Breast

BREAST SURGERY

Breast Augmentation

For the last fifty years, breast augmentation operations are among the most performed plastic surgery interventions. Breast augmentation, called “augmentation mammoplasty” in the technical jargon, is the surgical intervention performed with the aim of augmenting the size and modifying the shape of a woman’s breast. In this method, the cup size is increased by placing the breast implant under the breast tissue. However, the purpose of breast augmentation operations is not the augmentation of the breast only; a proper contouring is also aimed.

Who is qualified for breast augmentation?

Breast augmentation operations are among the most satisfying operations for our patients. The women who, for personal reasons, think that their breasts are too little or whose breasts shrink in volume after pregnancy may undergo a breast augmentation intervention in order to have well-contoured breasts proportionate to their bodies. In some cases, the breasts of a woman congenitally differ in size –which can be corrected by breast augmentation. In addition, breast augmentation can be used as a reconstructive technique after a breast surgery performed because of cancer or a trauma.

Which features do the implants have?

A breast implant is a silicone shell filled with silicone gel or a salt-water solution known as saline.
The usage of these implants differs depending on the condition of the person, on breast structure and the will of the patient.

Is it possible to find an implant which is suitable to my body?

Silicone implants produced by various firms are currently available in different structures and shapes. Thanks to this situation, together with the patient, we can decide on the size as well as the contour of the breast.

Do silicone implants cause cancer?

Health authorities worldwide have conducted detailed studies related to the suspicions that silicone implants cause cancer. The studies conducted have not detected any finding regarding an increase in cancer development with the use of silicone implants, and such suspicions proved to be groundless. On the contrary, it has been observed that the risk of breast cancer for patients with breast implants is 30% lower than the risk for normal women. However, such data should not be taken to mean that breast implants reduce the risk of cancer. For this situation may result from the reason that the women in the high-risk group may not prefer implant operations much.

Can anything else be used instead of implants?

In breast augmentation operations, fat injections may be used instead of implants in order to augment the breast. But this method is used for selected patients only. Fat injection may be performed on those patients who do not desire a major augmentation or those who have asymmetrical breasts. The augmentation achieved with this method may not be permanent and it may be necessary to repeat the procedure.

How should I prepare myself before the operation?

As in any kind of operation, you should not use anticoagulant medicines or similar drugs during the week before the breast augmentation operation.
For any kind of breast operation, mammography or breast USG is recommended for the patients over 40 years, and breast USG is recommended for the patients younger than 40 years. Considering the future follow-ups, it is essential to have a radiological image taken before the procedure to be performed on the breast. Mammography/breast USG is taken once again after a year following the operation.

Where are the breast augmentation operations performed?

Breast augmentation operations are performed in the surgery room of a fully equipped hospital.

Will I need to be anesthetized for the breast augmentation operation?

In breast augmentation, the most preferred types of anesthesia are local anesthesia and sedation. We can also perform the procedure under general anesthesia depending on the patient’s preference. In neither of these cases does the patient recall the operation process nor feel any pain.

How long does the operation take?

In general, breast augmentation operation takes an hour and half .

What kind of a procedure is performed during breast augmentation?

In breast augmentation operations, an incision is made through which the implant is applied. This incision can be made in the infra-mammary fold where the breast meets the chest, around the areola (the pigmented skin surrounding the nipple) or in the armpit.
The incisions are made in such a way to ensure that the scars, that is, the operation marks are the least visible as possible. By using the incision made, the breast tissue and the skin are lifted, and a pocket is prepared either immediately beneath the breast tissue or beneath the breast wall muscle (the pectoral muscle). Then the implants are centrally emplaced beneath the nipple.
we suture the incisions and place medical tapesare sealed by sutures, and medical tapes may be placed on the site in order to provide better support. In order to accelerate healing, surgical pads may be placed on the breasts. In general, drains are not used for this operation.

What difference does it make to emplace the breast implant beneath the muscle or on the muscle?

