By Dr. Masino Scutari
Among all the possible interventions in cosmetic surgery, that of breast augmentation is one of the interventions that has the greatest demand from the female public.
Near rhinoplasty and liposuction, there is a consistent number of women who wear breast implants because they have undergone breast augmentation.
For a woman, the breast is undoubtedly the most visible sign of femininity: if for various reasons (due to pregnancy, progressing age, weight loss ...) the breast becomes empty, it comes to missing an element that turns out to be fundamental for being a woman. The woman, therefore, feels a strong desire to regain the breast that she previously had and so uses cosmetic surgery.
Many women, on the other hand, have never had beautiful breasts and decide to give themselves one that can really make them feel like women and give them full femininity.
Since, nowadays, there are ever more precise and sophisticated techniques to realize this desire, few refuse to undergo this intervention if they feel the need.
Many of them, often, to find harmony and feel good physically and, sometimes even psychologically, go against the opinion of the husband, family or boyfriend and undergo the intervention of breast augmentation.
For whom it is recommended
The breast augmentation is used to increase the volume of the breast and to improve its shape.
This type of operation is particularly indicated for small, underdeveloped breasts or breasts that have shrunk in volume and are slightly relaxed over time.
If the relaxation is too excessive, you will have to act later with a mastopexy to lift it up; mastopexy is also used if the breasts are deformed or asymmetrical.
Before performing breast augmentation surgery, it would be preferable for the development of the gland and breast to be complete, ie after the age of 18. To perform at best during the operation, the surgeon - before carrying out the operation - will perform a series of breast and chest measurements, assess how tonic and thick the skin is and finally establish the state of the mammary gland and its position.
Before the operation
Before the operation, the patient will have to undergo an interview with the surgeon to decide the size, content and shape of the prosthesis.
The doctor starts by evaluating the size of the breast, the chest and the constitution in general, but always keeping to the personal preferences of the patient himself; then it proceeds to assess whether there are asymmetries in the gland and defects in the position.
The doctor will prohibit the intake of aspirin two weeks before and two weeks after the operation, since this drug prevents the total ability of blood to clot and can cause complications during the surgery.
A month earlier, the contraceptive pill should also be suspended.
However, before undergoing surgery, a good physical condition must be verified with laboratory tests and a clinical evaluation, adding an electrocardiogram and a chest X-ray to the latter.
The surgeon must give his patient a clear and complete type of information about the complications that can occur with the use of breast implants. Often, in fact, we tend to emphasize only the positive aspects and never the risks.
As a last thing before the intervention, the doctor must have the patient signed the informed consent sheet, naturally after having explained it in all its details.
The moment of the operation
Breast augmentation surgery can be performed under general anesthesia, where the patient is completely asleep and breathes through a tube or mask; or, it can be performed under local anesthesia with sedation: in this case, the patient is sedated, the incisions and intervention plans are anesthetized. Then the prosthesis is inserted through an incision of about 5cm on the lower outer quadrant or inframammary sulcus, or in the axilla or in the lower contour of the areola.
Another technique, little used, for inserting breast implants is performed transombelically by introducing only prostheses filled with physiological solution.
Below the gland or pectoral muscle, a pocket is prepared, inside which the prosthesis will be inserted. Depending on how the surgery is performed, it may be probable that two drainage tubes will be placed, which will be stored after two days.
The duration of the intervention can last from one to two hours.
During the first few days, following the operation, the breast may appear a little higher than normal; but in the time frame of 3 to 6 weeks it is positioned in a natural way.
After the operation
If the operation has taken place with the patient under general anesthesia, the latter must remain in absolute bed rest until the following day.
It is allowed to drink and eat light food. The surgeon can administer analgesics or antibiotics.
After carrying out the check-up, the patient can return home the following day.
If the operation was performed under local anesthesia, the patient is discharged on the same day that the operation was performed.
The patient will then have to undergo a visit after forty-eight hours and another visit to remove part of the stitches after 3 - 5 days.
The rest of the points are removed completely after another week.
If the surgeon used a glue to close the incisions, the session will not be necessary to remove the stitches.
Only a dressing is particularly necessary: a fairly consistent bra that must be removed by the surgeon himself.
Routine activities can be resumed after a week of rest, for light sport (such as tennis, soccer, sailing ...) you will have to wait at least three weeks and for heavier sports (like swimming, dancing, jogging ... ) a period of at least six weeks must be waited for.
If the patient practices sport and the prosthesis is positioned below the muscle, recovery will be much slower and during and after the augmentation surgery there is a greater chance of bleeding.
