Among the available options, Dr. Antonio de la Fuente, a plastic surgeon with more than 40 years of experience, maintains that the choice of the implant is one of the most important choices when the patient seeks to obtain natural results.
The choice of the implant should be made basically according to the shape of the breast and the distribution of the parenchyma, that is, the breast tissue, and the measurements of the patient’s thorax, which we call the bio-dimensional concept. We should not exceed these measures or place implants that produce an exaggerated filling if we want to achieve a natural effect while avoiding problems.
The distribution of the parenchyma must also be taken into account, depending on whether we wish to smooth or fill the upper or lower pole of the breast. In my experience in patients with little development of the lower pole of the breast or a filled upper pole I prefer anatomical prostheses.
On the contrary, in involutive hypoplasias, that is, patients who after pregnancy or weight loss, or simply because of age, in which the position of the breast is correct but the upper pole has been left empty, I prefer a round prosthesis.
I also prefer moderate or intermediate profiles to achieve a natural look, as this naturalness is not compatible with an exaggerated projection or excessive volume.
Finally, I place the implant in the submuscular plane in order to reduce the incidence of capsular contracture and to have a better and firmer additional coverage.
Preparation before surgery
Apart from the preoperative study by anesthesiology to assess the health status of the patient (blood test, ECG, etc…) and previous radiological diagnostic tests (ultrasound, mammography, etc.) to rule out any breast pathology, from the point of view of the choice of implant must be assessed the anatomical characteristics of the patient as height and contour of the patient, base and height of the breast, etc.. The characteristics of the mammary parenchyma and skin coverage such as the thickness of the skin and subcutaneous tissue, elasticity, etc. must also be evaluated.
With what guarantees can the final result be foreseen?
It is not possible to guarantee a surgical intervention, but if one adheres to the indications mentioned above, as long as the breast has adequate skin coverage, without ptosis (sagging), or without significant alterations of the breast parenchyma as in cases of tuberous breasts, the results should, barring complications, conform to expectations.
Who is the ideal patient for this procedure?
Patients who desire a natural and proportionate augmentation and who have an adequate mammary parenchyma, elastic skin, non sagging breasts, not excessively thin thorax and with adequate measurements in terms of breast base, breast height, distance from the nipple areola complex (Cap) to the submammary fold, etc.
Finally, as far as personal aspects are concerned, that patients are receptive to the information they are given, as well as to the indications, that they follow the pre and post-operative instructions and that their expectations in terms of results are reasonable.
Is there an age limit or minimum age limit?
This procedure is not recommended for patients who have not yet completed the development of their breast and, unless circumstances dictate otherwise, such as psychological factors, it is recommended to wait until they reach the age of majority.