Additive mastoplasty
What is additive mastoplasty?Additive mastoplasty, popularly known as augmentation mammaplasty, is one of the operations most in request in cosmetic surgery.Additive mastoplasty allows the modification of the shape and the size of a chest too small and to correct breast asymmetry, thus improving the appearance of the body and the sense of self-esteem. Who is this kind of operation indicated for?The operation of additive mastoplasty is indicated for the women who wish:
Are there age limits to undergo additive mastoplasty?There are no age limits to undergo this kind of surgery, but it is preferable to wait for the complete development of the breasts, which normally occurs approximatively at the legal age.What surgical interventions can be performed together with additive mastoplasty?Additive mastoplasty can be performed alone or in association with other surgical techniques such as mastopexy, abdominoplasty, liposuction or other jobs.What are the risks and the complications of this operation?Additive mastoplasty is a relatively simple surgical procedure which usually gives excellent results and is very rewarding both for the patient and for the surgeon who performs the operation.Thousands of such operations are performed successfully every year all over the world. However, it is essential not to underestimate the nature and the risks of a surgical operation and not to give in to the temptation to apply to non-specialists who offer services at relatively cheap prices inside non-qualified facilities (health centres, consulting rooms, etc.), because it is anyhow a real surgical procedure whose complications are rare but may occur and can be easily resolved only if the intervention is performed by a specialist in plastic surgery and within duly qualified facilities. One possible complication of additive mastoplasty is the so-called implant contracture (or “prosthesis rejection”) which results from the reaction of the human body to the introduction of foreign matter. The implant contracture involves the formation of a scar (or “capsule”) around the prosthesis which, with the passing of time, may cause pain and compromise the cosmetic result of the operation. Infection, hypersensitiveness or hyposensitiveness of the areola and the nipple, prosthesis displacement or formation of skin folds around the implant may rarely occur. In order to reduce the risks of complications, it is anyhow essential to follow the advice and the instructions given by the surgeon carefully before and after the operation. Smokers should reduce the use of cigarettes because smoking may increase the risk of complications and slow down the recovery. What does the preoperative examination consists in?Additive mastoplasty is very customized kinds of surgery that, as such, needs a meticulous specialist examination.During the first examination, the surgeon will assess the shape and the size of the breasts, of the areola and of the nipple, and show you the possible modifications in the shape and the volume that the very latest in surgery makes available for your situation. The surgeon will also assess your physical condition in order to exclude the presence of troubles (such as high blood pressure, clotting or healing disorders) which might affect the final result of the operation. Before the operation you will receive specific information about the preoperative and postoperative diet and the use of drugs, alcohol and cigarettes. At the end of the examination, the surgeon, in tune with you, will choose the type of implants to be used, the most suitable access technique (periareolar, implantation from the submammary sulcus or axillary) and the correct positioning of the implants (subglandular, dual plane or inframuscular). The implants used in breast augmentation surgery are made up of an external silicone cover and by an internal part of silicone gel or saline solution. Other substances used in the past, such as soya oil or else, have been gradually gone out of use. Depending on the breast shape that the plastic surgeon wants to obtain, it is possible to choose round, anathomical or drop implants. The external surface of mammary prostheses may be smooth or rough (texturized prostheses). The prostheses with smooth surface have a slightly softer coating and are less likely to be noticed by the touch, even if positioned under the mammary gland. Texturized prostheses are instead a bit firmer and, today, more used than the smooth ones because their “rejection” is lower (the so-called implant contracture) once they are introduced into the mammary region. Breast implants do not cause nor increase the incidence of breast tumors, auto-immune diseases or connective tissue diseases. Rather, a lower incidence of breast tumors in women with breast implants has been recently observed. Most manufacturers guarantee the implants for about ten years, after which they recommend to replace them in order to prevent any deformation or deflation of the implants due to their use. The replacement of the implants may be a personal choice (if one wants to change the kind or the size of the implants) or a necessity caused by the onset of complications (such as implant contracture) and may occur few years or 10-20 years after the surgical operation. Where are the incisions made?The most common access areas used by the cosmetic surgery that increases the volume of the breasts are the areola, the submammary sulcus and the axillary region.The incision are not very visible in that they are hidden along the contour of the areola or inside the skin folds of the axilla or the breast, respectively. The breast implants can be positioned under the greater pectoral muscle or under the mammary gland. Normally, positioning the implant under the greater pectoral muscle allows the achievement of a better, more natural and long-lasting cosmetic result, also reducing the risk of implant contracture that might occur as a consequence of the implantation of a breast prosthesis.
What kind of anaesthetic is given?Additive mastoplasty can be performed under local anaesthesia with sedation (which means that you will be awake but relaxed and insensitive to pain) in outpatient care, or under general anaesthesia with one or two-day hospitalization.How long is the operation?The additive mastoplasty operation lasts 1-2 hours and ends with a dressing which consists of a bra that will be replaced after a few days.What happens during the post-operative period?During 48 hours following the operation of additive mastoplasty you will have to rest up.Starting from the third day, you will be able to resume your normal life, avoiding, nevertheless, tiring activities, saunas, sweat-baths and sunbathing. During the first two days, swelling, ecchymoses and soreness may appear in the chest area. After 4-5 days, you will be able to resume work, provided that it is not excessively tiring. Three weeks after the intervention, you will gradually resume all your normal activities, including the sports activity. What kind of result can be achieved?Additive mastoplasty usually gives excellent results and is very rewarding both for the patient and for the surgeon who performs the operation.The result achieved is long-lasting but cannot be described as permanent, in that it is subject to the normal ageing process of the body and to the effects of gravity. If you wish to take this subject further, we advise you to visit the mastoplasty and mastopexy FAQ page, where you will find the answers to the most frequent questions asked by the patients. |
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Chirurgia-plastica-estetica.it Prof. Mario Dini Chairman and Director of Plastic Surgery Dept. - University of Florence |
