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Breast Augmentation

General

Nowadays, breast augmentation is among the most popular procedures of plastic surgery.

The breasts have always been considered as one of the stronger elements of femininity. Therefore, women who do not have the appropriate breast size for any reason may feel less favoured compared to other women in terms of femininity and might develop feelings of intense inferiority that may reflect on their overall behaviour and personality. These women may have small or aplastic breasts, breast asymmetry or may have undergone a mastectomy. We can help these women through a breast augmentation procedure.

Which breast augmentation techniques are applied in modern plastic surgery?

  • Non touch - No pain Technique
  • Dual plane technique
  • Subfascial technique

What can we promise? What are our goals?

The goal is to increase the breast's volume using silicon implants in such a way as to obtain a natural result in harmony with the patient's body characteristics.

However, the new techniques introduced in breast augmentation and proposed by us for achieving the most natural results are: the subfascial technique where the implant is placed under a thin membrane that covers the muscle and is called fascia and the Two Level technique where the implant is found half under the muscle and half under the muscle fascia.

See all videos on breast augmentation.

Careful planning as to the type and volume of the implant, before surgery.  The plastic surgeon performs 5 important measurements of the patient's chest.  The patient then tries on the silicon implants.  This is very important since the patient will be able to have a good idea of what her breast will look like after surgery. Therefore, the patient's will in combination with the measurements of her chest define the type of implant and, most of all, its size.
A number of lab tests are performed before the procedure, usually including the following: full blood count, coagulation test and heart examination, chest X-ray and mammography, if the patient is older than 35. However, in case of specific problems based on the patient's medical history a relevant examination must be carried out before surgery. In general, patients are advised to stop taking any vitamins, refrain from smoking and alcohol and avoid aspirin for 1-2 weeks before the procedure as well as after. A healthy diet and everyday habits without exaggerating practices may contribute to a better and faster recovery.

Type of anaesthesia

The most popular type of anaesthesia is general anaesthesia, however, especially in new techniques mentioned above may also be carried out with local anaesthesia with or without a sedation combination.

How long does the breast augmentation procedure last?

The procedure lasts approximately 1 hour and overnight stay at the hospital is not usually necessary.

Recovery time

Surgery is followed by a mild oedema that subsides after 3-10 days.. The patient may resume her daily activities almost immediately except intense exercise and weight lifting. Depending on the type of work, the patient may go back to work in 7-10 days.
Due to the atraumatic technique no breast drains (tubes) are required, or compression garments around the chest. No compression garments around the chest; no restrictions in arm movements. Patients shall be well able to raise their hands high immediately after surgery.
All this combined with perfect anaesthesia result to minimum feeling of nausea or vomiting after surgery.

Scars

As mentioned above, incisions may be made either under the breast or the armpit, or around the nipple. If everything goes well during recovery and in a period of 6-12 months incisions shall appear as thin lines almost invisible.
Duration of result (e.g. 5-8 years, life etc.) Implant manufacturers give implants 15-20 years of useful life. However, in practice, we have seen implants that last much longer than 20 years.

Possible complications

A candidate patient must be informed about implications even if these are rare. More specifically, there is a <1% chance of haematoma or inflammation, while a capsular contracture is between 1-5%. There is also a slight chance of alteration of the nipple appearance which shall return to normal after approximately one year.

Non touch - No pain Technique

 

Θεαματική Aνάρρωση μετά από Αυξητική Στήθους

The greater public has the impression that breast augmentation is followed by pain that lasts for 2-3 weeks, compression garments or suffocating bandages, tubes inserted in the breast, bruising around the chest and long stays in bed. And if all this used to be true, it is now all left to the past.

So what would you think of the idea of almost pain-free breast augmentation, without tubes, suffocating compression garments around the chest and movement restrictions? Is it too good to be true?

Well, no matter how hard to believe, modern techniques allow 90% of the patients who have been submitted to breast augmentation to resume regular activities 24 hours after the procedure.  Forget narcotic analgesics, tight compression garments around the chest, drains or special bras that press against the breast.  You may also forget bruising and breasts that make you look like a beating victim.

How is this possible?

This is not an exaggeration and of course it didn't happen all of a sudden. The technique was developed and published in 2002 in the best plastic surgery journal by Tebbetts, a plastic surgeon in Dallas, Texas.  So what is it that makes the difference? The secret unveils below:

A. Before breast augmentation surgery.
Careful planning as to the type and volume of the implant, before surgery.  The plastic surgeon performs 5 important measurements of the patient's chest.  The patient then tries on the silicon implants.  This is very important since the patient will be able to have a good idea of what her breast will look like after surgery. Therefore, the patient's will in combination with the measurements of her chest define the type of implant and, most of all, its size.

