Breast augmentation is a widespread and popular procedure around the world with very good aesthetic results, aimed at patients who want to increase the size of the breast, improve its shape and correct a small drop on it. Prospective breast augmentation patients are those women who have always had a small breast and those who have lost enough of their breasts due to childbearing. Patients with a large difference in size between the two breasts may, if desired, either operate on either side or increase both breasts with a different volume of silicone insert on each side to achieve symmetry.
Mr. Konstantinos Benetatos shows a special interest in breast surgery and safely performs breast augmentation surgery using high quality silicone inserts approved by the American Drug Agency (FDA) and the latest surgical techniques available worldwide .
Breast augmentation surgery involves placing a silicone insert under the female breast. The insert can be placed directly under the breast (under glandular position) or under the chest muscle (major thoracic – under the muscular fit). Placement of the insert can be done through a small incision in the armpit or nipple, or more commonly in the subatural fold. The advantages of these different options concerning both the approach and insertion of the insert are discussed in detail below.
Mr. Konstantinos Benetatos, after your clinical examination of your breast, will advise you on what is best for you, always on safety and on the best aesthetic result. The placement of the silicone insert under the muscle is usually recommended in patients whose skin is very thin and there is a risk that the insert is visible, especially in the inner part of the new breast and over time if it is placed under the gland; or in patients specifically requesting this type of surgery for reasons of mainly sports (swimming, tennis, etc.).
With silicone inserts that are placed directly below the breast (gland), it is better to reduce skin relaxation, so better breast lift can be achieved. It is a relatively less painful process and often reduces the possibility of using drainage.
Placing the Silicone Insert under the chest muscle has the advantage that the insert is covered with more tissue than a thin skin and therefore reduces the likelihood that the tip of the insert is visible or palpable over time. It is usually preferred in very thin patients where the sides, especially in the sternum area, are obvious. An important advantage of submucosal placement of the silicone insert is the statistically lower probability of creating a “shrinking of the capsule”, which can cause many problems with the deformation of the breast shape and intense pain over time. The submucosal placement requires a partial cross-section of the muscle, which can cause a minor discomfort after surgery, and slightly increases the risk of low bleeding and drainage use. However, the incision in the muscle prevents the insertion or movement of the silicone insert when it is contrasted.
This is the most modern silicone insertion technique where it combines the advantages of the two above. Therefore, the silicone insert is placed half under the muscle and half under the gland, where the skin has been partially detached from the underlying muscle (Dual Plane I, II or III), to achieve better recovery – such as sub-adherence – but and better coverage of the insert-such as its submucosal placement. It is the surgery that most of the time chooses to offer to his patients Mr. Benetatos, always after consultation during the preoperative session.
The incision in the armpit has the advantage of preventing scarring in the breast, however, it leaves a scar in the area, which may be visible in some patients and which is only indicated in submucosal placement of the silicone insert. It also has the disadvantage of the possible injury of many small sensory nerves that nerve the wider breast area from the outside of it.
The incision under the breast in the sub-mastectomy (sub-mammalian approach) is most often applied by all other methods worldwide and can be used for any different choice of the surgical insertion plan (sub-adeno or sub-muscular). The incision is healing well and ‘hiding’ on the breast crease.
Approach through the nipple is beneficial as long as the nipple is large and the chest is small. Some incidence of infection of the insert by this type of approach still persists as well as problems with nipple sensation, but if you want to follow this option, the risk rates will be discussed during your session with Konstantinos Benetatos.
The Autologous Fat Injection method involves the use of the patient’s own fat, which after a special treatment is repositioned in the same body to increase breast size, stimulate facial features, and a host of other applications for both aesthetics and for remedial purposes.
Fat is removed by liposuction from the thigh or abdomen and by special treatments it is reinfused in the area using small needles of 1-2 mm. The autologous fat injection technique is applied to both breast augmentation and correct asymmetry of the breasts (anisomastyia). It is also an established technique for restoring small imperfections or cavities created after removal of part of the breast due to malignancy.
The greatest advantage of the technique is the ability to permanently improve the areas in which the patient’s own fat is transplanted, the disadvantage of which is the unpredictable fat survival and the possibility of multiple sessions until the desired result is achieved. Usually survives about 50% of the fat injected into each treatment and may need to be repeated. No incisions are created and, depending on the affected area, the fat injection technique is performed in the context of daily hospitalization under local or total anesthesia.
In Greece, this technique is not widespread as the literature is still incomplete with regard to the safety of the technique for the injection of fat into the wider region of the breast and its association or not with possible progression of malignant transformation due to the stem cells injected into of breast. In the next few years, however, all the necessary decades-long research will solve, which will solve all our queries at this moment, remain unanswered. It is a duty of every plastic surgeon to fully inform his patients about the possible dangers before performing the above surgery.
The scars will depend on the technique of intervention applied (as mentioned above). The incisions along the nipple over time become almost invisible. At first they will be quite pink / red for the first 6 weeks, purple in the next 3 months and then they will weaken and get the white color of the normal skin. The process of full maturation of the scars reaches up to 12-14 months. Generally, the quality of scars in most patients and over time will be extremely good. Some patients arrive at this point relatively quickly, but others take longer. In rare cases, hypertrophic scars or even scarring may occur. The way other wounds have healed in the past.
