Chirurgie esthétique seins | Dr. Patrick Trevidic

Breast augmentation with implants

Breast hypoplasia is defined by an insufficient volume of the breasts in relation to the morphology of the patient. It can be the result of insufficient development of the breast at puberty, or subsequently appear through loss of volume following pregnancy, breastfeeding, weight loss or hormonal disturbances. Sagging of the breast, distension of the skin and areolas, which are too low, can also be linked to the condition.

This operation is carried out on an outpatient basis and can be performed from the age of 18 years old.

Operating procedure

Mammoplasty increases the size of the breasts by inserting implants, which are pre-filled with silicone gel. Their size is chosen in advance, during consultation, by the patient with the advice of Dr Trevidic.

Depending on the anatomical characteristics of the patient, several incisions are made through which the implants will be inserted. They will be located either at the level of the lower segment of the areola’s circumference, or where the lower breast tissue meets the chest wall (inframammary fold). Two positions of the implants are possible in relation to the pectoral, pre-muscular or retro-muscular and these choices will be defined during the consultation. The operation lasts about one hour and is performed under general anaesthetic.

Post operation

The patient will leave the clinic a few hours after the procedure, with a secure elastic dressing, which should be kept on for five days, until the first postoperative appointment. A reinforced supportive medical bra should be worn for two weeks after the operation.

There may be pain during the first few days, especially when the implants are large and are placed behind the muscles. Pain relief will be prescribed. A feeling of tension, swelling, bruising and discomfort when raising the arms are common in the early stages, as well as minimal swelling of

Sun, sea bathing and sport can be resumed after two weeks. The final results will be seen after 2–3 months.

For sagging of the breasts, a reduction of the skin can be carried out to elevate the breasts.

*During your consultation, Dr Trevidic will show you examples of before and after cases.

Frequently asked questions

Pregnancy / lactation

It is recommended to wait at least six months after having breast implants inserted to consider pregnancy. It is possible to breastfeed in most cases, but this also depends on the patient. Breast augmentation is possible six months after breastfeeding or pregnancy.

Implants and cancer

Breast implants do not increase the risk of developing breast cancer. They do not interfere with the interpretation of breast radiological examinations. However, it is essential to always specify that you have breast implants at these examinations.

Dr Trevidic only places smooth implants.

Life expectancy of implants

It is not possible to estimate the exact life expectancy of implants as it depends on how each individual reacts to them. Life-long breast implants should not be taken for granted. Their guarantee in France is 10 years, but the average lifespan of implants is estimated at 15 years or more. Replacements are therefore not considered routine but will only be carried out if the implants show signs of pre-rupture, visible on ultrasound or mammography, which should be performed regularly.

Monitoring

After the post-operative check-ups, it is important to continue to attend any regular consultations with the gynaecologist. A specific consultation of implants is recommended every 2–3 years. Apart from this follow-up, it is essential to consult as soon as a change is detected or after any violent trauma. Breast ultrasound is a non-irradiating and a very accurate examination that can assess the integrity of the implants.

Reduction mammoplasty

Also known as breast reduction surgery, this operation is designed to reduce the size of excessively large breasts, correct sagging breasts and possible asymmetry, with or without reduction in areola size.

Breast hypertrophy is defined as when the volume of the breasts is too large, when, compared to the patient’s morphology. This is frequently a genetic issue. This excessive volume can have a physical, psychological and functional repercussions: pain in the neck, shoulders and back, or discomfort whilst playing sport.

The procedure can be done from the end of growth (17 years) and throughout life.

There will be two or three scars, depending on the technique used:

– either a scar around the areola and another vertical from the lower pole of the latter to the inframammary fold, which is where the lower breast tissue meets the chest wall . This is the so-called “vertical” technique,

– or a peri-areolar scar, a vertical scar up to the inframammary fold and a horizontal scar on it. This is the inverted “T” or marine anchor technique.

The length of the horizontal scar, hidden in the inframammary fold, is proportional to the extent of the hypertrophy and ptosis.

