Silicone Breast Augmentation Implants

By admin, on August 7th, 2010

Browse through our page of Silicone Breast Augmentation Implants

What is Silicone?

Silicone or dimethylpolysiloxane, is a derivative of silicon, a metal similar to that when it combines with oxygen to form silica, such as, for example, quartz. Silica, when heated and mixed with carbon at high temperature, is transformed into silicon. Further processing converts the silicon into a polymer, called silicone.

It is considered an inorganic substance and, therefore, has high durability. It is odorless, tasteless, colorless and resistant to decomposition by heat, water or other oxidizing agents.

It is available in liquid form, gel consistency or similar to rubber, also known as silicone elastomer. In medical practice, the silicone is a more inert material (non-reactive) among those used.

History of the Evolution of Silicone on Plastic Surgery

In mid 1940, some Japanese women began to inject substances such as paraffin, sponges and industrial silicone into the breasts, so they could enlarge.

Prótese de Silicone nos Seios, Mamas, em Londrina, ParanáAfter a while , with the idea of creating something to give the breast volume in 1960, the first breast implants made of silicone for medical use were developed by two American plastic surgeons: Frank Gerow and Thomas Cronin.

Timmie Jean Lindsey, in an exchange of favors with Frank Gerow, accepted be submitted to the first breast implants plastic surgery in the developed world in exchange for which he operated her ears. She was then the first woman to perform plastic surgery breast augmentation, also known as Breast Implant Surgery with Silicone Implants, which, despite all glamor to have this title, she had severe contracture and underwent lot of pain. This all happened because the first silicone implants were produced with silicone coating and silicone sponge filling inside.

Since then, several modifications were made, including the jacket, also known as ‘envelope’ was thinner and pad was replaced with silicone gel that gives the series a more natural aspect, much closer to a natural breast.

At present, silicone breast implants are made with high cohesiveness silicone gel , and its extremely small envelope in terms of thickness, now even with polyurethane foam coating that prevents capsular contracture and other complications.

The silicone implants used by Dr. Zamarian is of very high quality, made by Silimed, and was recently considered by the European Committee of Silicone Implants, the best Silicone Implants in the world.

Silicone Gel Breast Implant Surgery – Breast Augmentation Implants

Various parts of the body can benefit from the silicone implants, namely, the breasts (breast augmentation – breast implants), buttocks (gluteoplasty), chin (genioplasty) and calves (calf implants).

Protese Silicone LondrinaHowever, silicone breast implants surgery (breast augmentation plastic surgery) has gained prominence among them, becoming one of the plastic surgeries more popular and held in recent years in Brazil.

With the silicone implants, patients who are unhappy with their breasts, and in size, shape or how they project themselves, can quickly resolve your problem and boost their self-esteem. There are many technical options for performing breast surgery with silicone implants, many of which have been perfected by Dr. Zamarian. The goal of surgery is to improve the shape and size of the breasts, reshaping them to acquire an attractive appearance, firm and proportionate.

Dr. Walter Zamarian, member of the Brazilian and American Societies of Plastic Surgery, has developed a great reputation for performing breast augmentation plastic surgery with excellent results in his clinic in Londrina, Paraná. Surgery for breast enhancement has become less invasive, faster and more effective when it comes to creating youthful tits and a beautiful and sexy profile.

What is the difference between Prothesis and Implant?

In general, the prosthesis is an object used to replace a member, in whole or in part. For example, a person suffers a trauma that leads to loss of one of his hands. One alternative is to use a hand prosthesis made of synthetic material that may have even encouraged by the muscle movements that are left in the stump of amputation. Thus, a breast prosthesis, would, in fact, be a synthetic material that would be similar to the other breast and would cover the area of sequela of trauma, for instance.

Furthermore, an implant is an object added or introduced in any region of the body. In the case of breast implants, for example, what is added is the volume, because the breast already exists, only acquiring more volume.

Therefore, the correct term to use when referring to Breast Augmentation Plastic Surgery is: Breast Implant and not breast prothesis.

When are you given Silicone Breast Augmentation Plastic Surgery?

The Silicone Breast Implants Surgery can now be held from 15 years of age. The exception to this is for cases when the first menstruation does not occur until the age of 15, and then the breast augmentation surgery should be  postponed until after the occurrence of menstruation. It is with menstruation that complete maturity of the breasts comes. It is important to mention that for women with very low areolae or with significant sagging in the breasts, the statement would be not only the placement of the prosthesis, but rather undergo a Mastopexy (Breast Lift) with silicone breast implants – a Plastic Surgery in which the breasts are lifted and silicone implants are placed at the same time.

Silicone Gel Breast ImplantsThus, considering the minimum ideal age, the breast augmentation surgery can be performed in patients who present amastia (congenital absence of breasts), hypomastia (breasts too small), asymmetry (inequality between the breasts), bulging breasts, tuberous breasts, sagging breasts (along with mastopexy), breasts with ugly forms, and other imperfections.

In both cases of amastia and hypomastia, the surgical treatment is usually carried out with silicone breast implants of same volume, as well as  in most cases of sagging.

