Breast Augmentation
Breast augmentation is a technique that enhances the figure of the breast and is able to achieve the shape and volume of the breast according to the anatomy of each woman. As a Plastic and Aesthetic Surgery clinic, with our specialist Dr. Miguel Fernández Calderón we offer breast augmentation in Madrid.
How breast augmentation in Madrid is performed
This surgery can be carried out using two techniques: the implantation of cohesive silicone gel prostheses or by means of autologous fat grafting or lipofilling.
The scar and incision in breast augmentation
To carry out breast augmentation we need to make a scar to insert the prosthesis. This can be located in the submammary fold, through the lower part of the areola or in the armpit.
- When it is necessary to reduce the size or treat deformities of the mammary gland such as tuberous breast, the areola is the precise incision site.
- Incision in the submammary sulcus is the best option when this sulcus is very marked and the breast has an adequate shape. Over time this incision is virtually invisible.
- Another possibility is the incision in the armpit for breast augmentation in Madrid. The mark is thus lodged outside the breast, in an axillary groove. So it is barely noticeable, months after the operation. This is the ideal incision for patients who are very concerned about the scar or who have poor quality scars.It is especially indicated in patients with very small breasts, in which the groove of the breast is poorly defined, as the scar in the submammary groove or in the areola will be very visible and may worsen the aesthetic result of the operation.
How long does the operation last?
The operation lasts approximately 2 hours and a general anaesthetic is used, usually with a one-day hospital stay. It involves 5 to 7 days of moderate discomfort.
In addition, it is necessary to wear a non-wired bra for the first month. During this period, sporting activities are limited.
The duration of the breast augmentation with lipofilling in Madrid is approximately 3 hours and general anaesthesia is also used. Normally the patient stays in hospital for one day. The patient must wear a compressive garment on the liposuctioned areas for one month. Professional and sporting activity can begin once the discomfort of the first 5-7 days has passed.
Breast augmentation with body fat
Breast augmentation with body fat is an option. Autologous fat grafting, or lipofilling, consists of the extraction of the patient’s own fat. It is performed using a liposuction technique. This fat, after being properly treated and processed, is infiltrated to increase the volume and improve the shape of the breasts.
The advantages of this technique are the improvement of the body contour, the absence of scars and the possibility of improving the appearance of the breast with the patient’s own fat. It is a procedure that is increasingly in demand by our patients for breast and buttock augmentation.
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The first decision
The first decision is which approach (scar) to use to insert the breast implant. We have three options, the submammary fold scar, the periareolar scar and the axillary scar.- When the breast has a nice shape, no treatment of the mammary gland is necessary. In this case the aim of the procedure is only to enhance it. The patient has the possibility to make this decision completely independently. However, my advice would be to use a scar outside the breast, the axillary scar. This also allows us a quicker recovery, as the care of the scar is minimal as it is in an area of minimal aesthetic importance.
- If the breast has a shape that we want to improve (tuberous or caprine breast) or a symmetrisation in the size or position of the areolas is required, sometimes it is necessary to treat the gland. In this case we will need an approach that allows us to do so, which is undoubtedly the areolar approach. In this situation, the specialist's recommendation is essential and the patient generally takes advice in order to achieve the best result. The areolar scar is normally located in the lower part of the areola. But occasionally, it is enlarged to modify the size and position of the areola.
- Finally, I advise the approach through the submammary fold when it is very marked. And we have enough skin from the nipple to the sulcus for the scar to be quickly hidden. This scar is the most used by the majority of surgeons who do not use the axillary approach. But it has the disadvantage that it is sometimes visible. And if over time a replacement of implants is needed to have more volume (this is the most frequent reason for reoperation in the first 5 years) it will become even more visible.
Both axillary and submammary approaches have the advantage of keeping the mammary gland intact for breastfeeding. And, when there is no improvement to be made to the areola or the gland itself, they are usually preferred by my patients. Although these are cases where my advice is secondary and the decision will be made by the patient.
The second decision
The next decision is in which plane to place the breast implant. Below or above the muscle (subpectoral or subglandular). This is a very important decision in the short term and even more important in the long term.
Placing the implant in the subglandular plane has short-term advantages, in that the postoperative period is much less uncomfortable and recovery is quicker. In the long term, the advantage is that the mobility of the implant, with pectoral contraction, will be less apparent than with submuscular implants.
