Only plastic surgeons are able to perform breast enlarging surgery to beautify ladies breasts. Implants are placed under the tissue of breast and by this way a larger breast is produced then the original was. Besides the newly shaped breasts have a natural touch, shape and behaviour. This kind of operation has been made for more than 40 years now and today we have very rich experiences. Millions of ladies are wear breast implants today.A mellnagyobbítás a mellplasztika kiemelt területe, a mai napig csak a plasztikai sebészeti módszerekkel lehetséges.
The media engaged in a silicon scandal during the years since it was broken out in 1992. Although the accusations never had been verified, the US’s authorities, which controls the food and medicament products/ FDA/ have bound to more rigorous terms for implanting silicon.
Therefore American colleagues have applied salt filled implants in the past 8-9 years/ The first steps towards the abolishing of this prohibition have taken place. The community of plastic surgeons in most European countries never accepted the American’s opinion because the charges again the silicon couldn’t be certified. The operations have continued, in Hungary as well. During the last years several hundred thousand check-ups were made. The analysis of statistical data proved there aren’t any connections between the operation and illnesses, or damage of health. It hasn’t been proved that implants cause breast-cancer or increases the risk of it. It couldn’t be proved that implants makes weaker the immune system, or grows the possibility of any autoimmune illness. It couldn’t be proved that silicon got into mothermilk or damages anyhow the embryos’ or foetus’. It has never succeeded to show, that in the background of any kind of sicknesses there was as a cause factor the recent input breast-prosthesis. The committee of EQUAM, which consists of plastic surgeons and other doctors from European countries, officially declares their stand points in the „CONSENSUS DECLARATUM” based on the analysis of check-ups made during the actual year. Of course, just as after any other operation there might occur complications, but these happen rarely, are local and cause no danger for health and generally with another intervention may be corrected. Later we will tell you more about it.
The silicon implants manufactured today have no expiry date. So, if no problems occur the implants remain in place. If the changing of them would be needed later their taking out is a simple operation. Pregnancy doesn’t generate difficulties and neither does breast-feeding, but there may be exceptions. It is imaginable that after more births the breast slackens which can also happen sometimes without implants, but this problem can be solved by a newer operation. Some months after the operation every kind of activity can be done, the patient can travel by plane. Simply put: There is no influence on one’s style of life.
In early stages, breast cancer is examined by touching. The implants are placed behind the gland so they don’t disturb these checks. In some cases, the mammography, which is X-raying the breast, can’t be evaluated, but instead of it there are up to dates picture producing techniques /CT ,MRI, ultra-sound /their picture-creation is better then that of mammography.
The development of permanent shape and dimension of breasts finishes after the puberty period. So it isn’t justified to operate sooner then the age of 18 years. A significant number of interventions are needed after this age, when the ladies realize their breasts are smaller and less developed than the average and there isn’t any hope for it to grow. /The total missing of breast-gland is a literary rarity/. Young ladies sometimes also need this operation if their breasts have different shapes or dimensions. The placing into one or two side silicon implants is often a part of the intervention in this circle. The other groups of ladies are those who have given birth one or more times and the regressing gland, that is to say, the breast slackening causes mental problems. There is no upper limit to the age, so a breast-enlarging operation can be done the above age of 50 years.
Although this operation can be done under local anaesthesia for the patient’s comfort and higher safety we do it mostly under general anaesthesia. A general health check, laboratory tests /blood, urine, ECG / are needed before the operation and these can be made in our clinic. At the age of 35-40 years a mammography test is proposed.
The implants are put through a short cut behind the tissue. This can be done
1. At the armpit’s furrow.
2. Around the edge of nipple’s yard.
3. Under the breast at the lower bending furrow.
under the muscle
|under the glandula|
or under the membraine of the
The material can be placed under the gland or deeper, under the muscle of chest, or under the membraine of the muscle. All of the three have advantages and disadvantages. More often the personal possibilities decides upon which one is the best solution.
The duration of an operation is 1-l,5 hour. After having finished we put drains (thin tubes) to lead of the body’s fluids from the big wound surface inside. These drains are connected to a sucking-bottle. These are together a closed sterile system and so decrease the possibility of complications, in the day after the operation they are removed.
After the operation, a bandage is put upon the operated surface, which consists of gauze sheets, a shape-tightening, non-allergic, fast sticking strip, and a tight brassier which is specially made for this purpose.
The rest cure: Generally the ladies spend the first night in our clinic. Next morning they may go to their hotel. It is better to go in car but nor driving. Driving is allowed only after the operation in the 3rd-4th day. After the operation the patient has to have 7-10 days rest, mainly in bed besides the utmost care. The wide moves of arms and every physical activity has to be minimised. After the 7th-10th days easier physical or mental works, sitting in an office are allowed. In the course of the first two weeks the patient has to see us about two times a week to let us supervise the wound and to change the bandage. In the 12th-14th day we take off the seams.
