This form has been prepared to inform the patient and their relatives about the operation to be performed. It is a legal obligation to have it read and approved. The data sheets describe the anticipated risks and adverse events (complications) of surgical treatments; They are used to convey information about other treatment options. The risks identified have been defined to meet the needs of most patients in most circumstances. However, this form should not be considered as a document that includes the risks of all treatment modalities. Depending on your own personal health or medical knowledge, your plastic surgeon may give you different or additional information. Do not sign the form on the last page until you have carefully read all the information below and answered all your questions.
Breast pots are divided into two as round and anatomical (drop). According to their content, there are prostheses filled with silicone gel and prostheses filled with physiological saline, that is, physiological saline. When we look at the surface structure, the prostheses are divided into two groups as flat and rough prostheses. It was determined that the formation of capsules around rough-surfaced prostheses was less than that of smooth-surfaced ones. The Relationship of Breast Prostheses with Pregnancy and Breastfeeding: Breast augmentation surgery may affect breast-feeding in patients who have undergone breast augmentation surgery, but may be due to technical reasons. For example, in incisions made around the teat, the milk ducts coming to the lower half of the teat can be cut. However, such a situation is not encountered in under-breast and armpit incisions; Since the prostheses are placed in the submammary or submuscular planes, there is no harm to the mammary gland. Association of Breast Prostheses with Rheumatic Diseases: A relationship between anti-silicone antibodies and the disease has not been proven in patients with breast prostheses. Among the various symptoms faced by patients in recent studies, only those related to autoimmune diseases have been investigated. Some of these symptoms have been reported: *swelling and/or pain or arthritis-like pain in the joint *skin rash *general weakness *memory problems, headache *unnatural hair loss *muscle weakness and burning *unexplained or often unobserved loss of energy *nausea, vomiting *frequent colds, virus infection *bowel problems *swollen glands and lymph nodes and fever Surgery We have 4 different incision options for breast prosthesis placement. These are armpit, nipple circumference, inframammary and umbilical incisions. Each has its own advantages and weak points. The most preferred are incisions under the breast and around the nipple. Although the incision made around the nipple heals with a very small scar around the brown part called areola, technically it may be necessary to cut the milk ducts. In the submammary incision, there is no damage to the mammary gland and milk ducts; Healing occurs with an indistinct scar that sits in the submammary groove. In the armpit incision, there is no incision on the breast and the intervention is made from the armpit. Usually, prostheses are placed endoscopically through armpit and belly incisions. Although the scars are slightly reddened in the early postoperative period, they gradually fade over time and become indistinct. This surgery is performed under general anesthesia. General anesthesia means that the patient is fully put to sleep and his breathing is controlled by the anesthesia team with a tube placed in the trachea. After the surgery, nothing is given by mouth for at least 4-6 hours. These times can be changed by the patient’s doctor. The operation takes about 1.5-3 hours. A set of bands surrounding your operation area and a sports bra that grips your breasts are put on. You are usually allowed to have watery food and stand up in the fourth hour after surgery. In prostheses placed behind the muscle, pain increases with arm movements. This situation is limited to the first days. Edema (swelling), which increases gradually in the first two days, starts to decrease from the third day. Arms and body relax. On the third or fourth day, the bands on your chest are removed. Only heat resistant tapes placed on the seams are left. You are allowed to shower with these. After breast prosthesis applications, activities should be strictly limited for the first three weeks and gradually increased after this period. Sauna, solarium and steam bath should be avoided within 6-8 weeks following the operation.
Other Treatment Options: Breast augmentation surgery is an optional surgical procedure. Other treatment options include the use of external breast prostheses or pad support, or tissue transfer from other parts of the body.
Risks of Breast Augmentation Surgery:
1.Bleeding: Although rare, it is possible to encounter bleeding during or after surgery. When there is postoperative bleeding, the accumulated blood (hematoma) may need to be drained urgently. Do not take aspirin or pain medications starting ten days before surgery, as this may increase the risk of bleeding.
2. Infection: Infection is not common after this type of surgery, it can be observed in the immediate postoperative period or in the period following the placement of the implant. If infection develops, treatment includes antibiotics and the possibility of removal of the implant, or additional surgery may be required.
3. Capsule Contracture: It is the complication that should be known best among the late complications. A capsule naturally forms around every foreign object that enters the body, and despite all precautions, the body may sometimes overreact to these prostheses due to the presence of a foreign substance.
4. Change in Nipple and Skin Sensation: It is normal to have some changes in the nipple sensation immediately after the operation.
5.Skin Marking: Excessive scarring is not uncommon. In rare cases, abnormal scars may occur.
6.Implants (Prostheses): Breast implants can rupture and leak. The implant may also be damaged during surgery. Damaged or torn implants are impossible to repair and must be removed or replaced
7.Skin Folding Wrinkle: Visible and palpable folding of the implants is possible.
8.Displacement of the Implant: Poor placement or slippage of the breast prosthesis may occur from the first time it is placed, or may develop with discomfort and breast shape disorder.
9.Removal/Replacement of Breast Prostheses: Removal or replacement of the breast prosthesis and the surrounding scar tissue envelope in the future is a surgical procedure with risks and potential complications.