Operating procedure

This intervention, which lasts between 1.5–2.5 hours, is performed under general anaesthetic, and on an outpatient basis. The patient leaves the operating room with a reinforced bandage.

The stitches are removed one week later during the post-operation check-up. A reinforced supportive medical bra should be worn for three weeks after the operation.

The post-operative effects are not very painful, with swelling, bruising, and a slight discomfort when raising the arms are frequently observed. The scars usually heal well. The removed tissues are systematically sent to a specialized laboratory to be microscopically examined, even if the mammography and / or ultrasound is normal.

The final result can only be judged one year after the operation. Although rare, it is important to know of possible complications, such as infections, bruises, delayed healing, etc.

Pregnancy after this surgery is possible. Breastfeeding is usually possible but cannot be guaranteed in all cases. Breast sensitivity may also be changed.

*During your consultation, Dr Trevidic will show you examples of before and after cases.

Sagging Ptosis

Breast ptosis is defined by sagging of the breast and distension of the skin around it. Mammary surgery for sagging or mastopexy lifts and shapes the breasts when their size is acceptable, but they have become saggy. They have usually become droopy over time, following significant weight loss or after breastfeeding. The size of the breasts can also be increased at the same time of the surgery by inserting a silicone implant or by an autologous fat graft. This procedure can be performed from the end of growth of the patient and throughout life.

There will be two or three scars, depending on the technique used and depending on the case:

-either a scar around the areola and another vertical from the lower pole of the latter to the inframammary fold. This is the so-called “vertical” technique.

-or a peri-areolar scar, a vertical scar up to the inframammary fold and a horizontal scar on it. This is the technique called an inverted “T” or marine anchor. The length of the horizontal scar, hidden in the inframammary fold, is proportional to the extent of the volume and drooping.

The scars usually heal well.

Operating procedure

The operation is performed on an outpatient basis, under general anaesthetic and lasts one and a half hours. The patient leaves the operating room with a reinforced bandage. The stiches are removed a week later. A reinforced supportive medical bra should be worn for three weeks after the operation.

The post-operative effects are not very painful with slight swelling and bruising. Slight discomfort when raising the arms is frequently observed. The final result can only be assessed one year after the operation.

This surgery does not affect the chances of becoming pregnant. Breastfeeding is often possible, but it cannot be assumed in all cases. Breast sensitivity may be changed.

*During your consultation, Dr Trevidic will show you examples of before and after cases.

Gynecomastia

Gynecomastia is an increase in the size of tissue in men. It is most often bilateral and symmetrical, of firm consistency and sensitive to palpation. Gynecomastia should be distinguished from adipomastia which is much more frequent and corresponds to a local accumulation of fat. In this case, the consistency is soft, insensitive and bilaterally symmetrical.

Adipogynecomastia is a combination of the two problems.

Usually there is no cause for its occurrence. However, in some cases, it can be related to a hormonal imbalance or related to the use of certain drugs. Blood and radiological tests are necessary to check for one of these possible causes.

The purpose of the surgery is to restore normal anatomy as much as possible by reducing breast volume, by liposuction and / or resection of the breast. It is rarely done to remove excess skin.

In obese or overweight men, diet and exercise are started as weight loss can regress or even make gynecomastia or adipomastia disappear.

Operating procedure

This surgery requires a general anaesthetic and lasts about one hour. It is performed on an outpatient basis. The scar remains hidden in the lower edge of the areola. When gynecomastia and excess skin are very severe, longer incisions may be necessary. In predominantly fatty gynecomastia, excision can sometimes be done with liposuction alone. The scars are very short (a few millimetres) and can be located at a distance from the gynecomastia, such as in the submammary or axillary regions.

A reinforced bandage is made and will be kept for five days until the next appointment. Then, a compression band should be worn day and night for ten days.

*During your consultation, Dr Trevidic will show you examples of before and after cases.

Post operation

The post-operative period may be slightly painful in the first few days, an appropriate pain relief will be prescribed. Swelling, bruising, and discomfort when raising the arms are common at first. Sensitivity may occasionally be affected for a few months.

The improvement is often marked and immediate; however, a period of 4–6 months is necessary to assess the final result.