In cases of treatment of more pronounced breast asymmetry, with gel breast implants, Dr. Zamarian often uses breast implants of different sizes to match the breasts. As an alternative to this treatment, a mastopexy plastic surgery (breast correction by removal of excess skin), getting more volume from the bigger breast,  and thus utilizing breast implants of the same size, reducing the existing imbalance.

More recently, some patients who want to reduce the volume and raise the breasts through breast reduction, have opted to add breast implants to gain two main effects: firm breasts and sensuality. Today, the demand for reduction mammoplasty along with silicone breast implants has been approximately 25% of patients seeking to reduce the breasts. Those who want a major change in the volume and the result of small breasts chooses not to use breast implants. When the gel breast implants is associated with breast reduction mammoplasty, the final volume of the breasts may have only a minor change because the implants may have an approximate weight and volume of the tissue that is removed in this surgery. Breasts submitted to reduction without silicone breast implants are less firm, the projection of the upper pole is smaller but have the advantage of not requiring another surgery (to replace the breast implants, for example).

Before Breast Implants Surgery – Breast Augmentation Surgery

Classification of Silicone Breast Implants

Silicone Breast Implants were developed in order to increase the volume, correction or reconstruction of the breasts. There are several types of breast implants with certain features targeted to meet the different needs of each surgeon. The breast implants used by Dr. Zamarian consist of thin membrane of silicone elastomer and silicone gel-filled with high cohesiveness and external coating of polyurethane foam (Silimed trademark).

Beautiful Breasts BrazilThe silicone breast implants are classified by: type of surface, profile and shape.

There are three types of surfaces that silicone implants may have:

  • smooth surface: Silicone implants with smooth surface are often used by Dr. Zamarian in Gluteoplastia and Calf Implant Surgery;
  • textured surface: Silicone Implants with textured surface is technically easier to be introduced, but they give a breast as a result more mobile and may weigh on the breast, increasing the risk of ptosis (drooping) breasts;
  • surface coated with polyurethane foam: silicone implants surface coated with polyurethane foam are technically more difficult to be placed fairly and adhere to adjacent tissues. Do not weigh on the breasts after being placed, not so cause breast ptosis and have lower rates of contraction (bounce), so those considered safer;

And they can present the following profiles:

  • low: usually used in Breast Reconstruction Surgery and the average volume used between 500 and 800 mL, once in Breast Reconstruction Surgery is needed to reset the entire volume of a breast;
  • high: Profile is the most used Zamarian Clinic, the most recommended for having the best results and more predictable;
  • natural or anatomical: never been used by Dr. Zamarian, considering that is a profile of prosthesis that does not provide lap and is very large relative to its projection;
  • natural or extra-anatomic projection: a profile is used less frequently by Dr. Zamarian, being reserved for very thin patients who need a little volume;

May have the following formats:

  • Round: is the format most commonly used prosthesis. Serves to improve the appearance of breasts in all directions, including in the upper pole, giving the same lap;
  • natural or anatomical: also known as ‘drop in Prosthodontics,’ Dr. Zamarian recommends its use in the Extra-profile projection only to the volume of 215 mL, otherwise it leaves a flattened appearance in the breasts, making them very ‘beaked’ ;

Finally, the breast implant is available with the difference in its drawing

Silimed has the silicone breast implant coated with polyurethane foam Pintaguy / Rebello that differs from the coated polyurethane foam for having cut different: the edge of the implant was specifically designed to not score in patients thinner and thin skin.

What is the cohesiveness of Silicone Gel?

The cohesiveness is a characteristic of molecules of silica gel must remain linked to each other, not allowing the gel to drain if the implant is ruptured.

A common mistake is to say that cohesiveness is synonymous with rigidity, however, a silicone gel to be high cohesiveness is not necessarily hard.

Polyurethane: The Breast Implant Pitanguy / Rebello

The silicone prosthesis currently used in clinical Zamarian comprises thin membrane of silicone elastomer and silicone gel-filled by high cohesiveness and external coating of polyurethane foam. The high cohesiveness provides more security because of no do not let the silicone to spread throughout the body in unwanted places in the event of a disruption, as was common in the early introduction of silicone prosthesis in Brazil for over 30 years.

The spread of silicone prosthesis coated with polyurethane foam Pitanguy / Rebello is in its design: the edge of the implant is specially designed not to score in patients thinner and thin skin, because her sewing is not aparete nor palpable. It is for this reason that Dr. Zamarian uses Implants coated with polyurethane foam Pintaguy / Rebello, Silimed brand in all of its Silicone Implant Surgery.

Moreover, the silicone prosthesis coated with polyurethane foam has the lowest rate of contraction of the market and a national technology. Silicone Implants Silimed, used by Dr. Zamarian, have a ten year guarantee against contracture (“rejection”). If nothing else, the European Committee of silicone implants considered the Silicone Implant Silimed (Brazilian Industry) with high gel cohesiveness and polyurethane coating Protese the best in the world.

On his doctor’s appointment, the patient should provide the doctor what the outcome you want and the size of silicone prosthesis is chosen in conjunction with the patient, which proves sizes with molds in the office to try to view the results closer to reality. The result is an increased rate of satisfaction with the surgery, silicone prosthesis.

