Augmentation mammoplasty

The Augmentation mammoplasty is breast augmentation, which can be performed either with the implantation of autologous fat (lipofilling) or with the aid of prostheses.

Lipofilling involves a double procedure (fat harvesting site and subsequent implantation in the breast), which generally needs to be repeated, at least once, about a year later due to partial reabsorption of the implanted fat (furthermore, the fat generally reabsorbs irregularly).

Breast augmentation with implants

Augmentation mammoplasty with implants provides a more stable result over time.

Type of prosthesis

Currently, we have 3 types of prosthetics on the market:

• Prostheses coated with a silicone capsule and filled with cohesive silicone gel
• Prostheses coated with a silicone capsule and filled with saline solution
• Polyurethane-coated prostheses.
  These latter ones are mostly used as a second or third option in patients with a history of significant capsular contractures, being a little more rigid, and given that there are no conclusive studies in the literature on potential negative effects of polyurethane.

Cohesive silicone gel prostheses

The most common prostheses are those with a silicone coating containing cohesive silicone gel. Of these, some are guaranteed for life by the manufacturing companies (Mentor and Allergan primarily), which means that, potentially, patients will never have to replace the implants during their lifetime. Cohesive silicone gel prostheses can have:

• Anatomical (teardrop) shape: generally allows for an extremely natural breast shape, with more volume in the lower half and an “oval” appearance when viewed from the front, although in some cases they can rotate on the vertical axis, highlighting an unsightly asymmetry.
• Round shape: they allow for volume in the upper part of the breast and, being spherical, do not create asymmetry issues in case of rotation.

Prosthetic placement

Implants can be positioned either in a deeper submuscular space, or in a more superficial subglandular plane, or in a double-plane position – generally yielding more satisfactory results – with the implant placed submuscularly in the upper part and subglandularly in the lower part: the double-plane technique. Regardless of the implant’s placement, patients will be able to breastfeed if they become pregnant and undergo all breast screening tests (CT, mammography, MRI).

Additive mammoplasty consists of the surgical implantation of prostheses (implants) to increase breast size and reshape the breasts in cases of important asymmetry or to restore breast volume lost after pregnancy or weight loss.

Prostheses can be inserted through small incisions made at the level of the inframammary fold, the areola, or the armpit. The procedure can be performed under local anaesthesia with sedation (day surgery) or general anaesthesia (with an overnight stay). This type of treatment Cosmetic surgery It is tailored to the physical characteristics of each patient; in cases of tissue sagging, the placement of implants may be combined with a procedure to Mastopexy, whereas if the requirement were the opposite, namely a reduction in breast volume, one would resort to Breast reduction surgery.

Post-operative recovery following breast augmentation surgery

Physical activity involving the upper limbs (weights, tennis, swimming) is prohibited for the first 2–3 months (depending on the type of procedure). It is important to note that the long-term stability of the aesthetic outcome is dependent on the patient's stable weight, as significant weight fluctuations negatively impact the breast.

The first 48–72 hours following the operation are the most challenging and debilitating (though this can be managed with painkillers); however, the patient generally regains 80–90% of her independence within a week.