The procedure | Breast augmentation

Breast augmentation is one of the most popular aesthetic operations, with women ending up feeling more happy and balanced after fulfilling what often has been a long-standing wish. There have been many advances in safety and durability of the implants used in breast augmentation and complication rates have declined dramatically as a result of that. Breast implants are nowadays made in many different shapes and sizes, which makes it possible to adjust to the desires and needs of each individual.

The consultation

During your first consultation it is the aim to clarify what you would like to achieve with your treatment as much as possible. Your surgeon will determine whether you are a good candidate for treatment by conducting a physical examination, which will include measuring your current breast dimensions. It is important to realise that no two breasts are the same – it is normal to be asymmetrical – and that some of these differences will remain after surgery or even become more obvious after surgery. Your physics also play a role in determining whether to place the implant directly underneath the breast gland, or one layer deeper under the muscle (“dual plane”). The final and essential part of the consultation will be to experience the effect of different sizes of external sample implants on your body image, in order to determine the volume that best fulfils your expectations and wishes. During the consultation you will be given an overview of options, which will include the preferred option, the risks and the possible complications.

Where will I be operated?

The operation will be performed in one of the private clinics of Vienna. If you have a preference then we will of course take this into consideration.

What can I expect of the operation?

Your surgeon will always see you before the operation and will talk you through the steps. Markings will be made on your breasts and pictures will be taken for documentation. The operation will be performed under general anaesthetic and will take approximately 45 minutes. The procedure will start with a small incision in the fold underneath the breast. A pocket will be made either under the gland or under the muscle, as discussed during the consultation. With a small instrument the blood vessels that are transsected will be sealed. Only when the pocket is made exactly according to plan, the implant will be taken out of its sterile wrapping and inserted immediately. The wound is then closed in layers to cover up the implant. After the operation you will have to remain in hospital for the first postoperative period. The drains that are left in your breasts at time of the operation will be removed before you are discharged.

What are the risks?

In breast augmentation surgery the risks are limited. Most common complications are the risk of postoperative haemorrhage or infection (1-3%). Both can be dealt with effectively and at limited physical cost if noted at an early stage. Significant infections however may require removal of an implant, which then can only be reinserted after a “cooling down period” of 3 to 6 months. The sensitivity of your nipples may be changed after surgery, both loss of or increased sensitivity does occur in a minority of cases, but in most cases this normalises over time. Long-term complications include the increasingly uncommon capsular contracture, most of which are transient. In some cases however, this may require a re-operation to remove the scarred capsule.

What can I expect after the operation?

Immediately after the operation you will experience tightness upon your chest as the implants not only enlarge your breasts, but also rest on your ribcage. Your skin will adjust to the new situation and the initial swelling will subside in a matter of days, after which this feeling will disappear. You are allowed to shower on the day after the procedure, but should take care not to remove the shower resistant tape covering your wounds, until the postoperative consultation after one week. You are required to wear the sports bra we provide you with day and night for 6 weeks.

What will the scars be like?

The scars will be placed in the fold underneath your breasts, so cannot be seen in most positions. Scars are usually visible in the first few months because of the difference of colour compared to their surroundings. Thickness and colour however will disappear over the course of a few months and the scars will be come less conspicuous over time.

How long before I can resume my normal life?

Most woman manage to return to light activities in the first few days after surgery, while some manage to return to work after a week (depending on physical requirements). Realistically it will take two weeks to reach this stage for most. Sports activities can on average be resumed after 6 weeks. Please listen to your body though; pain is a protective mechanism so if certain movements are painful please refrain from doing them. In the following months the final swelling will slowly disappear, but it may still be uncomfortable to lie on your front for a while. Sometimes unexpected movements still may give rise to sudden twinges, but this frequency will reduce over time. Total healing time is known to take one year.

What is good to know about the long term?

Breast-feeding

The implants are positioned behind the glandular tissue and should therefore not interfere with breast-feeding. However, it is good to realise that the ability to breastfeed is not guaranteed for woman in general. While a breast augmentation aims to optimise the current physical situation, the process of ageing, changes in lifestyle or variations in weight may all influence the shape of your breasts. This means that over the course of your life these alterations may result in a situation that is not to your liking.

Breast cancer

International studies have proven that the use of breast implants does not interfere with the occurrence of breast cancer. For the screening of breast cancer an X-ray taken with the use of the so-called “breast displacement” technique is preferred. Alternatively, an ultrasound or MRI may be of benefit.

Palpable implants

Implants used to enlarge the breast need to be covered by the breast tissue as much as possible. Implants however may be palpable, especially as the breast tissue thins over time. This may result in rippling which for instance can be noticeable in your cleavage when bending over. At the first consultation this risk is evaluated and in order to reduce this as much as possible, both the operative technique as well as the choice of implant are adjusted accordingly.
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