The decision to place breast implants in front of or behind the pectoral muscle depends on several factors, including the patient's anatomy, personal preferences, and surgeon recommendations. Here is an explanation of the two options:

In front of the Muscle (Subglandular)

Advantage:

• Recovery plus rapide : Recovery is generally faster and less painful.
• No deformation during muscle contraction : Implants are not affected by movements of the pectoral muscle, which can avoid visible deformation during physical exercise.
• Simpler intervention : The surgical technique can be simpler and less invasive.

Disadvantages:

• Less natural appearance in thin patients : In patients with little breast tissue, implants may be more visible and give a less natural appearance.
• Increased risk of complications : There is a slightly increased risk of complications such as wrinkling or rippling of the implant.

Behind the Muscle (Sub-Muscular)

Advantage:

• More natural appearance : Implants may look more natural, especially in thin patients, because the pectoral muscle provides additional coverage.
• Less risk of capsular contracture : The risk of capsular contracture (hardening of scar tissue around the implant) can be reduced.
• Better breast imaging : Mammograms may be easier to interpret when the implants are placed behind the muscle.

Disadvantages:

• Longer and painful recovery : Recovery may be more painful and take longer.
• Deformation during muscle contraction : Implants may shift or become deformed when the pectoral muscle is contracted.
• More complex intervention : Surgery may be more complex and invasive.

The choice of breast implants is a personal decision that must be made in close collaboration with your plastic surgeon. Here are some key factors to consider when choosing breast implants:

1. Implant Type

• Silicone implants : Silicone implants are filled with silicone gel, which mimics the natural consistency of breast tissue. They are generally preferred for their natural look and feel.
• Saline Implants : Saline implants are filled with sterile salt water. They are often less expensive and can be adjusted in size during surgery.

2. Implant Shape

• Round : Round implants can give a fuller appearance at the top of the breast and are often chosen for their ability to create more cleavage.
• Anatomical (teardrop shaped) : These implants are designed to mimic the natural shape of the breast, with more volume at the bottom than at the top. They can provide a more natural look.

3. Implant Texture

• Smooth : Smooth implants can move more freely within the implant pocket, which can provide a more natural appearance with less risk of visible creases.
• Textured : Textured implants adhere better to surrounding tissues, which may reduce the risk of displacement and rotation. They may also reduce the risk of capsular contracture.

4. Implant Size and Profile

• Select : Implant size is measured in cc (cubic centimeters). Choosing the right size depends on your personal preferences, body shape and aesthetic goals.
• Profile : The profile of the implant (low, moderate, high) determines the projection of the breast. Higher profiles provide more projection and can be used to achieve a more pronounced look.

5. Implant Placement

• Subglandular (in front of the muscle) : The implants are placed in front of the pectoral muscle. Recovery is generally faster, but implants may be more visible in thin women.
• Submuscular (behind the muscle) : The implants are placed behind the pectoral muscle. This can provide a more natural appearance and reduce some risk of complications.

6. Personal and Medical Considerations

• Morphologie : Your height, weight, width of your rib cage and the amount of existing breast tissue influence the choice of implant.
• Style de vie : Physical activities, especially sports involving the upper body, can influence the decision on implant placement and type.
• Aesthetic preferences : Your expectations for shape, size and feel should be discussed in detail with your surgeon.

7. Consultation with your Surgeon

During your consultation with Dr. Stéphane SMarrito, you will be able to try different simulators and discuss your aesthetic goals in detail. Your surgeon will take precise measurements of your breasts and torso to recommend the implants that best suit your anatomy and your expectations.

Recovery varies from patient to patient, but it is generally recommended to take at least a week off after the procedure. Strenuous physical activities should be avoided for approximately 4 to 6 weeks. Your surgeon will provide you with specific instructions to ensure optimal healing.

Like any surgical procedure, breast augmentation carries risks, such as infection, bruising, scarring, pain, rupture or displacement of the implant, and complications related to anesthesia. I will explain in detail these risks and the measures taken to minimize them.

There are several types of breast implants available, each with their own features and benefits. Here is an overview of the main options:

1. Filling Type

Silicone Implants:

• Description : Filled with silicone gel, these implants have a texture that closely mimics that of natural breast tissue.
• Benefits : Natural feel, less risk of visible creases or waves.
• Drawbacks : Require regular monitoring to verify their integrity, generally more expensive.

Saline Implants:

• Description : Filled with saline (sterile salt water), these implants are inserted empty and filled once in place.
• Benefits : In case of rupture, the body absorbs the saline solution safely, adjustable size during surgery.
• Drawbacks : May be more prone to visible ripples or folds, less natural feeling than silicone implants.

2. Shape of Implants

Round Implants:

• Description : These implants have a spherical shape and offer a uniform volume.
• Benefits : Create a more pronounced neckline, rotation of the implant does not affect the appearance.
• Drawbacks : May appear less natural in some patients.