A complete medical history should be taken before each surgery. As a precautionary measure, doctors without prescription or herbal products / drugs should not be taken before surgery and for 3 days afterwards. Also, strict non-steroidal anti-inflammatory drugs such as salospir, ibuprofen (Nurofen), diclofenac and any other anticoagulant or antiplatelet therapy should always be avoided, always with the physician. It would also be very helpful to bring a list of any prescription medicines you receive for your preoperative control.
If you are a smoker try to quit smoking at least six weeks before and after a surgery, as this will dramatically reduce the chance of post-operative complications.
There is no direct correlation between silicone inserts and breast cancer. In fact, the incidence of breast cancer in patients with silicone inserts is marginally lower. If you are considering augmenting with silicone inserts and there is a family history of breast cancer, we would suggest that you report it to your Benetato counselor, do a mammogram and have a breast exam by a specialist physician before proceeding to the surgery of breast augmentation.
Silicone inserts may make palpent examination and mammography examination a little more technically difficult than patients without inserts, as the pad will be a bit harder than the normal breast parenchyma. For this reason, it may take more than normal shots during mammography. This fact will have absolutely no impact on the diagnosis and validity of mammography for a construct likely to occur in the future (benign or malignant).
There is no ideal insert for all patients. The main differences between silicone inserts lie in the shape, texture, silicone gel composition, and their projection (the projection profile). The silicone inserts are round or teardrop / tear-shaped (anatomical inserts). Regarding the type and shape of the Silicone Insert that will best fit your body shape and your needs, this will be discussed during your session with Mr. Constantine Benetato.
Anatomic Silicone Implants give the breast a natural result as they have a slightly smaller volume in the upper part, which will help to avoid unwanted tumors in the upper part of the breast, giving a sense of fake, thus giving a more natural effect. Therefore, in patients with very small or “empty” breast the anatomical inserts can give a more natural appearance, as the insert will play the biggest role in the shape of the breast. Anatomic Silicone Inserts are available in many different proportions (some are taller and less wide and others just the opposite).
Silicone Round Inserts have excellent results in many patients, especially if they wear a size B bra by the size or larger. Many of our patients are asking for a fuller and more rounded breast shape that can be achieved by adding Silicone Round Inserts.
Silicone inserts are available in three different viewing profiles: low, medium and high. The higher the visibility of the insert, the higher the visibility gets the breast by looking at it from the side. The ideal type of Silicone inserts that will fit your body shape and needs will be discussed during your session with Konstantinos Benetatos.
Mr. Konstantinos Benetatos has never used PIP (Poly Implant Prosthesis) Silicone Implans, for which the world community has been particularly interested in recent years, as it was a premium grade (household) and not a medical grade silicone. Instead, it uses two of the world’s best companies, Allergan / Natrelle and Mentor, both of which are approved for use by the US Food and Drug Administrator (FDA).
All silicone implants are made of an outer silicone shell filled with either silicone (usually used) or normal saline. Silicone implants have a better feeling in general than those containing saline but this difference is less noticeable when the insert is placed under the muscle. The silicone initially used to fill the inserts was fluid, but most of the implants now contain a cohesive gel / gel (similar to jelly) which is called Cochesive. There is a degree of consistency of 1 to 3, with grade 3 being of the highest and better stability. These silicone pads are designed so as to assist in maintaining the shape of the insert theoretically prevent escape of the gel in the event that the shell of the insert break. All Silicone Adhesive Implants contain a consistent grade 3 gel.
This is in part a matter of your preference, but it basically has to do with the proportions of your body. In order to find the size you are looking for, Mr. Constantinos Benetatos will help you with his experience of making the right decision for you. It also has a special silicone prosthesis kit that you can try under your brassiere so you can see in the mirror before the surgery that suits you.
Silicone implants are absolutely safe. Silicone is the most used of all medical substances and has been used for over 40 years. Extensive studies have shown that there is absolutely no correlation with breast cancer, arthritis, autoimmune diseases or fatigue syndromes. Based on these data, Mr. Constantinos Benetatos uses the silicone inserts in his patients with absolute safety. However, it can also use saline inserts if patients want it for their own reasons.
Although they are not in themselves dangerous, there may be some problems associated with the silicone inserts and these are described below.
In all patients who place a foreign body like silicone, the body recognizes it and entraps it, creating around it a membrane of fibrous tissue, called “kapsa”. In the majority of patients the capsule remains as a thin and soft layer, helping the insert to be held in place. However, in a small number of patients and for specific reasons the capsule becomes thick and rises, resulting in the breast becoming stiff. This can lead to breast disfigurement as well as mild or intense discomfort-pain. The treatment of the problem is the surgical removal of the capsule and the replacement of the insert (often in a different surgical plan, eg by the muscle) and so the problem can be solved by about 50% of the individuals presenting them.
Incidence of infection is very rare, especially in breast growth, but it may lead to the need for temporary removal of the silicone insert until the infection is completely cured.
