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Breast operation - enlarging with implants, reducing, reinforcing

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Breast enlargement (augmentation)

Breast enlargement, known also as breast augmentation, is based on surgical insertion of implants behind each breast in order to enlarge their volume and improve shape. Enlargement of breasts is required by women, who consider their breasts as too small or sagging or in case, there is a decrease in the gland tissue, such as due to breast feeding or weight loss.

You must come fasting for the surgery (the patient should not eat, drink and smoke 6 hours prior to the surgery) in an agreed time for surgery and after general hygiene, with washed hair and without any make-up.

Operation procedure
The surgery itself lasts about two hours and it is performed in general or epidural anaesthesia. The choice of surgical approach for introduction of implants is based on the agreement of the surgeon with the patient. There are basically three surgical approaches:

- from the armpit
- around the areola
- in the submammary groove

The patient remains hospitalised in the clinic for 1 to 2 days after the surgery. Drains are removed after this time during a change of dressing and the patient is discharged to home care.

Since the wound is closed with absorbable sutures, it is not necessary to remove them. The patient should rest for 10 days and keep a regimen without any physical exertion - especially avoiding lifting things and rest sufficiently. The patient may join the daily routines in case of uncomplicated course as early as from the second week post-surgery.

Breast reduction

In adolescence or also due to pregnancy an extreme enlargement of the breast size, their hypertrophy (macromasty, gigantomasty), sometimes occurs. This condition may be resolved by a surgery, i.e. reduction surgery of the breasts, which is in principle similar to the reshaping surgery. This surgery may also reduce the size of the breast, sagging of the breast or adjust mild asymmetry. The size of areola may also be adjusted.

Operation procedure
The surgery is performed in general or epidural anaesthesia, which means that during the whole surgery the patient is sleeping and surgery lasts in average 3 - 4 hours. Areola with the nipple is moved several centimetres upwards and the breast tissue around is "wrapping" the gland body whereas the excessive skin and the actual mammary gland is removed. The cut, which is made in the breast, has a shape of a "keyhole" and the resulting scar which is created around the areola is directed downwards and than transversally in the whole submammary groove. Reshaping of the breast is possible in certain situations only from one cut around the areola but this has however certain advantages and disadvantages.

In the first hours after surgery you can experience pain which may be very well relieved by pain-killers. Breasts are covered with sterile dressing and you must stay at rest in the first days after the surgery. Dressing will be removed after several days and it will be replaced by a surgical bra. This needs to be worn exactly according to the recommendations of the physician.

It will be possible to start changing the surgical bra with normal firm bra after 8 weeks. You will probably stay in hospital for the following one or two days after the surgery.

Healing is a gradual and greatly individual process. In the first days your breasts will be swollen and you will have bruises which start to disappear quickly. Some swelling could persist for several weeks. Sutures are absorbable and it is not necessary to remove them. After a week you can return to your job again. If you perform physically demanding job, it is better to defer your return to job for few more days. It is necessary to wait for at least a month with sport and similar activities. Your nipples will be more sensitive for a certain time after the surgery.

The interventions are performed in general anaesthesia with 1 or 2 day hospitalization.

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