Getting breast implants is never an easy task: you have to be certain of the type of breast you want and its size, and accept the idea that you will be operated on at least another time to replace them, two to three times if you go there at 25. Because an aesthetic operation is never harmless, despite advances in anesthesia and safer technical gestures. And the question of security remains central (see below).
WHAT IS BREAST AUGMENTATION?
A surgical procedure which consists of placing breast prostheses to increase the breast. In some cases, this can also correct slight breast ptosis, especially when the loss of volume is limited and following pregnancy or weight loss. When the relaxation is important, the surgeon will advise to do a breast plasty at the same time. “When the nipple goes lower than the submammary groove, you also have to go up the breast,” says Dr. Bertand Matteoli, a cosmetic surgeon. When the desired increase is small, around a bra cap, lip modelling is sometimes considered (see below).
THE FIRST CONSULTATION
– The surgeon asks you about your medical and surgical history in order to rule out any contraindication such as a coagulation disorder, cardiac disorders…
– He then examines the silhouette, the bust, the size, the shape and the positioning of the breasts, the place of the areolas, and the shape of the thorax. If he detects an asymmetry, he will report it because it is likely to be noticed more once the brustvergrösserung are in place. The tone and thickness of the skin are essential and will guide the choice of implants: if it is of poor quality, they should not be too large, therefore too heavy, not to accentuate the natural sagging of the breast.
– The surgeon asks you which breast you would like, and what size: an essential point to define to be satisfied with the result.
– He explains which implants are best suited and how he will put them in place: he will choose the access route according to his experience and different morphological criteria: the route can be areolar, axillary (incision in the armpit) or, more rarely, submammary (the surgeon cuts into the fold under the breast, the only solution to introduce polyurethane prostheses). Thus, the scars will be located in the armpit, around the areola, or in the submammary fold. It also specifies whether it will place the prosthesis in front of the pectoral muscle or behind it, ie retro-muscular, or partly in front and behind, a technical decision taken according to criteria such as thinness or the quality of the skin. .
– The surgeon then describes the procedure, the exams to do before (mammography and ultrasound), the precautions to take: no aspirin the previous days, or tobacco which increases the risk of complications and poor healing. It provides information on the risks and possible complications, from the slightest (folds, waves, hypertrophic scar) to the most troublesome (loss of sensitivity, infection, shell, rupture), to the most exceptional, phlebitis, embolism (see below). Finally, he gives you the quote, which includes the cost of implants, operating room costs, anesthesia and his fees, along with informed consent. Two documents to bring back signed during the second consultation or on the day of the intervention.
THE DIFFERENT BREAST PROSTHESES
The majority of them consist of a silicone casing, more rarely of polyurethane foam, and a filling product. The surgeon explains the parameters to take into account to choose the model most suited to the desired result. “The choice is complicated because there are more than ten possibilities for the same volume depending on the shape, the projection, the texture”, explains Dr Mattéoli. In agreement with his patient, the surgeon will therefore choose:
– Implants filled with a more or less cohesive silicone gel (= hard in expert language), these are the most used because they give a more natural result than those filled with physiological saline, both on sight and on touch. In the case of the rupture of the implant, the viscosity of the gel limits the leakage of silicone in the body. The advantage of physiological serum: it is completely harmless if the prosthesis breaks.
– Round prostheses, more rarely anatomical prostheses which have the projected shape of a breast. “They are more used in reconstruction or in women who have very flat breasts,” notes Dr. Mattéoli. Their disadvantage: if they move, they will have to operate again.
– The texture of the silicone envelope: it can be smooth, micro-textured, textured, macro-textured.
– The projection: an implant generally exists in 3 different projections.
THE RIGHT VOLUME
It is not easy to imagine what a “300 cc” prosthesis can give, the average volume placed in France. “You have to think honestly about the kind of breast you really want,” warns Dr. Mattéoli. Otherwise, you risk being disappointed, either by breasts that are too large, or by breasts that are too small once the post-operative edema is deflated. “Dr. Volpeï insists:” The woman must ask herself if she wants something classic, elegant, or if she is ready to assume a result that is not “natural”. Most surgeons have test implants to slide into the bra to see the result. It is best to bring a white V-neck T-shirt, which will give a good idea of the increase and its impact on the neckline and the silhouette.