Why has using silicone implants been banned in the United States?
For years, the use of silicone implants has been the subject of campaigns, both for it and against it, in the United States. After prolonged controversies among plastic surgery societies and commercial firms, it was scientifically proved that silicone implants do not produce cancer. However, the debate goes even further in reality and there seems to be a dilemma with personal interests involved. In whatever way, even though nothing has been demonstrated, both in the United States and in the rest of the world, silicone still continues to be accepted by the scientific community and plastic surgery societies.
Will I be hospitalized?
This is an out-patient surgery. This means that the patient is admitted into the clinic in the morning and she would be returning home in the afternoon hours.
What type of anesthesia is required?
In some cases, implant insertion may be attempted under local anesthesia and sedation. To a larger extent, the procedure is performed under general anesthesia, since it is more comfortable and safe, both for the patient and for the surgeon.
How long will the surgery take?
On average, it should take between half and hour and one hour. It is to be taken into account that some time is required to prepare the patient for surgery and some more time for the patient to recover from anesthesia.
Where will the implants be inserted through? Will that leave a scar?
There are several ways to place breast implants. The most frequent incisions made are: axillary (in the armpit), submammary (under the breast) and peri-areolar (around the nipple). This latter location is generally preferred, as the scar left is not broadly visible and can be perfectly concealed.
During the first thirty days, reddening of the area is common, as the result of the dressing used and as a reaction to stitches. Between thirty days and twelve months, the scar may become exhibit thickening and a change in color from red to brown. During this period, patients tend to worry about the results of the scar. However, between twelve and eighteen months, the scar will be clearer and less consistent.
Generally, people with fair skin do not have problems of scar thickening. In patients with a history of scar thickening, we follow the most adequate and effective treatment to minimize scars.
What should be my implant’s volume?
Any volume that is harmonious with your body and you are comfortable with..This means that we have to talk to our doctor and agree on the breast size we want to get. We have to take into account that the patient’s expectations are not always the most adequate thing to follow. Mammary tissue has a very large stretching capacity and, once a definite volume is placed, it may be changed for a bigger volume in a few months. During the surgery, the surgeon tries on with different sizes, which will him to decide on a final volume. A resource applied by doctors to lessen a patient’s qualms is to use photographs provided by the patient. Although the patient is well aware that she will not end up being exactly at the person in the picture, this allows to reach some agreement on an approximate final size.
When will I see definitive volume, consistency and results?
No breast will be perfect during the immediate postoperative period (from the end of surgery to some thirty days after it). The period between thirty days and three months allows is to see better results. It really takes between three and eighteen months for the breasts to reach their maximum, definitive results in terms of consistency, volume and sensitivity.
What can I do and what should I not do during the first week after the operation?
- You have to sleep on your side or on your back.
- You have to wear a push-up bra day and night, at least for four weeks.
- You may take a shower on the following day after surgery, taking good care of covering your chest around with plastic wrap to avoid that your breasts get wet.
- You may return to work after the third day, provided that your professional activities do not require major physical efforts.
- You must undergo postoperative therapies after the second day.
- You may drive after the fifth day.
- Sexual intercourse may be resumed a week after the operation but special care for your breasts is to be observed at least for a month.
- Avoid exposure to direct sunlight for at least three months after the operation.
Will there be pain during the postoperative period for this surgery?
In general, there should not be any pain. The period itself will not be unpleasant, provided that you follow your doctor’s instructions, particularly in what pertains to arm movements during the first days after surgery. You may experience eventual pain that can easily be fought back with common painkillers prescribed by your doctor.
When will the stitches be removed?
The sutures used are intradermal (into the skin) and they are removed between eight and fifteen days after surgery. In some cases, absorbable sutures can be used.
When can I resume workout?
It will depend on the type of workout. Exercises involving lower limbs may be resumed between ten and fifteen days after surgery, provided that you avoid high-impact exercises. For exercises involving the thorax, you will generally have to wait some thirty to forty-five days after the operation.
I have heard about breast hardening or retraction of the fibrous capsule… what is it?
Our organisms react very similarly in the presence of foreign bodies. Our body creates a capsule or wrapping around the implant, as a way of defense, in order to isolate it and not to be in direct contact with it. All implants are wrapped up in this fibrous capsule, which may vary in thickness (sometimes, very fine; others, slightly thick and sometimes so thick that they tend to calcify. We do not know exactly their formation mechanism or the time it may take for them to retract. Retraction sometimes may generate asymmetries, pain and even leaks in the case of implants filled with physiological saline solution.
What complication may be brought about by the implants?
- Hematomas: depending on their dimension, they may be self-digested by the body or require surgical drainage.
- Infection: it occurs in a very low percentage of cases. You have to follow your doctor’s therapeutic recommendations and strictly comply with the ingestion of antibiotics.
- Retraction of the fibrous capsule: tear or break of the implant’s shell occurs very rarely.
- Atrophy of the mammary gland.
- Breast drooping following a number of years: this may occur if the implant is too big and there is very flaccid skin.
How long will the implant last? When should I have it replaced?
Nowadays, it is recommended that implants should be replaced after twelve to fifteen years. If you want to change your current implants for bigger or smaller implants, we recommend that you should wait at least three months after the last surgery.
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