Submuscular breast prosthesis implantation is believed to reduce the risk of capsular contracture. In this type of prosthesis emplacement, mammographic examination findings may be affected less in comparison to the method in which the prosthesis is emplaced immediately beneath the breast tissue. Nevertheless, submuscular implantation of the prosthesis may lead to a higher level of pain for a few days following the procedure compared to other types of implantation.

Will I need to stay in the hospital after the operation?

Yes, after the operation you stay in the hospital for 1 night. After you recover at the hotel.

What will I experience after the operation?

We use only absorbable subcuticular sutures , you will not need stitches removal after the surgery.
You may feel exhaustion for a few days following the operation, and during this period of time, painkillers will relieve the pain gradually . However, you can normally start to move in 24-48 hours. After a few days, medical assistants will remove the surgical pads and you will receive a surgical bra. You will need to wear this bra for a 2-4 weeks.

Is breast augmentation a painful procedure?

You may have mild pain for a few days following the operation. In such a case you may use painkillers. Since your breasts may be oversensitive to direct stimulation for two to three weeks, you should avoid high physical contact. After some time and the pain disappears, physical contact with your breasts gives no harm.
Besides, you may have a burning sensation at your nipples for a few weeks but this complaint will fade away as the bruises disappear.

How long will it take for me to resume my ordinary life after the operation?

Depending on the level of activity your occupation requires, you will be able to turn back to work in a few days.

Will the operation leave any scars?

The operation marks will be rough and pink during the first 6 weeks. They will remain the same or even seem to expand for the following few months. After this period of time, the scars will start to shrink. Although the scars will never disappear totally, they will fade.

Will I experience loss of breast sensation after the operation?

Some of the patients may report oversensitivity, loss of sensation or numbness on the nipple. You may experience limited lack of sensation with a narrow site around the incision. The lack of sensation will gradually subside .

What kinds of adverse situations may I experience after the breast augmentation operation?

Although breast augmentation operation is a relatively simple procedure, there are some risks related to the surgery and some complications specific to this procedure, as is the case in any other operation.
Being the most frequent problem, capsular contraction occurs as the scar around the prosthesis (the fascia) or the capsule begins to contract. The contraction of the prosthesis which has a soft structure may cause a feeling of hardness in the breast. There are various techniques to repair capsular contracture . Sometimes it may be necessary to remove the scar tissue or perform the procedure called “scoring”, or even to remove or replace the implant.
Bleeding or infection may develop, although very rarely, as in any kind of surgical intervention.
A low proportion of women with breast implants have reported symptoms similar to those experienced by patients with immune system disorders (e.g., scleroderma, arthritis or other similar conditions). Although the conducted researches could not establish any clear correlation between breast prostheses and the disorders that the physicians call “fascia disorders”, FDA (Food and Drug Administration) has demanded a detailed research on this issue.

Does a breast implant deflate?

Rupture or leakage of the breast implants occurs only with extremely serious traumas. The removal of the implant should be the priority for your health.Either on the same surgery your doctor may change the implants or in some conditions he may wait couple more months for a second surgery.

May it be necessary to explant or replace the prosthesis?

Each brand or type of breast implant have different expire dates and for long years that was a concern.But this is no longer necessary thanks to the new prosthesis. Nowadays, almost all brands have lifetime guarantee without any major complications.

What if I get pregnant? Will I be able to breastfeed?

There are no findings which demonstrate any impact of breast implants on fertility, pregnancy or breastfeeding. However, if you have breastfed a baby during the year preceding the breast augmentation operation, lactation may occur for a few days following the surgery.

Do the breast prostheses have a negative impact on mammography?

There is no evidence to suggest that breast implants cause breast cancer but prostheses may require a change in the mammography technique used for cancer screening. If you want to have a mammography as part of your routine controls, please consult a radiology center which employs technicians who have experience in the special techniques that provide the kind of x-rays that is suitable for patients who had breast implants. With some of the women with breast prosthesis, the procedure called ultrasonography may be of assistance in evaluating the lumps in the breast or the condition of the prosthesis.