Different brands of Silicone Implant

As already mentioned, Dr. Zamarian uses only prosthesis silicone Silimed the coated polyurethane (national technology and considered the best in the world by the European Committee of Silicone Implant). However, we list here the various brands of silicone implants for you to have knowledge (only Silimed produces polyurethane):

Arion – France

Eurosilicone – France

Silimed – Brazil

 Mentor – United States

Mcgahn – United States

Perthese – France

The choice of the size of the silicone prosthesis to be placed

During the consultation, is most common questions about the size of the silicone prosthesis to be placed. How sure?

Protese Silicone Mamas Londrina ParanáFirst, it is for the patient to explain in detail how to think and how you would like to stay, being clear about the outcome you want to achieve. There are several sizes of silicone prosthesis, and some sizes are better matched to individual anatomy. Thus, the most important information to be transmitted to the plastic surgeon is the desired outcome is more apparent on the breasts or breasts smaller and more natural, while being proportionate.

Then the surgeon will evaluate the anatomy of the patient, the width of his chest, his height and weight, the width of the base of the breast, the size of the areola, the amount of skin and the thickness of the dermis, and the amount of mammary gland that will cover the silicone prosthesis.

In Clinical Zamarian, sizes silicone prostheses used are: 215, 235, 255, 285, 305, 325, 355, 385, 435, 485, and 525 mL, with the majority lying between 285 and 385, but this is very individual.

Among the prostheses being used, the volume 285, 325 and 385 remains relatively the same proportion, being indicated for most of the breasts. The prosthesis of 305 mL is slightly flattened and has been referred to breasts that require more bandwidth than projection. Already Protese of 355 mL has its projection proportionately larger than its base, is indicated for patients who want results more marked or less natural.

Dr. Walter Zamarian prefers to choose the size of the silicone prosthesis with the patient, days before surgery and during the consultation, he uses various silicone molds so that the patient may have more sense and make this choice without making mistakes, giving the patient his suggestion according to your anatomy and expectations of outcome.

The choice of format to be placed silicone prosthesis

In virtually all patients, Dr. Zamarian silicone gel prosthesis placed high cohesiveness of Silimed, with round shape, high-profile, with a coating of polyurethane foam-type Pitanguy Rebello, like the professor Pitanguy.

The anatomical implants in their experience, they are beautiful to the size of 215ml, the EP type (extra projections), being designed for much larger volumes and for that reason he prefers the round implants.

However, the signs vary depending on the case: Dr. Zamarian will evaluate the conditions of the patient to enter it the best format possible Silicone Prosthesis.

In front or behind the pectoral muscle?

Protese Silicone Seios Retroglandular RetromuscularOne of the points to be clarified during medical consultations carried out for the silicone implant surgery is where you will get the Breast Implant. There are two options: put the silicone prosthesis in front of or behind the pectoral muscle pectoral muscle, also known as breast implants and retroglandular retromuscular respectively.

Usually, Dr. Zamarian prefers to put the silicone prosthesis in front of the pectoralis major, the latter being behind the mammary gland, for presenting a result with greater projection, with less pain and postoperative complications.

In rare selected cases, the choice of implant retromuscular, or behind the muscle, it is ultimately the best, for example, when it provides a more natural contour in very thin patients with little mammary gland to cover the silicone prosthesis.

Eventually, in some patients, the pectoralis muscle may begin to protrude above have in their upper third after placement of silicone prosthesis. Thus, the placement of Prosthesis Silicone retromuscular, it makes sense that if you have the beginning of the breast is too high, resulting in an artificial aspect and this is one of the reasons Dr. Zamarian retroglandular prefer the space in front the pectoralis major muscle.

Another point opposite the prosthesis retromuscular is that the pectoral muscle can only cover two thirds of the superior-medial part of Prosthodontics and discovery is inferior-laterally. In some cases when the patient performs effort, especially abduction or tighten the waist, the lower edge of the pectoral muscle can perform Protese causing a split in the so-called “double bubble sign” that can be visible in thin patients with little, gland, which is the main indication for this technique.

Exams by Dr. Zamarian for plastic surgery silicone breast prosthesis

Before performing plastic surgery silicone implants, it is necessary to perform some tests, for greater safety of the procedure:

  • Full hemgrama + plaquetaas
  • TAP + INR KPTT
  • urea
  • creatinine
  • fasting glucose
  • total proteins and fractions
  • Urine I
  • electrocardiogram
  • surgical risk (a cardiologist)
  • ultrasound to age below 35 years and above age for mammography

Surgery of silicone breast implants

Types of Plastic Surgery Incision of silicone breast prosthesis

There are alternative sites for carrying out Incision Plastic Surgery in Silicone Breast Prosthesis, this incision to permit entry of the silicone prosthesis. They are:

  • Periareolar inferior (or incision Webster): the incision is located at the lower edge of the areola, following its shape, half-moon. Not interfere with the sensitivity of the areola in the same way through the incision in the inframammary fold, because who determines the sensitivity is the fourth intercostal nerve and not the access route. Where the patient is known to have a tendency to hypertrophic scars or keloids, the periareolar inferior (or incision Webster) is the choice for producing the best results;
  • Inframammary fold: this incision has the advantage not to leave scars on the areolas, but the esthetic result can be good or not, depending on the very body of the patient, who may have a tendency to make a hypertrophic scar. When result in an unsightly scar, their treatment can be difficult;
  • Vertical: Vertical incision goes from the lower edge of the areola to the inframammary fold. It is only used in cases of Plastic Surgery or Mastopexy Breast Reduction with silicone prosthesis, for providing large opening for implant placement;
  • Transareolopapilar (Pitanguy Technique): this procedure is performed through a horizontal incision that divides the nipple and areola (papilla) in half. This technique that was developed by Professor Ivo Pitanguy in order to not injure the breast milk ducts, however, results in a horizontal scar that can call attention to breasts with dark areolas. Should a need for further Mammoplasty Mastopexy or Reducing the breast would have operated beyond the scars required by Mammoplasty, this also horizontal scar that could have been avoided if the technique of choice had been the Periareolar Lower;
  • Axillary: This incision is made in the armpit, followed by a detachment of the pectoralis major muscle. Not used by Dr. Zamarian to have the following disadvantages: it is an incision away from the area of placement of prostheses leaving the patient more vulnerable to the risk of haemorrhage and an asymmetric positioning of the prostheses. The scar in the armpit – this is a region of folds – usually has one outcome and appear unsightly when the patient raises his arms, demanding yet Silicone Implant Surgery Axillary incision with more time for its performance in comparison to other types of incisions by requiring endoscopy to visualize the structures. Finally, it is proven that the armpit, as a potentially contaminated area, it becomes susceptible to infections.
  • Umbilical (TUBA technique): TUBA incision (transumbilical breast augmentation – breast augmentation trans-umbilical) or at the navel incision is made in the margin of the umbilicus. After the incision made with the help of an endoscope, it creates a path, like a tunnel through the subcutaneous fat all the way to the breast. The inflatable implant, even withered, it is rolled and pulled through the tunnel to the site. Then, the inflatable implant is filled with saline (saline) and positioned correctly, then ending, the doctor, with the suture. This type of incision is very rare here in Brazil and is widely used in the United States. Dr. Zamarian desvantavens some points of this technique, among which, the procedure requires inflatable implants, it is not possible to use a prosthesis of silicone gel high cohesiveness; in TUBA, silicone implants can only be positioned behind the pectoral muscle; and finally, in case of complications, the umbilical incision can not be reused, ie, the plastic surgeon will make incisions to work with new implants.

The best way of incision is discussed in the consultation between Dr. Zamarian and his patient, so that, to obtain the best outcome for each case.

The incision most often used by Dr. Zamarian for the placement of the silicone prosthesis is the half-moon at the bottom of the areola, the incision Periareolar Bottom (or incision of Webster), which results in an excellent scar and who disguises herself as well. Where the patient has areolae small or silicone implants is proportionately large in relation to the areolae, Dr Zamarian recommend using incision in the inframammary sulcus. When the removal of the breast is associated with silicone implants, silicone implants are placed via vertical incision, which is part of the breast lift surgery (Mastopexy), as stated earlier.

Each country has their preference with respect to incision by means of the silicone prosthesis. The greatest example is the United States, which have mainly used the umbilical incision, or through the navel, the Inflatable implants which are then filled with saline (saline). Despite finishing in less scarring, this technique provides a breast much more mobile, since the Saline Breast Implant weigh more on the breasts, increasing the risk of sagging and stretch marks, with results not as good as compared to the implantation of silicone gel high cohesiveness, which does not allow placing the Navel.

We, Brazilians, we have the advantage of having developed the technology of polyurethane and silicone gel high cohesiveness. This technology results in firmer breasts with the placement of the silicone prosthesis with the lowest rate of contraction (rejection), and the implant to adhere more to the surrounding tissues, reducing risk of sagging and stretch marks. However, it is possible to put this type of silicone prosthesis for the navel.

Whatever the chosen access route, Dr. Zamarian ensures that the Plastic Surgery of silicone prosthesis will provide immediate results and with great improvement in self-esteem.

Epidural Local Anesthesia in High X Plastic Surgery Silicone Implants

Anestesia Protese Silicone SeiosEpidural anesthesia is high made with one puncture in the dorsal region with the patient lying on her side and already sedated. This is a sensory block anesthesia in a large region encompassing from the clavicle and extends to the navel, no motor block and do not interfere with the muscles of respiration.

Already in the local anesthesia is necessary to perform an intercostal block in at least three to five ribs (ribs). This blocking is done with anesthesia close the ribs on his bottom lip. The superior medial pole normally can not be anesthetized. The preference is for Dr. Zamarian Epidural high to be more effective with only one puncture.

The Plastic Surgery Implants Silicone (Silicone Prosthesis)

Before starting the surgery is done Antisepsis of the patient in routine clinical Zamarian with chlorhexidine germ, followed by 70% alcohol, so there is no allergy to povidone iodine (Povidine).

