BREAST AUNMENTATION - Dr. Jánky György plasztikai sebész
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Since 1962 medicine has used silicone, povably silicone implant has
been used for breast augmentation since 1968. We must know that
every good quality implant’s external mantle is silicone.
Its internal can be:
1. standard cohesive silicone jelly – soft, solid, elastic material.
It inhibits the corrugation of the mantle. Used most frequently.
2. strong cohesive silicone jelly – very solid, harder touch.
3. physiological saline solution – steril injection water: 0,9%
NaCl. According to observations because of the rubbing character of
the salt component of the saline solution, which increases the risk of
the mantle’s „tiredness”, no producer assumes 100% responsability for
the filling valve, after some time the water can extravasate in small
quantity. This is not morbid, breast will not let down like a baloon, buti t
loses its tensity, its shape and if the other breast’s implant does not let
out the same quantity of water, breast sizes will be different. Althogh
int he USA this is the most preferred , till in Europe number 1.
4. Polyvinyl-pirolidin (PVP) – harmless material with high water
concentration. I have no experience with it.
5. Hydrojelly – can be made with lot of compositions, can be
called jellic water. Permitted only some years ago in Hungary, so I do
not have hundreds of experience with it.
6. vegetable oil, soya oil – bacame fashionable abroad some
years ago, but then, after 3 years they realized that it is very bad,
because it can lose a lot from its size, it has srtong odour, not stable,
become rancid, taking out is complicated, if it sustain an injury can
cause many problem to the patient and to the surgeon. It is prohibited
in Hungary.

Int he last decade the quality of the implants developed a lot, their wall
thickness grew, so the microscopian silicone seeping decreased to the
minimum. All the modern imlpants are already villose, so calles textured
surfaced, thick walled. According to statistics with these implants occur
in less percentage the known as „capsulation”, capsularis kontaktura.

Photos1 Photos2

Its occurance according to big statistics 4-6%. Significantly dicreasable
by making regularly exercises with the breast. Women who have
already given birth and suckled know how to milk the breast. For all the
other woman-patient, after suture-taking, I show what it means and
how to do exercises with the breast.

Frequently occured questions:
– For how long do they need to make exercises?
My answer is very simple, I also ask the ladies:
After having a bath or a shower does she usually dry herself? Of course
everyboby anwers yes. So during drying for 2-3-5 minutes massage the
breast the way Ihave tought it. This connects also to the self-
examination of the female breast which is considered important by the
sanitary information in order to notice early the possible nodes.

– For how long is a breast implant good?
All the famous producing companies give 10 years garantee. This does
not mean that after 10 years you need tor un to the surgeon to take
the implant out, but you need to keep in mind that any kind of material
implanted into the body (for example cardiac valve, hip prosthesis,
artificial blood vessel, grafted tooth, pace.maker etc.) after a while it
gets older and need changing. There are many patients who wear the
implants for 12-15 years or even for 18 years.

Some years ago I had a patient who had worn implants for 15 years,
moreover that time these implants were not very good quality. (The
first ones were not implanted by me, I work as a plastic surgeos since
1991, before I worked at the general surgery ward at a hospital in
Budapest for 10 years).
The lady at the first implantation were 50 years old. When she turned
to me, she passed the 65. She did not have problems with the implants
but with the flexibility of her tissues. Her breasts didn’t have very nice
shape, so she asked me to change the implants. Changing them I
found old type, thin walled, smooth surfaced implants, with apparently
intact mantle. But I could see the time tried the relatively thin mantle-
wall and its content were yellowish-turbid, which made probably that
tha body’s cells crossed the thin, smooth mantle-wall.

Other significant point of view: int he 99% of the cases I implant the
implants under the pectoral muscle, and not under the mamma
subsatance. This results much more lasting shape and even according
to statistics there are fewer expulsion (capsula).

At a plastic surgery congress was announced the only lady who has
had a breast implant for 26 years. Generally stasistics show that after
12-15 years women’s 25-30% have greater-smaller complaints. These
are related in most cases to the shape, the skin’s strech, the possibly
formed capsulation. If these complaints bother her life, of course the
implant must be changed or taken out permanently. Always patient
decide if she wants a new one or not.

About the operation:
I do the breast implantation in narcosis, with 1 day in-patient. All the
operation in narcosis are made on Saturday, you need to stay 1 day in
hospital, then with the bandage and sutures you can go home. I have
a safe hospital background. The incision is under the mammary fold,
about 4-5 cm long and later the bra’s bottom edge covers the very thin
scar completely.

About the incision:
According to my opinion the incision around the areola of the nipple is
not good. I can prove it with photos made by other surgeons. Ir
scarres, deforms, the nipple becomes insensible and the scar can be
seen more stronly. (Scar could be changed to the same colour with a
microtatoo machine if there’s a need). From this incision implant cannot
be put safely under the muscle. Implants can be put in also from the
armpit and from an incision at the navel, but only in special cases.
Every type has its advantages and disadvantages.

I prefer the incision made under the mammary fold.

I take out suture after about 12 days, till that adte you need to come
to my surgery 1 day every week to change the bandage. Operation
date shold be chosen when 5-8 days before and after tere’s no

If the patient has a light, office job or works at home, then after 3-5
days can easily go to work. Under the dress bandage cannot be seen.
Doing sports is suggested only after suture-taking.
After the operation you need to wear a special bra day & night for 4-5
weeks. Its upper strap compresses the muscle in order that tha area
under the areola becomes round.
Photos1 Photos2

At the first consulting you get the written information sheet and we
discuss the details. I can show hundreds of photos about done
operations, how it was before, how it is after. So you can measure the
Photos1 Photos2 Photos3 Photos4 Photos5

You can give birth and suckle after the operation, (hiszen) I had many
patients like this, but you take into consideration that giving birth and
breast-feeding can change the breast’s shape greater and smaller,
even if you had any operation or not.

The fee of the operation contains: operation, narcosis, in-patient,
assistance, fee of the anaesthetist, his assistant, operation-room
nurse, night and day nurse, suture-taking, controls.

Above this fee there’s the price of the implants, depending from which
firm you order it. I only measure the size, I tell which one would give
the best result then I show you the catalogues, pricelists and samples
of the firms (forgalmaz) in Hungary. You get information sheet too
about these, then you choos the one you like from 70.000 til

There are cases when we combinate implantation with mastopexy (see
at Mastopexy) when the breast’s substance is very little but the skin is
streched out. Nipple must be put upper, areola should be made smaller
and the lacking volume is substituted by the implant.
Photos about combined operations

For any other questions that you are interested in and you didn’t get
from this text, please contact me vis e-mail or telephone.