Breast Augmentation

Breast augmentation surgery in Kiev, mammoplasty

Mammoplasty is a plastic surgery of breast augmentation and transformation. The purpose of this surgery is to both make the breast larger and to achieve a natural look and beautiful shape for you to feel yourself at comfort and ease and which will be proportional to your body while making it more attractive.

Proprietresses of beautiful exuberant breast often become a center of high attention from the part of men. This fact cannot be denied as this is the way the nature is. The dream to have an attractive large breast became feasible due to plastic surgery. Nowadays this is one of the most popular and highly demanded surgical procedures as an ideal shape of breast helps a woman to improve her self-esteem and feel herself with greater confidence.

Doctor Zykov for PLAYBOY, April 2016

Round-shaped Polytech 450 cc high profile submuscular implants

Doctor Zykov for PLAYBOY, April 2016

Ways of breast augmentation: implants or lipofilling?

Let us begin with the most efficient and safe method as of today – which is installation of silicon implants.

1) With Breast implants

Breast augmentation with implants (which referred to as endoprosthesis replacement in medical language) – is a plastic surgery aimed at change of size and shape of breasts with the help of installation of silicone implants underneath or over greater pectoral muscle.

Multiple clinical tests and trials have confirmed reliability of modern implants and proved that silicon prostheses may withstand even the highest level of traumatization. If we turn to video search on Youtube, we may see a number of videos with testing of implants for strength, for example, where a vehicle runs over an implant and it does not explode from it and does not even deform. It is important to note that cohesive gel which is a filler of implants possesses a memory effect which always allows it to return to its original shape. For greater safety, the capsule of implants contains a special barrier layer which prevents penetration of low molecular components of silicon into the body.

VIEW BEFORE AND AFTER GALLERY

2) Fat transfer breast augmentation (lipofilling)

Breast lipofilling – is a good method yet not a universal one. It is ideal for correction of deficiencies of breast (pits, light asymmetry). However, for breast augmentation even by one size – implants are better!!!

The main drawback: large quantity of fat injected into a small mammal gland, muscle, subcutaneous fat tissue is simply incapable to succeed.

Another disadvantage: it is problematic to extract fat from patients with normal body weight or slim ones. In order for the patient to see an increase in volume by at least half a size, it is necessary to inject at least 100 ml of processed fat into each breast. Overall, including treatment of fat, one has to extract at least 300 ml for both mammal glands. As you may believe, extracting 300 ml in a girl with no obvious signs of obesity and avoiding doing irregularities in areas of liposuction is very difficult and I always worn about it.

Choice of breast implants

Surface. There are 3 types of coating of implants: smooth, textured (rugged), textured with polyurethane surfacing. An undisputable advantage of rugged and polyurethane implants is preservation of unchanged position inside the body which excludes the risk of sliding or turnaround. As far as smooth implants are concerned, those are mainly implants of round shape as in the case of rotation of an implant, visually this will not change the look of a breast. Many girls note that they are softer. Also smooth implants are cheaper and have lesser risk of folding (Bottoming out – is an excessive lower pole, typically a mistake of the surgeon: too low installation).

Capsule and filler. Capsule of all implants is made of silicon and filling can be of 2 types: cohesive silicone gel or saline. Implants with saline are practically not used any more by advanced plastic surgeons for the following reasons: they cannot keep the shape for a long time unlike implants with gel filling that have an “effect of memory” and are more natural and resilient by touch; 2) In case of a damage, saline may leak throughout the body while gel remains in place; 3) Silicone implants are lighter than saline ones.

Shape.By shape, implants can be round and anatomical (drop-shaped). Anatomical shape of the implant is the most highly demanded one among my patients. In about 70% of cases I install anatomical implants. However it does not mean that I dislike the round one. Round-shaped implant is also good, however, it has certain requirements about the shape of mammal gland. If the shape of the mammal gland is sufficient (more precisely, certain necessary distances are in place), I can guarantee that the effect will also be very nice on a round-shaped implant. Also, if a girl is willing to obtain a large gorgeous breast, it is most probably about a round-shaped implant. There also nuances of perception: round-shaped implant looks impressive in clothing, blouses, while anatomical implant is less noticeable in clothing, however in a naked view it looks very beautiful and natural. Therefore, choice of shape of an implant is based on physical parameters of the patient and of course on her wishes.

Manufacturer. Implants of the following manufacturers are represented in the market of Ukraine: Polytech, Allergan, Eurosilicone, Mentor, Motiva. I try to work with the most top brands only because in our field safety is the main factor. Most of all I like brands Polytech, and I am also using Eurosilicone and Mentor. More and more patients are interested about my opinion concerning Motiva Ergonomix implants. So far, I can only note the fact that there no long-term observations on implants of this company. This is not a surprise as they emerged in the market only few years ago. Some of the obvious drawbacks of Motiva Ergonomix are as follows: excessive softness of capsule which causes rippling, corrugation at the edge of an implant (especially in slim girls).

Anatomical implants Allergan 370 ml. Looks nice in any position – while sitting, standing and lying

implants anatomy cen

Percentage of complications after mammoplasty depending on surface of the implant

Polyurethane implants like regular ones are filled with silicone inside, however they have an additional surface layer of polyurethane. If to compare polyurethane and texture (rugged) implants regardless of the brand, according to global statistics, (detailed results of trials in Aesthetic Surgery Journal), polyurethane practically gives no complications,, for example:

capsular contracture in textured silicone 5%, in polyurethane 0.01%
seroma in textured silicone 5%-10%, in polyurethane 5%
shift or turnaround in textured silicone 5%-10%, in polyurethane 0%
rippling in textured silicone 5%-10%, in polyurethane 0.01%.

