Breast Augmentation in Mexico by Dr. Manuel Gutierrez Romero

Warning: Content may not be suitable for children, contains nudity & graphic surgical procedures.

Provably one of the most common cosmetic surgery procedures now (statistics) The only safe device to incise the size of the breast is the breast implant. They can be from Saline solution, and silicone, (both FDA approved). They have to be replaced every 10 years. Breast augmentation, or augmentation mammoplasty, it is one of the most common plastic surgery procedures performed today. Over time, factors such as age, genetics, pregnancy, weight changes, sun exposure, and gravity can cause the size and shape of the breast to change. Women who are dissatisfied with the size of their breasts, or have experienced changes in breast appearance can achieve a fuller, shapelier breast with breast implants. During breast augmentation, a breast implant is placed inside a pocket over or under the pectorals muscle. This can help to increase or balance the size of the breast, and will provide breast volume and restore the shape of the breast after partial or total loss. It is important to realize that breast augmentation will not correct sagging or excess of skin in the breasts. If this is the case, a breast lift will be necessary, which may be performed in conjunction with this procedure. The most important factor to be happy with your surgery is that “You have to know very well what you want”. The more clear in what you want the easier to make it happened. I normally send patient to measure different size and shape of bra’s, and also look for before and after pictures of naked breast that they like, and bring those pictures on the day of the operation.

Preoperative Instructions

Patient’s must have blood work before the surgery and a preoperative evaluation with a cardiologist if they have any medical condition. They must stop taking the following medications and supplements (aspirin, Motrin ibuprofen, multivitamins, vitamin E, gingoviloba, gin seen , and green Tee) all of these medications are blood thinners and patients will bleed more in the operation.

They have to take a shower the morning of the operation, and don’t drink alcohol couple of days prior to surgery. They must disclaim all medical conditions and medications and drugs prescribe of the Drs.

Types Of Breast Implant

There are basically 2 type of implants: saline solution and silicon implants.

Saline solution implants: The saline solution implant is a deflated bag made of silicon, this bag has a small valve were the surgeon will plug a connector and fill the bag with saline solution up to the manufacturer suggested volume. Once the implant installs and the size is ideal you disconnect and close the valve. (the most common problem with saline solution implants is the water like or gradual deflation of the implant from the valve, this deflation usually will bring rippling that you can perceive when you touch or sea the breast, the water jiggling specially with some bubbles are also possible) this can happens up to 30% of the patient in the next 5 years.

Silicon Implants: You have 2 types, the silicon gel, and the cohesive gel or gamy bear.
Regular silicon gel: this implant is ideal, it has a natural filing and consistency, when you touch the breast it is very similar to the natural breast tissue, the new type of implant is very UN likely to like which is the most common concern for patients. The implant eventually has to be replacing between 10 no more than 15 years.
The cohesive silicon gel implants have a more firm consistency like gummy bear; this implant has the dis advantage of being more firm and hard. This is a down fall for many patients.

Silicon implant linkage
The new type of silicon implants are tested so the implant will last up to 10 to 15 years before the implant leaks.

The linkage if one silicon implant is a mayor concern for many patients but they have to remember our body is so wise that as soon as the implant gets in to your body, he will create a natural capsule or scaring tissue to isolate the implant from the rest of your body, all the patient with implants have the natural capsule around the implant, in up to 10% of the patients there body will react more exaggerated, and build a thicker capsule (up to 10 times thicker than normal). If an implant likes the silicon is contain in the normal capsule created, so the silicon will not migrate to other areas or organs it will stay in side the capsule. When breast implant likes or rupture your body will produce a thicker capsule and patients describe to have one breast harder than the other.

Most of the patients I evaluate with breast implants with more that 15 years and hardness they have a rupture implant in 90% of the cases. At the time of the implant exchange I try to remove the capsule intact with the implant in side this will make the operation cleaner, and then we place a new implant.

FAQ

When is the best time to have a breast augmentation? The recommended age to have a breast augmentation is after 18 years of age that is the average time when the breast tissue has complete his development and patients are a good age to take a firm decision to change there body. If you just had a baby it is important to wait Until you finish breast feeding and there is no milk production. As far as what is the oldest you can get a breast augmentation. I Don’t think it is the age but the general health condition is more important to have a healthy patient. Breast implants cause cancer? No in many studies they have proven that breast implant do not increase the risk of breast cancer.

Where Is The Best Place For Breast Implant Placement?

The implant can be located over or under the pectoral muscle.
The guideline is the amount of tissue on the chest, if on the pinch test the patient don’t have more than 2 inch of tissue in the upper part of the chest we must go under the muscle. If the patient has more that 2 inches of tissue, the implant can go over the muscle.

Advantages and disadvantages, when the implant is place under the muscle the patient must expect to have more gap in the center; the muscle has the tendency to push the implant apart. More separation and this will be a big draw back for many patients. Over the muscle more a chance of cleavage but is it cleavage is the most important thing? One of the disadvantages is it more chances to have capsular contraction. More chances to see rippling and irregularities of the implant especially in saline solution.

The most common incision is:

Around the areola and the infra mammary crease The operation it self is very simple normally we use twilit sedation or regional anesthesia with a sedation, the operation is done in 1 hour, the majority of patients go home the same day, you will wear a compression bra with a strap on the top for 3 to 4 weeks, that will push the implant down.

Recovery time usually 5 to 7 day, before driving and office work must have a daily shower, and minimal arm movement, go back to the gym in 3 to 4 weeks.

The most common complication of breast implant is The capsular contraction, we don’t know who, when it can happen under or over the muscle, saline or silicon, Mexico, or USA, Latinos, Caucasian, oriental, 1 month or 10 years after the operation.

