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Breasts are structures that complete the physique of the womans body appearance. Breast volume has an important place in the measurements of shoulder width, chest circumference, waist and hip circumference. In these measurements, when the breast volume is small, the body shape appearance is incomplete. One or both of the breasts may be small or asymmetrical for different structural reasons. Or it may not be one at all. Today, there is no other option other than silicone prostheses to make both breasts equal or increase their volume. Breast augmentation surgeries have been tried with the persons own tissues, but have not yielded results. The main ingredient in breast prostheses is the silicone on the outer surface of the prosthesis. Only the filler can be different. Each prosthesis has its own advantages and disadvantages. These should be discussed in detail before the operation and it should be decided together which one to use.


What is a silicone breast prosthesis?

Silicone prostheses, which started to be used in the 1960s, are still widely used today. Today, more than 2 million women in the USA carry silicone breast prostheses. In the last 20 years, significant innovations have been achieved and scientific studies have shown that silicon is the least harmful substance to the human body. Products containing silicon are also used for other purposes in the cosmetic industry and medicine. Breast prostheses are balloon-like structures prepared in the form of breasts. They differ in content, shape, height (profile) and structure of the outer cover. There are round and drop-shaped ones called anatomical. One of them is chosen according to the situation in the womans breast. The balloon part is made of silicone; The surface of the prosthesis may be rough or smooth. However, those with rough surfaces are preferred more frequently. It can be low, medium or high profile depending on the base-to-top distance of the prosthesis. The materials filling the balloon can be silicon gel or physiological saline.


What you need to know before surgery

Before the operation, breast tissue is evaluated with radiological examinations called mammography and, if necessary, ultrasonography, in patients who will be placed prosthesis. Every surgery has general or unique risks. Edema and pain in the breast area are the postoperative complaints. Bleeding and infection due to surgery are rare conditions.


Some patients complain of increased or decreased sensitivity in the nipples or numbness around the incision after surgery. This is usually temporary. It has been suggested that against the prosthesis, which is a foreign body, some connective tissue diseases develop in the body (connective tissue disease), it is difficult to give milk to the baby, and the prosthesis causes cancer. However, none of these have been scientifically proven.


In breast augmentation surgery, there may be problems related to the prosthesis, since the enlargement of the breast can be achieved with a foreign substance for the body. Contracture may develop due to the development of a membrane called capsule around the prosthesis. This capsule can be of different thicknesses. The thin capsule does not cause any problems, if a medium-thick capsule forms, a slight hardness in the breasts and a distinctiveness at the base of the breast can be noticed. In rare cases, the body may not accept this foreign substance, it forms a thick capsule around the prosthesis, tries to compress it, trap it, and sometimes throw it out of the body. In case of thick capsule formation, hardness and sometimes asymmetry can be seen in the breasts. In case of mild and moderate capsular contracture, external massage and, if necessary, additional surgeries can be performed to remove the capsule around the prosthesis. When severe capsular contracture occurs, there is no other option but to remove the prosthesis.


Although the outer surface of silicone prostheses is very thin, they are highly resistant to external impacts. Normal and moderate massages do not hurt. The person can lie face down 2 months after the surgery. Occasionally, leakage of the prosthesis contents out of the balloon can be seen. If a gel-filled prosthesis is used, these substances leaking into the tissue spaces may cause mass formation. It is not yet known how soybean oil works. If saline-filled is used, the saline filled in the prosthesis may leak out of the prosthesis, into the tissue spaces, in this case the leaked serum is quickly absorbed by the tissues without causing any harm to the body. In fact, this substance, which can be given intravenously and used for other treatment purposes, has no harm.


Prosthesis rupture is a rare condition, it can occur with jams, falls from height and penetrating injuries, as in in-vehicle traffic accidents. In such a case, the content of the prosthesis becomes important. If the prosthesis inflated with saline is used, there is nothing to be afraid of.


It is known that the evaluation of mammography images to be made later on breasts with prosthesis will be difficult, early mammographic findings of breast cancer may be overlooked, or the prosthesis may cause additional images because it acts like a foreign body. However, with the recent developments in mammography techniques and the use of MRI (magnetic resonance imaging) in breast examination, these concerns have disappeared. It is recommended that control mammograms be performed in centers with experience in examining breasts with prosthesis in patients who have undergone breast augmentation surgery. If cancer develops in a breast with a silicone breast prosthesis (the risk of developing cancer is the same as breasts without a prosthesis), surgery and other forms of treatment for cancer are applied in line with the standards.


Operation

The operation is performed under general anesthesia in the operating room under hospital conditions.1-1. It lasts for 5 hours. It leaves a trace according to the place opened for the prosthesis to be placed. Under the breast fold, armpit. It can be entered from the edge of the nipple. It has been reported that it can be placed by entering around the navel recently. However, this method has not been accepted yet. No matter where the entrance is, traces remain. These are the scars that are obvious at the beginning and become vague over time. The surgical scar is adapted to the junction of the brown nipple skin and the light-colored skin, and becomes completely obscure over time. The prosthesis can be placed behind the breast tissue or behind the chest muscle. Every application has its advantages and disadvantages.


Postoperative

Post-surgery is usually comfortable. Pain is very little. If the prosthesis is placed under the muscle, there may be limitation in arm movements for a few days. A bra-like wrap is applied on the breasts. A separate dressing is put on the nipple. The dressing is opened after 2 days and the wound is controlled. After 7 days, the dressing is opened. The sutures are removed after 7-10 days. The patient is dressed in a sports bra for 6 weeks and massage is recommended. There may be swelling in the early period, numbness on the nipple and purplish discoloration on the skin. These go away on their own in a short time. The patient can return to work in 3-4 days. It is recommended to stay away from heavy


The operation is performed under general anesthesia in the operating room under hospital conditions.1-1. It lasts for 5 hours. It leaves a trace according to the place opened for the prosthesis to be placed. Under the breast fold, armpit. It can be entered from the edge of the nipple. It has been reported that it can be placed by entering around the navel recently. However, this method has not been accepted yet. No matter where the entrance is, traces remain. The surgical scar is adapted to the junction of the brown nipple skin and the light-colored skin, and becomes completely obscure over time. The prosthesis can be placed behind the breast tissue or behind the chest muscle. Each application has its advantages and disadvantages.


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