BREAST PLASTIC SURGERY

 

BREAST AUGMENTATION

Breast enlargement, breast augmentation and enhancement is one of the most popular cosmetic surgery procedures available. The breast is the symbol of femininity, it expresses attractiveness and desire. For many women the form, size and the shape of their breasts are important aspects, it affects their self –confidence and thus it has an affect on their private and social life. Breast augmentation or augmentation mammoplasty, also known as bob job, is a surgical procedure to enhance the size and shape of a woman’s breast by inserting an implant. A harmonious and naturally looking breast correction can be realised in an appropriate way by using the state-of-the-art operation technology and breast implants. By inserting breast implants the breast can get back its desired form and size, possible asymmetries can also be balanced, but the breast size should always stand in relation to the body proportion of the person. 

 

Preparation for your surgery

Your will get some useful instructions from your plastic surgeon to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications. While making preparations, don’t forget to arrange someone who drives you home and who helps you at home for a few days after your surgery.

Instructions before the operation

• Women under 40 years have to undergo an ultrasound examination for both breasts and the Axillary area, too. The laboratory report must not be older than 6 months.
• Women over 40 years have to undergo a mammography examination. The laboratory reports must not be older than a year.
• Your general practitioner has to issue a medical certificate to release you for the operation.
• A routine laboratory test must be made (blood cell count, ions, liver and kidney function, Prothrombin, blood sugar, blood group).
• Smoking and drinking alcohol is forbidden.
• Do not take aspirin and any medicine containing aspirin for 2 weeks before surgery.
• If you are regularly taking medicines, then you have to discuss with your surgeon which must be taken or left off.
• Do not eat or drink or smoke 6 hours before surgery. Chewing gums and drops are not permitted either.
• Before surgery you have to take off your rings, jewellery, piercing and take out your dentures, contact lenses and remove your make-up.
• The surgery of women should be performed outside the menstruation period.

 

Initial consultation

During the initial consultation you have to discuss your goals, expectations and results of the surgery with your plastic surgeon, as well as the size and shape you are looking for, and your feelings about the procedure. You are going to plan the surgical procedure, make decisions about the type of implant, the incision location, and the placement of implant, as well as about the necessary preliminary medical and laboratory examinations and tests. The plastic surgeon may recommend that a breast lift and breast augmentation be performed at the same time. This is most commonly recommended to treat the sagging appearance that results from aging or pregnancy. During this combined procedure, some breast tissue is removed, the breast skin is tightened and lifted, and an implant is inserted.

 

The breast augmentation surgery

The operation is performed in a well-equipped state-of-the-art operating theatre under general anesthesia. The surgery takes approximately one and a half hours. At the initial consultation you have to discuss and plan together your plastic surgeon every part of the surgical intervention, you make decisions about the type of implant, the incision location, and the placement of implant, as well as about the necessary preliminary medical and laboratory examinations and tests. During the surgery a small incision is made in the natural crease underneath the breast, or around the nipple (around the areola) or in the arm pit. The implant (silicone) can be placed either under the breast gland (sub-glandular) or behind the breast muscle (sub-muscular, subpectoral). Most plastic surgeons prefer placing the implant sub-muscular, because the muscle can cover the implant better. All breast implants used are manufactured at the highest standards and have a CE certificate. The surface of the implant is textured (uneven). Implants with textured surfaces were designed to reduce the chance of capsular contraction. The size and selection of implants is something that you are to discuss with your surgeon in detail at consultation. Before closing the cut a thin drainage tube may be placed into the implants hole, so that blood and wound excretion can leave in the first post-operational days. After the surgery a special surgical bra has to be worn night and day, so that the implants remain in their correct position.

Recovery after your breast augmentation surgery

You need to spend at least 1 night in the clinic’s well equipped, comfortable, air-conditioned ensuite recovery-room. In the first two days antibiotics are given to the patient. If fever occurs, then you have to take antibiotics for a further 6 days. On the second day the drainage will be removed. There may be some uncomfortable, streching and painful feeling after the surgery that will cease in a few days. The special surgical bra has to be worn day and night for 6 weeks. Removing of the stitches takes place in 2 weeks after surgery. Taking a shower is only permitted after the removal of the stitches. Easy body exercises are only permitted 4 weeks after surgery. Doing sports (tennis, jogging, swimming) is only possible after 6-8 weeks. Avoid intensive exposure to the sun for at least 2 -3 months in order to prevent pigmentation of the scars. The scars will swell and turn red in the first six months, only after 9-12 months they begin to flatten and fade away. You should know that scars will never disappear completely. Depending on the level of activity required, patients are generally able to return to work or school in approximately one week’s time.

Complications and risks by breast augmentation surgery

Every surgery carries some uncertainty and risk. One can’t exclude the possibility of the occurrence of operational risks and complications,for example: infection, unexpected reaction to anesthesia, excessive bleeding etc. With proper precautions by the surgical team, complications are typically minimized or prevented. Risk can be further reduced by fully informing your doctor about your medical history prior to surgery and by carefully following pre- and post-operative instructions. After the surgery can occur post-operative bleeding (hematoma), fluid collections (seroma), surgical site infection, breast pain, alterations in nipple sensation, interference with breast feeding, visible wrinkling, asymmetric appearance, wound dehiscence (with potential exposure), thinning of the breast tissue and synmastia (disruption of the natural plane between breasts). Further risks are: Capsular contraction (the most common problem). The conjunctive tissue forms a capsule around the implant which begins to tighten and eventually squeeze it. In a more advanced phase an intervention is needed and the removal of the implant may also be required and in some cases the implant has to be replaced, too. Hyper or hypo sensitivity of their nipples and numbness near the incision area. Such symptoms usually disappear in time but can also be permanent. Breaking of breast implants due to an accident, but rarely spontaneously.

