A woman’s femininity is expressed in her smile, her attitude and her demeanor, but it also manifests in her body. Full, well-rounded and well-positioned breasts are one of the greatest symbols of womanhood there is, yet not everyone is lucky enough to have been born with these attributes. Sometimes surgical enhancement with implants is required to achieve a larger, more attractive breast shape and size. In some cases, a woman who started out with such full breasts will undergo a shift in their appearance following breastfeeding and pregnancy, or will lose breast volume as part of the natural aging process. Sometimes a woman will lose breast fullness due to breast cancer and will require implants as part of the reconstructive process.
Breast augmentation is one of the most popular procedures performed at Op. Dr. Ali Murat AKKUS’s Istanbul plastic surgery facility. This procedure is consistently one of the top cosmetic plastic surgery procedures performed by members of the Europen Society of Plastic Surgeons. Op. Dr. Ali Murat AKKUS offers both saline and silicone breast implants. Op. Dr. Ali Murat AKKUS, a board certified plastic surgeon, is a world recognized expert who specializes in breast augmentation and breast implant revision for women who have had previous breast surgery.
Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman’s breast for a number of reasons:
The scar for our Istanbul breast augmentation can be placed either in the underarm, under the breast itself, or at the lower border of the areolus (the pigmented skin surrounding the nipple). Many patients, when given the option, prefer an underarm scar because it removes all scarring, and anxiety relating to scarring, from the breast. Top Istanbul plastic surgeon Op. Dr. Ali Murat AKKUS performs this procedure using an endoscope. This means that instead of bluntly tearing the lower border of the muscle, and risking implant malposition due to incomplete muscle division, the muscle is precisely divided under magnified endoscopic visualization, allowing for control of any bleeding and precise implant positioning.
“Throughout my years of practice, it has been very satisfying to achieve a natural-appearing breast appearance without any scar on the breast,” says Op. Dr. Ali Murat AKKUS. “It is very rewarding to see these patients both early after surgery and years after their operation, maintaining their results, and all without any breast scars.”
The breast augmentation/breast implant plastic surgery operation involves several important choices on the part of the patient. What size would you like your breasts to be after the surgery? Are you interested in saline or silicone breast implants? Where would you like the incisions to be placed? Should you have the implants placed above or below the muscle (pectoralis muscle)?
Implant size is selected based on a thorough consultation as well as obtaining a full understanding of the patient’s goals and concerns. Implant size will also depend on the patient’s individual anatomic considerations including skin laxity and chest diameter.
“There are two general ways to perform breast implant sizing,” says Op. Dr. Ali Murat AKKUS. “One method is for the doctor, based on his or her experience, to select the size that he or she feels would look best on the patient. Although I will always share my aesthetic opinion with the patient, I do not like this technique, and I do not want to be the one to decide what looks best for the patient. Ultimately, I feel that this is a very personal decision and my aesthetic taste may not match the patient’s. Clearly, the patient’s preferences are the ones that matter.”
For this reason, Dr. Ali Murat Akkus has his assistants perform very careful sizing with the patient, trying on a variety of breast implant sizes and profiles. With the doctor’s expert guidance, the patient herself decides which size is best for her. Dr. Ali Murat Akkus will clearly indicate if a patient’s request for size is not compatible with her anatomy and will review in great detail what tradeoffs may be involved in her particular size selection.
These decisions may seem overwhelming, but board certified NYC plastic surgeon, Op. Dr. Ali Murat AKKUS MD will discuss all your options with you during your consultation.
With regard to breast implant position when undergoing breast augmentation, Op. Dr. Ali Murat AKKUS generally recommends positioning the implants under the pectoralis muscle. The muscle covering the top part of the implant results in a more natural appearing breast with less likelihood of a visible implant edge or visible rippling.
Secondly, there is a reduced likelihood of capsular contracture, or hardness, developing over time. This is believed to be due to the massaging action of the muscle on the scar tissue surrounding the implant. Finally, the submuscular implant position allows for a better view of the breast when a mammogram is obtained. Just like the fact that other choices noted above involve tradeoffs, implant position also does involve a trade off. The dissection required to place the implant under the muscle does result in increased postoperative discomfort. Patients commonly take pain medication prescribed by Op. Dr. Ali Murat AKKUS for two or three days after surgery and find the discomfort to be quite tolerable.
A final trade off with the implants being positioned under the muscle is that when the patient flexes her pectoral muscles, the breasts will actually move upward. This is generally an unflattering situation, but this muscle action only happens rarely when one is out of clothing. The overwhelming majority of patients enjoy the advantages of submuscular implant placement and accept the tradeoffs noted above.
