When a patient comes to the office in search of a breast augmentation, the general approach of the specialist is how to perform an aesthetic improvement in the most natural way possible, both in shape, size, mobility and symmetry. In addition to a good result, the concern is that the patient has the least number of complications, both in the medium and long term, which would involve a new surgical procedure.
Anatomically, for most specialists in plastic, aesthetic and restorative surgery , the most natural plane of choice is behind the mammary gland or above the muscular plane. In case it can not be done by these routes, a biplanar option should be used.
Risks of Breast Implant Surgery
In a breast augmentation, the most common complications in the medium and long term, inherent to the implant, regardless of the brand or model are:
- capsular contracture or tightening of the breast by the creation of a thick scar tissue around the implant.
- rotation of the implant, displacement or turning of the same.
- rupture of the implant.
Types of Breast Implants
All breast implants are currently made of medical grade highly reticulated silicone gel. The difference is in:
1º- the shape of the implant: round or anatomical.
2º in the cover that covers the implant:
- smooth surface of silicone, which produce statistically many capsular contractures.
- rough or irregular surface of silicone or textured, which have a much lower incidence of capsular contractures.
- thinner surface, microtexturized or ultratexturized, also of very low incidence in terms of contracture.
- Polyurethane foam. In the latter, an outer layer of polyurethane microfoam is added to the normal structure of a silicone implant.
In the medical literature, percentage data are collected regarding the periprosthetic capsular contracture of smooth, textured and micro or ultratexturized implants that speak of a rate of 5% when the implants are placed in the submuscular plane. However, in the subglandular natural plane, a smooth implant has a possibility of up to 50%, the textured ones of 20% and the micro or ultratexturized of 5%.
In the early 1990s, the application of polyurethane implants in Europe was very small, unlike in South American countries such as Brazil, where the incidence of capsular contracture of polyurethane implants was low. The European situation was of great ignorance about its use due to some problem of detachment that happened with some mark that manufactured certain implants like a double periprosthetic capsule. Years later, the manufactured was perfected and continued to be used without more particularity.
Advantages of Breast Implants with Polyurethane Microfoam
The application of this type and implants both in patients with problems of repeated capsular contractures and in surgeries without previous treatments have shown different advantages with the passage of time:
- Placement in the more natural plane, subfascial subglandular bone, without damaging the muscle, results in a very painful postoperative period.
- Reduction of capsular contracture. In the medical literature only 1% is spoken in subglandular or subfascial placement.
- They do not move or move from the implantation position.
- Improved aesthetic results with anatomically shaped and pleat-free models on the breast surface, called reepling.
- Implants are ideal for secondary surgeries.
- Less formation of seroma or periprosthetic liquid accumulations.
- They are very safe.
Despite its great advantages, it also has two drawbacks:
- They are a bit more expensive for the patient than normal textured ones.
- They are more difficult to implant and can take a few more minutes of surgical time, but the result pays off.
These implants, with already about 20 years of world experience, are manufactured in Germany. They have a lifetime warranty in case of rupture of the implant wrap, as well as 10 years in case of rotation, dislocation or capsular contracture.
As a curiosity, say that these implants have been tested in female runners, known as running , to see the resistance to the dynamic forces that occur with the practice of exercise. After 36 million cycles, the implants remained intact. That would be equivalent to running about 180 km per week for 10 years!
If you are interested in a breast augmentation, remember that all patients have different breasts and body constitutions, so they require an analysis performed by a plastic surgeon.