Medical Health Information

What are the disadvantages and risks of breast augmentation?

When breast implants are placed behind the pectoral muscle, elongation and pressure of this muscle is to cause pain in the chest. They are relieved by simple analgesics (paracetamol, anti-inflammatories) or muscle relaxants but never aspirin.

The "shell" is a reaction of the tissues surrounding the prosthesis, causing a stronger or breasts, appearing more or less rapidly (2 years on average). Fifteen days after surgery, it is necessary to massage the breasts daily to mobilize dentures and get a faster relaxation. It is also a prevention hulls.

The risk of infection is very low, less than 1% of cases. Infection requires a removal of the prosthesis to at least 6 months.

The risk of hematoma is too low (less than 5%).

Massage (stretch mark creams, essential oils ...) can limit "crackling" scar.
Attention to the risk of rupture or deflation: any hardening or, on the contrary, softening of the chest must see a doctor, the sole judge of the necessity of an x-ray or ultrasound.
Pregnancy is not recommended within 2 years after surgery.

What are the time, cost and reimbursement?

This cosmetic surgery is not supported (rate = 0%) Social Security (or by any mutual), hypotrophy outside the breast and congenital malformation syndromes (Poland syndrome, tuberous breasts).

Breast asymmetry can be supported provided that the asymmetry of at least two different sizes bra.
The extra fees are possible and must be signed by a quote or surgeons to perform all or part of the operation: quotations in accordance with Decree No. 2005-777 of 11 July 2005, signed receipt the patient.

Incompressible follows a period of 15 days of reflection necessary informed consent of the patient. There are preset consent forms ready to sign. Some surgeons do copy the text by the patient to ensure proper understanding. Sometimes there is a third informed consent for clinical conditions of hospitalization.
Off the cost management of breast augmentation varies between 3,000 and $795,000.

Who practice breast augmentation?

At the public hospital or private clinic accredited, the surgeon must always have the specialty of "plastic surgery, reconstructive and aesthetic" officially recognized by the Council of the College of Physicians. Other surgeons are qualified to perform cosmetic surgery in the limited context of their anatomical specialization (Maxillofacial Surgery, for example).

Breast Augmentation

The breast augmentation is to correct the breast volume considered insufficient by the introduction of an implant (prosthesis) behind the mammary gland in place. There must be a harmonious volume to avoid ptosis (falling breasts) in the short term. The implant shell is made of silicone elastic is smooth or rough (textured) filled with silicone gel (99% of implants) or saline.

The implant is inserted through a small incision in the skin is located on the areola or in the underarm area or in the inframammary fold. It is placed either in front or behind the pectoral muscle, depending on the size of the existing gland and the surgeon's preference.

What are the uses (indications) of breast augmentation?

Apart from women who wish for aesthetic reasons, three malformations justify the use of this surgery: the hypomastie congenital (that is to say the absence of breast), Poland syndrome (unilateral malformation that may affect more or less strongly chest and upper limb on the same side) and tuberous breasts (tube-shaped) anomaly often bilateral.

How is the cosmetic surgery of the breasts

Before the intervention, two surgery consultations spaced at least 15 days is recommended. Routine preoperative mammography after 35 years or when risk factors for breast cancer. The anesthesiologist is seen in consultation at the latest 72 hours before the mammaplasty. Smoking cessation is recommended 2 months before surgery, only one month for oral contraception. Aspirin, anti-inflammatory drugs or oral anticoagulants are stopped 15 days before to reduce the risk of bleeding.

The procedure, performed under general anesthesia and lasts 1-2 hours. Modeling is a dressing is crafted with elastic bands or with a bra. The breasts are swollen, firm and painful to the touch and very few moving for a period of up to one month. When implants are placed behind the muscle, many gestures of everyday life are hard for 1 week. The sport should not be taken before 1 month.

