This surgical procedure is indicated for women with breast hypotrophy (insufficiently developed breast volume in relation to their body morphology), either innate, which manifests itself during puberty, or acquired, following significant weight loss or after pregnancy or breast-feeding. In this case, the hypotrophy is often associated with breast ptosis, which may require an associated procedure to cure the ptosis (breast lift).

THE PRE-OPERATIVE CONSULTATION :

This is essential in order to ascertain the patient’s wishes and to carry out a thorough questioning and clinical examination:

  • Obtain the patient’s medical, surgical and obstetrical history.
  • Determine breast measurements and skin quality .
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  • Choose the type of prosthesis to be fitted (“round or anatomical” shape, textured or smooth “silicone gel” type, “low, moderate or high profile” size and projection) and test the templates for the different types of prosthesis (using trial prosthesis).
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  • Choosing the right implant position depends on the patient’s morphology and the quality of the breast skin.
  • In the case of a very hypotrophic gland (just a skin lining) with no ptosis (i.e. no sagging of the breast), positioning behind the muscle (retropectoral position) is essential to ensure that the breast implant is masked by the muscle and as little palpable as possible.
  • If, on the other hand, there is breast ptosis, retropectoral positioning presents a disadvantage, as the implants will be too high and will not fill the actual breast space. In this case, we prefer to place the breast implants in front of the muscle (retroglandular or pre-pectoral position).
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  • Scar type: in the case of isolated hypotrophy, the scar is sub-mammary or inferior hemi-areolar . Other types of approach present more risk, do not allow good visualization of the area and are increasingly abandoned.
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  • Whether or not an associated procedure is necessary (in the case of breast ptosis: drooping breasts with low areola), it is preferable to reduce the skin envelope in addition to simply placing an implant. The scar will be larger: periareolar scar, vertical
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  • Detailed explanation of the procedure that is right for the patient and the post-operative course
  • Information on any complications arising from the procedure
  • Request for biological and radiological assessment

Intervention and aftercare :

  • After consultation with the anaesthetist and viewing of the check-ups
  • Procedure: In the case of breast augmentation alone, the operation lasts 1 hour; in the case of associated ptosis correction, it lasts 2 hours.
  • In some cases, the surgeon may use external drainage in the breast area, which will be removed before leaving the clinic.
  • The shaping dressing is replaced by a breast implant support bra, which must be worn for at least 4 weeks. Painkillers are also prescribed before leaving the clinic to soothe post-operative pain.
  • Hospitalization at the clinic lasts 24 hours.
  • A 7-day leave from work is recommended. Carrying heavy objects, sports activities, sun exposure and smoking are strongly discouraged for the 1st month following surgery.
  • After breast surgery, results can be appreciated from the 3rd month onwards (scars will fade, oedema will disappear and tissues will soften).

Complications

Complications of breast augmentation : Insufficient tissue coverage of the breast prosthesis, infection, haematoma, hypertrophic cicatrisation, temporary insensitivity of the areola-mammary plate, periprosthetic shell formation…

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