There is no clear time, but on average Silicone implants can last from 10 to 40 years.
Mr. Konstantinos Benetatos advises all his patients, especially the younger ones, that they may need to replace their inserts sometime in their lives.
There is evidence that the shell of the insert weakens after the first two decades. This may lead to a potential breakage of the insert and, although not dangerous, may cause problems as the silicone leaks out of the capsule surrounding the insert. One of these problems may be the appearance of silicone bumps (silicone) in the breast or lymph nodes. If there is a suspicion of rupture of the silicone insert (change in shape or texture), it is necessary to perform an ultrasound or a MRI in which 95% of the patients are detected.
It is possible, in less than 1%, and especially after the decade, to have a rupture in the silicone shell, so the insert should be removed. If the silicone is confined within the insert capsule, there is no hurry to remove the insert since the insert may remain within the breast for several months / years without causing a problem for the patient. However, if there are signs of rupture outside the capsule, then the insert should be replaced within a few months.
If you have any questions about Silicone or rupture of implants please discuss this with Mr. Benetatos during your session.
Surgery lasts from 1 to 1.5 hours depending on the type / type of technique applied to the insertion of the Silicone Inserts.
Usually stay in the hospital can be from a few hours to one night.
You will wake up and there will be only a small adhesive gauze on the cuts which will remain for 2 days. There will be no stitches that should be removed as they are all absorbable. The re-examination of the wounds will be done in seven to ten days.
The gauzes are waterproof, so patients can shower after surgery. However, we recommend that you avoid a heavy wash on the wounds for the first five days. After this time you can be less careful.
Drainage placement may be necessary, but in most cases no. They are usually used for silicone inserts placed under the muscle in the dual plane technique, and remain within the breast for 24 to 48 hours
You should bring a soft (non-batik) sports bra with you to the hospital, which will be in line with the new breast size. The bra should be comfortable while providing support. You will need to have two bras in the house that can be worn consecutively. The measurement of the chest circumference does not change. After eight weeks you will be able to wear a bra with a bracelet that should fit your new breast size and size.
People differ in recovery time from breast augmentation surgery with silicone inserts. Generally it will take at least 2-5 days for someone to be able to get back to work. Patients with jobs requiring intense movement may take longer.
Patients usually feel able to walk on an exercise pace within five to seven days and swim in ten to four days (if they have fully recovered). However, intense exercise (aerobics, etc) should be avoided for six weeks.
From the first to the fourth day you have to rest. You should not take care of very young children or do homework without help.
From the fifth to the fourteenth day you can start exercising longer, like hiking for a longer time, shopping, etc. By the end of this time you will feel little pain. If all the wounds appear healed on the tenth day it is unlikely to cause a problem with increasing your activities. Start your activities if you feel healthy.
From the third week you will be able to fully return to your normal lifetime before surgery and do whatever you want.
Patients who have undergone a breast augmentation with silicone inserts should avoid driving until they are totally relieved of any inconvenience and limitation so that they are perfectly able to make a sudden movement, such as direct braking, unobstructed and pain free. This is proposed so that patients can obtain cover from their insurance company in the event of an accident. It may take up to two weeks to fully recover. Of course there are patients who feel able to drive after 1-2 days, always with their own responsibility.
It is possible that some bruises and a slight swelling in your chest will take up to three weeks. Your chest will be slightly stiffer and slightly higher than the expected end result. Within a short time your chest will soften and get a very nice and natural shape, without being easy to say that you have surgery. This will happen around the fourth to the sixth week, continuing to improve continuously within the next six months.
Your wound will be checked on the second and seventh day after surgery. If you need any further follow-up, this will be done by Konstantinos Benetatos. Your next appointments will be after one and three months respectively, where postoperative photos will be taken. There will be no extra charge for any monitoring associated with your surgery.
Breast augmentation is a routine surgery and crowns with absolute success for the overwhelming majority of patients. However, as with any surgery, it is very important to understand that there is a possibility of complications. Possible complications that may occur are listed below.
It is common for the patient to have a loss of nipple sensation initially after breast augmentation surgery with silicone inserts but the feeling returns to the overwhelming majority of patients within the next few weeks. It is also common to affect only one side of the chest. Less than 5% of patients will experience a permanent loss of nipple sensation.
Most women have different breast sizes and with Breast Augmentation surgery we try to smooth out and improve any asymmetry. However, it is possible that one breast or one nipple is slightly different from the other side after surgery.
The quality of scars varies among patients.
Very rarely and especially in smokers, there may be a small break in the surgical incision.
There is a possibility of a chest haemorrhage, which will result in the patient returning to the surgery to remove it. Hematoma usually occurs within the first 24 hours after surgery and occurs in about 2% of patients.
Approximately 98% of women can breastfeed after abnormal breast surgery completely normal.
The onset of post-operative infection is a very uncommon, but if it occurs it can be severe and sometimes leads to removal of Silicone Inserts
Chest infections and thrombosis in the foot or lungs (DVT or PE). Although rare to occur, it is important to avoid smoking, not being too overweight and moving as soon as possible after surgery.