Breast Lift

Women’s breasts loose performance by factors such as pregnancy, breastfeeding, and gravity over the years. Breasts often lose their shape and firmness and start sagging when the skin begins to lose its elasticity. Breast lift surgery or so-called breast reduction or mastopexy is a procedure which raises and reshapes the sagging breasts – at least for a while.

Breast lift surgery can also reduce the size of the dark-colored tissue surrounding the nipples, i.e. areola. If you have small breasts or have lost breast volume due to pregnancy, then mastopexy combined with breast implants can increase both firmness and size of your breasts.

Who is a good candidate for breast lift surgery?

Best outcomes are usually obtained from women who have smaller and sagging breasts. Breast lift surgery can be performed on any size breasts.

Who can undergo breast lift surgery? And who can not?

Many women require breast lift surgery for stretched skin due to pregnancy and breastfeeding and decreased breast volume.

How should I prepare for the surgery?

You have to stop smoking and taking blood thinners before the surgery. If you are a smoker or on a medication, you must share this information with us during the planning stage of the operation.

Where can I get a breast lift surgery?

Breast lift surgery should be carried out in an operating room setting at a general hospital.

Do I need to get an anesthetic for the breast lift surgery?

In most of the breast lift surgery general anesthesia is a must and patient sleeps through the operation. With some patients, particularly when a smaller incision is being made, local anesthesia and sedation together might be enough. You will be sleepy and relax but will not feel pain or discomfort during the operation.

How long does the surgery usually take?

Breast lift surgery lasts for 1.5 to 2.5 hours depending on the procedure.

What is the process of a standard breast lift surgery?

Although there are several methods for breast lifting, the most common technique is starting with a keyhole-shaped incision along the natural contours of the breast. The incision will be on the outline area where we are removing the breast skin and define a new location for the nipple. When we remove the breast tissue, nipple and areola will locate to a higher position. Then the skin surrounding the areola will come down and together reshape the breast. Sutures are usually terminated in a vertical line around the areola, extending downwards the nipple. The inverted “T” scar is avoided except for very large breasts.
For some patients, particularly those with relatively smaller breasts and minimal sagging, modified techniques which require smaller incisions help to decrease the trauma of the surgery. One of these techniques is; ‘periareolar mastopexy’ in which circular incisions are made around the areola, and a circular strip of skin is removed.

Breast Lift with implants?

Yes, implants can help to increase the size and helps lifting effect in the breast lift surgery. If we use breast implant with the breast lift surgery we will place the implant under the breast tissue or deeper under the muscle of the chest wall.

Will I stay at the hospital after the surgery?

You may need to stay overnight in the hospital following the surgery. If we your health condition is not adequate or you are not feeling well then we keep yo one more day in the hospital.

Is breast lift surgery a painful procedure?

You may have bruising, swelling or discomfort for a day or two after the breast lift surgery, but you shouldn’t expect severe pain. Medications will be sufficient to relieve any discomfort you may have.

What should and shouldn’t I do after the surgery?

You will need to use an elastic bandage or a surgical bra over the surgical pad following the surgery. After 3 days surgical assistants will remove the bandages and surgical bra will be and replace with a soft supporting bra. This surgical pads will stay for 3-4 weeks. As your surgeon used internal stitches, you can take a bath even 5 days after the surgery.
If your breast skin gets very dry after the surgery, you can apply a moisturizer several times a day. You should pay attention not to pull hard your skin while applying the moisturizer and keep it away from your suture areas.

How long will it take to go back to my normal life?

Recovery takes time and gradually you will heal in couple of weeks. You may return to work after 4 or 5 days. Patients should avoid lifting anything over your head for three to four weeks. You may need to avoid sexual intercourse at least for a period of one week. Similarly, you need to avoid strenuous activities for one week.

Will there be a surgical scar?

Breast lift surgery leaves a scar either around the areola and/or extending down from the areola. These scars are usually small, and aesthetically they tend to heal well. Surgical scars are often palpable for the first months, and they remain red. They gradually become less visible, and sometimes fading away into white lines. Fortunately, surgical scars will not be an handicap for you wearing low-cut tops.

Will I have any loss of sensation in my breasts following the surgery?

