Breast Augmentation

BREAST AUGMENTATION

Many women wish to undergo a breast augmentation. It is important that women do not have a breast augmentation because others want them to. It needs to be her choice. A breast augmentation in general is not the solution to any social or sexual problem. A breast augmentation is in particular useful when the breasts are underdeveloped and before the age of 18. The volume of the breasts may sometimes reduce after pregnancies or a slimming diet. Sometimes an asymmetry can be corrected by placing a larger prosthesis under the smaller breast. Some women have breasts that are in proportion, but they want to be even bigger. When breast are ptotic a breast lift needs to be performed as well. In all cases the patient needs to be well informed on what is and what isn’t applicable to her and the consequences thereof. As with any other operation the advantages need to be weighed against the disadvantages and risks. Therefor a consultation with a plastic surgeon is the first step.

MAKE INTAKE APPOINTMENT

DETAILS OF THE TREATMENT

THE FIRST CONSULTATION

During the first consultation the advantages and the disadvantages of a breast augmentation will be discussed (see 10 questions on breast augmentation). The different prostheses, the scars and the location of the prostheses will be highlighted. If your breasts are hanging too much a breast lift will be needed as well. Future investigation of lumps or other abnormalities will continue to be possible after a breast augmentation. In general, a breast size that fits your figure is aimed for. Bra sizes vary greatly between different brands making it difficult to use bra size as a measure to determine the size prostheses. A more reliable way to determine this is to place different size prostheses in the bra and judge the figure and size of the breast in front of a mirror. A bra without padding or a bikini under a plane white T shirt works best.

PROTHESEN

Prostheses are made up of a casing made of silicone filled with either silicone gel of saline. Scientific research has never found silicone to cause breast cancer or auto-immune disease. The lifespan of prostheses is limited and all prostheses will need to be replaced sooner or later. The quality of the prostheses nowadays has improved greatly since the first breast prostheses were placed fifty years ago. In general most prostheses will last 10 year and longer. The reason that prostheses need to be replaced is contracture of the capsule around the prosthesis, which results in hardening and eventually deformation of the prosthesis and the breast into a ball shape. Factors that play a role in capsule contractures are leakage of the prosthesis, infections and patient related. It is advisable to make an appointment to see a plastic surgeon after 10 years or when changes in stiffness or the shape or the breast occur.

THE PROCEDURE

The procedure is performed as a day case under a general anesthetic and takes one hour. Most often the prosthesis is inserted through an incision in the fold under the breast. It is also possible to place the prostheses through an incision in the axilla or through the areola, but the risk of bacterial contamination and capsule contractures in greater. The prostheses can be placed between the breast and the muscle or between the muscle and the chest wall. The most appropriate method in your case will be discussed. Sometimes small drains will be placed and connected to two small vacuum bottles. Any fluid that may accumulate in the breast can then be drained.

AFTER THE PROCEDURE

After the procedure the breast may feel tens and tender. This will subside in a couple of days. The nipples may be hypersensitive or less sensitive. This will normalize to what it was before the procedure. When you are fully awake you are discharged and have your first follow up appointment the next day if drains were placed. The stitches will all be dissolvable and do not need to be removed. It is sensible to organize help at home for the first couple of days. For the first 6 weeks it is advised to wear a bra without under wiring that is comfortable and supportive. It should be worn day and night. All movement that are painless are allowed. For the first six week after the operation, you should not go horseback riding, jogging, or any other sport that causes the upper torso to shake. Other sports like swimming and cycling on the other hand you can start gently after two weeks. The future possibility of breast feeding is not affected by a breast augmentation.

RESULTS

A breast augmentation is a safe and reliable surgical procedure. While a breast augmentation yields larger breasts right away, the final result may take a few weeks as the swelling subsides and the skin stretches. Most women by far are pleased with the results. It may improve your body image and self-esteem. Your expectations should be realistic and don’t expect perfection.

RISKS AND COMPLICATIONS

As with any other surgery, complications can arise with breast augmentation. A wound can bleed or an infection can occur. In rare cases, a prosthesis is ejected. The risk of complications is therefore present, but small. The scars may temporarily become red and thick after the procedure. In addition, impaired wound healing can cause a permanently wide scar. If the prosthesis hardens or the breast changes shape, it may be that the prosthesis has started to leak and must be replaced. There are also the normal risks of anesthesia. These risks are no greater or less than with any other procedure. The anesthetist will discuss this with you.

ALCL

A rare recently reported complication in breast implants is BIA-ALCL (Breast Implant Associated – Anaplastic Large Cell Lymphoma). This is not breast cancer, but a form of Non-Hodgkin's lymphoma (lymph gland cancer) that can occur in the capsule and fluid around the breast implant. You can recognize it by the relatively rapid enlargement of the breast due to fluid accumulation around the prosthesis or by getting a lump in the capsule around the prosthesis. ALCL is curable when the correct diagnosis and treatment are made in time. In a 2018 study, BIA-ALCL was investigated for the Netherlands. Women with breast implants have an increased risk of ALCL compared to women without breast implants. By the time a woman with a breast implant turns 50, the chance that she has contracted this disease is about 1 in 35,000. That will be 1 in 7,000 by the time she is 75 years old. In this study, as in other international studies, BIA-ALCL appears to be more common in implants with a coarse roughening of the shell, so-called macro-textured implants. Importantly, BIA-ALCL appears to occur in all types of implants, including implants with less rough or smooth surfaces and polyurethane-coated implants. The Health Care Inspectorate indicates that breast implants comply with the applicable regulations and that breast implants do not need to be removed preventively. As a result of the above publication from 2018, it is expected that follow-up research at European level will be launched to further substantiate these current recommendations.

MAKE INTAKE APPOINTMENT

SEND EMAIL

BEFORE