What is breast augmentation?
Breast augmentation is performed by means of a implant, an autologist (= originating from one's own body) fat transplantation or a combination thereof. Both the shape and size of the breast can be adjusted. A good plastic surgeon always takes the shape of the chest into account. You are more or less free to choose which method and (in the case of implants) which implants you want. In addition, we take into account the amount of breast tissue and skin you have, the size of your breast and the extent to which your breasts naturally hang or sag. There are several things to discuss during your consultation:
- Do you want textured or smooth implants?
- What size do you want?
- Do you want saline or silicone implants?
- What shape do you want? Round or teardrop?
- What kind of profile do you want? Low-medium-high-oval-…?
- How much volume do you want?
When assessing where to insert the implant, we take into account your figure and the amount of breast tissue, fat tissue and mammary gland tissue. After your first consultation with Dr. Doornaert we know what the best option is for you.
The options: implants or autologous fat transplantation or lipofilling
If you implant you can choose between implants filled with saline or silicone. However, both options have a silicone shell. Because implants filled with saline sometimes feel less natural when placed directly under the skin or the mammary gland, they have now largely been replaced by silicone implants. Silicone gel feels more natural and offers a long-term stable shape and projection. In addition, This gel is now dimensionally stable and safe. In the unlikely event of a damaged shell, the gel will never leak. Long-term follow-up studies have shown that the current generation of silicone implants does not adversely affect general health. Implants made of dimensionally stable gel are available in both round and anatomical shapes. Implants filled with saline solution are only available in a round version. On the other hand, they can be inserted through small incisions, which in certain cases can give excellent results when placed under the pectoral muscle. The implants we use are from the brands Sebbin, Motiva, Mentor or B-Lite and have a 10 to 15 year warranty.
In addition to implants, there is also autologist (= of one's own body) fat transplantation or lipofilling are applied. During this procedure, we use liposuction to remove fatty tissue from areas where it is stored, such as the thighs, abdomen and hips. After treatment, the fat is suitable for lipofilling. We inject small amounts of healthy fat into the tissue that needs to be enlarged. In certain cases, a natural-looking, lifelong enlargement without scars can be achieved. In other cases, lipofilling can be applied as an addition to a smaller implant to achieve a more natural and long-lasting result.
Who is a good candidate for breast augmentation?
This technique is suitable for everyone. Please report your health or medical history during the consultation, so that we can make a good assessment. If you already have some breast volume and want to go up one or two cup sizes, lipofilling can be a good solution. If you want bigger changes in shape or volume, an implant or a combination of implants with lipofilling is possible.
How do you prepare for breast augmentation?
- If you are over 30, a recent mammogram is required.
- Quit smoking.
- If you have opted for lipofilling, a lipo panty must be ordered (by us or by you).
- Special breast bandage for post-operative use: comfortable and improves results and can be ordered by us or by you.
- If you are taking any medication (e.g. blood thinners such as aspirin), please inform our doctor in advance and ask when you should stop taking this medication.
How is breast augmentation performed?
Depending on your medical history and any additional treatment with lipofilling, the procedure can be performed under local anesthesia with sedation or under general anesthesia (which is usually the case). The surgery will take an average of 1 hour, although it can be longer if methods are combined.
If implants are used:
An implant can be placed in front of or behind your pectoral muscle. Incisions are made in the armpits, through the areolas (= the dark, circular tissue around the nipples) or under the breasts (our preferred method because of more control) to insert the implants.
- When they boven the pectoralis major muscle are placed:
- This provides a natural result.
- This placement is not recommended if you are naturally thin or have very thin skin, as the edges of the implant may become slightly visible. Please note that your skin will become less elastic and even thinner over time.
- The implant has minimal support because it is placed above the muscle.
- When placed under the pectoralis major muscle:
- The breasts will be firmer and will also feel harder.
- You will not see the edges of the implants.
- There is less chance of capsule formation than above the muscle. Sometimes it looks less natural though.
If an autologous fat transplant or lipofilling is used
First, you will undergo liposuction to remove fat from other parts of your body, such as your abdomen, hips or thighs. Then, the fat cells will be injected into your breasts. This method does not leave any scars. However, liposculpture is not suitable for everyone. Again, a consultation with your doctor will show you what the best option is for you.
Recovery and post-operative advice
You will receive a folder with post-operative instructions and advice. Please read them carefully and contact your doctor if you have any questions.
- When you wake up, you will feel numb, pulling or aching in your chest. When moving your torso and/or arms, you may experience discomfort due to swelling and stitches. If implants have been placed under the muscles, it is normal to experience more postoperative pain. Nausea and vomiting may occur as a result of the general anesthesia.
- Immediately after the operation, you will wear a support bra and/or liposculpture pants. You must wear these for 6 weeks and you may never take them off during this time, except to change your dressings or clean wounds. Even after this period, we recommend that you wear a sports bra for a while for optimal support.
- After about 4 hours you may only go home, after a thorough check. You may only leave when you can drink and urinate and are fully conscious. Your blood pressure and respiratory functions must also be stable. If you have to make a long journey, we recommend staying overnight nearby.
- For the first 24 hours it is mandatory for an adult to stay with you.
- After 48 hours you may shower, but avoid standing water (pools, hot tubs, etc.) for at least 2 weeks. Be gentle and take your time drying off.
- Slight capsule formation in the beginning is normal and is a natural reaction of the body around the implants. It ensures that the implants adhere well to the surrounding tissues. Furthermore, it ensures that they can no longer move. This process takes an average of 6 weeks. Therefore: no physical exertion, no heavy household chores and no sports (including sauna) for at least 6 weeks.
- We recommend not driving for the first 48 hours after surgery.
- Drink no alcohol.
- Please do not lift anything heavier than a 1,5 liter bottle of water.
- Do not raise your arms above your head.
- Never lie in the sun with your scars exposed.
- Try to sleep on your back for the first few months.
- Schedule check-ups with your surgeon:
- After the first 10 days.
- After the first month.
- After that, only in case of problems.
- After your recovery, you can schedule standard check-ups with your family doctor or gynecologist. Ask them for advice.
- If you do not experience any problems, we recommend having the implants checked by ultrasound after 12 years.
The result
The final shape of your breasts will look their best about three months after surgery, but again recovery takes time and varies from person to person.
The breasts may look higher, firmer and 'less natural' for the first three months due to swelling and the surrounding tissues still settling. It can take up to a year before the final result is visible.
Possible complications
What are the risks of breast augmentation?
Short-term
In the first 24 hours after the operation, bleeding or hematoma (= a local accumulation of (clotted) blood in the tissue) may occur. After that, as with any operation, a wound infection may develop. An infection that necessitates removal of the implant is extremely rare.
Long-term
The silicone shell of the implant has a special surface that allows the surrounding tissue to adhere firmly to the implant (encapsulation). This is a normal reaction that keeps the implant in the correct position. However, in the long term, this capsule can contract in the same way as scar tissue (capsular contracture) causing the breast to change shape. This can sometimes lead to discomfort or even pain. The smaller the implant is in relation to the existing tissue, the less likely this is to happen.
With implants placed behind the muscle, upward displacement may occur, especially if the muscle is subjected to excessive strain immediately after surgery.
Sensitivity of the nipple and areola may be temporarily reduced after surgery because there are differences in the rate of innervation that cannot be predicted.
Chronic pain: A very small number of patients experience atypical chronic pain without an obvious clinical cause, usually on one side only.