breast enlargement (augmentation mammaplasty)

It is the surgical procedure that enables an increase in the breast volume through the inclusion of a prosthesis under the mammary gland or the chest muscle.
The surgery is performed under general anesthesia and a small incision is required
(in width and length) without an evident scar: it is a periareola incision that is hidden within the wrinkled skin of the area. After the procedure a particular bra must be worn for around 6 weeks.

For the younger patient an ecography is required, while for women over 40 a mammography is necessary before the procedure. All blood tests, the electrocardiogram and chest X-Rays are required. The purchase of the bra of the desired size to be worn after the operation and during the following weeks is required. Medicines containing acetylsalicylic acid must be suspended 14 days before. Antibiotic therapy must start the day before and be prolonged for the following four days after surgery.

- axilla (the scar is hidden in the armpit)
- periareola (the scar affects the inferior middle part of the areola)
- in the mammary sulcus

The prosthesis can be inserted under or above the pectoral muscle.
In the case of particularly thin patients, with particularly thin skin, the implant under the muscle is preferred to assure a reduced visibility of the capsule that is always around the prosthesis, since this last is recognized by the body as a foreign body..
On the other hand, the prosthesis under the muscle tends to move upwards, and sometimes during exercise involving this muscle, to create a deformation of the mammary region.
In the lowered breast (ptosic) an under the muscle implant is not advised.
On the contrary, the prosthesis above the muscle and under the gland does not imply any deformation during exercise, and can be inserted in a moderately lowered breast.
The periprotesica capsule, if accentuated and contracted, is more evident than an implant positioned under the muscle.

Under general anaesthesia and in an equipped operating theatre the planned incision is performed and a pocket is created under the mammary gland or under the pectoral muscle as planned.
The haemostasis must be accurate, the introduction of the suction drainage tubes limit the risk of haematoma. After inserting the prosthesis and evaluating the symmetry and shape with the patient half-seated the cutis and the sub-cutis are sutured layer by layer.
The bandage concludes the procedure. While the remodelling bra will be worn only for one week when the stitches are removed.
The drainage tubes, if used, are removed after 24 hours, the patient can be discharged and antibiotic therapy continued.
The stitches are removed after 7-10 days.
The bra must be worn day and night for 3 weeks and only by day for another two.