Mammoplasty

Mammoplasty means surgical corrections, when the shape or the size of the breasts is differing from the ideal. Types of mammoplasty:
Breast lift is made, when the breasts are saggy, but their size is normal.
Breast augmentation is made, when the breasts are too small. The procedure involves placement of silicone gel prosthetics. Breast atrophy may occur after pregnancy and breast feeding –joint procedure of breast lift and breast augmentation. Breast reduction is recommended if oversized breasts cause discomforts.  Combination of all the above listed mammoplasties can help those, who have asymmetric breasts.

1. Breast lift

Hereditary factors, pregnancy, breast feeding or important weight loss often make breasts saggy. Sagging of oversized breasts may occur due to the weakening of connective tissues. Droopiness and sagging of breasts can be amended with breast lift, the excess skin is removed, and nipples are lifted.
Breast lift is performed, when the size of the breast is normal, i.e. there is no need of implant. The deformity is caused by stretching of the skin and the connective tissue. Surgeries are performed according to the type and extent of the deformity. We are aiming at minimizing the scars necessary to achieve the optimal breast shape. There is no mammoplasty without scars, it is impossible to make scares disappear; but the width, thickness of the scar, suturing technique and material, and how the surgical site is visible – are not indifferent.
In optimal case, scars are to be seen only at the areolar periphery, but unfortunately this technique can rarely be applied.
The Vertical scar technique involves another vertical scar, in addition to the scar around the areola. In the middle of the breast, this second scar is going from the areola to the inframammary fold.
The most common technique the “inverted-T incision” comprises one more scare as the vertical scar technique. This additional incision is in the inframammary fold.
Some mammoplasties can be performed under local anaesthesia; others are carried out under epidural or general anaesthesia. Patient’s demands are also considered, when choosing the anaesthetic technique. Before surgery photos are taken from the original conditions and planned incisions are marked on the skin. Sutures are generally removed two weeks after surgery.

2. Breast reduction

Breast reduction may be option, if oversized breasts cause spine discomforts or hinder exercise and to find ready-made garments.
About the surgery:
Pain after surgery can be numbed with usual analgesics we are providing our patients with. Removal of stiches is a minor discomfort.
Flexible bandage or sports bra is are to be worn after surgery, the latter is recommended for permanent use. Bandage and wound are to be left dry till removal of stitches.
The final shape of the breasts develops in some months. Scars start to fade some months after surgery, this process last about a year.

3. Breast augmentation

Breast augmentation is one of the most popular aesthetic surgeries; the volume and shape of the breasts are enhanced with implants. 
Candidates for breast augmentation:
There are two basic types of patients. The first have small breasts from nature. The second had normal breasts, but after pregnancy, breast feeding or important weight loss their breasts shrank. Breast atrophy often occurs together with drooping.
Breast augmentation cannot be carried out without implants. This is a silicone pocket, filled up with silicone gel, saline solution, of which the cohesive gel implants are considered the best; they don’t leak, and even when ruptured, the body doesn’t absorb the gel.
As to the consistency and touch the cohesive gel implants are the most similar to the breast tissues. The pocket is very resistant; it doesn’t interact with the environment. Earlier smooth, nowadays textured implants are applied.
Breast implant shapes can be round or pears shaped and there are so called “anatomic” implants.
Smaller implants are recommended for those, who want natural look, bigger implants for those, who want fleshy breasts. Expectations are limited by the anatomic characteristics of the patient (chest size) and by the conscience of the plastic surgeon.

Breast implants positioning:
Sub-glandular
Sub-muscular
Sub-fascial

About the necessity of general anaesthesia

Some mammoplasties can be performed under local anaesthesia; others are carried out under epidural or general anaesthesia. Patient’s demands are also considered, when choosing the anaesthetic technique.  Before surgery photos are taken from the original conditions and planned incisions are marked on the skin.


About the risk of silicone gel filled breast implants and other surgical complications

According to our today’s knowledge, the silicone gel implant is not harmful to the health and it has proven by scientific researches. The possible surgical complications are similar to those of other surgeries; they are relatively rare. Risks can be reduced to a minimum by appropriate questions and examinations, eventual supplementary medication.
The so called “Capsular contracture” can be a special complication from breast implants. . Capsular contracture occurs when the collagen-fibre capsule tightens and squeezes the breast implant, destroying the aesthetic result. Later it can become painful. Risks can be diminished with up to date implants and suitable surgery techniques, but there is no 100% success in the prevention. In most of the cases the complication can be eliminated with a new surgery.