Anatomical Implants (shaped like a drop of water):

• Description : Designed to mimic the natural shape of the breast, with more volume at the bottom than at the top.
• Benefits : More natural appearance, particularly for patients with little breast tissue.
• Drawbacks : Risk of rotation which can lead to an asymmetrical shape, generally more expensive.

3. Surface Texture

Smooth Implants:

• Description : Smooth and soft surface.
• Benefits : Less friction with surrounding tissues, allowing for more natural movement.
• Drawbacks : Slightly higher risk of capsular contracture (hardening of the scar capsule around the implant).

Textured Implants:

• Description : Rough surface designed to adhere to surrounding tissues.
• Benefits : Reduces the risk of rotation, less risk of capsular contracture.
• Drawbacks : Risk of ripple, some studies have suggested a link with rare forms of lymphoma.

4. Implant Profile

Low profile :

• Description : Implant with less projection compared to the base.
• Benefits : More discreet appearance, suitable for women with a large chest.
• Drawbacks : Less projection, therefore a less marked neckline.

Moderate Profile:

• Description : Provides a balance between projection and base width.
• Benefits : Suitable for the majority of patients, natural and proportionate appearance.
• Drawbacks : May not provide enough projection for those looking for a very pronounced neckline.

High Profile:

• Description : Implant with a greater projection compared to the base.
• Benefits : Creates a more pronounced neckline, often preferred by patients wanting a more dramatic look.
• Drawbacks : Less suitable for women with very large chests, may appear less natural on some.

Breast augmentation with prostheses

1. Volume and shape:

• Advantage: This technique allows great precision in terms of volume and shape of the breasts. With a wide range of implant sizes and shapes, we can customize results to your desires.
• Disadvantages: Dentures can sometimes feel less natural, especially when they are very bulky. However, recent advances have significantly improved their look and feel.

2. Durability:

• Advantage: Implants are designed to last for many years, often more than ten years. They offer a sustainable solution for those looking for a significant increase.
• Disadvantages: There are risks of complications, such as implant rupture or capsular contracture, sometimes requiring subsequent surgery.

3. Surgery and recovery:

• Advantage: The procedure is well established and controlled, guaranteeing maximum safety and efficiency.
• Disadvantages: Recovery time may be longer compared to fat transplantation, with an increased risk of infection and visible scarring.

Autologous fat transplantation (lipofilling)

1. Natural and touch:

• Advantage: This method offers extremely natural results, both visually and to the touch. There are no foreign bodies, which can be a significant advantage for some patients.
• Disadvantages: The volume of fat transferred may be partially resorbed, sometimes requiring several sessions to achieve the desired result.

2. Use of own grease:

• Advantage: Using your own fat, we can sculpt other parts of your body via liposuction, while increasing breast volume.
• Disadvantages: This method requires that you have enough fat available for transfer.

3. Surgery and recovery:

• Advantage: The procedure is less invasive than implants, with minimal scarring and often a shorter recovery time.
• Disadvantages: Results may be less predictable than implants, and multiple treatments may be necessary to achieve the desired volume.

Factors to consider

• Aesthetic goals: What appearance do you want? Natural volume and shape or a more pronounced increase?
• Health and medical history: An assessment of your overall health is essential to determine the best option for you.
• Cost : Compare the initial costs and possible long-term costs for each method.
• Personal preferences: Consider your preferences for touch, feel, and psychological comfort with implants.

Personalized consultation with Dr. Stéphane Smarrito

It is crucial to discuss your goals, expectations and available options during a personalized consultation. As an experienced specialist, I am here to provide you with recommendations tailored to your specific needs and personal situation.

Each method has pros and cons, and the best option depends on your individual preferences. Do not hesitate to make an appointment for a consultation to discuss your breast augmentation project in detail.

Contact us today to schedule your personalized consultation.

During breast augmentation, anesthesia plays a crucial role in ensuring the comfort and safety of the patient throughout the procedure. I will explain in detail how the anesthesia works during this procedure.

Types of anesthesia

For breast augmentation, two main types of anesthesia can be used:

1. General anaesthesia :

   • Description: The patient is completely asleep and unconscious during the entire operation.
   • Advantage: Ensures total comfort, no sensation of pain or movement.
   • Disadvantages: Requires close monitoring and carries risks associated with any general anesthesia, such as allergic reactions or respiratory complications.

2. Local anesthesia with sedation (conscious anesthesia):

   • Description: The operated area is numbed with a local anesthetic, and the patient is given sedatives to relax and remain in a semi-conscious state.
   • Advantage: Less invasive than general anesthesia, faster recovery.
   • Disadvantages: Less comfort than general anesthesia, because the patient may feel sensations of pressure or traction.

Anesthesia process

1. Preoperative consultation: Before the procedure, a consultation with the anesthesiologist is necessary to assess your general health, medical history, allergies and possible reactions to previous anesthesia. This step is crucial in determining the most appropriate type of anesthesia for you.

2. Preparation before the procedure:

• Young : You will need to fast (no food or drink) for at least 6 to 8 hours before the operation.
• Medicines: Follow the instructions regarding medications to take or avoid before the procedure.

