Breast
Augmentation
Breast Augmentation Surgery
Breast augmentation is one of the operations in plastic surgery that brings the most happiness to women. A more feminine silhouette, more balanced body proportions, and increased self-confidence are the main benefits that come with this surgery.
How is Breast Augmentation Surgery Performed?
We perform breast augmentation using silicone breast implants. Silicone implants have been used safely in plastic surgery for over 60 years and have been the subject of numerous studies over time. Thanks to this, we now have clear and accurate information about implants:
* Silicone breast implants do not cause breast cancer.
* They do not interfere with breastfeeding.
* They do not obstruct cancer screenings such as mammography and MRI.
* They do not have a specified "lifespan"; there is no fixed time interval for their replacement.
Where is the Implant Placed?
We can place silicone implants in two different planes, depending on the patient's needs and anatomical structure:
* Under the muscle (subpectoral)
* Under the muscle fascia (subfascial / over the muscle)
The choice of which plane to use is determined by the patient's skin thickness, amount of breast tissue, exercise habits, and aesthetic expectations.
Details of the Surgery
* Duration: Approximately 1 hour and 15 minutes
* Anesthesia: Performed under general anesthesia
* Recovery process:
* The post-operative period is quite comfortable with over-the-muscle placement. No specific movement restrictions are recommended for the patient after the first week.
* With under-the-muscle placement, the use of pain relievers may be necessary for the first 4 days. The arms should not be raised above 90 degrees for the first week, and no force should be applied with the arms for the first month.
Is a Breast Lift Necessary?
One of the issues that must be evaluated when planning a breast augmentation is whether there is any breast sagging. If there is sagging in the breast, an augmentation surgery alone will not be sufficient; in this case, a breast lift (mastopexy) should also be performed in the same session. This can significantly affect the technique to be used.
Additionally, if there is an unusual anatomical condition such as asymmetry, depression, or protrusion of the chest wall, this can also affect both the planning and the results. If such conditions exist, they should be discussed in detail with the patient, and expectations should be managed correctly.
What Kind of Implants Do I Use? Teardrop or Round?
I carefully select the silicone breast implants I use in breast augmentation surgery from the world's most reliable and scientifically studied brands. Implant selection is not just an aesthetic choice; it is also of great importance for health, safety, and long-term satisfaction.
I Always Prefer Textured Surface Implants
All the implants I use have a textured surface. The reason for this is that smooth-surfaced implants carry these two significant risks:
The risk of capsular contracture (the formation of a hard capsule) is about 30% with smooth implants.
The risk of implant displacement (rotation or shifting) is higher.
Therefore, for many years, I have minimized these risks by using only textured surface implants.
The only potential risk associated with textured surface implants is a rare condition called ALCL (Anaplastic Large Cell Lymphoma), a type of lymphoma.
This risk, according to the literature, is extremely low, at about 1 in 10,000 people.
In daily life, we unknowingly take risks that are much higher than this every day. Therefore, taking this risk to avoid much more common problems such as capsular contracture and implant displacement is both logical and medically sound.
Implant Shape Options: Teardrop and Round Shape
Implants vary not only by their surface properties but also in terms of shape and profile.
Teardrop (Anatomical) Implants:
* They are generally preferred for patients with no breast tissue at all.
* Since the entire breast shape will be created by the implant in these patients, the teardrop form provides an advantage in achieving a natural look.
* However, contrary to popular belief, the notion that "a teardrop implant leaves the upper part of the breast empty" is not true.
* Regardless of the implant shape, all modern implants fill the upper part of the breast.
Teardrop implants have a 3% risk of rotation. In this case, the shape of the breast may be distorted. Therefore, it is safer to prefer round implants over teardrop ones in patients at risk of rotation.
Round Implants:
* They are our first choice for patients who have existing breast tissue and only want an increase in volume.
* With round implants, both fullness is achieved and there is no shape distortion if the implant rotates.
* They also effectively fill the upper pole of the breast aesthetically.
Profile Selection: Low, Moderate, High?
Silicone implants differ not only in shape but also in profile (height). The profile selection is determined by the patient's chest wall anatomy:
* For patients with a flat chest wall: Moderate or high profile
* For patients with a protruding chest (pigeon breast): High profile
* For patients with a sunken chest (funnel chest): Low or moderate profile is preferred.
Under or Over the Muscle in Breast Augmentation?
Which method is more suitable for you?
One of the most frequently asked questions in breast augmentation surgery is where the silicone implant will be placed: under the muscle or over the muscle?
First of all, I would like to say that both methods are successful and safe. Neither is absolutely superior to the other. The choice of which method to use is determined entirely by the patient's needs and anatomical structure.
I frequently and safely use both methods.
When is Over-the-Muscle (Subglandular) Placement Preferred?
Over-the-muscle implant placement means placing the implant under the breast tissue but on top of the muscle. This placement is considered as the first evaluation in the following cases:
* If the patient's subcutaneous and breast tissue thickness is sufficient: If there is enough tissue to prevent the implant from being visible from the outside, there is no need to go under the muscle. Over-the-muscle placement is more comfortable.
* If the existing breast diameter is at least 2 cm larger than the diameter of the implant to be placed: In this case, the implant is better enveloped by the breast tissue, providing a more natural appearance.
* If breast augmentation is to be performed in conjunction with a breast lift (mastopexy): In such combined surgeries, it is technically necessary to place the implant over the muscle.
When is Under-the-Muscle (Dual Plane) Placement Preferred?
In under-the-muscle placement, the implant is placed under the pectoral muscle, and sometimes between the muscle fascia and the muscle. This method is preferred in the following cases:
* If the patient's breast tissue is very thin: If there is not enough thickness to cover the top of the implant and prevent it from being visible from the outside, muscle support is necessary.
* If the diameter of the implant is equal to or larger than the existing breast diameter: In this case, since the edges of the implant will protrude more, under-the-muscle placement provides better camouflage.
* In patients with slight sagging of the lower breast, but a normal nipple position: In this anatomical situation where the lower pole of the breast is long, under-the-muscle placement provides a more natural and balanced appearance.
Which is More Painful?
There is no single correct answer to the question of "under the muscle or over the muscle?" in breast augmentation surgery. We determine the most suitable plan for each patient together, based on their body structure, expectations, and needs.
Goal: To achieve a natural, healthy, long-lasting, and aesthetically satisfying result.
Let's create the most suitable plan for you together.