Surgery for prosthetic breast augmentation

Surgery is performed under general anesthesia, sitting, to better judge the symmetrical positioning of breast implants in each breast.

The breast prostheses used are pre-filled with silicone gel and may be round or anatomical. In 80% of cases, I use round prostheses, most often positioned at the front of the large pectoral muscle for a more natural result, thus respecting the anatomy of the breast. The position of the prosthesis behind the muscle is reserved for very thin women, with small breasts and wanting a large breast increase. In these rare cases, the prosthesis would not be covered in the upper part and would be too visible under the skin. In this case, I use the Dual plan technique that allows a moderate muscle detachment and a lower gland detachment with a lowering of the underwater sill. In the case of Dual Plan, the prosthesis is ideally covered in its upper third by the large pectoral muscle and is naturally behind the gland in the lower 2/3 of the prosthetic height (see photos).

I no longer use the axillary incision under my arm, because in my experience in evaluating various techniques for increasing the breast, the risk of hematoma is greater with a more difficult positioning of the breast prosthesis.

Therefore, potential infectious risks were also described when using this incision in the hair under the arm.

To achieve a more natural result, with breasts with even more harmonious volume and curves, I systematically use test, shape and volume sizers or prostheses during the operation to better judge the choice of the definitive prosthesis.

A compressive dressing is performed at the end of the intervention to prevent the mobilization of the prostheses and to reduce the risk of hematoma.

Antibiotics are prescribed during the procedure to prevent infection around the prosthesis.

Interviewed on France 2 on Sophie’s Davant’s program, Masson explains the placement of breast prostheses in front of or behind the muscle.

Analgics are routinely prescribed in postoperative procedures to obtain the most painless wake up and surgical suites possible.

Postoperative pain is significantly less when the prosthesis is at the front of the muscle.

The drain, positioned under the arm, is removed by the nurse the following day during the first dressing before leaving the clinic.

The dressing is performed using silicone-based compressors for better healing. This simple completion dressing must be performed daily by the patient for approximately 10 days.

Maintenance of the dressing is performed by a prescribed throat support for approximately one month. Prescribed medical throat support, is systematically associated with the installation of a restraining band to allow better prosthetics to be maintained in their compartments. This restraining band is prescribed day and night for a period of 15 days. The final result of the breast increase with prosthesis is ideally achieved after two to three months.

The first postoperative consultation appointment is conducted at one week with a follow-up consultation in the first year to one month, three months and one year post-operative. An annual clinical examination will then be conducted by the surgeon with mammography and post-operative ultrasound prescriptions every two years.

The lifespan of commonly accepted breast prostheses is 12 to 15 years with new implants.

In the vast majority of cases, resumption of professional activity is possible between the 3rd and 5th postoperative days.

It is advisable to stop the sport for about one month, and if the prosthesis is positioned in the back of the muscle, sports that make significant use of the upper chest should be avoided for two months.

A foreign-object reaction (hull or capsulite collapsis), unpredictable over time, can occur with any type of breast prosthesis, in less than 5% of cases. The breast gradually becomes hard, changes shape to become spherical and painful. Breast and prosthetic massages are recommended at this stage every day for 10 to 15 minutes. In some cases, rare and evolutionary, surgical reinstatement is proposed. In this case, the re-involvement is simple and consists of a prosthetic change with the lowering of the subbreast groove and removal of the thickened and retracted capsule (see photos).

Since 2011, an exceptional occurrence lymphoma called Large Cell Anaplastic Lymphone (LAGC) may occur around some prostheses. Fewer than 200 cases have been referred around the world. Texting the envelope of some prostheses may be responsible for this. A classification of this lymphoma is currently underway and its evolution is most often favourable after appropriate treatment.