The result is assessed at 3 months, but only after 6 months or 1 year's breasts acquire their final appearance. Their volume drops by about 15-20% compared to the immediate postoperative period.
The implants silicone gel involves monitoring by ultrasound and mammography annual biennial.

Breast Reduction

Reduction mammaplasty for hypertrophy: what do we talk about?

The reduction mammaplasty for enlargement (or reduction mammoplasty) reduces the volume of the breasts by removing excess glandular tissue. It is associated with appropriate correction of ptosis (sagging breasts) or an asymmetry between the two breasts (remodeling).

What are the uses (indications) of breast reduction?

Motivations are not only aesthetic (generally after pregnancy or weight loss ... very important). Breast hypertrophy often involves a physical impact, functional pain (back, neck, shoulders, sport delicate clothing problems) and psychological (self-image, eye contact), especially in juvenile breast hypertrophy occurring around puberty. It is reasonable to operate until the end of puberty, approximately 2 years after menarche.

How is the surgery?

Routine preoperative mammography after 35 years or when risk factors for breast cancer.
The anesthesiologist is seen in consultation at the latest 72 hours before the mammaplasty. Tobacco cessation is recommended 2 months before surgery, only one month for oral contraception. Aspirin, anti-inflammatory drugs or oral anticoagulants were stopped 15 days before to reduce the risk of bleeding.

Always performed under general anesthesia, reduction mammoplasty lasts between 1 hour 30 minutes and 3 hours. The end of surgery, the surgeon fashions a dressing or with bands or with a bra. Swelling (edema) and bruising (bruises) on the breasts, discomfort to the elevation of the arms are quite normal.

The output occurs after 1-3 days, dressing and consultation for 15 days. This is an opportunity to choose a bra ensuring good contention to wear 1-2 months, 24 hours/24. It is reasonable to stop working for a fortnight and not get back to sport before 2 months.

The result is judged at least 1 year after the intervention monitoring period during which the patient consults each quarter.

What are the risks and disadvantages of breast reduction?

Postoperative pain - especially tension on scars - is relieved by simple analgesics (paracetamol, anti-inflammatories, but never aspirin). The evolution of scars is unpredictable, some may expand or become hypertrophic, that is to say in relief. Necrosis of the areola can be total or partial, is favored by smoking.
Thromboembolic events (phlebitis, pulmonary embolism) are rare prevented by stopping the pill last month, wearing stockings, sunrise early or anticoagulant therapy. Antibiotics is usually sufficient to stem a possible infection, but sometimes surgical drainage is required. Nipple sensitivity can be altered, it reappears, usually after 6 to 18 months, but not always. Breastfeeding is a priori not compromised after a breast reduction of average importance, but sometimes discouraged because of the risk of abscesses and skin damage (falling breasts). In fact, it is a personal choice, the only requirement is to wait two years before attempting pregnancy. Reductions in breast significant, the surgeon cuts the plates are located where the areola and nipple, then grafted onto an area where he removed the skin. He then severs the milk ducts that allow the arrival of milk. However sometimes the sensitivity returns, breastfeeding can although absolutely not guaranteed.

What are the time, cost and reimbursement of breast reduction?

This intervention is supported 100% by Social Security if the glandular volume collected is greater than 300 g per breast (or 2 cup sizes less) without prior agreement. The inspection may take place subsequently, the weight of the tissue samples. There may be additional fees of the surgeon about 1500 euros.
Below 300 g reduction, this surgery is not supported: it takes between 3000 and 5000 euros.

Who practice breast reduction?

At the public hospital or private clinic accredited, the surgeon must always have the specialty of "plastic surgery, reconstructive and aesthetic" officially recognized by the Council of the College of Physicians. Other surgeons are qualified to perform cosmetic surgery in the limited context of their anatomical specialization (Maxillofacial Surgery, for example).

What are the risks and disadvantages of breast reconstruction?