Protese Silicone MamasBegins the surgery with silicone prosthesis, the patient under anesthesia (epidural or local) and sedation. Dr. Zamarian makes the incision and creates a space, usually retroglandular for placement of the silicone prosthesis. Hemostasis or cauterization is done carefully with electrocautery to prevent future bleeding.

During the procedure is placed a suction drain very thin, which is externalized by the armpits to allow the silicone prosthesis is always dry because the body tends to accumulate around 100ml of liquid in each space created for the placement of implants Silicone in the first 24 hours.

The silicone prosthesis is then inserted through the opening in the skin using the principle of the hourglass (because the opening is smaller than the diameter of the silicone implant), and stays comfortably in place created by Dr. Walter Jr. Zamarian

The internal suture (closure procedure) incision is made with the suture Vicryl (subcutaneous and subdermal), composed of Polyglycolic Acid, which is synthetic, absorbable, disappearing from the body in three months. The exterior is sealed with cyanoacrylate glue, allowing enough to be seven times stronger than conventional simple points, and safer and to allow a scar aesthetically better.

The suction drain and Cyanoacrylate Glue: Differential Plastic Surgery Prosthesis Silicone made by Dr. Zamarian

Suction drain, Negative-Pressure

The suction drain is a device composed of semi-flexible thin tubes attached to a system of negative pressure, so that it works even if it is above the patient. It is introduced into the patient in order to keep the prosthesis always dry, reducing the net present wrapped the prosthesis, since the body has a tendency to accumulate about 100 mL of liquid in each breast in the first 24 hours after placement of silicone prosthesis . The drain is externalized by the armpit, leaving marks and then allowing the prosthesis to be dry the next day, drastically reducing the incidence of complications such as striae, infection and contracture (rejection).

Dr. Zamarian uses Cyanoacrylate glue to close the outside of Surgery Prosthesis Silicone Tits, instead of giving points. Thus, the surgery presents no mark points after healing, and the fact that the glue give better cosmetic results and increased safety to the surgery because no bacteria can grow in cyanoacrylate glue. In Brazil, it is marketed by Johnson & Johnson under the name of Dermabond. The cyanoacrylate glue alone can fall by up to three weeks, failing this, Dr. Zamarian will remove it in the office.

Cyanoacrylate glue

The cyanoacrylate glue was recently introduced in Plastic Surgery and few surgeons who use it. Its main features:

  • APPLICATION facility;
  • reduces the time of surgery;
  • decreases the risk of infections (bacteria do not grow in the glue, and it seals the wound);
  • gets to be seven times stronger than the simple points on the skin;
  • has a better aesthetic result (leaves no marks and spots on the skin resulting in a thinner scar);
  • is more aesthetically appealing than the presence of points;
  • practically does not allow leakage of blood soiled dressings in the postoperative period;
  • its removal, when necessary, is virtually painless.

After Plastic Surgery silicone prosthesis

Postoperative care of Plastic Surgery in Silicone Prosthesis, Londrina, Parana

The recovery of silicone implant surgery is quite rapid, with virtually no complications and with cyanoacrylate glue instead of points on the outside, no need to remove points.

Plastic surgery silicone prosthesis is very quiet and is usually held in the morning, and the patient is in hospital two hours before surgery. The patients who undergo plastic surgery silicone implants remain hospitalized until the following morning, completing a total of 24 hours of hospitalization. It’s the next morning that Dr. Walter Zamarian Jr, in his usual visit, remove the suction drain and also change the dressing of the patient, when she gets high and can go home and should take some precautions that are recommended in the post- surgery.

The guidelines of the postoperative period are:

  • Rosa-mosquetaThe hydration of the breast skin: hydration of the breast skin can be made with Rose Hip Oil, with the recommendation to be initiated in the first days after surgery. Dr. Zamarian recommends that the patient does not pass the Oil Rosa Mosqueta close-cyanoacrylate adhesive to prevent its premature detachment. Application of Oil-Rosa Mosqueta should be done the evening before sleep, the skin is clean. Drip a few drops of oil over the area to be hydrated, using a circular motion when spreading and massaging gently until its complete absorption occurs. In cases of very dry and fragile is the recommended two daily applications. Preferably, the patient should not be exposed to the sun when applying the product on the skin;
  • The Healing: The patient should not get wet dressings until the first return to the office, which normally happens around the third day after surgery performed;
  • The Bra (Bra): bra recommended postoperative bra is a seamless, usually done with cutting laser that is comfortable not tighten the breasts and shall not have rim or bulge, being used only to give comfort breasts because he does not, in this case, supporting function. Should be used for two months (60 days);
  • The Smoke: The patient should not smoke or fifteen days before and fifteen days after the surgery performed;
  • The Diet: totally free. Feeding should continue normally, as usual the patient. This includes saying that eating eggs, fish, pork and chocolate are allowed;
  • The Sun: a patient who performed the surgery should avoid the sun for six months, and after three months is allowed to catch the sun from early morning (8am to 10am) and end of the day (from 16h) with sunscreen factor 30 or 40 in the scars;
  • The rest: in the first 30 days of surgery, the patient should sleep on their backs. After the first month of surgery, the patient may sleep on your side and just after the second month that you can sleep on your stomach;
  • The Physical Activity: until the first month is not recommended weight and load or perform physical work. The patient should avoid physical activities expected during the first month, always bearing in mind that activities heavier, are authorized only after the second month;
  • The Environment: always give preference to fresh room with air conditioning, if possible, always remembering that the heat increases the swelling of breasts;
  • The Movement of Arms: How the patient herself is operated with open arms, after the silicone implant surgery, you can perform all movements with elbows below shoulder level. You can even comb their hair and brushing teeth.
  • The Direction: It is only the first three weeks after the surgery that made the patient should not drive;

