Pre-surgical examination – breast examination before the surgery is important and it is recommended to all women that undergo breast augmentation. This examination enables to compare pre-surgical finding with later check-ups. In women up to 30 years old ultrasonography of breast is sufficient, in older women mammography.
Size of implants – new breasts should be in harmony with the shape and size of chest and should look natural. Natural look depends on the height of breasts and their width – base and their distance from the center of chest. Breasts should overlap the chest so that they are in one line with hips.
Naturally it is possible to form almost any size of breasts, although the bigger the implants are, the faster the skin weakens and the breasts droop. Implants that are too large can be visible underneath the skin or palpable.
Choice of implants – see work Modern Implants – Entner M.D. – Anatomic implants have been produced already in the 80th without reaching any greater expansion. Intense advertising campaign in the 90th caused activation of the interest in the implants. Their biggest disadvantage is their relatively high price. Their advantage was rigidness of cohesive gel – there was no ribbing in the implants inserted under the skin. More rigid gel have nowadays practically all good implants. With their teardrop shape profits approximately 15% of women. In other women it presents useless high costs for a fashion product. I have used anatomic implants since 1996 and approximately after a year from the surgery it cannot be said which patient has anatomic or round implant.
Surgical approaches – see work Breast Augmentation – Tocikova M.D.. Basically it can be said that at first every surgeon is lead by his/her experiences and offers the surgical procedure with the best results. Statistic figures show though that the most complications appear by the approach in the armpit and the least by the approach under the infra-mammary fold. Regardless the approach the complication should not exceed the border of 5%.
It is obvious that a surgeon that has great experience with a certain incision reaches better results that a surgeon with small knowledge.
Placement of implants – also here see work by Tocikova M.D.. More natural breast shapes are reached by placement under the gland. Another possibility is placement of the implant partially under the gland and partially under the muscle – dual plane – method that is still more popular by aesthetic augmentations. Inserting the implant under the muscle has naturally its reasons and sometimes it is the only possibility for creation of new, larger breasts.
A whole range of studies e.g. from U.S.A., Canada, Denmark have confirmed that there is no increased occurrence of breast cancer in women with breast implants.
Most of the studies performed by common mammography machines have confirmed no difference between average time needed to find cancer nor the state of disease.
Today there are even special mammography machines that are used in patients with implants.
It has been also proved that if there is cancer disease in woman with implants it is usually clinically found earlier than in women without implants.
A number of studies, also a study with more than 7000 women with breast implants in Sweden, have confirmed that there is no direct relation between these diseases and silicone.
Association of American rheumatologists states that there is no reason to reject augmentation with the use of implants in women that suffer from rheumatism.
Psychological studies show that men find the most attractive women with same size around of chest and hips e.g. 96-74-96 cm. Too large breasts don’t make aesthetically positive feeling.
Excessive increase of implant cover has many reasons. If we assume that it is similar to creation of swollen scar, then much mechanical irritation – massage – only makes the situation worse. The capsule can spontaneously get better or worse – hormonal influence, pregnancy, general disease etc.
In the first 3 years after the surgery in U.S.A. it is necessary to reoperate 28-35% of all patients. There are many reasons for that and there is no space to describe them here. However, it is necessary to realize that there are no measurable parameters for aesthetic breast like for example in face that is measured in millimeters. Breasts are anatomic organs that change the most during life – puberty, pregnancy, climacteric etc. Moreover the shape and form of breast change even with every move.
It is obvious that undergoing augmentation should not be quick and momentary decision but very well considered step. It presents change that can stay as positive but also negative for years.
For good result, which will make pleasure for long time, it is not sufficient to have just an experienced, surgeon with aesthetic feeling. Without cooperating, wise and realistic patient the result will always be maximally average.
Authors of the article are Michael Entner M.D. and Jiri Vrbicky M.D..