What is the additive mastoplasty?
Breasts represent one of the main expressions of femininity in a woman and therefore additive mastoplasty is today one of the most requested plastic surgery operations. Mammary hypoplasia (small breasts) can lead to psychological problems in social relationships and is the main aesthetic indication for this procedure. Other indications for mastoplasty are constituted by anomalies in development (such as Poland Syndrome, that is the reduced development of one side of the chest and of the breast), or marked asymmetries in the breasts, or lastly the tuberous malformation of the breast (that is a conical elongated shape). Another large group of potential candidates for the operation are all those women who have lost the tone and firmness of their twenties, for example after breast-feeding or losing weight.
Breast augmentation can already be carried out once the patient is fully developed but it is only carried out in patients of full age, who have already acquired a complete and mature knowledge of their own bodies. The operation consists of inserting a prosthesis of bio compatible material (generally silicone gel), into the space under the mammary gland or under the muscle, which is well tolerated and permits clinical or radiological diagnosis of any pathological condition of the breast.
What are the differences between the implants?
The characteristics of today’s implants make them safe and durable, like an external surface with a micro-textured shell rather than a smooth surface, with a clear decrease in the possibility of developing capsular contracture (around each implant a fine fibrous capsule forms which, when it becomes excessive can cause the breast to harden), the almost total impossibility of the silicone liquid leaking, or the possibility of having the choice of different shapes, such as the so-called anatomical implants, which better replicate the natural lines of the breasts as they are tear-drop shaped. It is important to stress that there is no best type of implant in an absolute sense. The choice of implant is therefore carried out based on what the patient is looking for, but also on her height, the volume of her existing breast, its consistency, her chest and muscle structure. With the right choice of the type of implant and a suitable surgical technique it is possible to obtain excellent results which are extremely natural, without interfering with possible breast-feeding or altering the sensitivity of the nipple. Finally it is essential to remember that implants are not dangerous, do not cause tumours, do not increase the incidence of tumours and they allow the normal preventative check-ups for pathological conditions of the breasts.
The implants can be inserted under the mammary gland, between this and the pectoralis major muscle (subglandular), or under the muscle itself (submuscular), or in certain cases in a dual plane both submuscular and subglandular. The incision can be positioned in the crease below the breast or around the areola of the nipple, based on the anatomical characteristics of each breast, of the size and the type of implant.
The submuscular placement of the implant is usually the preferred choice because in this way the implant is well covered by the pectoralis major muscle, it is less evident, soft and the lines blend in naturally, as well as there being a lesser possibility of contracture. The life span of implants is long but not infinite. Normally we advise regular checks and substituting them after 10-15 years.
In the pre-operative phase it is important to carry out a careful diagnostic review of the breasts (both with ultrasound and x-rays). The surgical operation is carried out under a general anaesthetic, and lasts about two hours, in day surgery or with admission for one day. At the end of the procedure suction drains are inserted (sometimes they are not necessary) which in any case are removed after 24-48 hours. During the first few days after the operation you could have a little pain, which is well-controlled using common painkillers, also there may be some swelling which will gradually subside. It is advisable to wear a support bra for about a month after the operation, but normal daily activity can be resumed after a few days. You are advised to wait at least a month before undertaking sporting activities. It is not advisable to expose the scars to the sun for about six months unless you use total sunblock creams.
Effects of additive mastoplasty
As for any surgical operation, there are possible complications. The most common specific complication (but in absolute terms not frequent) is the so-called “capsular contracture”. Implants in fact constitute a foreign body which is introduced into the organism, to which the tissues react with a normal isolating reaction, via the production of fibrous tissue which isolates the foreign body. Sometimes, however, the reaction can be very significant and the implant is encapsulated in a greater way. This may result in an unsatisfactory appearance aesthetically, which is sometimes accompanied by an out-and-out capsular contracture, which takes the form of hardness to the touch and painfulness. In these cases massages may be sufficient, but in some cases it is necessary to proceed with an operation to enlarge the pocket that the implant is in, to remove the capsule (capsulotomy or capsulectomy), and to substitute the implants. Another possible but rare specific complication is linked to the movement and bad positioning of the implants with an ensuing aesthetic result which is sometimes unsatisfactory.