B.  During breast augmentation surgery.
It is reasonable that the less we injure the tissues during surgery the less bleeding is caused and of course best recovery is achieved.  This is the plain secret of this technique.  Using specially designed tools, we prepare the pocket for the silicon implant inside the breast with a FULLY atraumatic method (almost no blood is lost during surgery). This results to minimum injury of the tissues. A minor surgical trauma means minimising pain after surgery as well as minimising ecchymosis (bruising) after surgery. The standard principle of this new technique is that the surgeon must fully avoid using his fingers to create the pocket since he may cause extended injury or bleeding of the tissue that will lead to intense pain or slow post-surgery recovery.

C. After breast augmentation surgery.
Due to the atraumatic technique no breast drains (tubes) are required, or compression garments around the chest,  or restrictions in arm movements. Patients shall be well able to raise their hands high immediately after surgery.
All this combined with perfect anaesthesia result to minimum feeling of nausea or vomiting after surgery.

So, what do we achieve with this new breast augmentation technique:
This technique is characterised by accuracy and high respect for the tissues. Thanks to careful planning before surgery and the fully atraumatic technique, our patients may go back home safely 6 hours after surgery.
Since there are no tubes, compression garments or surgical bras, the patient may move around freely. She may go out for dinner on that same day or drive 2-3 days after the surgery.

What is also important, if not most important, is that this technique reduces immediate as well as long-term complications of the surgery. Thereby, in a recent analysis of the results of 1250 breast augmentation procedures during the 11th Congress of ESPRAS in Rhodes, haematomas were 0.05 %, inflammations were 0 %, and capsular contracture formation was 0.4 %.

Dual plane technique

nontouchQ. In June 2007 your paper “Composite Plane Breast Augmentation: A new Concept” was awarded in Berlin, among 500 papers from around the world during the International Plastic Surgery Conference . In this paper, you present a brand new technique for breast augmentation.
A. This technique is in reality a modification of the technique first presented by Dr Tebbets from Texas, the guru and great teacher in breast augmentation.

Q. What exactly does this technique involve?
A. Until now we knew of two techniques in breast augmentation: the subglandular and submuscular implant placement techniques. In 2002, the subfascial technique was also introduced. Our technique combines the two last techniques. I.e., silicone implant is placed both underneath the muscle and underneath the muscle fascia.

Q. I believe this sounds a bit complex.
A. In reality it is not. Look at figure 1. The above part of the silicone implant is covered by the pectoralis major muscle and the lower part by the muscle fascia (a thin tissue that covers the muscle).

Q. And why should we stop using the old techniques?
A. Because no technique is perfect. Each new technique is launched in order to offer something new.

Q. So, which are the advantages and disadvantages, if any, of the new technique.
There are many advantages:

1. Less complications, such as the formation of capsular contracture. A complication that concerns 1-20% of women who have been submitted to breast augmentation surgery. By placing the implant below the muscle and the fascia we minimise the implant’s contact with the mammary gland. This is a manoeuvre that can possibly minimise the formation of capsular contracture.
2. A natural result particular for thin patients with very small breasts. This can be achieved as the upper part of the implant is covered by the muscle.
3. The possibility of implant dropping is reduced. The muscle and fascia secure the implant and keep it in the right position.
4. We avoid malformations to the implant due to the strength exercised by the pectoralis major (as is the case in the submuscular technique). The so-called “open breast” abnormality.
5. The possibility of palpating the implant’s borders is reduced.
6. No wrinkles are formed on the upper part of the body.

Q.  What about the disadvantages:
A. There are no actual disadvantages, apart from the fact that the doctor has to have more experience in performing this technique.

Q. Does surgery last longer compared to other techniques?
A. No. An experienced surgeon can perform the procedure within 30-45 minutes.

Q. Are there any drains placed on the breast?
A. No, no drains, no bandages, no suffocating compression garments around the breasts.

Q. Why?
A. This is where the first part of the title applies.

Q. So, what does the “non-touch, no pain” mean?;
A. It literary means no touching of the breast and no pain. To elaborate: In surgery, the way you treat tissues is of outmost importance. If you “respect” tissues, i.e. avoiding abuse and following the advised anatomical and non-blood techniques, the problems that may appear after surgery will be minimised. In our fast-paced society, patients ask for fast recovery. Our goal is to allow patient to go out to a restaurant or to the movies on the same day, after surgery.

Q. And how can this be achieved?
A. By using 1) special tools 2) fully atraumatic techniques and 3) special exercises after surgery.
With the above combination we can achieve,
1. Speedy recovery
2. In 90% of patients, pain is minimum. They can even go out for a dinner on the same night
3. No drains
4. No bandages
5. No compression garments around the breasts
6. No bruising after surgery
7. Dramatic reduction of complications such as haematomas or inflammations.

