Aesthetic surgery of the breastsBreast augmentation can correct the size of small breasts or restore volume to breasts that lost volume, e.g. after pregnancy, lactation or hormonal changes.
1. Breast augmentation with implants
The implants contain a silicone gel that has a similar consistancy and feel to a natural breast. The implants come in round or anatomic shapes, depending on the effect one tries to achieve.
Round implants equally increase the volume in the superior quadrants, which may present a less natural superior contour to the breasts but that is also a desired effect by many women. These implants may have a beneficial lifting effect in case of breast droopiness.
Anatomic implants have a more natural shape and volume distribution, creating a more natural transition between the chest and the breasts. However, they may accentuate breasts droopiness and alter the shape of the breast if they turn spontaneously after implantation.
The incision is either around the nipple areola, in the breast fold under the breast or in the axilla. Each of these approaches have their benefits and limitations to be discussed with your surgeon. The implants are positioned in a surgically dissected pocket.
The implant can be either positioned under the breast gland or under the pectoralis majoris muscle. Placing it under the gland is more natural and physiological. The implant will remain mobile with the breast. The best indication for a subglandular pocket is in the context of sufficient skin coverage that is thick enough to conceal the underlying implant. In slim individuals it might be better to place the implant under the muscle to avoid visibility and this position also gives a more natural feel. A combination of placing the implant superiorly under the muscle and inferiorly under the gland is called “dual plane“. This combination pocket allows to help lift a droopy breast.
2. Breast augmentation with autologous fat injections
Fat transplantation allows to increase the breast size by about one cup size. It involves harvesting the patients own fat and transplanting it into and sculpting the breast. This can be used to harmonize the breast shape or complement the breast augmentation with an implant.
Of note, hyaluronic acid injections for breast augmentation or molding are currently not recommended and have unknown long-term impacts on breast gland physiology.
Breast augmentation: the surgery
The operation usually lasts 90 minutes and is done under general anesthesia. Usually it requires staying the night after, occasionally it can be done in the inpatient clinic. Sedentary work can be resumed three days after the surgery, sports not before 3 weeks. A special sports bra will be prescribed and is worn by the patient for the first post-operative month.
It is relatively easy for a surgeon to create big breasts, but much more difficult to produce an aesthetically balanced and pleasing result. During the consultation your surgeon and you will discuss and choose the best surgical approach for an optimized result.