There are centres that take advantage of this strategy to also perform the operation under local anaesthesia and thus reduce costs. Of course, this is not an advantage and may involve certain risks.
Short – term disadvantages
The main disadvantage of placing the implant in the subpectoral plane is that recovery from breast augmentation surgery takes a long time. The discomfort is somewhat greater in the first few days, but in the long term the advantages are numerous.
Firstly, the visibility of the implant in the upper pole is reduced, making the result more natural. Secondly, it reduces the rate of the dreaded capsular contracture making it almost non-existent. And thirdly, it makes the long-term result more stable.
Long-term disadvantage
The only “disadvantage” in the long term is that there is always some mobility of the implants with the forced contracture of the pectoral muscle. But of course, nobody performs this procedure under local anaesthesia.
97% of my breast augmentation patients in Madrid have the implant under the muscle and only 3% above. And only 3% above. The latter are patients who have enough glandular tissue to cover the implant and very good quality skin. They also choose small implants for their augmentation and are very fearful of the postoperative period.
This is despite the fact that the discomfort with good analgesic control in the subpectoral augmentation is quite manageable. And they also allow a return to work within 3 to 7 days depending on the type of activity.
The third decision
The third decision is the most important: choosing the breast implant or breast prosthesis. What your new breast will look like will depend on the initial condition of your skin, your mammary gland, the shape of your chest and, above all, the type of breast implant you choose.
We will have to choose the type of implant, its volume and projection.
We have two main types of breast implants, the anatomical or drop-shaped breast implant and the round breast implant. The anatomical breast implant is narrower in the upper region and wider in the lower region, so it provides more volume to the lower region of the breast. In addition, the inner gel is usually more cohesive than in round implants.
The round breast implant
The round breast implant distributes its gel equally in the upper and lower region of the implant. Compared to the anatomical breast implant, it therefore provides more volume in the upper pole. Generally, the round prosthesis provides more filling in the upper pole of the breast. And it also offers the possibility to enhance a beautiful starting breast and make it more lush.
The anatomical breast prosthesis
The anatomical breast prosthesis provides a very natural shape to the breast in patients with a small mammary gland.
In the breasts of women who have undergone pregnancy or breastfeeding, this type of prosthesis offers a push-up effect. That is to say, if we make a small suspension of the gland, the lower filling of the
anatomical implant, allows us to lift the breast without added scars.
In the tuberous breast, the anatomical breast implant also recruits the skin we need under the areola to achieve a natural and beautiful breast.
Choosing the type of implant
The choice of the type of implant is made together between the patient and the professional, depending on the patient’s wishes and anatomy. Only in cases where the breast is slightly sagging, i.e. in the case of a tuberous breast, I try to convince my patients to use anatomical implants, because the result is a natural breast with minimal scarring.
In cases where you want to enhance the breast, in the consultation we jointly analyze similar situations with different implants. And therefore leaving in the hands of my patients the final choice.
Volume and measurements of the breast implant
In order to choose the volume and measurements of the implant and knowing beforehand the type, we will take into account above all the base of the patient’s breast.
This should correspond to the base of the implant, in most situations, with slight variations depending on the size that the patient desires. It is also necessary to choose the projection or final volume of the implant, which may be somewhat larger in patients with more excess skin (after pregnancy and breastfeeding), than in very young patients.
Very young patients, although they have a very elastic skin, will not be able to adapt large volumes of breast implants in the best conditions, because there would be a risk of weakening the skin. This would result in the implant becoming more visible and could also cause the appearance of stretch marks.
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More information about Breast Augmentation Surgery in Madrid and Albacete
Breast augmentation with breast implants in Madrid is a surgery with very satisfactory results and with very few complications.
Breast prostheses are regulated medical devices and must be authorized by the European Community and the Spanish Ministry of Health. This demand is essential to the surgeon or clinic with which the augmentation procedure is performed. And, all patients must know before the intervention, not only the type of implant or the volume of the prosthesis to be placed, but also the commercial house and the guarantees it offers.
Currently, most of the highest quality commercial houses offer a lifetime guarantee for implant rupture. This is due to the great confidence they have in the quality of the latest generation of breast prostheses.