You will be discharge from the clinic with: antibiotic, pain relives meds, special bra.

Things we do to minimize capsular contraction:

At the time of the operation: I remove very well the powder of my surgical globes, no body touch the implant but my, I dip the implant in Iodine solution, apply antibiotic in the pocket I created, and introduce the implant, if the surgery is with more bleeding than normal I like to place a drainage. The massage will consist of applying pressure and circular motion to the implant. The idea is to make sure the implant will occupant all the pocket I have created, the larger the pocket the less chances to the implant to become encapsulated.

Post Operative Instructions

The patient will take antibiotic for 7 days, empty the drainage 2 times a day, and will begin massaging the breast implant after 2 weeks when the breast is not tender any more.

Minimal arm movement, no lifting any thing heavier than 5 ponds, daily shower and blow dry the tape for 5 to 10 min, empty your drainage 3 times a day, you can apply ice to reduce swelling, take your antibiotic and pain relive medicine as prescribe, drainage tube must be remove after 7 days or went the fluid turns yellow for more than 24 hrs.
You must begin massage with your breast after 10 to 14 days, the massage consist in displacing the implant in circular motion so it can occupied all the pocket, you must massage 5 min in the morning and 5 min in the evening for at least 6 months, Driving for 4 to 6 days wear your compression bra for 4 weeks day and night.

Breast Lift in Mexico

A woman’s breasts help define her femininity, and with the vast differences in shape, size, and appearance, breasts further help to define her individualism. Therefore, changes to the breasts can be dissatisfying and make women feel as if they are losing some of their femininity and youthful vitality. Like other areas of the body, the breasts undergo changes in response to factors such as genetics, the aging process, pregnancy and breast-feeding, weight gain or loss, and hormonal fluctuations. Breasts that were once firm and shapely often begin to sag and droop giving them a loose or heavy appearance. A breast lift, or mastopexy, can help restore a firmer, shapelier breast, which will improve body contours and give the breasts a perky, youthful appearance.

A breast lift can be combining with augmentation at the same time.

Although there are many factors that can contribute to sagging of the breasts, the aging process and the effects of gravity play a primary role in these changes. Just like facial skin, the skin around the breast loses its elasticity in response to a gradual breakdown of the skin’s support network, which causes it to become lax. In addition, the suspensor ligaments that attach the breast to the chest wall weaken and stretch in response to gravity. The breasts enlarge during pregnancy and breast-feeding, which further causes the skin to stretch. As the breasts reduce in size following pregnancy, the skin that was once stretched, is now loose and sags. Lastly, fluctuations in your weight and even hormonal changes can cause your breasts to change in appearance. In combination, these factors can cause the breast to droop and sag, or in some cases rotate in a downward direction.

At the time of the consultation I always begin with this question:

What size of breast do you want: same, more or less? This will help my understand what type of procedure will be ideal. If my patient answers is the same: I mention that a traditional lift or mastopexy can give the appearance of ½ a cup smaller if you don’t what to go smaller I like to suggest a small breast implant.

The second question I like to ask in the consultation is: How long do you what your breast to be lifted?

The patient replies what? Yes, how long you want your breast to be lifted? You have to remember the skin is an elastic organ so when we do a breast lift we are basically removing a lot of excess of skin, the next day you will see your breast lifted, perky, and firm. At the time the swelling and inflammation is reduce the breast will have a “NATURAL DROP” in 3 to 6 months, If you are not going to like a natural drop I like to suggest a breast implant for enhancement and shape in the long run. An implant doesn’t mean you have to go necessary to a larges size we can use a small implant to live you in the same size. (I always insist my patient bring photos of breast they like this will give me a better idea what do they want)

TYPE OF BREAST LIFT’S

There are different types of breast lift and it will depend on the amount of breast tissue, the degree of sagginess, and the size you like to be after. All of these factors will determine what procedure you need. The most important factor for a breast lift is the position of the nipple, the nipple has to be located in the middle distance of the arm, and if the nipple has migrated down we must lift it up.

In a patient with A or B cup that wants a small augmentation we normally suggest a per areola lift, (only an incision around the Areola) in this moment if the patient want, we can also reduce the size of the areola standard size 3.5 to 4 cm.

If the patient has more that a C or D, most likely we have to do the inverted T or the keyhole; this means the incision is located around the areola.

It is very common for us to suggest a breast implant in our entire breast lifts this will give a more projection and firmness especially in the long run.

The post operative instructions are similar to the augmentation.

Breast Reduction in Mexico

There are several reason way patient look for a breast reduction, cosmetic or reconstructive.

Either because of excessive weight on the shoulders, heavier creases by the bra, upper back pay by bad posture or moisture and humidity in the infirmary crease that turns in to mycosis, or simply for cosmetic appearance, a breast reduction is a very gratifying procedure. The size of the scar has to justify the discomfort of a large breast. At the end the only difference is the size of the reduction, but the scar is the same, the typical scar is the key hole for inverted T.

Most of our surgeries we live drainages, an there are removed in one week, sutures are remove in tow weeks, Young patients that have not had children have to be suited to a technique that preserve the center of the breast tissue and all the milk duct connected to the nipple, this is very important to allow breast feeding in the future. (The reduction can be perform medially, laterally and preservation of the center in the breast) If the actual consistency of the breast tissue is fatter and does not have firm consistency there is an alternative to remove excessive tissue and replace the excessive resection with a breast implant this will provide a long term internal support to the breast and will have a better shape in the long run.

If the patient has firmer breast tissue there is no need to add a breast implant.

Most of the large breast reductions patients can expect to loose sensitivity at the nipple areola complex, but patients gradually can slowly recover during the first year.

The post operative instructions are similar to augmentation and lift.