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The breasts, at the heart of femininity

The use of implants to increase the volume of the breasts

Enhance the size of your breasts with a cosmetic procedure

Unlike breasts that are too large, breasts that are considered too small do not cause discomfort or physical pain. Their small size, of genetic origin, has no impact on health, libido or breastfeeding. The pain is elsewhere; some women suffer deeply from a real lack of confidence. A breast augmentation seeks to increase the volume of the breasts. Its goals are to help women feel better about their body, to increase their well-being, and to restore their self-confidence by improving their self-image. People often view breast augmentation as a desire for sexual seduction but this is not the norm. It is primarily done to please themselves and to feel better every day in their skin.

Why do you want a breast augmentation? Women who complain about their “non-existent” breasts usually respond “To feel more like a woman, a real woman!” Pleasing others like men for example seems to me to be secondary. Of course, patients want to be more seductive, more beautiful, and more desirable, but their primary motivation for this procedure is to be happier. A young patient said to me one day with a radiant smile “Overnight, I felt more beautiful, sexier; I had the impression of being noticed!”. After the cosmetic procedure, women feel happier and more feminine and that is the true goal.

Breast implants

Silicone was discovered in 1942, but wasn’t widely used until the 1960s, and contributed to a huge leap in the field of breast augmentation surgeries. It allowed for a successful breast augmentation, with a natural volume and consistency. The silicone aroused a craze that was stopped abruptly in the early 80s when it was discovered that complications could appear: first, the rupture of the implant, which released the small balls of silicone into the breast. More importantly, the silicone was accused of promoting the development of diseases such as arthritis. Evidence was lacking, but these prostheses were singled out as the cause. The affair broke out in France at the same time as the infected blood scandal. An official commission was appointed by the Ministry of Health to determine the real risks and, pending its conclusions, the use of silicone was banned in cosmetic and reconstructive surgeries. The product was then cleared but its use was not re-authorized. Administrative justice was seized by plastic surgeons, and this gave them an advantage but, in spite of this advantage, the situation was not unblocked until 2001. This came after years of confusion, when silicone implants were finally re-authorized for aesthetic procedures of breast augmentation.

Now, the silicone gel is of a more cohesive consistency than before and enclosed in a membrane made of a silicone polymer that prevents the body from being in contact with the gel. To protect itself from this foreign body, the body naturally produces a living capsule around this membrane.

Patients must participate in follow-ups, with a check-up every two years, and the renewal period for prostheses is about ten years.

Natural is the priority!

Breast prosthetics adapt to the anatomy of the patient. Today, we have a very broad choice of several hundred models, varying in shape, texture, consistency, and capacity. The new prosthetics focus on naturalness, with “anatomical” or asymmetric models “- a prosthesis for the right breast, another for the left breast – adapted today to all thorax morphologies. The volume of a prosthetic can vary from 125 to 575 cm3 on average, but there are also customized prosthetics. It is interesting to note that the average standard volume implanted during a breast augmentation varies according to the continent. It’s a question of culture. The average size of prosthetics is 280 cm3 in Europe but around 350 cm3 in the United States. A prosthetic of 200 cm3 on average, allows a patient to go up one bra cup size and go, for example, from a size A to a size B or from a B to a C. A prosthesis of 300 cm3 makes it possible to gain a size and a half, passing, for example, from an average A to a C. Since there are more and more options available, this choice requires more and more consideration. It is recommended to choose an implant that is both in harmony with the silhouette and close to the original shape of the breast. We must also anticipate and plan for the future because over time, the body has a tendency to round out and this must be taken into account while choosing an implant. For this, a constructive and confident dialogue between the patient and the surgeon is the key to success. Generally, round implants create an uplifting effect because they give more volume in the upper part of the breast. But they are not suitable for all types of breasts. The final volume also depends on the elasticity of the skin and the pectoral muscle. When presented with a request for breast augmentation, one of the first things to do is to measure the width of the hemithorax so as not to choose prostheses that would exceed this width. We then discuss with the patient another important point: the insertion zone, which determines the place of the scar. For a long time, the incision was practiced only in the inframammary fold, that is to say the point of contact between the breast and the thorax. On one hand, this facilitated the introduction of the prosthesis and, on the other hand, the scars were undetectable when the woman was standing or sitting (but visible while lying down). Today, this technique is practically no longer used, and in France, two types of incisions are used: the areolar incision, around the nipple, and the axillary incision under the arm.

If we have chosen the areolar incision for a breast augmentation we must then decide on the “prosthetic pocket” which is the space where the implant will be placed. This choice also effects the conditions we will have if we need to intervene at a later time to change the implant. When using this incision, it is possible to position the prosthesis either in front of or behind the mammary muscle. In most situations the scar is only slightly visible. The axillary incision is placed horizontally in the natural fold above the axilla, i.e. under the armpits. With this type of incision, the incision can be performed “blind” or under endoscopic control, depending on the case and the surgeon’s preference. On a technical level, the axillary incision allows the surgeon immediate access to the retro-pectoral region and allows for an easy detachment. For the patient, it has the advantage of leaving the breast free of any scarring. For all these reasons, it is the most practiced type of incision, but still remains the choice of the surgeon and is made on a case by case basis.

Regarding the placement of the implant, the again surgeon has the choice between two solutions: in front of the pectoralis major muscle or behind it. The first option is used in cases of heavy or slightly drooping breasts, to promote the projection of the breast. The more painful second option is chosen both for reasons of promoting long-term tolerance of the implant and to facilitate mammographic surveillance.

The procedure is performed under general anesthesia, the patient is often placed in a sitting position. A bandage is placed at the end of the procedure and it is recommended to wear a sports bra for one-month post-op 24 hours a day. This restraint aims to keep the prosthetic in place until the pocket heals to avoid the displacement of the implant into the wrong position.

Because pain is continuous for about ten days after a breast augmentation procedure, appropriate medications are prescribed and exertions should be avoided.