First breast augmentation operations were performed already in the end of 19th century. Nowadays, breast augmentation is one of the most often performed aesthetic surgeries in the world. Indications for this surgery are different for each woman; the most frequent indication is the patient’s desire to improve the shape, size and symmetry of the breasts. Such surgery also enables correcting the appearance of the breasts in case of their degeneration and sagging after weight changes, pregnancy and breastfeeding. Breast reconstruction is performed after breast removal (e.g. due to breast cancer). There are various reconstruction options; the best method depends on the amount of tissue removed (breast reconstruction with own fatty tissue, an implant, autologous reconstruction with or without an implant etc.). Several operations may be necessary to achieve full reconstruction of a breast.
For years, researchers have tried to find evidence to prove a link between silicone implants and diseases caused by them; however, extensive research has not revealed any links between silicone implants and systemic autoimmune diseases. Silicone implants do not increase the risk of breast cancer, although, in certain cases, implants may make it harder to display the mammary gland during a mammography examination (X-ray image). Silicone implants pose no threat to the foetus.
Modern selection of breast prostheses enables to find the best prosthesis for each patient. Most frequently used prostheses are Polytech (www.polytech-health-aesthetics.com), Motiva (www.rinnaimplantaadid.ee), B-Lite (www.b-lite.eu), Nagor (www.nagor.com), and Natrelle (www.allergan.com).
The expectations of the patient and options for meeting them are identified during a pre-operative consultation. The discussion will cover the health status of the patient and the medications used. The need for a pre-operative breast examination (ultrasound or mammography) and a blood test is identified on a case-by-case basis for each patient.
During the examination, the patient’s chest and mammary glands are assessed. Photos of the breasts are also taken for the medical records. Finally, the breasts are measured to select the best-suited implants, and also the location of the wound (later scar) and the position of the implant in respect to the mammary gland are planned.
Course of surgery and recovery
The surgery is performed under general anaesthesia and it usually takes 1 hour. We perform this procedure at Kotka Private Hospital.
The patient is usually allowed to go home on the next morning after the surgery. Recovery is individual, depending on the patient. Post-operative pain treatment is necessary for the first days after the surgery because of swelling caused by tissue damage and stretching of the breast muscle if the implant was placed under the muscle. Wounds are covered with wound tapes for up to 2 weeks, followed by the treatment of the scars. The need to wear a special support bra is individual; however, it is advisable not to wear push-up bras post-surgery. Breast massage will also be initiated after the surgery. Heavy physical exertion must be avoided in the first weeks after the surgery.
Results and risks
The final result may take up to 6 months to develop. The result is permanent.
Immediately after the surgery, swelling, discomfort, changes in the sensitivity of the nipples, and subcutaneous hematomas are possible. If a hematoma develops around the implant, repeat surgery may be indicated. Infection, as well as formation of a capsule around the implants (shrinkage of the connective tissue surrounding the implant) that may lead to pain and changes in the shape of the breast are possible problems which may develop later. Rupture of the implant or leaking of silicone from the implant cannot be ruled out.
Operations are performed by plastic and reconstructive surgeons Dr. Pille Kirjanen and Dr. Mart Eller.