The ache: The patient can count on a tense and blunt ache which isn’t unbearable and gradually decreases. Simple painkillers such as DEMALGON, ALGOPYRIN are efficacious. In the first two days slight fever might occur. The itching: at the operated area in the 4th-5th days is the sign of healing. For some ladies it causes difficulties the prohibition of sleeping on stomach.
Washing: Don’t be let water to the wound for 4 days. In the fifth day the patient may have a shower, /no bath! / If clean or soapy water flows over the operated surface, it doesn’t cause inflammation. After a short shower the area of the wound has to be dried by a soft newly washed and ironed towel without rubbing the breasts. After this a sterilized gauze sheet has to be placed onto the wound and take up the brassier.
The patient two weeks after might return to her normal style of life. Works can be continued. Patient from abroad may go home. Yet we don’t advise the intense sporting, the ones, which need wide arm moving, such as playing tennis, swimming or moving with heavier shakes (dancing, aerobics, gymnastic etc). For a couple of weeks e a higher care is needed at sexual life. Sunbathing, solarium is also not advisable two week after the homemade cure.
We propose using a sunbathing cream against the strong sunlights for six month after the operation. Very important is to wear a brassier during the day, for 2-3 months.
Firms in the USA and also in Europe are manufacturing breast-prostheses, which can be inbuilt, and most of them sell their product in Hungary as well. Having the obligatory European qualification accepted by CE shame as at the other health product is the guaranty of quality. Now a days the outer cover of every implants is silicon-elastomer, but their inner side contain different filling materials. The best results are given by the implants filled with silicon gel because their effect is similar to the behaviour of the fat-tissue of the womanly breasts. In the case of more modern implants the microscopical leaking of silicon gel decreased after the structure of the housing has been changed. The structure of gel also has changed and was spreading the gel-like cohesive gels. After the silicon-hysteria in the US, they used more often the prosthesis filled with solution of salt. Its disadvantage is the often leaking of the solution and so disturbs the touching. Implants filled with vegetable oil, the so named TRILUCENT implants aren’t used anymore because the proofs become unreliable. The reliability of hydro gel-filled materials is studied, too. The implants might significantly differ in the structure of coverings. At the beginning the thin and smoother covers were made but later these were succeeded by thicker covers with more layers and even with double cavities. During last 8-l0 years covers with rugged surface had been produced and by them a very common complication, the so-called capsular contracture, became decreaseble. Besides these there are also common lentil shaped, low or high profiled, shape like anatomic implants.
Cohesive silicon gel filled breast implant cut into four part
silicon gel filled breast implant
silicon gel filled breast implant teardrop shape
Owing to the implanted materials the most often complication is the capsular contracture. The implant is tissue-friendly and is never thrown out, but the human organism as it is a strange material, surrounds it and covers by a thin layer of connecting tissue. This covering is being created two-three weeks after the surgery and in most cases causes no complaints and also cannot be felt. It also might occur the thickening of the housing, the cover, starts to shrink and so caused the deformity of the pliable implant and even moves it off or creates furrows. Depending on the different rates of course the breasts might become hard while touching, their shapes vary and at the end a tensing, discomforting feeling arises.
This kind of complication doesn’t appear during the weeks after the operation but later in months even in 1-2 yeas after. The solution is a new operation by which the original situation can be restored. At this case the implant, not by all means, has to be changed. These complications are occurring, according the statistics in the cases of 10-15%. – Nevertheless such intervening has to be done only in few percentages. The most possible reason of it is the general using of rugged surface in the last years. The moving off the material might happen without the housing in the first days. The chance of it is 1-2 % and has to be repeatedly operated. A very rare complication is the cracking of the silicon wall. It might be caused by a serious injury, eg. a car accident. The filling material at that case has got into the tissue. If it is salt solution it absorbs tracelessly, at the case of silicon, it must be taken off and putting in a new material. Very rarely happen the spontaneous cracking of the silicon wall, without any outer intruding. Not depending on the implant might occur internal haemorrhage; its chances are 2-3 %. Only at a few case is needed the taking off the haematoma, by an operation. The case of inflammation is similarly. This can be healed without operation using antibiotics, drain etc. but if it has to be operated, the material has to be taken off and after, not sooner then 3-4 month, can be replaced.
Generating pathological cicatrice in the wound might occur in a few percentages. At these, the time of healing is longer, the environment of wound is redder, the scar is shining, its touching is thicker. Their improvement could be spontaneous and can make it hurry by different creams, silicon sheets, rarely by injecting the cicatrices or more rarely by an operational correction. Defects of sensation arouse in 4-5 %. Around the nipple or its environment might happen the changing of sensation or insensibility. Regeneration is mostly spontaneous but its time may be longer even one year.