 

The cost of breast augmentation has everything:

• Consultation
• Breast augmentation surgery
• Implantation (all sizes)
• General anesthesia (full narcosis)
• Medicines
• One night in the hospital with full service and professional supervision
• Special breast bra after the surgery, which should be 6 weeks
• Bra strap
• Stitches
• Controls

Clinical stay: 1 night
Stitches: after two weeks
Return to work: 4-5 days after
Advance payment: 50% of the surgical fixation to

As the surgery necessary to:

• Routin Labor:

Blood: HTC, HGB, RBC, WBC, TCT
Ions: Na, K
Liver and kidney functions:
Se-Bi, GOT, GPT, LDH,
Gamma-GT, ALP, CN, creatinine
Glucose, Prothrombin

If necessary, the donation can be solved locally.

• 40 years Ultrasonography
• Over 40 mammograms

 

 

BREAST REDUCTION - MAMMOPLASTY

Women often suffer from oversized breasts. Large breasts can often be uncomfortable and distressing, and they are also the cause of significant physical discomfort and self-consciousness. For this main reason are women considering a breast reduction surgery that could help them to relieve their constant backache and shoulder pain. After the breast reduction surgery these complaints will disappear. In contrast with breast augmentation and breast lift that are purely cosmetic procedures, breast reduction is a medically necessary surgery procedure that offers both health and cosmetic benefits. The aim of the surgery is to create more proportional breasts with the overall body shape, and so to ease problems with health, activities and clothing. If breasts are not equal sized this surgery can help achieve breast symmetry. Nipple surgery can also be made to reduce the size of the areola. In fact, the breast reduction can be perfomed together with breast lift to achieve a fully satisfactory outcome. Breast reduction is almost the same process as with breast lift, but in this case a certain percentage of skin, fat and breast glands will be removed.

Preparation for your surgery

Your will get some useful instructions from your plastic surgeon to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications. While making preparations, don’t forget to arrange someone who drives you home and who helps you at home for a few days after your surgery.

 

Instructions before the breast reduction operation

• Women under 40 years have to undergo an ultrasound examination for both breasts and the axillary area, too. The laboratory report must not be older than 6 months.
• Women over 40 years have to undergo a mammography examination. The laboratory reports must not be older than a year.
• Your general practitioner has to issue a medical certificate to release you for the operation.
• A routine laboratory test must be made (blood cell count, ions, liver and kidney function, Prothrombin, blood sugar, blood group).
• Smoking and drinking alcohol is forbidden.
• Do not take aspirin and any medicine containing aspirin for 2 weeks before surgery.
• If you are regularly taking medicines, then you have to discuss with your surgeon which must be taken or left off.
• Do not eat or drink or smoke 6 hours before surgery. Chewing gums and drops are not permitted either.
• Before surgery you have to take off your rings, jewellery, piercing and take out your dentures, contact lenses and remove your make-up.
• The surgery of women should be performed outside the menstruation period.

The breast reduction operation

Breast reduction surgery is performed under general anaesthesia. Before entering the operating room, the surgeon will ask you to sit upright and surgical markings will be drawn on your breasts to make the correct incisions later during surgery when you are lying down. Then the incision is made along the surgical markings. The procedure takes 2-3 hours depending on the complexity of the case. The excess skin, fat, and glandular tissues will be extracted. In most cases the nipples are moved to a higher position on the breast, but remain attached to the nerves and blood vessels. For very large breasts, however, the nipples may need to be moved to a completely new location. In these cases, the nipples will be removed from the underlying connecting tissues and you will lose sensation in the nipple. Upon completion of the procedure, stitches remain around the areola and nipple area, in a vertical line beneath the nipple and horizontally under the breast. Small drain tube will be places in your breasts to help avoid the accumulation of fluids and to help drain them off. Gauze dressings will be put on your breasts and covered with an elastic bandage.

Recovery after your breast reduction surgery

Due to the incisions and tissue removal your breasts will be sore, swollen, and bruised. This pain can be treated by medicaments that you can get from your plastic surgeon. After your surgery you have to spend at least 1 night in the clinic’s recovery-room. In the first two days antibiotics are given to the patient. If fever occurs, then you have to take antibiotics for further 6 days. On the second day the drainage will be removed. A special surgical bra has to be worn day and night for 6 weeks. Removing of the stitches takes place in 2 weeks after your surgery. Taking a shower is only permitted after the removal of the stitches. Refrain from heavy lifting and straining after surgery for three or four weeks. Easy body exercises are only permitted 4 weeks after surgery. Doing sports (tennis, jogging, swimming) is only possible after 6-8 weeks. Avoid intensive exposure to the sun for at least 2 -3 months in order to prevent pigmentation of the scars. The scars will swell and turn red in the first six months, only after 9-12 months they begin to flatten and fade away. You should know that scars will never disappear completely. Depending on the level of activity required, patients are generally able to return to work or school in approximately one week’s time.

Complications and Risks of breast reduction

Everyone who is considering any kind of surgery should be aware of both its benefits and risks. As with any surgery, there is also a risk of complications for example: infection, bleeding, reactions to anesthesia. Immediately after surgery you may feel some pain, which can be treated by a prescription from the plastic surgeon. If the pain is more severe, additional follow-up visits may be scheduled. List of complications may include: infections, bleeding, skin and tissue necrosis, permanent loss of breast and nipple sensation, breastfeeding will not be possible after surgery, permanent unaesthetic scarring, breast asymmetry etc.