No compression garments are required for polyurethane implants as they do not shift, one can sleep on a side and raise hands from the first day. Texture silicone and polyurethane are the same by touch. The downside of polyurethane, it is more demanding to technique of a surgeon as it is more difficult to install.

Preparation to surgery for breast augmentation

Before the procedure it is mandatory that the patient passes a number of tests and undergoes diagnostics.

Video of breast implants operation - Doctor Zykov

List of necessary tests and examinations before mammoplasty

Common urine analysis
General blood analysis with blood count
Biochemical blood test (overall protein, bilirubin and its fractions, ALT, ACT, blood glucose)
Markers of hepatitisHBcAg, AtHCV
Antibodies to HIV
Blood group and Rhesus factor
Blood forRW
Coagulogram
Ultrasound examination of mammal glands
ECG

In addition to preliminary examinations, one has to refuse from taking medicines influencing an increase of blood clotting ability. It is recommended to withstand from smoking and alcoholic beverages at least in half a month before surgical operation. Also, if you plan to “lose weight” or instead plan or gain wait, it is better to do all these corrections before the operation as if you do it after – sharp changes of weight may negatively affect the final outcome.

Where incisions are made in mammoplasty? Types of surgical accesses and places of installation of implants

Successful result of a surgical operation is influenced by right selection of place where an implant will be installed and surgical access which actually helps the surgeon to “reach” that place. This choice will determine if the patient will be able to feed with breast in the future, where incisions will be placed and accordingly scars, as well as generally, to what extent the result will be beautiful.

Places of installation of the implant:

Under pectoral muscle (in 2 plains) when upper part of the implant is installed under the greater pectoral muscle and the lower one under glandular tissue. The implant is reliably protected by pectoral muscle and tissues of mammal gland itself, palpation and translocation of implants are minimized.
Under glandular tissue – is only possible upon availability of a sufficient volume of soft tissues and small size of mammal glands. Is applied extremely rarely.
Under fascia of greater pectoral muscle – this method secures additional fixture of the implant compare to installation under the gland due to development of more expressed connections between breast prosthesis and major pectoral muscle.

Choice of a method is influenced by physical condition of the patient: position of breasts, presence of breast sagging (ptosis), elasticity and resilience of skin, expression of breast muscles, etc.

Breast augmentation is done through incisions located in places referred to as ways of surgical access. In order to make postsurgical scar unnoticeable to anyone, incisions as a rule are done in natural folds of the body. There are three ways of access:

The most common, convenient and low traumatic way is an inframammary incision. As it comes from its name, incision is made by the surgeon under the mammary gland in a natural fold of the body and it gives the surgeon the best view and access. In such a way, tissue of mammary gland is practically uninjured, post-surgical scar is least noticeable and is not visible to anyone.
Periareolar (peripapillary) incision is made at the edge of areola. It excellently hides post-surgical scar and provides for good access for the surgeon.
Another method of access which allows hiding the scar in a reliable way is axillary incision. However, it is applied rarely as big distance between armpit and mammary gland makes it difficult for the surgeon to access the area of intervention.

Scar after breast augmentation, 10 months

Rehabilitation after breast augmentation

Compression garments. During rehabilitation period after mammoplasty it is necessary to wear special compression garments which help to accelerate and improve the period of restoration.

Such garments carry out the following functions:

passive hemostasis in the first couple of days
limitation of edema
fixation of the right position.

I request to wear compressive garmentsfor an implant with polyurethane coating only for the first 5 days. Within that period edema may build up and 1-2 days are sufficient for hemostasis. Fixation of position with garments for this implant is not needed as it fixes very well on its own due to coating. Another thing is textured or smooth implants. They may change their position within the pocket. Compressive garments shall be worn for at least one month for such implants (Allergan, Mentor, Eurosilicone, textured Polytech, Motiva).

Pain sensation. Application of modern surgical technology enabled us to reduce pain sensation substantially in post-operative period and most of patients do not require additional pain relief. Sensations remind of muscular soreness. This also allowed us to refuse from drainage tubes. Girls are released home the next day after surgery and enjoy active lifestyle (one can raise hands, sleep on the side, drive a car, fly an airplane and go to work). Yet it is better to refuse from fitness and jogging for 2 months.

Sutures and scars. Nowadays there is no need to do dressing and remove sutures as stitches dissipate and surface level is treated with a special compound forming unnoticeable trace. Compaction and reddening of post-operative scars in the first two months after mammoplasty is a normal reaction of the organism. Within 5-8 months they will go white and become almost unnoticeable. Scar after breast augmentation will practically be invisible in a month.

Breast Augmentation Cost Kyiv, Ukraine

Breast Augmentation:	Price*
With Breast Implants Polytech, Eurosilicone, Motiva or Mentor	5 200 euro
With Lightweight Breast Implants B-Lite Microthane (Polytech)	6 500 euro
Fat transfer breast augmentation	3 000 euro

*Price includes: surgery, anesthesia, hospitalization, implants, compression underwear, dressing