Breast implants

Reasons for the intervention:

You asked me for advice because you think that the volume of your breasts is insufficient and that the installation of prostheses could improve this situation.

If your chest is flat, it is the only possible solution. We have discussed the problems arising from the prostheses: an immediate, perfect, remarkable result but reflection on your side of the “hull” problem.

On the other hand, if your breasts seem flat because they fall, because the top has emptied, with nevertheless an acceptable volume, even if they are a little small in your bra, a correction of ptose intervention by concentration of the gland and ablation of the excess skin, would be more advisable. Otherwise it would be necessary to put a very large prosthesis to avoid the falling effect, and your breasts would then be disproportionate in size. It is better to concentrate what already exists, even if it involves the installation later of a small prosthesis if you find that your breast’s size is really not sufficient.

Implants:

Let us return to the problem of the prostheses, supposing that you present the ideal case of small breasts which do not sag. The prostheses consist of very flexible envelopes, filled with physiological salt solution (water) or with siliconed gel.

The operation:

The prosthesis is placed behind the mammary gland, on the pectoral muscle, or even sometimes behind it. I explained to you that your mammary gland would thus be in front of the prosthesis, which could then be normally examined and mask the prosthesis.

I carry out the installation of the prosthesis incision either in the armpit (there is thus no scar on the breast) or in the areola.
Generally, the scar becomes practically invisible.
The intervention is carried out under general anaesthesia, with on average a 24 hours hospitalization.

The choice of the type of prostheses, the incision and the position of the prosthesis depends on many factors (volume of your breasts, desired volume, life style, sports…) which I will discuss with you.

Operation follow up:

I told you that you would have a bandage for a few days, and then, after three weeks, you would have to wear a light control bra which will maintain everything in position. You will only have a compress on the scar.

The operational follow ups are not particularly painful, most patients practically don’t suffer. If the prosthesis is placed behind the pectoral muscle, the operation is a little more painful. If the scar is in the armpit, it will be necessary to avoid raising the arms for two to three weeks. The first night, a sedative can be necessary, to attenuate a feeling of tension. I will see you the day after the intervention to put a new bandage on before your leave.

How will you feel in the days following the surgery?

Your chest will seem too large to you and too tight because of the swelling (oedema).

Your breast’s final volume will be reached only after a month.

During a week or so, you will find any movement uncomfortable.

No sports activity is to be undertaken during this period.

After several weeks, you will have forgotten that you have bean operated because the pains will have completely disappeared and you will have accustomed yourself to the prostheses.

Which elements can worry you following the surgery?

1. A brutal swelling of a breast with a feeling of tension: it is caused by a bruise. It will sometimes have to be evacuated under general anaesthesia. Quickly treated, it will be without consequence.

2. An asymmetry in the form of the breast can be noted.
It is related to the bad positioning of one of the prostheses which can be positioned too high. This generally can occur in the case of an armpit incision and can require a reintervention in the days which follow. This incident is rare but you must be informed of it.
(+++) This situation is to be differentiated from a preoperative asymmetry of your breasts. The installation of prosthesis will not correct this congenital asymmetry.

Evolution:

I explained to you that the only problem involved in the prostheses and likely to appear was a cicatricial reaction around the implant which appears and is likely to lead, if nothing is not done, to a round and hard breast.

This “hull” problem around the implant occurs in approximately 5% of cases.

I will also explain to you how to apply local treatments and massages. It is exceptional to have to completely surgery reoperate to break the hull. Once again, it will be necessary to measure the pros and the cons. If your chest is really flat, the risk is worth it. But, on the other hand, if you want to increase the size of your breasts which you simply find a little too small, it will be necessary to reflect seriously.

As for the risk of cancer, it does not appear to be increased by the operation following the supervision of the patients, which have been operated with prostheses for a period of more than twenty years.

You will be able to have children, if you wish.

Not only, is a mammography (breast X-rays) not a risk after the intervention, but I advise you to have one done within the year which follows the intervention. It will make it possible for your gynaecologist to have a radiographic reference which could be useful in the future.

Should the prostheses be changed in a systematic way the every 10 to 15 years? The answer is no if no modification of the aspect of the prosthesis (thinning of the side/wall for example) is noticed through the mammography. If a modification is noticed we will then discuss the replacement of the prosthesis.