3. Administration of anesthesia:

• General anaesthesia :
  • Induction: A numbing medication is given intravenously to put you to sleep.
  • Maintenance: Understand the maintenance demands. Fiberglass pools typically require less upkeep compared to concrete pools with liners. The anesthesiologist continuously monitors your vital signs (heart rate, breathing, blood pressure) and adjusts doses of anesthetic to maintain unconsciousness throughout the procedure.
• Local anesthesia with sedation:
  • Sedation: Sedatives are given to relax you and make you sleepy.
  • Local anesthesia : The anesthesiologist injects a local anesthetic into the operated area to block the sensation of pain.

4. Monitoring during the procedure: The anesthesiologist and his team continuously monitor your vital parameters to ensure your safety and adjust anesthesia levels if necessary.

5. Awakening and recovery:

• General anaesthesia :
  • Awakening : After the procedure, the anesthetic medications are stopped, and you gradually wake up in the recovery room under close monitoring.
  • Recovery: You may experience nausea, headaches, or a feeling of tiredness. These effects are usually temporary.
• Local anesthesia with sedation:
  • Awakening : You recover more quickly and are usually awake shortly after the procedure.
  • Recovery: Less feeling of grogginess compared to general anesthesia.

Postoperative follow-up

After the procedure, follow-up is essential to monitor your recovery and address any discomfort or side effects. You will be provided with specific instructions on home care, medications to take, and signs to watch for.

Breast augmentation, performed by Dr. Stéphane Smarrito, is not only a physical transformation, it also has profound repercussions on the psychological well-being of patients. Here are some of the most common positive psychological impacts:

1. Improved self-confidence : After breast augmentation, many women feel more confident in their appearance. This boost in self-esteem is often reflected in various aspects of personal and professional life.
2. Reduction of complexes : For some patients, insecurities about the size or shape of their breasts can be a real emotional burden. Surgery can correct these discomforts, bringing a sense of relief and greater self-acceptance.
3. Body Image Harmonization : Breast augmentation allows patients to feel a better symbiosis between their body image and the way they perceive themselves internally. This creates a feeling of well-being and balance.
4. Improving social relations : A body that feels good can facilitate social interactions, improve intimate relationships, and reduce feelings of self-criticism or inhibition.

Ultimately, breast augmentation, when performed by a specialist like Dr. Stéphane Smarrito, provides much more than an aesthetic improvement. It allows women to reconnect with themselves, feel more in tune with their bodies and strengthen their psychological fulfillment.

1. Importance of the support bra: The support bra is specifically designed to provide optimal support to the breast after breast surgery. It keeps the implants in place, reduces swelling and promotes rapid healing by limiting excessive breast movement. The bra also helps minimize post-operative pain and prevents the formation of folds around the implants, which could affect the final aesthetics.
2. Duration of wearing the support bra: Dr. Stéphane Smarrito generally recommends wearing this type of bra continuously, day and night, for approximately 4 to 6 weeks after the operation, depending on the case of each patient. During this period, it is essential to follow these guidelines rigorously to ensure the correct position of the implants and an optimal result.
3. Features of the support bra:
   

• Without frame : Post-operative bras are designed without underwire to avoid any friction or pressure on scars and implants.
• Breathable and soft fabric : The fabric is typically lightweight, soft and hypoallergenic, designed to minimize skin irritation and scarring.
• Front closure : To make it easier to use, especially in the days following surgery, the bra often has a front closure to prevent excessive arm movement.
• Additional support band : In some cases, an additional support band may be placed above the breasts to stabilize the implants and keep them in the correct position during the healing phase.

Steps to wearing a bra:

• Immediate post-operative phase : As soon as you leave the clinic, the support bra is worn 24 hours a day. It must be kept on even while sleeping in order to stabilize the chest during nighttime movements.
• Removal and adjustment : During the first few weeks, it is recommended to only remove the bra for showering and to put it back on immediately afterwards. It is essential to ensure that the bra fits well, neither too tight nor too loose, so as not to hinder blood circulation or healing.
• Medical monitoring : During post-operative visits, the surgeon will check the healing and fit of the implants, and may adjust the instructions regarding wearing the support bra. The time when you can switch to regular bras will be determined by the doctor based on the progress of healing.

Back to classic bras: After 4 to 6 weeks of wearing the support bra, Dr. Smarrito will allow you to wear regular bras, but it is recommended that you choose non-wired models for a few more weeks. Underwired bras could put pressure on the scars, which are still maturing. It is also recommended to avoid push-up or tight bras until the breasts are fully recovered.

Hygiene and maintenance: It is essential to keep the support bra clean to prevent infection at the scars. A second bra can be purchased so that you can change it regularly while the other one is washed. Washing should be done by hand with a mild detergent to preserve the elasticity and structure of the bra.

Wearing a support bra after breast augmentation with implants is a crucial step to achieve a satisfactory aesthetic result and ensure a smooth recovery. By rigorously following the recommendations of Dr. Stéphane Smarrito, you put all the chances on your side for optimal healing and well-positioned implants.