After a month, Dr. Zamarian already released to let the patient sleep aside, make light walks, ride a bike, drive (after 3 weeks), raise your arms, carry light weights (10 kg) and woo. In two months, you can perform any physical activity, including gym with weights. Always remembering that the use of surgical bra it is necessary for two months of Plastic Surgery.

What happens in the post-operative who has enough to skin the size of the silicone prosthesis placed?

Typically during plastic surgery, the inframammary fold is restored and its new position is approximately 2-4 cm below the original groove. Most patients do not have in this region, skin enough to give the final shape required to silicone prosthesis. Thus, the prosthesis has a pressure from the inside out, the skin of that region, which will undergo a process of expansion and over 2-6 months there will be enough skin to give rounded contour and attractive to the lower pole of the breast prosthesis Silicone.

As the Cigarette interferes with healing?

Cigarro e Protese SiliconeThe patient decided to carry out any plastic surgery, including the increase of the breasts underwent breast enlargement surgery, you should stay away from cigarettes, as much as twenty cigarettes a day, has the same interference in the healing process.

Cigarette closes the microcirculation, reducing the supply, ie the arrival of blood in the scar, thereby reducing the formation of scar tissue, delaying the whole process of healing and recovery. Plastic Surgeon, with the trained eye, can easily see the influence of cigarette healing, because the scar is marked by reddish lips, swollen and slightly apart.

Breastfeeding and Plastic Surgery of silicone implants. Is it possible?

In general, the placement of silicone prosthesis does not interfere with breastfeeding, even though the surgery performed by means Periareolar Bottom, because it preserves half of the milk ducts, which are already sufficient for optimal breastfeeding. Furthermore, after some time, recanalization occurs in many of those milk ducts that were cut in surgery.

However, it is recommended the patient wait about a year after the breastfeeding period to perform breast enlargement surgery.

Breast Cancer and Plastic Surgery of silicone implants

The insecurity of patients who will perform the surgery Implants Silicone is completely understandable when we’re dealing with breast cancer because, according to data from INCA (National Cancer Institute), the breast cancer is the second most common type of cancer in the world Moreover, it is more common among women, who account for 22% of new cases each year.

Câncer de Mama LondrinaBut the good news is that for Plastic Surgery Implants Silicone in view of breast cancer, patients do not have much to worry about besides always keep up with their exams.

In scientific work reliably, published more than five years, it was proven that the placement of Prosthesis Silicone Tits causes our body to recruit a greater number of defense cells, for the silicone implant case of a foreign body. The same defense cells serve as responsible for exterminating a breast cancer in its early stages. Thus, if there is any relationship between the prosthesis and Silicone Breast Cancer, this relationship is good, because having a larger population of defense cells in women with silicone prosthesis capable of preventing the development of cancer, your chances of defense are even bigger one that has not performed plastic surgery.

And during the treatment of breast cancer, silicone implants hindrance?

Dr. Zamarian explains that with modern techniques that we have today, which include the treatment of breast cancer, we can hardly stop interfering by Breast Implant performed after surgery. However, if the silicone prosthesis is very close to injury or is hindering access to the tumor, it can be removed temporarily until they finish the treatment.

Examination of Mammography with ‘maneuver Eklund’ for women who have silicone prosthesis

The Mammography and Breast Cancer

Mammography is a special type of radiograph, performed by an x-ray machine specifically for the breasts, known as mammography. It is an examination of diagnostic imaging, which aims to capture images of breast tissue to assess the breasts. Mammography can detect the lesion in its initial state is she millimeter, but can also detect breast cancer up to two years before it becomes palpable. That is why, among other reasons, that routine mammography is the best way to detect early any changes in the breast even before you or your doctor detect it, not only today, as always has been, since the beginning of its use for diagnosis of this type.

The recommendation of mammography is for women from 35 years of age and is considered routine, because it should be done annually.

Besides mammography, medical experts recommend breast self-examination after 20 years of age and a clinical examination, which is that made by the physician, every three years when the patient has up to 34 years and shall be held annually while with 35 years or more.

A ‘maneuver Eklund’ Examination in Mammography for women who have implants

The mammography exam can be done usually in those with silicone implants and in such cases is held a special maneuver called ‘maneuver Eklund’, which basically pulls the breast, pushing the Breast Implant, leaving behind free glands, thus, the x-ray will only reach the breast tissue. If doubts still remains even with this maneuver, the test of choice becomes the MRI.