The procedure may result in differently positioned nipples or permanent loss of sensation in the breast. Some loss of sensation may occur in your nipples and breast skin due to post-surgical swelling. In general, this loss of sensation will gradually disappear within the next 6 weeks after the procedure.

What complications should I expect after the breast lift surgery?

Complications or a reaction to anesthesia may occur as with any other surgical intervention. Bleeding and infection are uncommon in breast lift surgery, but the development of an infection may widen the surgical scars.

What if I become pregnant? Can I still breastfeed?

While there is no specific risks for future pregnancies, it is most likely will stretch your breasts again, counteracting the outcomes of the surgery. However, breast lift surgery does not have negative effect on breast feeding. Your ability to breastfeed will be as it is since there is no damage on the milk channels or nipples.

Is there any risk of developing cancer with breast lift surgery?

Breast lift surgery does not increase the risk of developing cancer in both patients who underwent breast lift surgery alone and with breast implants.

Is the resulting appearance permanent?

Please keep in mind that breast lift surgery will not keep your breasts firm forever. Your breasts may sag again as a result of those factors such as gravity, pregnancy, aging, and changes in your weight. Women who have implants combined with breast lift surgery may have better outcomes.

Breast Lift with implants

A breast lift with implants combines two surgeries into one.
A breast lift, also called a mastopexy, is when a plastic surgeon lifts and reshapes the skin and tissue of the breasts to give them a more lifted and round appearance. With implants or breast augmentation, the breast is enlarged by placing silicone or saline implants into the breast.
In a combined procedure, not only are the breasts lifted, but also enlarged.

How does a breast lift with implants work?

As women get older, breasts lose their elasticity. This can cause them to sag or droop, especially if they’ve gained or lost weight. A breast lift raises the breasts and reshapes them to be rounder.
In breast augmentation, or when you get implants, an implant is surgically placed behind each of your breasts. The implants are either behind the chest muscles or behind your breast tissue. Implants alone won’t usually lift your breasts if they are sagging.
Together, a breast lift with implants will both lift your breasts, reshape them to make them rounder, and increase your cup size.

What’s the procedure for a breast lift with implants?

The procedure can vary, depending on the size and shape of your breasts, how much lift you might need, and your implants.
Prior to surgery, a full medical history will be taken and patient education will be discussed: the risks of the surgery, what you should and should not do before and after the procedure, and when to call the doctor.
There are many different kinds of breast lift techniques, but the one that is chosen will be based on your physical exam and goals of surgery. Generally, the procedure involves the following:

The surgeon will assess and mark you while you’re standing, to see the lifted position of the nipple on the breast.
You will be given general anesthesia.
The surgeon will make an incision around the areola, extending down the front of the breast.
Your breasts will be lifted and reshaped, and the implant will be placed.
If necessary, your areolas will be moved to the correct position on your breasts.
Incisions will be closed with stitches or surgical tape.

Not all surgeons do the lift and implant at the same time. The combined surgery does present some risks to the nipple and areola, as well as wound healing. Improved techniques for the combined surgery are being developed to minimize risk.
If you do need two surgeries, the lift is generally done first, then the implants are done at a later time.

Are there risks from a breast lift with implants?

There are risks inherent in every surgical procedure.
Risks can include:

anesthesia complications
breast asymmetry
changes in nipple or breast sensation
partial or total loss of nipple or areola due to restricted blood flow to area
deep vein thrombosis (blood clots) or cardiac/pulmonary complications
fluid accumulation
infection
poor incision healing
possibility of needing revision surgery
wrong positioning of the implant

Along with the risks of surgery, there are risks with implants as well. These risks include:

implant leakage or rupture
wrinkling of skin over the implant
thickening of scar tissue around the implant
anaplastic large cell lymphoma
severe muscle and joint pain
cognitive difficulties
fatigue

What to expect after breast lift with implants?

