For a long time, the breast has been the symbol of women’s beauty and fertility. This symbolism begins to manifest especially during women’s adolescence when female teenagers like to watch their figure in the mirror, or what their classmates tell about them, and the stares of boys. Also at this time, they begin to feel their breast are not proportional and think that they do not favor their figure. Some of them do not like to participate in fashion trends because they think they are not pretty enough for that which troubles them. Thus, small breast, or big breast, or breast with droopy nipples, flaccid breast, or differences in their size, are enough reasons to feel preoccupied.

ammoplasty

Pertaining to the “Contour Surgery”, mammoplasty groups in this concept different procedures that modify the volume and shape of the breast periaerolar (around the nipple) area.

eri-areolar (Around the nipple) ubmammary (Underneath the mammary glands) bdominal Dermolipectomy (the approach is through the navel) xillary Endoscopy (a small scar in the underarm)

he amount of tissue developed by the breast from adolescence to adulthood varies considerably due to different physical and biological conditions. It is clear to observe cases where women did not developed enough volume of the tissue according to their complexion and do not show proportional breasts. Others, knowing they have attractive breasts, notice the tissue becomes loose after pregnancies or with age.

ndestand your needs:

With a delicate and fine operation, Dr. Juan Piña lifts the skin and tissue and places the implant very carefully modeling it, and following the natural form of the own breast. To perform this operation, Dr. Piña studies the case, and suggests one type of surgery among the four types of surgery he can perform:

In every case the doctor assess the necessity to modify the position of the areole and the nipple. The incision is sutured and leaves no traces of the surgery. All the procedure takes about two hours.

reast Reduction.- The procedure to reduce the breast consists in taking out fat, skin, and glands looking for a more attractive position for the areole and nipple. We always look for the best alternative for the patient, here it is possible to combine several techniques without Scalpel or that inclusive they could be treated via hydrolipoclasia, or liposuction.

natomic Assessment

It is necessary to determine if the skin is flaccid and to assess the amount of mammary gland, the complete size of the areole-nipple area, and exact measures of the thoracic wall. Likewise, it is important to determine if the two nipples are at the same height and if the breasts have the same size and also the configuration of the breastbone.

natomic Assessment It is necessary to determine if the skin is flaccid and to assess the amount of mammary gland, the complete size of the areole-nipple area, and exact measures of the thoracic wall. Likewise, it is important to determine if the two nipples are at the same height and if the breasts have the same size and also the configuration of the breastbone.

lacement methods Endoscopy.- To place the prosthesis, the surgeon approaches with a precise small incision and the scar is dissimulated in the underarm; therefore, there is no cut in the breast itself. Advantages.- Because the distance between the underarm and the breast is very small, in addition to that of the endoscopy admits to separate and approach the breast’s internal natural tissue step by step as well as not affecting the mammary glands or the process of breast feeding and the nipple sensitivity. Considering that the procedure does not use the scalpel to cut the external tissue, it does not leave a scar in the patient’s breast. This procedure is less aggressive than the aforementioned procedures. The results are evident, the patient can change from size “A” to “D”. To be sure the placement is correct several considerations are taken into account.

(Before and After, see more examples)

rosthesis Types

The most common implants are made of a soft silicon bag that could contain a saline solution, silicon gel, or both, in several compartments. They can be round, with high and low profile. There is also the cohesive silicon prosthesis, which is not a silicon gel, but a little more consistent. They are a little bit harder. In addition, there are soy oil prosthesis, triglycerides prosthesis, and other new types of prosthesis.

To make sure that the placement of the prótesis is successful Dr. Juan Piña takes into account several considerations

he intervention does not require hospitalization. The patient leaves the doctor’s office the same day on their own feet. Normally the operation is done using general anesthesia. The type of bandage to use after the operation varies according to the surgeon’s preference. At the same time, he can recommend to massage the breast since early post-surgery stages to avoid the retraction of the capsule that the body forms around the prosthesis, although other surgeons prefer a more prolonged immobilization of the mammary glands. Breast implants allow small breasts to look bigger and uneven breast to equilibrate. However, it can happen that the bigger implant has the same tendency to drop and curve as others that are without implants. For conditions where the patient wishes to increase the size of her breast noticeably, the size of the breast will be studied along with the patient to decide what type of prosthesis is the best for her.

ormally, saline implants are used. The FDA requests the use of saline implants for primary augmentation. If you already underwent a surgery, you classify for silicone implants under a “Silicone Study” status. If you are older than 40, before the surgery you need a basic mammogram. Most of the women who undergo this type of surgery do it because they want to have more proportional bodies and to improve their figure and increase their self-esteem.

hat is the best size for you body?

The size of the implant that would be used is determined by the amount of tissue existing in your breast, your height, and weight. The tendency to develop breast cists does not increase with the implants. In some animals the use of implants has caused cancer, but there is not a cancer risk associated with implants on people. For unknown reasons, breast cancer tendency, according to most of the studies, is not related to breast implants; for example, calcifications can occur even in people who have not had an implant or massage their breast.

It's very important to avoid and detect risks

ow will your intervention be?