10. Anesthesia: Both local and general anesthesia carry risks. In all surgical anesthesia and sedation procedures, there is a possibility of undesirable situations, from the simplest to death. Small areas of your lungs may shut down. This increases the risk of lung infections. Antibiotic use and respiratory physiotherapy may be required. There may be swelling and pain in the legs as a result of blood clots. These clots rarely leave their place and travel through the bloodstream to your lungs, where they can cause death. Heart attack/stroke or death may occur during the procedure. Wound and respiratory tract infections, heart and lung problems, and intravascular coagulation may occur in obese patients and/or smokers.
11.Allergic Reactions: In rare cases, local allergic reactions to tapes, suture materials or applied creams have been reported. Allergic reactions may require additional treatment.
12.Seroma: Fluid may collect around the implant following trauma, excessive exercise, and surgery. Additional treatment may be required to drain the fluid.
13.Long-Term Effects: Changes in breast shape may occur as a result of aging, weight gain or loss, pregnancy, or other conditions unrelated to breast augmentation surgery. As a normal result, breasts may sag.
14.Thrombosed Veins: Thrombosed veins; cable-like stiffness, rarely develops around the breast and disappears without medical or surgical treatment.

15.Unsatisfactory Results: You may be disappointed with the results of your surgical procedure. After surgery, there may be asymmetry in the shape and width of the breast in the placement of the prosthesis. Unsatisfactory surgical scarring or displacement may develop. There may be pain following surgery. Additional surgical intervention may be required to correct the results.
16. Anaplastic Large Cell Lymphoma (ALCL): Implant-related (ALCL) BIA-ALCL has started to be heard in recent years as a very rare problem arising from the capsule formed around the implant. Fluid accumulation around the implant in the late period can be seen as a mass adherent to the capsule, mass formation on the skin or enlargement of regional lymph nodes, as well as during implant removal or replacement surgeries. As long as it is confined to the capsule and does not exceed the limits of the capsule and become a mass, it usually has a good course. It is thought that the roughness of the implant surface and the biofirm layer formed around the implant by microorganisms play a role in this disease. It has been shown to have nothing to do with the content of the implant and its placement for aesthetic purposes or for breast reconstruction after breast cancer. Late fluid accumulations that occur after one year must be evaluated by ultrasonography and breast MRI, and a fluid sample should be taken and an examination should be performed. Complete removal of the implant and capsule is considered sufficient for the treatment of BIA-ALCL limited to the capsule. A clinical check-up every 6 months and an annual ultrasonography are recommended for 5 years after surgery.
Statement of consent of the patient, parent or guardian: • My doctor gave me the necessary explanations about my health status. Complete removal of the implant and capsule is considered sufficient for the treatment of BIA-ALCL limited to the capsule. A clinical check-up every 6 months and an annual ultrasonography are recommended for 5 years after surgery. Statement of consent of the patient, parent or guardian: • My doctor gave me the necessary explanations about my health status. Complete removal of the implant and capsule is considered sufficient for the treatment of BIA-ALCL limited to the capsule. A clinical check-up every 6 months and an annual ultrasonography are recommended for 5 years after surgery. Statement of consent of the patient, parent or guardian: • My doctor gave me the necessary explanations about my health status. • I got detailed information about what the planned treatment/intervention is, its necessity, the course of the intervention and other treatment options, their risks, the consequences that may occur if I do not receive treatment, the probability of success and side effects of the treatment. • I understood the points that I should pay attention to before and after the treatment/intervention. • It was explained that all documents and samples taken during diagnosis/treatment/intervention could be used for educational purposes. • My doctor answered all my questions in a way I could understand. • I learned about the people who will apply treatment/intervention. • I am sane and I consider myself competent to make decisions. • I know that I don’t have to give consent for the treatment/intervention if I don’t want it and/or I can stop the procedure at any stage I want.
Estimated Time: 90 – 180 minutes Important Features of the Medications to be Used: During my stay in the hospital, I received information about the important features of the drugs to be used for diagnosis and treatment (what they are used for, benefits, side effects, how to use).
Lifestyle Suggestions Critical to the Health of the Patient: I received information about what I should do for my lifestyle (Diet, bathroom, drug use, movement status and/or restriction status) after my treatment/surgery.
How to Reach Medical Assistance on the Same Issue When Necessary: I received information on how to reach medical help (my own doctor, a different doctor, the clinic where he was treated, and 112 in case of emergency) on the same issue when necessary.
If I am pregnant, I have been informed that my unborn child carries a risk during examination/medical intervention/treatment/surgery and anesthesia procedures, primarily radiological procedures. I do not have a missed period or pregnancy.
PATIENT’S CONSENT
I was given the above detailed information about my disease and the planned intervention, and the possible complications and risks were fully explained. I was informed that if these develop, treatments, including surgery, may be required, but in some cases, complete cure or recovery cannot be achieved. I accept the implementation of the above-mentioned intervention and other additional interventions that may be required as a medical necessity during the intervention.
to this section;
The statement “I READ, I UNDERSTOOD, I GOT A COPY” written in the patient’s or Legal Representative’s own handwriting will be written..……………………………………………………………………………………..……………………
TO BE FILLED BY THE PATIENT:
Date of Consent:……………………………
Time :………………………………………………
Signature:…………………………………………………………………………………………
Patient’s (guardian or guardian for restricted and minors) Name and surname:……………………………
TO BE FILLED BY THE DOCTOR INFORMING THE PATIENT AND TAKING THE PATIENT’S CONSENT:
Title, Name and Surname of the Physician Receiving Consent:…………………………………………………..
Signature:……………………………………………………………………………………………

TAKING MEDICAL INTERVENTION
Name Surname Title:……………………………………………………………………..
Signature:……………………………………………………………………………………