Breast Augmentation

Augmentation of the female breast is one of the most popular operations in aesthetic surgery. It is either indicated by an undersized development of the breasts, a marked size difference, or "empty" breasts after pregnancy and breastfeeding, when a marked function-related enlargement and subsequent reduction in size after the weaning will often leave a noticeable volume deficit on the one hand and an excess of enveloping skin on the other. This process can also be brought about by natural ageing, with the loss of mammary gland and fat tissue causing the breast to appear empty and limp. In all these situations, the size and shape are out of synch with the rest of the body, which can markedly affect the self-image and how women feel about their body. The breast is enlarged by inserting silicone implants that are customized to local requirements and the patient's wishes by means of various shapes and volumes. Breast implants will not require replacement at regular intervals, but only if their outer envelope should rupture, for example. The durability of silicone breast implants can be meaningfully estimated to be ten years on average, but also considerably exceed this period.

The breast implants are inserted in an operation under general anaesthesia. This involves a ca. 5 cm long incision just above the side section of the inframammary fold (the fold underneath the breasts), through which portal a precisely positioned and sized implant site is prepared behind the mammary gland. This is my favourite positioning because the resulting shape is more natural and a deformation of the implant by contraction of the pectoral muscle is prevented.

Only occasionally, for example if the tissue layers of the skin and subcutaneous fat are very thin, will I preferably place the implant underneath the pectoral muscle. The skin scar will be least conspicuous in the fold underneath the breast, and is optimally concealed there. If excess skin plays a major role, this can create a need for simultaneous breast lift surgery.

Immediately after the surgery, the operated area and implants are protected with a special breast bandage, which is replaced by a sports bra providing good support after about one week. The wound is not permitted to come into contact with water for 14 days after the operation. It is important that the sports bra be worn consistently, day and night, for six weeks.