22 July 2019
Dr. Salvatore Carlucci, plastic surgeon in Turin (Italy), kindly answers the most-frequently-asked questions about this highly-requested surgery.
WHAT KIND OF SURGERY IS IT?
During the surgery, a bag is placed inside the breast and a prosthesis will be inserted inside it. To obtain a natural result, the prosthesis must be well covered by the breast tissues. For this reason, if there is enough gland in the surrounding area, the bag may be subglandular. Instead, if the covering tissues are thin, the prosthesis must be inserted under the pectoral muscle (submuscular).
The most used technique is actually a mixed one, in which the upper part of the prosthesis is covered by the muscle and the lower part by the gland. This type of mastoplasty is called “dual plane”, and allows you to obtain the desired volume, as well as a beautiful shape.
WHAT ARE PROSTHESES MADE OF?
Prostheses are made up of a silicone gel and are placed inside a silicone casing. This silicone is for sanitary use, so it does not create any problems for body tissues.
The casing can have several surfaces, each with different types of adhesion to the surrounding tissues.
Prostheses used nowadays contain a cohesive gel that, even if it breaks, does not tend to spread into the surrounding tissues. It is easy to find on the web images of prostheses cut in half, proving that the gel clearly remains inside the casing.
HOW TO CHOOSE THE RIGHT PROSTHESES?
It is the surgeon who will recommend the most suitable prostheses in each case. We almost always recommend anatomical prostheses, whose drop shape allows to obtain a more natural result.
Alternatively, there are round implants, which however give a more pronounced décolleté, with a more prominent transition between the thorax and the upper edge of the breast.
As for the choice of size, it will be extremely useful to try on some trial implants by wearing them inside a non-padded bra, with a tight-fitting shirt, to get an idea of the final look.
WHERE ARE THE SCARS LOCATED?
In most cases, the breast augmentation incision is in the inframammary sulcus. The scar will be a thin line of about 5 cm, which remains well hidden by the new breast volume.
It is also possible to make the incising on the edge of the areola. Yet, in this case, the scar is slightly more visible. This is why this option is generally chosen whenever it is necessary to reduce the areola or to move it higher.
IS THE SURGERY PAINFUL?
The pain experienced after undergoing a breast augmentation surgery truly varies from person to person. It can be more significant when the bag is submuscular. However, in the first few days painkillers are prescribed to make the postoperative period more comfortable.
WHAT SHOULD YOU DO AFTER THE SURGERY?
After a breast augmentation surgery, it is very important to wear a compression bra day and night. This bra—to be worn for a month—allows the prostheses to maintain the correct position until the body has formed the periprosthetic capsule.
During this period, efforts, trauma and significant arm movements must be avoided.
AFTER HOW LONG IS PHYSICAL EXERCISE ALLOWED?
As with efforts, physical exercise should also be avoided for a month after undergoing a breast augmentation surgery. This is because every effort made with the arms make the pectoral muscle contract, with the risk that the prostheses might move from their correct location.
This precaution is always important, but particularly when using anatomical prostheses and if implants are submuscular.
DO THE EFFECTS OF BREAST AUGMENTATION LAST ONLY FOR A CERTAIN TIME? AFTER HOW MANY YEARS DO PROSTHESES NEED TO BE CHANGED?
Prostheses do not “expire”. Modern types are very sophisticated and safe, so you are not supposed to change them after a specific time. If no issue comes up (e.g. a rupture, or a visible capsular contracture), prostheses can be kept for many years, while following periodic check-ups as prescribed by the surgeon.
ONCE DECIDED, WHAT SHOULD BE DONE BEFORE THE INTERVENTION?
The surgeon prescribes routine exams to make sure there are no health problems and that the breasts are normal. In cosmetic surgery, safety comes always first.
Only then, it’s time for taking photos and measurements.
For more information or clarifications, ask your surgeon or contact Dr. Carlucci through his website.