Augmentation mammoplasty/mammary implants

Mammary hypoplasia is defined as a breast volume which is insufficiently developed in proportion to the patient’s morphology.

It can be a pre-existing condition (small breasts from puberty) or appear later, after substantial weight-loss, a pregnancy, or hormonal problems.
It can occur alone or be associated with ptosis (sagging of the breasts and skin stretching and a lowered areola).

This is a purely cosmetic procedure and cannot be reimbursed by health insurance.

Only rare cases of total absence of breast formation (mammary agenesis) can be partly reimbursed after prior permission.

The great majority of implants used in France are pre-filled silicone gel implants.

There are classic round implants, anatomic shapes implants and smooth or textured implants.

The type of implant is chosen during a consultation.

Mammary implants: Before the procedure

During a discussion and a consultation, the surgeon will take into account all the relevant parameters for each case (height, weight, pregnancies, breast feeding, size of the existing breasts, skin quality, body fat, gland, muscle tone...).

After studying these anatomic features and the expectations of the patient, the surgeon will determine the plan for the operation.

This will also take into account the positioning of the scars, the type and size of implants, and the position of the implants above or below the muscle (see below).

A preoperative blood test is made following your surgeon’s recommendations.

An anaesthesiologist will see you in consultation at the latest 48 hours before the operation.

It can be helpful to use medical imagery (mammography, echography).

No aspirin-based medication should be taken during the 10 days preceding the operation.

You need to fast (neither eat, drink or smoke) 6 hours before the operation.

Mammary implants: The procedure

Doctor Santini has has her personal technical approach which is adapted to each individual client to obtain the best possible results.

However, there are common principles:

Incisions

• peri-areolar approach, the incision is either below the circumference of the nipple or horizontal below the nipple.
• axillary approach, the incision is below the arm, in the armpit.
• sub-mammary approach, the incision is in the fold below the breast.

Implants can be positioned in the prepared location through the incisions.

Two positions are possible:

• Implant in front of the muscle, behind the mammary gland and in front of the pectoral muscle.
• Implant behind the muscle, deeply behind the pectoral muscle.

In the case of ptosis (sagging breasts, a lowered areola), it is appropriate to associate a breast lift (mastoplexy).

This implies more visible scars (around the areola and/or vertically).

A small drain may be left in place in order to evacuate any blood which may form around the implant

At the end of the procedure an elastic bra-like bandage is put in place to maintain the bandage and the implants.

The operation lasts one to two hours depending on the incisions and the associated treatments.

Mammary implants: After the procedure

There can be pain for the first few days after the procedure, particularly when the implant is large and placed behind the muscle.

Pain medication of the strength necessary to dull the pain, is prescribed for several days.

Even if there is no pain there will be a strong sensation of tightness. Swelling, bruising and difficulty in raising the arms are frequent immediately after surgery.

The original dressing is removed the day after the operation.

An elasticised bra is recommended to be worn night and day for 4 to 6 weeks.

Most of the time, stitches are intern and absorbable.

Five to ten days convalescence is necessary before returning to work.

Patients are advised to wait for one to two months before practising any sports.

The benefits of doing an augmentation mammoplasty are : 

One night in a clinic.

4 to 7 days of professional unavailabity after surgery.

Final result 6 months after surgery.

The augmentation mammoplasty in summary...

What should you do prior to the operation?

• 1 or 2 consultations with your plastic surgeon where he or she will take medical photographs.
• Presentation and signing of the estimate with a 15 days legal delay between the first consultation and the operation.
• Anaesthesia consultation, blood test and mammography, as appropriate.
• Choice of the most adapted implant with your surgeon: round, anatomical, smooth, textured, silicon, saline solution...).

What does the procedure imply?

• General anaesthesia.
• 60 to 90 minutes in length depending on the technique used (dual-plan implants, implant behind the muscle...).
• Hospitalization is usually one night.
• A card with your implant references will be given to you. 

What is the follow-up?

• Medical elasticised bra sometimes with a pressure garment during 4 to 6 weeks.
• Follow up consultation with your plastic surgeon 10 days after the operation.
• Stitches are dissolvable.
• Non Practice of any sporting activity during a 45 day period. 
• You will need between 4 and 7 days of rest after returning home.
• Final result 6 months after surgery.
• Follow-up consultations to check the implants during one year and then once every two years.