The first esthetic increases are already over a hundred years of antiquity. It started with the utilization of injectable paraffin, originating a large percentage of complications. Because of this, it changed to the use of autologue tissues, or tissues removed from the same patient as lipomas or fat and skin grafts, until reaching the fat transference that was fashion during the 80’s. All these tissues produced fewer complications but the results were poor.

Due to these reasons silicone has arise during the 50’s and 60’s, with initial complications similar to the paraffin’s. They were used as a liquid for filling injections. The first silicone prosthesis was created in 1962, and consisted of a capsule covered by silicone and filled with saline solution. Until the 80’s prosthesis’ quality and materials were improved.

CANCER RISK

It was questioned for a long time, until multicenter studies were developed in many countries as the US, Canada, Denmark, Sweden and others, and proved that there is no correlation or that most cancers precede the prosthesis surgery, since it is considered that the latency between the beginning and the clinical manifestation is estimated to last more than 10 years. Therefore, many cancers will appear without the application of prosthesis.

There is a theory that says that a prosthesis (gluteal or mammary), can help the patient to palpate a tumoral mass, thus to realize a precocious diagnosis; but not all authors share this theory.

More than 100,000 women every year in the United Stated are subjected to an increase surgery with gluteal or mammary prosthesis, being these last the most demanded.

The studies have shown that the implants do not represent any serious health risk, they are not related to connective tissue’s illnesses and do not increase the risk of cancer.

PREGNANCY AND LACTATION

The mammary increase does not interfere with lactation, but it is recommended to wait for at least 6 months after lactation to be subjected to mammary increase.

SURGERY’S SEQUENCE

• Blood and heart exams, and a mammography or ecography are requested, according to the doctor’s criteria.
• The size is discussed with the patient, considering various factors as age, fall of the breasts, strias, women with or without children, etc.
• As routine we use texturized prosthesis that do not prick, with a highly cohesive silicon gel. They are anatomical and round (drop of water).
• They are placed in the front or at the back of the greater pectoral muscle, according to the patient type; for example thin women of small breasts are more susceptible to develop a capsular contracture around the implants, with greater possibilities if the prosthesis’ surfaces are soft rather than if they are texturized. Sub-muscular implants -at the back of the pectoral- must be applied to these patients. But there are other inverse cases as when there are fallen breasts with good mammary thickness in which the implant can be placed as sub-glandular or in front of the muscle.
• We have three incision or cut choices: on armpit, mammary wrinkle or around the areola. The last one is the most utilized.
• This is usually an ambulatory surgery that is performed with sedation and no general anesthesia, allowing the patient to return home on the same day. It takes about two hours, and the most utilized incision is at the areola, avoiding the mammary tissue for not compromising lactation, until reaching a plain muscular level where a sub-facial pocket or intramuscular pocket (new technique) is realized. This new technique provides more natural results and permits the use Endoscopic technology for greater surgery precision.
• In about two to four days the patient returns to her normal work activity, with restrictions to sun exposure and gymnastics for 21 days.