Any woman over 18 who is not satisfied with her small breast size due to incomplete development, shrinkage, partial falling or post-breastfeeding "emptying".
Any woman whose breasts are not symmetrical due to different development, surgical outcome or other reasons (congenital pathologies as the Poland Syndrome) and wishes to improve the asymmetry itself and/or the shape of the breasts.

This procedure can give extremely satisfactory results in very different cases, from aplasia (incomplete development) to hypoplasia (limited development) to women who had a normal breast development but wish to increase its size.
As of now, despite all the studies that are being made on the subject, there is no way to avoid prostheses insertion.
Being one of the most requested surgeries, in the past few years many urban legends have been spread about additive mastoplasty (such as prostheses exploding on planes, cold breasts or other fanciful stories), often performed by non-professionals causing serious damage to lots of people.
That's why the choices of which procedure to undergo and which technique to use will be discussed with the surgeon during the first visit in order to clarify every possible doubt.

DESCRIPTION OF THE PROCEDURE

This procedure can be performed only in operating rooms under conscious sedation or general anaesthesia.
The size, the shape (round or anatomical) and the placement (retroglandular or retromuscular) of the prostheses will be thoroughly discussed with the surgeon during the visit, because these choices will condition the post-operative phase and clearly the results as well.
Another critical decision that has to be made is where to create and insert the pockets in which the prostheses will be placed. There are three main options: from the armpits, areolar (from the lowest part of the nipple) and submammary.
This choice will be made according to the surgeon and the patient's taste and may be conditioned by the desired breast size, the patient's situation and expectations and the small changes that will occur during the post-operative phase. Each of these prosthesis insertion techniques has good and bad sides, so none of them is better over the others.
Once the pockets are ready and the prostheses are inserted, an aspiration drainage will be applied and then removed after 24-48 hours. There are different types of medications and sutures which will be chosen by the surgeon.

POST-OPERATIVE PHASE AND CONVALESCENCE

This procedure REQUIRES at least a one-night hospitalization, unless the patient asks for something different or the surgeon finds it necessary to make the patient stay longer.
For about 30 days after the surgery it is strongly recommended to wear a high-compression bra, like the sports ones.
During the first post-operative days the treated areas may look edematose (swollen) and sometimes ecchymotic (purple bruises that turn yellowish after a few days and eventually disappear), and this condition will end in the space of 7-14 days, depending on the patient's predisposition.
It may take up to 100 days for part of the edema (usually 30-40%) to completely recover.
In the first 24-48 hours the post-operative pain is more intense and can be managed with infusion therapies (drip). It will decrease gradually depending on where the prostheses have been placed (the retromuscular pockets are usually more painful), and can be relieved with painkillers.
During the first 7-15 days after the procedure the patient has to take antibiotics and anti-inflammatory drugs, or even other types of drugs if the surgeon or the anaesthetist find it necessary.
Intense physical activities and exercises must be suspended for about 30 days.
Smokers should not smoke at least 15 days before and 30 days after the surgery.

RISKS AND COMPLICATIONS

This procedure must be performed in a safe environment (Hospital operating rooms, Clinics and accredited Extended Care Facilities) and by qualified and expert physicians (surgeon, assistant surgeon, surgical technologist, anaesthetist and operating room staff), in order not to run into any risk of major complications, as long as the patient follows thoroughly all the post-operative instructions given by the medical staff.
The history of this procedure has been strongly influenced by a complication known as "capsular contraction", which consists in the thickening of the fibrous capsule (the natural physiological "barrier", the biological container that our body builds around the prostheses) beyond normal limits (around 0,2 mm / 0.008 inches). At the time when this surgery was just a few years old, this contraction was a very frequent complication that used to compromise the aesthetic results of additive mastoplasty.
Now these smooth surface prostheses containing fluid silicon are no longer in use, and also thanks to other factors that can't be properly discussed here, the frequency and seriousness of this complication have dramatically decreased.
What has been said so far is the reason why the choices of which procedure to undergo and which technique to use must be thoroughly discussed with the surgeon during the first visit in order to clarify every possible doubt and achieve the best results possible.
Unfortunately such good choices are usually more expensive, but I firmly believe that saving money endangering health, especially when it comes to aesthetic surgery, is both stupid and dangerous.

COSTS

Considering the wide range of available techniques and prostheses types/quality (consequently conditioning the duration of the procedure), of prices asked by the different Extended Care Facilities (and the huge importance of performing the procedure in safe facilities) and the fees for the anaesthetists and for the surgical and nursing staff, this procedure can cost from 6.500€ up to 9.000€.