The pain varies depending on the intervention, and also personal tolerance. Due to distension of the pectoralis major muscle in the breast implant, it is quite important the first days. Analgesics to remedy generally well (paracetamol, anti-inflammatory, never aspirin).

Postoperative edema and bruising are normal. Latter usually disappear within 3 weeks.
A flap necrosis, more or less extensive, may occur when an inadequate intake of blood (ischemia), the risk is greater if the flap is large or if the patient is a smoker.

The risk of pulmonary embolism, phlebitis and is limited by wearing stockings, sunrise early or anticoagulant therapy.

Complications of the prosthesis are cracking or rupture of the implant, or the formation of a capsular: fibrous scar reaction around the prosthesis which can deform the breast or be painful to change the prosthesis or the permanently remove.

The pedicled rectus muscle of the abdomen brings some advantages: in large volume without prosthesis, more natural and stable, silhouette enhanced by abdominoplasty, but also disadvantages: the heaviness of the operation (4 to 7 hours of general anesthesia), hospitalization (10-15 days) with thromboembolic risks, haemorrhagic necrosis and higher, the larger scars.

What are the time, cost and reimbursement for breast reconstruction?

After cancer, intervention is supported 100% by Social Security: with the exception of breast symmetrization will be handled on a case by case basis.

Breast reconstruction: definition
Breast reconstruction is to reconstruct the breast volume after mastectomy (partial or total removal of the breast) to treat breast cancer.

Four techniques of breast reconstruction are possible:

Temporary breast prosthesis
Temporary breast prosthesis called "skin expander" is an inflatable balloon that will develop skin bag. He will be replaced after 2-3 months the final prosthesis. In breast reconstruction after cancer, the major constraints (cons-indication if radiotherapy, perfect skin quality, skin bag initially sufficient, regular visits to inflate the balloon, the need for a second operation to replace the expander ... ) make this technique is now abandoned in favor of those with tattered described below;

The prosthesis associated
The prosthesis (usually silicone) with or without abdominal flap or "pedicle" of the latissimus dorsi muscle (means that there is pedicle attached to its blood and lymph vessels, and nerves). Flap technique is required when the skin after mastectomy is insufficient and / or when the blood supply is poor after radiotherapy;

Without breast prosthesis
The third solution, without prosthesis, using a pedicled rectus muscle of the abdomen;

Lambeau "free"
The final solution uses a flap "free" feeder vessels are then cut and reconnected on the vessels in the armpit by microsurgery.

Three separate surgeries several months are needed before optimal results because it takes to make the new breast symmetric with respect to its neighbor (contralateral) intact.

It is necessary to reconstruct the nipple by full thickness skin graft taken at the inside of the upper part of the thigh, and also the nipple through plasty (remodeling) in place of the skin or a piece of the contralateral nipple (s it is large enough to provide material).

What are the uses (indications) for breast reconstruction?
The breast reconstruction after amputation (mastectomy) is now part of the treatment of breast cancer.

How are the interventions?
Radiotherapy and chemotherapy often complement mastectomy that removes the breast cancer. As these treatments alter the healing of the skin, wait 1 year before considering breast reconstruction, if there was no immediate reconstruction.

An anesthesia consultation is required one month before surgery, it is almost always performed under general anesthesia. Laboratory tests and additional tests are usually requested by the anesthetist.

Preoperative treatment with iron may be more prescribed in anticipation of autotransfusion. Smoking cessation is strongly advised. Preoperative mammography and histological examination of the breast (gland and skin) are systematic.

What are the risks and disadvantages of abdominoplasty?

General anesthesia is safe today. Risks exist rather after surgery, mainly phlebitis and pulmonary embolism, where: sunrise early after surgery, wearing stockings during and after surgery and sometimes subcutaneous injection of anticoagulant therapy. Edema (swelling), ecchymosis ("blue") may persist for 3 weeks. Sensitivity protruding areas - became firmer appearance-over pubic may diminish or disappear over several weeks or months.

