Breast Augmentation

Interesting facts:

The smallest implant is 50 ml. The largest is 1000 ml.
Each manufacturer has about 300 combinations. If I work with 5 major manufacturers in Ukraine, it turns out that I need to choose the best option out of 1500 possible.

How do you do this, and how do implants from different manufacturers differ from each other?
All implants are made of the same material inside - medical silicone. Moreover, there is only 1 company in the world that produces this silicone.
Implants from different manufacturers differ not in the filling of the implants, but in the outer coating and some size variations. It is the roughness of the implants that is the subject of international patents.

The type of coating largely determines which implant is better to choose in a particular case - more rough, or vice versa - smooth.
Each implant should solve a specific task - preventing repeated prolapse, fixing the shape of the breast, filling, aesthetic aspects, and much more. The doctor, not the patient, should determine which implant is better to choose. Since only a doctor knows which of the 1500 available options will ideally solve one very specific problem.

In order to choose the right implant, you need to assess the condition of all tissues, take measurements, think about the possible development of events in view of chronic diseases, and of course - take into account the wishes of the patient.
But since

I am responsible for the outcome of the operation, I still have the last word. Although the patient always receives 2 equivalent alternatives in terms of aesthetics of the result - one is a little more expressive, the other a little more modest.

As one of my colleagues, a professor from London, used to say, plastic surgery is a craft surgery. Each doctor presents a beautiful breast and an attractive woman in his or her own way.

For me, it is natural proportions and a natural result. For other surgeons, a beautiful woman is a woman with very outstanding forms. Based on their sense of beauty, the doctor determines the type of implant. And here it is important that the doctor's and patient's ideas of beauty coincide.

Each manufacturer has more than 300 different implant options in terms of shape - round or anatomical, surface - smooth or textured, profile - low, medium, high, extra-high. Only a doctor with extensive experience can choose the right option.

This topic was especially relevant at all world congresses. As Patrick Malucci, a plastic surgeon from London, noted, this issue is “a struggle between science and the media.” This is because some journalists and bloggers have started to create outright hysteria around this issue.

So, what is the connection between implants and cancer?
According to international data by Professor Per Hadden, out of 35 million women who have undergone mammoplasty, only 17 deaths from anaplastic large cell lymphoma associated with implant placement have been reported. Thus, the mortality rate is 0.000049%.

If we consider the risk of death from implant placement, it is 0.4 micromortes (a unit of risk of death). For comparison, 2 days of life in New York is 2 micrometers, 2 hours of driving is 16 micrometers.

These cases were registered in patients who underwent both reconstructive and aesthetic surgeries 7-9 years ago. Experts note that the development of this type of cancer is influenced by geographical factors and the race of patients. But not only them. For example, in Australia, one doctor has registered as many as 8 cases of lymphoma associated with implant placement. This makes us think about the quality of the doctor's work - whether he chooses the right technique, whether he follows the rules of asepsis and antisepsis, in what conditions the operation itself takes place, what drugs are prescribed after the operation and what recommendations the doctor gives the patient for the rehabilitation period.

At the congress in Düsseldorf, we came to the conclusion that anaplastic large cell lymphoma can develop due to foreign microorganisms on the implant. They “hide” in the textured surface, the body tries to fight them, but over time, the infection that gets on the implant degenerates into this type of cancer.

I am sure that this issue will be considered and researched for a long time. But there is one important piece of advice I would like to give to all girls. Take the choice of clinic and doctor very seriously - not only your appearance, but also your life depends on their qualifications and skills.

How do you take care of scars? First of all, you need to follow my instructions and come to me for check-ups at the appointed time. It is during the examination that I can see if everything is going according to plan or if additional actions need to be taken.
But just in case, I also asked Maria Trifonova, Doctor of Aesthetic Medicine.

“One of the most popular myths about working with scars after plastic surgery is that you can't touch the scar until it matures, and only after 6 months can you start doing anything with it.
When should I start dealing with postoperative scars if the healing process is impaired?

Signs of abnormal scar growth can appear as early as 3-4 weeks.

What should you pay attention to? The appearance of additional sensations in the scar (itching, pain), increased brightness, hyperemia, stagnant bluish color indicate that the scar is beginning to grow actively, although it should gradually fade.

In this case, it is necessary to use therapeutic procedures that help to restrain the growth of the scar. The sooner you start this fight, the easier, faster and cheaper the treatment will be. And the better the final result will be.

This does not mean that if 2 weeks have passed, it is time to intervene in the scarring process. But if the patient was told to wait for the final result for six months, then he or she will come to the aesthetician in six months. And the scar, in the presence of the above symptoms, can grow significantly during this time.

Some operations are not without strong tissue tension: in the T-shaped suture after anchor mastopexy, in the sutures after abdominoplasty. It is this tension that can cause increased growth of scar tissue: connective tissue grows in an effort to close wounds faster and restore the integrity of the body. This is the law of pathophysiology: if the functional tissue does not have time to grow, the connective tissue will grow.

Such areas can become not only red, but also have a stagnant bluish tint, as the vessels sprout very actively, and the outflow of blood is difficult. Prolonged congestive hyperemia in a large percentage of cases will lead to hyperpigmentation.

In my practice, we actively use laser correction methods from 3-4 weeks after plastic surgery.
We are armed with the CANDELA fractional CO2 laser, the M22Lumenis vascular photosystem, and the Picoway CANDELA favorite. We combine all three lasers perfectly in the fight against scars after plastic surgery. We use the CO2 laser for resurfacing once every 2 months, and the Picoway laser for resurfacing pigmented scars once every 4-6 weeks.

But we do not forget about injection techniques. Botulinum toxin and enzyme injections always accompany laser therapy.”

Breast augmentation and sex. When can I have sex after surgery? I advise my patients to wait at least 2 weeks. This is my personal recommendation, and I insist on it.

But I also decided to ask what other doctors think about it. For example, Elena Berezovskaya, an obstetrician-gynecologist, researcher, and bestselling author on women's health, who now lives between Toronto and Kyiv.

Olena Berezovska says the following:

“Any surgical intervention is accompanied by a period of recovery and resumption of the activities that a woman was engaged in before the operation, including sexual activity. In the normal course of the postoperative period (no fever, severe pain, swelling of the postoperative wound, etc.), sexual intercourse can be resumed with caution after a week.

If a woman feels weak and is not mentally ready for sexual intercourse, sex can be resumed in 2-3 weeks. It is important to choose positions that do not cause discomfort to the mammary glands. The sexual partner should follow all safety precautions so as not to cause additional injury to the breast.

Stimulation of the nipples, especially with the lips and tongue, is strictly not recommended until complete recovery.

If any complications were observed after the operation, you should consult your doctor about when you can start sexual activity.

It is extremely important to think about reliable contraception, as it is not advisable to plan a pregnancy for 1-3 months (depending on the type and extent of the surgery). It is always advisable to discuss this issue with the doctor who performed the surgery.

Rumors that orgasm is dangerous and can harm after surgery are not justified and belong to the category of myths. Orgasm does NOT lead to a deterioration in the condition of the breast. BUT it is important that it is not caused by nipple stimulation. Some women after surgery MAY experience breast pain during orgasm, but it is short-lived and usually goes away in a matter of days.”

I know firsthand that after surgery, sex becomes especially attractive - for both men and women. But - be careful and cautious. It is better to be patient for 2 weeks.