Treatment of Tubers Tits (Tits Tube) with plastic surgery silicone prosthesis

Mama Tuberosa, aka Mama Tubular, is a severe deformity that can occur in one or both breasts. The breasts are born deformed, as tubers (tuber = root), due to the presence of a fibrous ring which lies on the breast base, located beneath the areola, which does not allow the correct breast development during puberty, preventing the growth of both the sinus horizontally and vertically, allowing it only the development of breast toward the areola. That is, the breasts are shaped cylindrical, elongated, whose inframammary fold is positioned more superiorly and usually the nipple is positioned lower than the groove. Although very common in the Indian race, can affect all races.

Treatment Breast Tubers with Silicone Implant consists of:

  • remove skin around the areola to flatten the breast (telescoping);
  • relaxing incisions inside the breast to broaden its base;
  • detachment of the inframammary fold to position it more inferiorly;
  • placement of silicone implants broad-based and projection is not much; pronounced.

Rejection of silicone prosthesis (Capsular Contracture)

Capsular contracture is healing spherical shape due to the silicone prosthesis, the excessive contraction of the capsule (scar tissue) that involves breast implants. The rejection of breast prosthesis is capsular contracture in advanced degree.

Baker called the degrees of capsular contracture as follows below:

  • Grade 1 – not visible and not palpable, the breast is similar to a breast is not operated;
  • Grade 2 (minimum) – palpable but not visible;
  • Grade 3 (moderate) – tangible and visible, though distorted capsule without pain;
  • Grade 4 (severe) – tangible and visible, marked distortion, breast hard and constant pain.

Dr. Zamarian explains that all patients who undergo plastic surgery for silicone implants, fit, early in the first degree of capsular contracture of Baker and normal is that this park contracture degree. The problem only began when the capsular contracture begins to move towards more severe degrees.

When the capsule is evident in thin patients without hardening of the breast and without deformity that alters their normal anatomy, it is characterized by rejection.

Grades 1 and 2 are considered normal for those making the Plastic Surgery Silicone Implants and nothing you do not require treatment.

It is considered “rejected” as popularly known, when the contracture occurs in grade 3, a level considered moderate, with deformity that changes the breast and moves upwards, giving the impression that she was tight and hard, and in grade 4, which is considered the most serious since the contraction is palpable, visible and capsule markedly distorted, causing the patient to feel constant pain.

The pathogenesis of this complication is not yet deeply known. Most recently in the United States, a study linked rejection of Silicone implants to a subclinical infection, but the experience of Dr. Zamarian, none of their patients to date showed grade 3 or 4, the prosthesis coated with polyurethane Pintanguy / Rebello.

The difference, scientifically proven, the prosthesis coated with polyurethane is that most patients who use it, have a degree of contracture of Baker as any other, but their chances of advancing to the next level of contraction are minimal.

Treatment of Capsular Contracture (“Bounce”)

Previously, capsular contracture was treated with the manual operation of external twist and squeeze the breast, until the rupture of the capsule, however, this maneuver has fallen into disuse because it is traumatic and can damage the silicone prosthesis.

When the capsular contracture is in grades 3 and 4, the treatments performed by Dr. Zamarian are:

  • capsulotomy – incisions are made in the capsule in order to relax her;
  • capsulectomy – consists of the removal of the prosthesis with total repositioning of the implants.

When it comes to dish it back to grade 1 or 2, Baker.

The Streaks and Cirugia Plastica silicone prosthesis

What are Stretch Marks?

Stretch marks are linear atrophies appearing due to the disruption of elastic fibers that support the middle layer of skin as well as when there is involvement of collagen in the skin. Disruption and commitment are the result of mechanical stress such as excessive stretching of the skin, or physiological stress, namely, that stimulated by hormones. Once the fibers are broken, they fill with blood and that is why the recent streak is reddish. Are formed, then, some lesions that show the skin as minicicatrizes. Over time they acquire a whitish color, and these were considered the most ancient grooves.

What is the relationship of silicone implant surgery with streaks? Cases are frequent?

The breasts that look like skin with increased fragility for the placing of Silicone implants may develop streaks yes, exactly for this stretch, the volume of Prosthodontics concerned, especially while the swelling is greater.

Some rare hormonal changes may also facilitate its occurrence.

But if we Clinic Zamarin had a case of stretch marks caused by silicone stent insertion in the last six years was too much. It is extremely rare in our experience, but not impossible.

What to do to avoid the appearance of stretch marks after Silicone Prosthesis Surgery?

Dr. Zamarian always recommended hydration in the immediate postoperative Rose Hip Oil, because in his formulation there emollient properties that increase the lubrication of the skin, aiding in natural moisture, all because of Vitamin E that is present. Important to emphasize that it is not the oil Rose Hip itself that prevents the direct formation of grooves, but indirectly, by helping to avoid them because it leaves the skin extremely hydrated.

The application of Rose Hip Oil is to be done at night before bed, the skin is clean. Drip a few drops of oil over the area to be hydrated, using a circular motion when spreading and massaging gently until its complete absorption occurs. In cases of very dry and fragile is the recommended two daily applications.

Preferably, the patient should not be exposed to the sun when applying the product on the skin.

The drain used by Dr. Zamarian decreases the amount of fluid in the breast and its volume in the postoperative period, being an important factor in preventing stretch marks.

