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breast augmentation

The only proven, safe method for breast augmentation surgery; It is a method of augmentation with a silicone implant.
Although fat injection is a method we currently use in selected cases, my personal opinion is that many years of experience are needed to replace the silicone implant. When the melting amount of the oil is taken into account, satisfactory results are rarely obtained in a single session. However, it is a method that we can sometimes prefer for excessively asymmetrical breasts and congenital breast deformities.
Breast augmentation methods with drugs or creams are definitely in the class of methods that cannot be recommended medically. It is medically and logically unacceptable to make the mammary gland grow by changing the hormonal balance.
In modern surgery we use today, the choice of technique according to the patient is very important. The following factors determine our choice among almost 50 different surgical techniques;
1. Whether there is sagging in the breast
2. The thickness of the breast skin and mammary gland
3. The shape and size of the silicone to be preferred
4. Patient’s expectations (in terms of naturalness, size and smallness)
5. The plan where we will place the silicone (submuscular, supramuscular, dual plan, submuscular)
6. The entry point where we will place the silicone (from the lower breast fold, armpit fold, nipple)
If there is sagging in the breast and this sagging is not excessive, we can create a space in the supramuscular plane and provide augmentation with anatomical silicone implants known as drop silicone. However, since the consistency of anatomical silicones is harder than other silicones (we say form stable), the breast skin and mammary gland must be thick enough so that the borders of the silicone are not felt when touched. If the mammary skin and mammary gland are thin and the amount of sagging is high, a space should be prepared in the submuscular plane and an operation to lift the upper tissues (breast skin and mammary gland) should be performed. In this case, our silicone option can be round. Because the muscle tissue presses on the upper part of the round silicone, ensuring that the transition in the upper breast area is natural as in anatomical silicone. However, if the amount of sagging is very low (especially for partial sagging in women who say that there is a decrease in breast tissue after breastfeeding), we can choose anatomical or round silicone by using a technique we call dual plan. The only thing we do not want in anatomical silicones is the rotation of the silicone inside, which can sometimes be corrected by the patients themselves, but sometimes surgical procedure may be required. This is a situation we encounter especially in the supramuscular plane.
Some of the frequently asked questions by patients are:
1. Will I be able to breastfeed?
Of course, you can breastfeed, as we place the silicone not inside the mammary gland, but under the layers under the mammary gland, that is, the silicone and the milk-producing tissues of the breast do not even come into contact with each other.
2. Will there be a loss of feeling?
In breast augmentation surgery, the nerve that provides the sensation of the nipple is preserved, only in the first weeks, the breast skin may suddenly stretch after about 1 hour of surgery and numbness may occur due to tension, which is a temporary condition that disappears when the tension is gone.
3. Do I need to replace the silicone in the following years?
As a matter of fact, we can say that the silicones produced with today’s technology can stay for a lifetime. However, if your breast tissue sags in the following years, especially after breastfeeding, which is a situation that is independent of silicone, which may normally occur, only a lift surgery may be required. As a matter of fact, when a patient of mine who had silicone surgery 15 years ago applied to me with the complaint of downward sagging of the breast tissue after having 2 children, I observed that the silicone was in the place and shape where it was first placed, and the breast tissue and skin sagged. I created the old integrity of the breast tissue-skin with silicone by only performing a lift surgery on this patient.
4. Will there be traces?
Until today, I have not encountered a breast augmentation patient with scar complaint. The incision we use in breast augmentation surgery is quite small, whether I place the silicone in the lower breast fold or the armpit fold, it is quite acceptable and only a 3-4 cm incision line can be seen when examined very closely. However, since the underarm skin is much thinner and its healing is much better, I prefer to place it under the armpit, especially in women who do not have lower breast folds, as the scar left by entering through an imaginary fold may disturb the person.
5. Is it a risky surgery?
In fact, it is a safer operation among plastic surgeries. Possible risks are those that can be compensated. If we are talking about the risk of bleeding after the surgery, the drains that we put in the surgery and remove the next day reduce this risk. Infection is a very rare situation, because we perform this surgery under sterile conditions in the operating room, and there is a protection against infection due to the good blood supply of the breast and muscle tissue. But we still reduce this risk by using preventive antibiotics. The risk of capsule formation is present especially in the supramuscular plane, it is very difficult to talk about this risk when we work in the submuscular plane. The risk of asymmetry is always a risk, which can be in two ways; Either the difference in the shape and size of both breasts beforehand (despite the equal size of silicone is placed on both sides) becomes noticeable after the surgery, or one of the silicone implants fits better in the prepared pocket, while the other can stay up or be placed lower. . If this situation is disturbing to the person, it can be corrected with a minor surgical intervention.
6. Will I feel pain after the operation?
Many of my patients come to me with the following statement: “My friend had surgery, he could not lift his arms for a month, he suffered a lot”. It is a fact that the postoperative period is painful, especially since we placed silicone on the submuscular plane. However, this pain is felt for a maximum of 24 hours, and since you are in the hospital during this period, the disturbing level of pain is eliminated with painkillers. In other words, although the pain does not completely disappear after the first 24 hours, it is not at a level that will distract you from life. Moreover, within 2-3 days after the first 24 hours, this situation disappears as the tension of the muscle disappears. So what’s causing this whole process is the muscle stretching of a silicone implant we placed underneath. By the way, the reason why I want you to return to your daily work as much as possible after 24 hours and exercise your arms and muscles is to ensure that this tension disappears more quickly. The massage techniques that I recommend and describe to you after the surgery also accelerate this process.
My preferred surgical technique:
I put the silicone on the lower breast crease and the armpit crease. If I am going to operate under the armpit, I perform the surgery with the endoscopic system. As a surgical plan, I often prefer the submuscular plan. However, in all patients with submuscular silicone implants, I use the approach we call dual plan 1, allowing the muscle to be released from the area where it is attached in the lower fold of the breast. I prefer the submuscular plan in patients where I will place silicone on the supramuscular plan. Since the muscle membrane is not as strong as muscle tissue, I don’t think it sees an adequate cover on the silicone. We can say that only the submuscular plane (especially seen in the supramuscular plane) acts as a protective function against the formation of the capsule. As silicone, I use gel-filled silicone, and as a silicone company, I use Mentor and Allergan companies today. As a form of anesthesia, I prefer general anesthesia and a 1-day hospital stay. I use the bodylogic system (provided by the mentor company) for surgery planning (detection of silicone shape and size).