Breast augmentation with implants

The surgery is performed under general anaesthesia, but can also be performed under local infiltration anaesthesia. Before the surgery, the markings are made and the surgical plan is set up.

At our Silvermount Clinic we work exclusively with implants from the US-based companies Mentor and Polytech.

The implant cavity will be formed as discussed in the consultation and the implant will be inserted after thorough haemostasis and foreign body revision. The compression bra is fitted in the operating theatre. The procedure takes between 30 minutes and an hour.

You will spend one night in our clinic for observation after the surgery. This involves pain relief, applying ice packs, mobilisation and continuous monitoring of the condition.

There are a number of conditions that can occur after surgery that you should know about:

• A painful feeling of tension that decreases day by day
• Temporary discomfort, pain similar to “muscle fever”
• Swelling or bruising with a feeling of “tightness”
• Moving the arms is harder
• Itch

• The complication of the first 24-48 hours is bleeding. During the surgery, the blood vessels are closed with electric forceps, they are coagulated. Before closing the surgical site, we will of course make sure that there is no bleeding. Unfortunately, straining, coughing or a wrong move can open up an already closed vessel stump and cause bleeding, which can be so severe that the wound has to be opened, meaning that a repeated surgery is required.
• The most serious complication is inflammation. (Which can happen during any other type of procedure, whether it is a hernia surgery or a vascular surgery). The degree of inflammation can range from mild redness, which does not require any special intervention, to severe, purulent inflammation, which can lead to removal of the implant and hospitalisation.
• Complications include implant displacement, which occurs by moving upwards in cases placed under the muscle, or downwards (this also occurs in cases placed under the gland), the so-called inframammary fold, where the breast meets the chest wall, sliding downwards. The most serious displacement is called synmastia, which is the two breasts sliding together in the middle. The above changes can be corrected with further surgery.
• The weight of the implant can cause the breast to “sag” after a while.
• Abnormal wound healing may also occur, the most severe form of which is a keloid, a burning, itchy, painful, wide, red, bulging, candle-drop-like change.
• Rarely, reduced sensitivity of the nipple, areola or skin of the breast may occur, which tends to be temporary but in exceptional cases may become permanent.
• Other rare types of complications include suture hypersensitivity, local bruising, etc., which are detected and managed appropriately during post-operative visits.
• Deep vein thrombosis, embolism, death, pneumothorax.
• Subsequent breastfeeding is not affected by the implant, but a case has been described where the implantation of too much material caused thinning of the glandular tissue.
• The above complications may occur in 1-2 per cent of cases, some even less frequently.
• After the surgery, the two breasts may be different from each other, causing asymmetry. This is usually because there was a difference between the two breasts before the surgery, but it can also be caused by the implant displacements described above.
• The most common late complication is capsular contracture, which is usually 8-10%. The causes are not known, so postoperative visits are important to identify it and, if it occurs, to define the treatment.
• A thin membrane of connective tissue, a capsule forms around any foreign material that is implanted in the body. The wall of this thin shell sometimes starts to thicken and shrink around the implant for an unknown reason. This is called capsular contracture. (capsular contractura)
• 4 grades are distinguished. The mildest form, grade I actually occurs after every implantation, a certain layer of connective tissue develops around the implanted material, which is a natural reaction of the body. If there is capsular contracture, the other stages occur: grade II, when the implant is firm and hard to the touch; grade III, when it is already noticeable from the shape of the breast; grade IV, when it is also painful.
• Grades IIII-IV require surgery to remove the capsule partially or in whole, but sometimes only a circumferential incision is made to relieve the tightness.
• There is no evidence that breast implants affect women during pregnancy or breastfeeding, or that they could cause cancer.

• The patient should rest for at least 48-72 hours and avoid any kind of exertion.
• Patients usually return to normal life after 5-7 days; exercise should be avoided for the first month after the surgery.   
• Regardless of the individual, it takes 3-4 weeks to get fully used to the new breast.
• Lifting heavy objects should be avoided for 3-4 weeks, especially lifting the arm above the head in the first few days.
• For 6 weeks, a bra (usually an elastic sports bra) must be worn day and night. After 4 weeks it can be skipped at night, after six weeks it is not compulsory to wear it during the day, but it is recommended in certain cases. Later on, you can fully return to your previous lifestyle, e.g. in the area of sport.

With good surgical technique, the results are satisfactory and self-esteem improves.