Breast augmentation in Niš

Breast augmentation (the medical term is augmentation mammoplasty) is an operation to increase the size or change the shape of the breasts. In everyday speech it is often simply called getting silicone implants. Through an incision a few centimetres long, the surgeon places a silicone implant. The implant has an outer shell made of silicone and is filled with a thick silicone gel. It is placed behind the glandular tissue of the breast, under the chest muscle or partly under the muscle. At Maja Hospital the procedure is carried out by specialists in plastic and reconstructive surgery. The plastic and aesthetic surgery price list also includes other breast procedures, such as breast lift and breast reduction.

Women most often choose breast augmentation for cosmetic reasons: because they would like larger breasts, because of a difference in size between the two breasts, or because the breasts have lost volume after pregnancy, breastfeeding or weight loss. Implants are also used for congenital differences in the shape and development of the breasts. In these cases more than one procedure is sometimes needed. The procedure is not planned during pregnancy or breastfeeding. After breastfeeding, it is usual to wait a few months for the breasts to settle. The procedure is also postponed in the case of an acute illness or an unexplained change in the breast, until the investigations have been completed. When the breast is sagging, the surgeon may suggest a breast lift, either on its own or together with an implant. The decision about the procedure is made by the patient and the surgeon, after a consultation and a discussion about expectations.

Implant shape. Round implants are symmetrical and usually give more fullness in the upper part of the breast. Anatomical implants are teardrop-shaped, with more volume in the lower part of the breast. The Maja Hospital price list shows procedures with round implants and with anatomical implants as separate items, as well as augmentation of one breast and augmentation combined with a small breast lift. At the consultation, the surgeon recommends which implant is suitable.

Implant position. The implant is placed behind the glandular tissue, under the chest muscle or partly under the muscle. The choice depends on the thickness of the skin and tissue, the build of the chest and the look you want.

Incision site. The incision is most often made in the fold under the breast. Less often, it is made at the edge of the areola (the darker ring of skin around the nipple) or in the armpit.

Size. The size is chosen at the consultation, based on chest measurements, breast width and skin elasticity. The surgeon explains which options are realistic for each patient's build and which methods they recommend.

You need to fast before the operation and arrive at the time agreed with the hospital. After you are admitted, you fill in the paperwork and sign a consent form for the procedure. The anaesthetist checks your test results and explains how the anaesthetic will be given. Before the operation, while you are standing or sitting, the surgeon uses a marker pen to mark the incision sites and the position of the implants. The operation is usually done under general anaesthetic and takes one to two hours. After you wake up, you stay in your room under observation. A dressing or a special support bra is put on. You go home once the doctor judges that your condition is stable. Before you leave, you are given instructions on aftercare and an appointment for your first follow-up. You should go home with someone accompanying you and not drive yourself.

Like any operation, breast augmentation carries possible risks. Swelling, bruising and pain are usual in the first few days. Changes in sensation in the nipple and the skin of the breast are common in the first few months. They usually pass, but in some women they are permanent. Less common problems are a collection of blood (haematoma) or fluid (seroma), infection, movement of the implant, rippling of the implant visible under the skin and a difference in appearance between the two breasts.

Hardening of the scar tissue around the implant (capsular contracture) can happen at any time, most often in the first few years after the procedure. An implant can also rupture. With a silicone implant, a rupture often causes no symptoms and is found on an ultrasound or MRI scan. Very rarely, most often with implants that have a rough (textured) surface, a particular type of lymphoma associated with breast implants (BIA-ALCL) has been described. It usually appears years after the implants were put in, as new swelling or a lump in the breast. Some women report general symptoms, such as tiredness or joint pain, which they link to their implants. The cause of these symptoms is still being researched.

Implants are not designed to last a lifetime, but they do not have a fixed expiry date either. Over the years, some women need another operation, for example to replace or remove the implants. For this reason, regular check-ups are advised and, if the doctor recommends it, a breast ultrasound or breast MRI scan. Prices for both scans are in the radiology price list. Any new swelling, pain, lump or change in the shape of the breast should be checked by a doctor, even if it appears years after the procedure. The risks in each individual case are discussed with the surgeon at the consultation.

Implants do not last a lifetime. At some point implant removal or replacement may be needed, for example because the shape or firmness of the breast changes, the implant is damaged or at the patient's wish. When a thickened scar capsule forms around the implant, the surgeon can remove it (capsulectomy). Implant removal and capsulectomy are described on a separate page, together with prices. Whether a new implant is placed in the same procedure is assessed by the surgeon at the consultation.