Q. Can the combination of this atraumatic technique and the dual plane technique further minimise the problems that may appear after surgery?
A. Dramatically. Complications and revision surgery are currently below one percent (1%). On the other hand, among women, the level of satisfaction from this operation reaches 98-99%, and this is what we are aiming for.

Subfascial technique

subfascialWhat is the SubFascial technique?
The subfascial technique is new and refers to breast augmentation. It was first presented in 2000 by Miss Craf , a Plastic Surgery Professor in Brasil. The presentation was made in the Aesthetic Plastic Surgery journal and in 2003 it was also published in the American journal of Plastic and Reconstructive Surgery.

Where is the silicone implant placed?
In the subfascial technique, the silicone implant is placed under the fascia of the pectoralis major. As you may see in the figure, the fascia is a very thin hymen that covers the pectoralis major.
What are the advantages of the procedure?

What are the advantages of the procedure?

1. Minimum or no pain.
2. Much faster recovery
3. Performed with local anaesthesia and sedation.
4. More natural shape of the breast, since the fascia is covering the implant and smoothes out the roundness that develops on the upper part of the breast
5. Minimisation of capsular contracture, possibly due to the fact that the implant is not in contact with the breast (the fascia separates the implant from the breast).
6. It may possibly limit the possibility of implant dropping in the future since the implant is well secured as is the breast.
7. In selected patients, it minimises the possibility of wrinkle formation mostly on the upper part of the breast.

As in all breast augmentation techniques, we perform the non touch, no pain technique in surgery.

In this technique we create the pocket in fully non-blood procedure.

What is your experience with this technique?
We are currently among world leading practices with more than 800 surgical cases.

Where have you presented this technique?
This technique is very popular and has been enthusiastically accepted by the most established conferences of our specialty. It has been presented in the following meetings:

1. 10th European Societies of Plastic, Reconstructive and Aesthetic Surgery Congress, Vienna, August 30th  - September 3rd, 2005
2. 7th Congress of Hellenic Society of Plastic Reconstructive and Aesthetic Surgery, October 27th – 29th, 2005, Loutraki.
3. 9th Congress of Pan Arab Association of Burns & Plastic Surgery, April 10th -13th, 2006.
4. 14th Congress of the International Confederation of Plastic, Reconstructive and Aesthetic Surgery (IPRAS) Berlin, October 26th - 29th, 2007.
5. IMCAS meeting in Paris, January 2009 (International Master Course on Aging Skin).
6. At 11th European Society of Plastic Reconstructive and Aesthetic Surgery Congress, Rhodes 2009.

We have also published our experience with this technique in the two most prominent international journals of Plastic Surgery: “Plastic and Reconstructive Surgery” and “Aesthetic Plastic Surgery”. In 2008 the procedure was broadcasted live in television for the first time.

Where?
In “Extreme Make Over” show by Mega Channel.

Is this when the technique was first applied?
We were among the first to perform it. We first started using this technique in London, in 2003.

What are your conclusions after so many cases, publications and presentations on this technique?
1. It yields the best possible results in selected patients
2. Complications have been drastically reduced. It would be interesting to see a slide presentation with comparisons of complications as presented in the Paris Meeting in January 2009, in Rhodes, in September 2009, in Berlin, in 2007 and in Vienna, in 2005. In Paris and Rhodes there were 800 cases, in Berlin, in 2007 575 cases and in Vienna 2005 190 cases. Complications and revision surgery has reduced dramatically.

Is this reduction in complications due to the Subfascial technique?
It is due to the Subfascial technique but also to the so-called non–touch, non-pain technique for pocket preparation.

  Paris 2009
800 cases
31.5 months
Berlin 2007
575 cases
19.5 months
Vienna 2005
190 cases
11.5 months
Complications 3,5% 3,1% 6,3%
Revision surgery 1,87% 1,4% 2,2%

What is this technique?
Lets just say that we are able to prepare the pocket without causing haemorrhage.  This way we avoid the use of drains, we do not use bandage or compression garments or bras on the breasts and no special massage is required. Research has shown that the average quantity of blood lost during surgery was 4 cc, which is equal to 0. Surgery time was between 75 and 22 minutes, with average of 40 minutes. Patient satisfaction was nearly 99 %.

What happens with older techniques such as the subglandular and submuscular procedures?
Personally, I perform two techniques. The subfascial and the dual plane technique. This is because these techniques have minimum complications and, particularly, I am able to prevent the formation of capsular contracture and displacement of the implant underneath the muscle.

Breast Augmentation Photos