BREAST ENLARGEMENT (AUGMENTATION MAMMOPLASTY)

The condition

Size and shape of the female breast can be enhanced, asymmetries and moderate skin laxity following large weight loss or breast feeding can be easily corrected by insertion of breast implants.

Treatment options

Breast enlargement surgery is usually done to enhance proportional but smaller than average breasts. The patient needs to openly discuss his or her expectations with the surgeon, however one has to keep in mind that the outcome to be expected is improvement of the present condition and not achievement of a perfect condition. Breast augmentation can change the body contour, enhance your appearance and your self-confidence. Implants developed in the mid 1960s were elastic bags filled with silicon gel. Advances in medical research and technology led to the appearance of double lumen (silicon gel-filled inner and an outer shell that can be filled with saline) implants. The surface of the implants may be smooth or textured to various extent. Patients want to either correct the above mentioned abnormalities or replace their implant with a larger one. Sometimes the implant has to be replaced because of connective tissue reaction or because it has been in place for too long. With the modern materials and surgical techniques used today pregnancy and breast feeding are possible in the presence of breast implants.

One day surgery

"One day surgery" means, that patients can leave the outpatient center on their own feet, accompanied by an escort, within 24 hours of surgery (usually after few hours of observation), and continue the healing process in the familiar confines of their own home. "One day surgery" requires strict professional, social, and various other preconditions that are discussed at the stage of the consultation when the need for surgery becomes clear. (i.e. good general health, absence of serious systemic disease, patient must take responsibility for arrangement of transportation and home care, must have phone to contact the clinic or the surgeon if necessary, etc).

Preparation for surgery

The patient is evaluated by the plastic surgeon prior to the procedure. After the exam the surgeon discusses options with the patient that might affect his or her decisions with regard to the surgery (the desired change in size or shape, etc.). Then we inform the patient whether he or she is a candidate for one day surgery. At this point we also discuss one day surgery as a special treatment option, the lab tests and other accessory studies (i.e. laboratory, medical) that are necessary, types of surgical anesthesia,the size, shape, type of the implant to be inserted, possible complications, home care-related issues, phases of healing, in one word, all the information that is necessary for the patient to determine which treatment option to chose.

The procedure

On the day of the surgery, the patient signs the consent form, the necessary lab tests are done and the fee for the procedure is paid. Immediately before surgery the patient is premedicated with an injection containing analgesics and sedatives. The surgery may be done with local, spinal or under general anesthesia. local anesthesia means infiltration of the surgical field with 1% Lidocaine. The 4-5 cm incision can be made in the crease below the breast, in the armpit or across the areola. In the pocket that is created for the implant we frequently place drain tubes to allow the serous secretions to escape; these are removed the next day. The implant is inserted between the breast tissue and the pectoral muscle. Then the wound is closed in layers, skin closure is always done with cosmetic sutures. At the end of the procedure pressure dressing is applied to the chest.

Possible complications

No doctor can guarantee an absolutely complication-free procedure. Complications may occur despite maximum care. Possible early complications: seroma, hematoma, postoperative bleeding, significant blood loss, possibility of transfusion-related complications, inflammation, damage to vessels and nerves, vasculitis, pulmonary embolism, fat embolism, skin necrosis if recognized early, are well treatable. Postoperative observation serves to recognize these complications. If at home, after leaving the clinic, you notice the slightest sign of complications you should call your surgeon immediately who will provide treatment for the complication. Late complication is excessive scaring or keloid formation. The latter can be resolved with injection treatment within 3 months after surgery. Esthetic complications: uneven surface contour, asymmetry, change in skin color may be avoided with correct surgical technique. This procedure like other surgical interventions carries risks, but is very commonly performed in our clinic and our patients always leave satisfied. Capsule contracture is the most common complication of breast augmentation surgery. This occurs because the body forms a strong connective tissue capsule around the entire surface of the implant in defense against the foreign material. This can later shrink, squeezing the implant, making the breast tight and rigid. This phenomenon may occur any time after the procedure. Sometimes it happens a few months after surgery, but it may present even after several years. It may affect one or both sides. Since the exact cause of the development of the capsule is not known there are no effective measures available for prevention or remedy. In severe cases incision and surgical removal of the capsule may be necessary.

Postoperative care

The procedure is usually followed by observation for 6-8 hours. During this time the vital functions (blood pressure, urine) stabilize, effect of premedications wear off and the patients can leave the clinic on their own feet. After general anesthesia the observation period increases to 16-18 hours. An elastic dressing is placed after surgery that the patient has to wear for one week. Pain relief is necessary for a few days after surgery. Strenuous physical activity needs to be avoided during the first week but continuous bed rest is not necessary. After the first week the tight dressing may be changed to an elastic sports bra that has to be worn for five more weeks in order for the implant to stabilize in the position it was placed during surgery. Sutures are removed after two-three weeks. For 2-3 weeks after the procedure the breasts may feel tight until the patient gets used to the extra tension and weight caused by the implant. We see patients back regularly for follow up and during these visits the actual management issues are discussed like when and how to start post operative massage one of the most proven measures to prevent the development of capsular contracture.

Fees

Exam and consultation: 10.000 HUF > Euro
Surgery in local anesthesia: 680.000 - 870.000 HUF (Fee plus materials for medium sized, excellent quality American implant) > Euro
General anesthesia: 80.000 HUF > Euro
One overnight stay: 30.000 HUF > Euro

50% of the total cost has to be paid as a deposit before surgery.
These prices are only representative, the final amount will also depend on the severity of the condition.

Appointments: Monday - Friday, 8 am - 8 pm.
Telephone: + (36 1) 266 7766