BREAST AUGMENTATION

What does breast augmentation consist of, Dr. Sospedra?
It’s a surgical operation that corrects the patient’s mammary volume by implanting prostheses, to counteract the low self-esteem caused by the complaint that “I can never find the right underwear” or “dresses don’t look right on me.” In many women, having small breasts causes a serious complex that prevents them from going to the beach or even from having normal social relations. In other cases, not only are the breasts small but they are very different from each other, with marked asymmetry. Finally, there are other women who, after pregnancy and the lactation period, lose a lot of volume in their breasts (the ‘empty breast’ condition). In all these cases, the operation can solve their problems and open up new horizons for their personal self-realisation.

Is hospitalisation necessary?
This operation tends to be performed with short-duration general anaesthesia and with a few hours of admission into the clinic.

Are the scars visible?
To perform a breast augmentation, it’s necessary to make a cutaneous incision some three or four centimetres long, which can be made in different zones. First: the armpit. This is the ideal incision because it is well removed from the breast. It’s a zone that scars very well, leaving a minimal mark a year after the operation. It’s our first choice of route, provided that the breast is not very fallen.Second: the areola. It’s performed in the lower half of the zone where the colour changes between the areola and the skin of the breast. It’s the technique of choice in breasts that have already fallen somewhat, and the aesthetic result is excellent. Third: the submammary crease: this is the oldest type of incision. It tends to be done at the patient’s request, and is always more visible than the previous two.

What are the implants like?
There are various types of breast prostheses – silicone, physiological serum, hydrogel, PVP, polyurethane and others – that are homologated by the Ministry of Health and Consumer Affairs for implantation. In general, we prefer silicone gel implants, because we have over thirty years’ experience of implanting them and their feel is the most similar to a natural breast. Nowadays there are over twenty million patients with this type of implant.

And what about the risk of the implants breaking or ‘exploding’?
Present-day implants have a planned minimal life of around twenty-five to thirty years, and can last perfectly well for the rest of the patient’s life without the slightest alteration. The implants made with physiological serum were the ones that sometimes ruptured due to changes of pressure (in planes, for instance), but with the silicone ones that rarely happens.

And the risk of capsular retraction?
This is related to the membrane with which the organism fixes and covers the implant; when retraction occurs, the implant compresses and hardens. Capsular retraction depends on the patient’s internal scarring, although with present-day implants and surgical techniques it’s very uncommon for this to happen.

Can mammary implants increase the risk of breast cancer?
No. It’s been demonstrated that the possibilities of a patient with an implant suffering breast cancer are the same as if she didn’t have one.

Is this operation painful?
The post-operative pain of a breast augmentation is variable, according to the technique used, but it ranges between slight to moderate and can last from twenty-four hours to five days. It may also require gentle and/or combined analgesia. The sutures tend to be removed between five and twelve days afterwards. In the first two weeks the breasts suffer moderate swelling, decreasing towards the third week. In the first two months there is a certain hardening of the implant, softening from the third month onwards and attaining its definitive soft feel between six and eight months.

When can the patient lead a normal life?
The sick leave associated with this operation varies according to the patient, from three or four days to two weeks. No physical effort must be made during the first two weeks, and sport bra must be worn day and night for the four first weeks. Check-ups must be conducted for a minimum of six months after the operation, and then periodical annual checks of the implants.