After your surgery, you will be groggy and tired due to the anesthesia. You may have to wear an elastic bandage or special support bra to support your breasts and help with healing. A drain may be placed under the skin to help with excess blood or fluid, and you will be given pain medication.
You will also be given instructions to follow after surgery, including:

how to care for your breasts and when to shower
medications to apply or take
any specific things you should look for along the incisions or with healing
which activities to avoid
when to come back for your post-op visit(s)

Gynecomastia

What is Gynecomastia

Men also have breast tissue like women, and sometimes it may be more than normal. It is a condition called “gynecomastia” as known in medicine. Men or teenagers with gynecomastia avoid shirtless activities as they feel embarrassed, which is most common among adolescents. It may result in problems such as avoiding taking shower -which is necessary after physical education classes or attending the classes. This condition does not improve with diet and exercise. Male breast reduction can only be performed by surgery. Excess breast tissue in men is removed by gynecomastia surgery, which offers a permanent solution to a permanent problem.

What causes gynecomastia?

Gynecomastia is generally related to hormones. Men with excess breast tissue have higher levels of estrogen, i.e. the female hormone. The hormonal imbalance occurs naturally at specific time periods. Specifically, it often occurs during adolescence and in the old age when levels of testosterone hormone, i.e. the male hormone, are lower than estrogen hormone. Although these hormonal imbalances are temporary, they can lead to distress, particularly in young men.
Accumulation of fat in the chest area may also look like breast tissue in obese people.
Some conditions and use of some medications can also be associated with gynecomastia.

Are there any other men who have this problem like me?

Gynecomastia is not an exceptionally rare condition. Among older men and adolescents, approximately one out of three men suffer from this condition.

Who can have gynecomastia surgery?

Surgery is not recommended for gynecomastia during adolescence since it is usually temporary during that period. We initially recommend to have hormone tests and come back if the condition still persists by the end of adolescence.

It is possible to treat gynecomastia without surgery?

Gynecomastia is not a condition that can be changed by diet or exercise. Surgery is the only treatment option.

How should I prepare for the surgery?

If you are taking a blood thinner, you should share this information with us during the first consultation, and discontinue it before the surgery.

Where can I get male breast reduction surgery?

Gynecomastia surgery should be carried out in an operating room setting at a general hospital.

Will I be given anesthetics?

Gynecomastia surgery is usually performed under general anesthesia.

How long does the surgery usually take?

Gynecomastia surgery lasts for 1 to 2 hours depending on the procedure.

What kind of a procedure is performed during a male breast reduction surgery?

If enlargement of your breasts is only associated with excess fat, then liposuction alone can be sufficient. Liposuction is a removal of excess fat by a suction technique where a pipe is inserted through a small incision. However, if it is accompanied with increased breast tissue, then removal of the excess breast tissue is also required. In that case, it is removed by an infraareolar semilunar incision.
Liposuction and the open incision can be combined depending on the patient’s status.

Will I be admitted to the hospital after the surgery?

Patients are usually discharged on the day of operation after male breast reduction surgery.

Is gynecomastia surgery a painful procedure?

The patient will suffer some pain due to the liposuction procedure, otherwise, male breast reduction surgery is not a painful procedure. The pain will be relieved by oral painkillers.

What should and shouldn’t I do after the surgery?

Gynecomastia surgery is a simple procedure. The only thing that you should do after surgery is to keep an eye on your medical dressing and use a special corset to facilitate healing and reduce edema for two weeks. Apart from that, you should avoid heavy sporting activities. However, you can start other sports activities after three weeks.

Will there be a surgical scar?

There will be no visible scar if gynecomastia surgery is performed with liposuction technique. If it is performed by using an open incision, then there will be a hardly visible scar around the areola, which will go unnoticed owing to the skin color in this area.

When can I go back to my normal life?

You can go back to your normal life within 2-3 days after the gynecomastia surgery.

What complications are expected after the gynecomastia surgery?

You may have swelling and bruises in the operation area for some time following the gynecomastia surgery, however, it is all temporary. Hemorrhage or infection is very unlikely after the surgery.
Sometimes there may be some irregularities like depression and waviness as a complication of liposuction, but they can be overcome by a good planning.

Is the resulting appearance permanent?

The result after gynecomastia surgery is usually permanent except for excessive weight gains.

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