What to do when it appeared the Stria?

The first alternative for treating stretch marks that appeared is the use of cream ESTRIANON, whose form, and only helps to correct stretch marks, scars and spots on the skin. Can be found at any pharmacy or drugstore. Its use should occur in small quantities of product, 2-3 times a day, always applying the product over the groove, and massaging the site for about 60 seconds. Treatment with ESTRIANON usually extends for 60 days and above 60 days for complicated cases.

The second alternative for treating stretch marks, which is usually done by dermatologist Dr. Zamarian, is the use of retinoic acid following the evaluation of each case.

Silicone prosthesis coated with polyurethane X Textured Silicone Prosthesis

Dr. Walter Zamarian Jr. explains the key differences: “The silicone prosthesis with polyurethane coating is a little more work to be placed, but the result is a breast firmer and less prone to stretch marks and sagging. That’s because the polyurethane is that there is greater adherence of the silicone prosthesis to the surrounding tissues, resulting in firmer breasts, as compared to the texture. The surgeon, however, need to adjust the height and lateral prosthesis of silicone with polyurethane coating at surgery because this type of implant does not migrate from the place where it is placed. “ - Explains Dr. Zamarian.

The fact is that both silicone implants are well accepted by physicians and patients, but there is a regional trend of silicon prostheses coated with polyurethane to be more accepted in Rio de Janeiro and Textured Silicone Prosthesis, more widely used in the state of São Paulo. Probably, the formation of the centers of each state is responsible for regionalism.

With regard to capsular contracture, also popularly known as “bounce”, it is found in lower rates with silicone prosthesis coated with polyurethane, but even with textured silicone prosthesis, the incidence of capsular contracture is currently very low.

How long should I change my Silicone Implant?

Depends. Although silicone implants are not lifetime limit prescribed or recognized by the scientific community, Silimed defines an average period of ten years as the expected lifetime of silicone implants. This parameter can be changed if a reason arises to justify it. Currently, we are aware of several patients in Brazil and abroad with the same implant for over 20 years without any problems. The patient should be monitored regularly for that evaluates the need for replacing the implant. Dr. Zamarian recommends conducting a study with magnetic resonance year after the tenth year with a silicone prosthesis and makes the exchange of implants when the test shows changes or when the patient Dejes so, from that time. On average, implants are exchanged between 10 and 15 years after emplacement, because in 20 years, 95% of MRI studies show that silicone implants should have been exchanged.

Syndromes Associated with Silicone in Breast Prosthesis

Poland syndrome

The combination of these signs featuring Poland’s Syndrome:

  • unilateral absence of pectoralis major (if the only way, is regarded as monotypic syndrome);
  • syndactyly (union of two or more fingers) on the same side of the hand;
  • brachydactyly (short fingers more than normal or other hand).

They may also be present:

  • hypoplasia or agenesis (ATEL) of the nipple;
  • hypoplasia (hypomastia) or agenesis (amastia) of the breast;
  • hypoplasia of fat (subcutaneous fat);
  • absence of costal cartilages (II, III and IV or III, IV and V) and
  • hypoplasia of the proximal portion of ribs.

The test of whether there is an absence of the pectoralis major on suspicion of Poland syndrome is performed asking the (a) patient place hands on hips and push the belt inward, while the doctor tries to palpating the pectoral muscles contracted at armpit. CT scan or ultrasound is used to confirm the absence of the pectoralis major muscle.

Poland’s syndrome is described here because their treatment in women, is the placement of silicone breast implants. Often this surgery requires some adjustments, such as surgical correction of breast asymmetry, or simply the use of silicone implants of different sizes in both breasts. The brachisyndactyly can be treated with specific technique, which involves local flaps and grafts. Some mild chest deformities and even moderate need no specific treatment, while some others may require muscle flaps or myocutaneous. When there is lack of skin in the region to adequately cover the silicone implant, you can use a skin expander in advance to make fabric.

Mondor’s Syndrome

In the process of detachment of the inframammary fold needs to sometimes perform the cauterization of some vessels who may bleed. In this searing, they form a clot at the tip of the vessels, in particular, mammary veins. If the clot of these veins is still a little into the mammary vein, we can form a fibrous cord, which can be asymptomatic or cause pain. This is Mondor’s syndrome, ie a superficial vein thrombophlebitis breast, which may be spontaneous or occur after cauterization of a blood vessel. The diagnosis is usually clinical, but can be investigated with ultrasound or mammography. His treatment is done with aspirin for two weeks to two months, depending on the response of each organism. There are no major complications and the symptoms disappear quickly when establishing the appropriate treatment.

Schedule a consultation for Plastic Surgery in Silicone Prosthesis

Schedule a consultation so that Dr. Zamarian can evaluate your case and offer you the best option for plastic surgery to enlarge the breasts with silicone prosthesis, aproveitanto also to clarify all your doubts and anxieties about Plastic Surgery, the silicone prosthesis used and on postoperative.

Our team of Plastic Surgery is prepared to meet you in a warm, pleasant and informative.

To learn more about plastic surgery breast augmentation or other mode of Plastic Surgery, please contact the Clinic Zamarian in Londrina, Paraná.


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