This procedure is made in our operation room as an outpatient surgery. You will receive local or general anesthesia. There is no pain during the procedure.

Because the procedure could cause bleeding the patient should not take products such as Aspirin, Advil, Ibuprofen, or vitamin E two weeks prior to the intervention. On surgery day, the patient should not eat from 6 to 8 hours before the surgery. In case you have eaten or drunk something just before your surgery, to avoid any risk notify your doctor about this fact. This way the surgery WILL BE CANCELLED and rescheduled for your own safety. Try to be at the doctor’s office a little bit ahead of time. Think only about nice things to be in a good mood for the surgery. After that, you will be in observation and more directions will be provided for you and for the person that is taking you to your home or hotel. We also recommend that someone stays with you for the first 24-48 hours after the surgery. This person would be able to see that post-surgery directions are followed.

uring the first days after the surgery you have to use a sport bra of the kind that is used for jogging, without underwires, that will be provided by Clinica Laser. You can sleep sitting or on your back or on your side. You can go to the bathroom and eat normally, but, you should not do any house work or carry heavy loads such as suitcases, supermarket bags, children, pets, toys, or anything heavy. Try not to do anything at home or receive too strong of a hug or squeeze. Remember, for two days you should not do anything, this way you will feel better and recover sooner.

It is important to be fresh and calm; try not to be in a hurry. Avoid the heat and try to be in a quiet place. You have to be nice to yourself during this time; do not pressure yourself, this way you eliminate the possibility of an accident or injury. You can raise your arms after the first day. The shower should wait at least one day. Although passive sexual activities could be resumed in the second day without performing any vigorous activity for at least one week, we recommend waiting for a week before you can have any sexual activity. You have to wear your bra all the time to help your breast to integrate the new tissue that will cover the implants.

emember that you have to be in contact with Dr. Piña to report any discomfort or unexpected conditions. The stitches will be withdrawn from 7 to 10 days. The time for your next appointment will be the next day after the surgery; the second one 7 days after. You have to attend your appointments after the first two weeks where you will be evaluated and receive instructions at no cost. Most of the discomfort will go away after the first two or three days. However, you could experience some emotional changes such as need to be pampered or depression. This situation could last for a few weeks. After the first two days you will be able to drive. It is important to take the medicine on time. You should avoid hot showers and vigorous activities for two weeks. You should not jog, swim, play tennis, or jump at least until three or four weeks after the surgery because you have to give time to your body to reestablish.

isks

Avoid and detect risks. Try to be quiet. Use neutral soap and water; do not expose your skin to the sun and massage your breast. Do not wear any deodorant that contains silver, because silver blocks the transpiration, in which the body expels toxins. In this case, the toxins will look for another way to leave the body and the toxins could enter into the new layers of connective tissue and cause complications.

Capsular retraction is one of the main complications that could result from mammoplasty. In this case the body covers the prosthesis with a layer of connective tissue and even though in the majority of patients this capsule maintains thin walls, in some patients, and some times on one side only, the capsule gets thicker and retracts resulting in the breast’s unnatural firmness and hardness. The cause for this complication is not known, and approximately 10% of the patients could develop this situation. Thus, the surgeon will indicate to the patient the necessary measures to correct it that in principle could consist in breaking the capsule externally and to loosen the implant partially or totally or to dry the capsule through the same approach, placing the prosthesis underneath the muscle if it is found above the pectoral. After the surgery, the patient can feel numbness, sensitivity or a burning feeling in the nipple or the skin around the incision peels. Usually, this sensation is temporary and due to the natural pull that the prosthesis is exercising. The change in the nipple’s sensitivity is not permanent, although it could happen.

In approximately 5-10% of the cases the tissue around the implant gets firmer. The implant itself is not firm, but the firmness is due to the formation of the scar tissue around the implant. If this is excessively short it could produce an undesirable firmness. Although a little bit of firmness is beneficial for some patients, excessive firmness is not desirable. Sometimes a second surgery may be necessary in case the implant is too firm. According to the opinion of Clinica Laser’s surgeon, there is a small percentage of women that cannot tolerate a breast implant without developing very firm breasts.

omments

Generally, there is a small risk in the use of local anesthesia. In some cases there is a reaction. However, local anesthesia is safer than general anesthesia. As in any surgery, you will have a scar. Fresh scars are firm and red and remain like that for a period of six months and it improves gradually in one year. The cut in the underarm area is less notable, and with the procedure there is no scar in the breast at all. We cannot guarantee anything with respect to the appearance of the scar. It is important to mention that some local complications could occur such as contusions, infection, intolerance to stitches, etc. that may require the proper treatment. The incidence of these complications is very low. Although rare, as in any surgery the patient can develop an infection if she is not clean or take the medication on time. Usually, the infection is limited to a very small area and takes a few days to recede. On the contrary, a serious infection could produce a lifting of the implant and after a satisfactory period of time, the implant will be replaced. In the following surgery, the patient can expect a bruise or red dot close to the incision and in the breast itself. Bleeding could occur but it is rare. In case of bleeding the doctor has to open the incision to remove blood lumps to control bleeding, and he has to reinsert the implant and close the superficial incision. Obviously the patient would feel concerned but the problem is not serious.