It is impossible to ensure the durability of breast implants, but the confidence is great on the part of the same commercial houses.
All you need to know about breast implants
The breast prostheses most commonly used in Spain and the ones I always use for my breast augmentation surgeries in Madrid are composed of a silicone shell and filled with a cohesive silicone gel.
There are also other types of prostheses with silicone shell and filled with saline, whose use in Spain is very rare. The texture and non-cohesiveness of the liquid results in less satisfactory results with these implants.
Breast implant coverage can be smooth or rough (microtextured or macrotextured).
Smooth implants were the first to appear and have been in disuse in recent years. Because this type of coverage is slightly more flimsy. It was also believed to increase the rate of capsular contracture.
This has only been demonstrated for breast augmentations performed in the subglandular plane, but not for breast augmentations in the subpectoral plane.
Currently, there is a small increase in its use, since it offers, to a certain extent, more naturalness in the medium term in the result, due to the improvement of the sliding surface on the tissues.
Textured or rough implants
The textured or rough implants are the most used nowadays in Spain. And the ones I prefer for my breast augmentation procedures in Madrid. The roughness either macro or microtextured helps us to make the long-term result more predictable, since the slippage with the tissues is less.
The filler, obviously, of the implants we use for breast augmentation, is always high or medium cohesive silicone gel, depending on the type of patient.
Silicone cohesive gel
This type of gel has been a revolution in the follow-up of breast implants and breast augmentation surgery in Madrid. Currently breast prostheses no longer have to be replaced every ten years as it was said in the past. This gel tends to remain compact and even if the implant were to break, it would remain inside the implant capsule.
After 4 or 5 years, a follow-up should be started. It is done through ultrasound of the implant status. And it will only be replaced if there is any evidence that proves such rupture.
The lifetime guarantee against rupture is the best guarantee offered by the breast implant companies. This is a great example of the confidence of these companies in the integrity of these breast prostheses.
Risks and complications in Breast Augmentation in Madrid and Albacate
Making the decision to have breast augmentation surgery in Madrid is an important step. For this you must know all the information first hand, which Dr Miguel Fernandez Calderon will provide you personally.
- Cosmetic surgery provides confidence to the patient and improve the quality of life of patients through very safe and predictable procedures. But these interventions are still medical operations and as such are not exempt from the possibility of certain complications.
- There is some misinformation about some aspects related to the risks of this surgery. Breast implants, especially in the case of those behind the muscle, do not interfere with the radiological analysis of the breast. Neither do they interfere with the possibility of breast-feeding, nor have they been shown to cause any type of oncological or immunological disease. In the same way, in the axillary approach it has not been demonstrated that it produces alterations in the lymphatic drainage of the breast.
Low complication rate
- This is a really satisfactory procedure because of its very low complication rate. Breast augmentation in Madrid offers great results. But, as in all surgical procedures, some complications may occur and this is something that all patients should be aware of. We are going to explain the three complications that are relatively more frequent and more important. We will provide you with all the necessary information:
- Hematoma or hemorrhage is the most frequent immediate complication (24 hours post-surgery) (1%). Although it can appear up to a week after surgery. It is originated due to the outflow of blood from a blood vessel and is directed towards the implant cavity by degradation of the hemostatic clot or increase of arterial pressure. This is solved by draining the hematoma surgically and redoing hemostasis of the possible originating vessels.
Implant infection
- Implant infection is a very rare complication in patients undergoing breast augmentation surgery in hospital operating rooms. But the breast implant can become contaminated through a systemic infection. In that case antibiotic treatment and even removal of the implant for a limited time may be necessary.
- Capsular contracture in breast augmentation surgery in Madrid is the most important long-term complication. All external implants that are well tolerated by the body create a tissue coverage. This is to isolate them in a certain way. But sometimes there is excessive scarring of the body against the implant, which is what leads to capsular contracture. With current techniques (subpectoral) and modern cohesive silicone gel implants, this is very infrequent to occur in this type of surgery. But it may require surgical treatment. If so, the capsule would have to be removed and the implant replaced.
Learn more about our breast augmentation surgery with lipofilling in Madrid.
Breast augmentation with lipofilling
Breast augmentation with anatomical prosthesis
Breast augmentation with round prosthesis
