of implants must be carefully chosen to be fully covered by the breast tissue. Otherwise the borders of implants can be easily visible and it makes a very unnatural look.

The cessation of bleeding is very important to avoid further complications – undesirable capsule, that is a scar or a coverage of the implant.

Drainage tubes may be used for several days following the surgery, it depends on the practice of the clinic and on the surgeon.

To close the wound different sutures are used (mostly intradermal, eventually separate), they are removed 7 to 10 days after the surgery.

The coverage of the wound is up to the practice of the clinic. After the surgery the breasts are day and night fixed with a special bra, it is recommended to wear it 4 to 8 weeks after the surgery. For one month after the surgery it is recommended to sleep in the position on the back and to limit sport activities.

Are you the best candidate for breast augmentation (mammaplasty)?

Enlargement of the breasts by means of implants, is a very effective surgery, suitable for women with insufficiently developed breasts or when the mammary gland system is shedding as may be the case after breast feeding or significant weight loss.

The optimal age limit for surgery varies. It is generally done after the development of the mammary glands is completed, which is not before the age of sixteen.

It is certainly better to insert the implants to the breasts that won’t change by breast feeding. Although it does’t eliminate the possibility to undergo the breast augmentation after the age of eighteen before pregnancy. You have to take into account that the lactation and pregnancy will change the size and quality of the mammary gland and therefore the surgery will probably need to be redone. The breast implants have no influence on the fetus and they do not expose it to any danger. The presence of the implants does not eliminate the ability to breast-feed. The world studies didn’t prove an increased content of silicone in the breast milk.

If you’re physically healthy and realistic in your expectations, you may be a good candidate.

Before your surgery

During your initial consultation, your surgeon will explain the surgery in detail, explaining which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone.

If your breasts are sagging, your doctor may also additionally use breast lift. Your doctor also will inform you which implants he or she will use and which size is appropriate for you to reach the best result.

Depending on your age and family history, your surgeon may require you to have a mammogram (breast x-ray) before surgery.

Be sure to discuss your expectations frankly with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each alternative.

Because it is a surgery under general anesthesia, a pre-surgical examination by general doctor or internal specialist is required, which will eliminate possible medical risks – allergies, auto-immune illnesses, and other severe illnesses. Before the surgery it is also necessary to eliminate breast illness, the best would be mammography, mainly by the risk group of patients with positive family anamnesis – there is a breast illness in the family.

Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, taking or avoiding certain vitamins and medication. You may be asked if you use any medication containing acetylsalicylic acid (such as Aspirin, Acypyrin, Alnagon, Mironal etc.). It can increase bleeding during and after surgery.

It is assumed that no acute illness occurred in the period of a least three weeks before the planned operation (viral illness, cold etc.) Report any illness to your doctor.

If you smoke, plan to quit at least one or two weeks before your surgery and do not resume for at least two weeks after your surgery.

While making preparations, be sure to arrange for someone to drive you home after your surgery and to help out for a few days if needed.

After your surgery

You are likely to feel pain for a few days following your surgery. The pain is more intensive by the surgeries where the implant is placed under the muscle. You will take painkillers for 2 to 5 days after the surgery. The pain will recede stepwise.

You will be released from the clinic after one or two days. Before you leave, the bandages can be changed and drains removed. That depends on the clinic and your surgeon. You may resume routine activities e.g. in the household after 5 to 10 days.

The question of recommendation of massaging after the surgery varies from clinic to clinic and also according to the used type of implants. It is recommended to shower the breast after the wound has healed.

You may resume routine activities after 7 to 10 days. One or two months after the operation, the breasts are considered to be stable.

You should be able to return to work within few days, depending on the level of activity required for your job.

The results are considered to be permanent after 3 months.

If the breast skin is dry after the surgery, you can apply hydrating creme several times per day. Be careful not to tighten the skin while doing some specific movements and avoid the contact with stitched area.

You should see your surgeon any time when your breast shape changes, when the consistency changes (your breast becomes hard) or any inflammation manifestation appears. Your surgeon visit is also recommended after any severe stroke to your breasts (car accident, fall from high etc.). Regular check-ups are after one month, after three months and after one year. Some clinics have no check-ups at all.

Always be sure to follow your doctor´s instructions.

How long will the effect of breast augmentation last?

The final breast augmentation is permanent, if there is no change in weight and proportion of breasts (see the above mentioned pregnancy). Regarding the change of quality of the implant after 10 to 15 years and the increased possibility of implant rupture (burst), it is necessary to count with possible implant replacement. The decision of breast augmentation is personal, very serious and with permanent character. If you have met your goals, then your surgery is successful.