When an infection occurs, it is between the 4th and 8th day. It is manifested by a red scar and painful, with a yellowish discharge and abscesses. Most often these are bruises unnoticed at issue.

There is also a risk of skin necrosis.
Abdominoplasty is not a cons-indication for a subsequent pregnancy, even if it is logically preferable to set the desired intervention after pregnancy.

What are the time, cost and reimbursement of a tummy tuck?

The patient receives a quote "an act concerning medical and surgical aesthetic purposes" or signed by the surgeons to perform all or part of the operation. This estimate must be consistent with Decree No. 2005-777 of 11 July 2005.

Follows a period of reflection incompressible required 15 days crucial to informed consent of the patient.
The surgeon's fee varies between 3000 and 5000 euros, plus the cost of hospitalization.

Abdominoplasty is supported by Social Security in case of "major damage the anterior abdominal wall with deck partially covering the abdominal Hair: after weight loss in morbid obesity in the aftermath of bariatric surgery, postoperative or postgravidique. "The level of support is then always 100%. But it is 100% tariff authority said Social Security, ie 266 euros. This includes the act of surgery, surgical assistant, 3 weeks post-operative care, hence the need for the surgeon in charge of most cases of excess fees, more or less returned to the patient based Mutual and its signed contract.

Who performs the tummy tuck?

At the public hospital or private clinic accredited, the surgeon performing abdominoplasty must always have the specialty of "plastic surgery, reconstructive and aesthetic 'recognized by the Council of the College of Physicians.

Other surgeons are qualified to perform cosmetic surgery, but they are limited to the anatomical framework of the specialty in which they are enrolled in the College: maxillofacial surgery, for example.

Abdominoplasty: What do we talk about?

The tummy tuck or abdominoplasty can correct a belly dystrophic, that is to say, whose shape is altered. Three types of excess are involved: excess fat (removed by liposuction), excess abdominal skin (the "apron" abdominal skin is removed and tightened) and sagging stomach muscles. Combine when excess skin and sagging muscles are added to abdominoplasty, a cure hernia (doctors speak of "diastasis recti").

The standard abdominoplasty is to resect the wall by cutting a flap of skin under the crescent-shaped umbilicus. The upper flap is sutured to the ras lowered and pubic hair, the umbilicus is given in good position. The scar is around the umbilicus and pubic flush, concave upwards to meet the natural folds.

What are the uses (indications) of abdominoplasty?

We can offer abdominoplasty after pregnancy or weight loss, and whenever there is damage and a significant distension of the skin (wrinkles covering the pubic bone). Apart from these aesthetic reasons, a tummy tuck for preventive is to operate midlife women with excess weight concentrated in the stomach which inevitably worsen with age. Abdominoplasty can then reduce weight gain in this region by taking a portion of the stock of fat cells (adipocytes).

How is the tummy tuck?

Before the intervention, two surgery consultations spaced at least 15 days are required, and a visit by the anesthetist (72 hours minimum).

Three medical instructions are to be observed: smoking cessation previous two months to reduce the risk of scar tissue necrosis; stopping aspirin, anti-inflammatory or 15 days before oral anticoagulants to reduce the risk of hemorrhage possibly interruption of oral contraception in the previous month (other temporary contraception) to limit the risk of thromboembolism.

The procedure is performed under general anesthesia always. It lasts between 2 to 4 hours depending on the size of abdominoplasty with 1-3 days of hospitalization. Eight to 15 days off work is recommended.
After surgery, local drainage (rubber blades or suction drains) reduces the risk of hematoma, for a few days to a few weeks. The dressing is removed on the second day, replaced by a high retaining sheath to wear for 24 hours/24 1-2 months. The son is removed between 10 and 15 days after surgery, one or more times. Every effort abdominal muscles (especially the charging port) is prohibited for 2 months. Postsurgical monitoring consists of four visits at 1, 3, 6 months and 1 year. Six to 12 months are needed to judge the final result.