A naturally small breast, a loss of volume after pregnancy and breastfeeding, or a marked asymmetry between the two sides are the most common reasons for a breast augmentation. Breast size in itself has no disease value; whether a procedure makes sense depends on how you feel about it and on the findings.
In a surgical breast augmentation (mammary augmentation) the volume is built up with an implant. It is one of the most frequently performed procedures in aesthetic surgery.
Reasons for a breast augmentation
- genetically small breast volume
- loss of volume after pregnancy and breastfeeding
- loss of volume after major weight loss
- asymmetry between the breasts
- reconstruction after an accident or breast cancer
If the breast also sags noticeably, an implant alone is often not enough. In that case a combination with a breast lift is an option. If enough of your own glandular tissue is present, a lift alone can be the better solution because it works without a foreign body.
Consultation for a breast augmentation
Dr Özdemir examines your findings: how much of your own glandular tissue is present, what the skin is like and what your proportions are. From this it follows which implant position and which size suit you.
He informs you about the surgical procedure, about risks and possible complications as well as about the costs. The practice is a private practice only; there is no health insurance contract.
The implants
Dr Özdemir uses round implants from established manufacturers. They are filled with form-stable silicone gel and have a multi-layer, leak-proof shell.
How the size is determined
The size is not determined on a screen but tried on in the practice. With trial implants in your bra you can see under your own clothing how different volumes affect your silhouette. From this impression and the measurements of your chest, the size that matches your expectations and your body is decided together.
Where the implant goes
Whether the implant is placed in front of or behind the pectoral muscle is decided mainly by how much of your own glandular tissue is present.
If sufficient glandular tissue is available, Dr Özdemir prefers to place the implant in front of the pectoral muscle. Your own tissue then covers the implant adequately and the muscle remains untouched.
If little glandular tissue is present, the implant is placed behind the pectoral muscle. The muscle covers the upper part of the implant and creates a softer transition, so that the edge of the implant does not show at the décolleté.
The access
In the vast majority of cases the incision is made in the inframammary fold. There it is hidden in a natural crease, the risk of infection is low, and the access gives the best overview when shaping the implant pocket.
In principle, access via the armpit or at the lower edge of the areola is also possible.
Course of the operation
The operation is performed under general anaesthesia and takes about one to one and a half hours. It is possible on an outpatient basis; if you prefer to take it more slowly or the procedure was more extensive, you stay one night.
Drains are usually not necessary. If the implant lies behind the muscle, they are placed more often. The sutures dissolve by themselves.
After the breast augmentation
For six weeks you wear a compression bra day and night, together with a stabilising band above the breast that holds the implants in position while the capsule forms. Without this band, implants can migrate upwards.
The breast initially feels firm and sits higher than it will later. This is normal: the swelling subsides, the tissue relaxes, and over the weeks the implant settles into its final position. The result can be assessed after about six months.
Capsular contracture
A capsule of connective tissue forms around any foreign body in the body, which is a normal reaction. If this capsule contracts and hardens, it is called a capsular contracture. This risk exists with every implant and cannot be ruled out entirely.
Its severity is classified into four stages. The first stages are inconspicuous or only palpable and are not operated on. Only when the breast is visibly deformed or causes discomfort is a procedure indicated. Which stage applies to you and whether treatment is needed is discussed by Dr Özdemir during the check-ups.
How long do implants last?
Manufacturers limit their specifications to about ten years. This does not mean that an implant must be replaced after ten years. If you are free of symptoms, the findings are inconspicuous and the result unchanged, the implant can stay longer. Conversely, a replacement may become necessary earlier, for example in the case of pronounced capsular contracture. What matters is the findings, not the calendar.
Breast augmentation with autologous fat (lipofilling)
For a small desired increase in volume, augmentation with autologous fat is an alternative. Fat is taken from another region of the body, processed and introduced into the breast. It works without foreign material, but the gain is considerably smaller than with an implant, and part of the transferred fat is reabsorbed.
Why there are no before-and-after pictures
You will not find before-and-after photos on this page, and Dr Özdemir does not show any during the consultation either. Initial findings, tissue, skin quality and body build differ so much that another patient's result says nothing about yours. What you receive instead: an examination of your findings, trial implants to try on and an honest assessment of what result is realistic for you.
