Overview of breast augmentation (silicone implants)

Beautiful breasts – the symbol of femininity

A woman’s breast has always been a symbol of femininity and an important part of feminine charisma and perception, both one’s own and others’, i.e. with an influence on one’s own perception and the perception of others. A beautifully formed as well as sufficiently and appropriately large breasts is both a desire and a goal.

Reasons for breast enlargement

There are congenital and acquired causes of unsightly breasts.
Among the congenital ones are:

• Aplasia: One breast is not applied.
• Hypoplasia: The breast is -very small- and does not fit the body.
• Tuberous / tuberous / tubular breast: Here the breast has a tubular shape, mostly the nipples are protruding: protrusion.
• The Poland – Syndrome: One side of the breast is smaller, much smaller or not applied. In addition, the large pectoral muscle may be missing completely or partially in this malformation. Combinations with malformations of the hand are possible.
• Malformations of the nipples, the nipples: They can be -variably- too large. Invaginated papillae mamillae: the nipple is retracted.

Mental stress as a result of a small bust

If any of the above faults are present, they are permanent and will not correct themselves. Plastic surgery helps to solve the problem.
Psychological impairments as a result are possible: the woman does not feel like a full / complete woman. She therefore has problems with the opposite sex, does not dare to undress etc.

The aim of the treatment is to increase the volume of the breast

The aim is a feminine, beautifully shaped and sufficiently and appropriately large breast. The scars resulting from each operation must be as unobtrusive as possible.

Breast surgery procedure

Such an objective can be achieved by the following procedures:

• With a silicone implant
• With own fat
• With the transfer of other body tissue, i.e. a flap, stalked or microvascular.

The silicone implant is most often used in such treatments. It is usually inserted behind the large breast muscle, the pectoralis major muscle, via an incision in the underbust fold, the submammary fold. Variations are possible. Care is taken to ensure that the enlarged breast looks round, harmonious and symmetrical to the other side.

There are anatomical, i.e. drop-shaped, and round implants. Depending on the shape to be achieved, one or the other variant is chosen.

After breast surgery, the stretched breast muscle is the main cause of discomfort. But: We have a motto. It says: If you want to be beautiful, you do NOT have to suffer! That’s why our patients in our clinic are given a so-called pain scheme, i.e. pain tablets and pain drops automatically every two hours. This blocks the pain before it develops.

You can also enlarge a breast with your own fat. The following things must be considered: There must be enough fat to be transferred. In other words: there is too little for very slim women. Enlargement is possible by a maximum of just under a cup size.

In most cases, the procedure must be repeated because not all of the transferred fat grows. Enlargement with other body tissue, i.e. a flap, can only be considered for reconstruction after cancer surgery.
If the breast shape remains unattractive after the enlargement, a breast lift must also be performed. In this case, breast implants alone are not sufficient to form beautiful breasts, two treatments in one are necessary.

Interventions on the nipple, the nipple, can be performed on an outpatient basis under local anaesthetic: Our patient comes, we operate, she goes home with everything necessary and comes back the next day for a check-up.

Aftercare

After breast augmentation, patients wear a special bra for six weeks, which they receive from us. If necessary, a Stuttgart belt is also worn. It holds the implants in place.

The stitches are removed after two weeks.
The upper half of the body must not be subjected to strenuous activity for about four weeks, otherwise the prostheses risk slipping. The breast implant must be allowed to heal in peace.

The final result, i.e. when the prostheses have found their final place and all swelling has disappeared, can be seen after three months.

Risks / Complications

In operative subjects there is no such thing as zero risk! With experienced, with good surgeons it is small. Besides the normal possibilities: post-operative bleeding, wound healing disorders and infection (these must be close to zero), there are specific risks associated with breast augmentation with implants:

Capsule fibrosis: If silicone implants are used, a capsule of fibrosis, i.e. coarse connective tissue, can form around the implant. The exact mechanisms are not clear. It usually forms in the first two years after the operation. Fortunately, there is a therapy: the entire capsule is removed surgically and the prosthesis is replaced. We have not had capsule fibrosis for the last three years.

Recently, a phenomenon has become known which cannot be precisely classified, i.e. it is not known whether there is a causal link or a purely numerical one: The appearance of a certain type of cancer of the lymphatic tissue: ALCL. There are no exact figures, but the risk of this is currently estimated at 1:38,000. What we do know is that if such a cancer does occur, it is easy to treat and can be completely cured. I would be happy to explain the details in a conversation.

When is surgery not advisable?

If you are aware of the low risk mentioned above, there are no firm reasons against such a breast operation. If a significant enlargement is required, an implant has to be taken, but the fat transfer will not work.

Costs/reimbursement by the health insurance company

The costs for an aesthetic enlargement are to be borne by the patient. If a restoration, a reconstruction, is planned, the cashier must be consulted.

More information about breast enlargement

The following doctors have studied the subject in detail: J. T. Tebbetts, P. Hedén