Breast Enlarge: Methods and Risks
Four questions to the experts for a current reason
We talked to Dr. med. Gerhard Sattler, founder of the Rosenpark Clinic for Aesthetic Surgery and President of the GÄCD (Society for Aesthetic Surgery Germany). ChroniquesDuVasteMonde.com: Doctor Sattler, is increasing the demand for breast augmentation? Gerhard Sattler: I would say that from 2010 to 2009, the number of breast augmentation surgeries has increased by about 20 percent. Is the breast surgery soon to be a birthday present for coming of age in Germany? Not at all. In Germany, on the contrary, the topic is usually dealt with very conscientiously. For German women, it takes an average of four years from the first consideration to the surgery. The British need eight months. Incidentally, I would not equate the legal age and the aesthetic. The latter has been reached at around 25. And the younger our customers are, the more intensively we advise. We rely on medical and psychological double counseling. What is the general risk or mortality rate for breast augmentation surgery? The mortality rate is negligible with augmentation (Editor's note: augmentation means enlargement). For example, the risk of hardening of the implant is 2 to 3 percent. Restriction of breastfeeding is extremely rare. Which OPs are most common among women? Which in men? Liposuction is very popular with women. At the back and waist. Then come the upper arms and chest. The men perform liposuction on the chest and abdomen.
Breasts: bigger, firmer, more beautiful?
While a few years ago B was still the most sought-after cup size, now C is the measure of all things. This corresponds to an implant size between 200 and 300 ccm (ie about one packet of butter on each side).
Especially very young women often feel small-breasted not feminine enough, Even 15-year-olds want to put themselves under the knife and can enlarge the breast - sometimes even with the consent of the parents. For example, an Emnid Survey commissioned by ChroniquesDuVasteMonde found that 18 percent of women under the age of 30 felt that they would have a better life if they had surgery and 23 percent of women between the ages of 30 and 39 were engaged . if he was not so expensive, The latest case of the erotic actress Cora, who fell into a coma after the sixth beauty surgery in a Hamburg specialty clinic and died after nine days, shows again that beauty surgery involves considerable risks. What exactly are these, we show by different Methods for breast augmentation on the next pages.
Zoom in with silicone
When padding is done, doctors still prefer to work with silicone. It's on longest tested and in their opinion brings the most natural result. The allegations made in 1992 in the US that silicone causes autoimmune diseases such as rheumatism in the body have since been rejected by the US Food and Drug Administration. In Germany, however, may only longer Implants with the European quality label (CE, Confirmité Européenne). In addition, modern implants are double-walled and contain thick silicone. Nevertheless, it can not be completely prevented that the silicone trickles out of the shell. Health damage is not to be feared, my experts such as Dr. med. Marita Eisenmann-Klein, aesthetic surgeon from the University Hospital in Regensburg. The amount is so small that the body can handle it well. But: When cut, bleeding, infection, thrombosis and wound healing disorders can occur as with any major surgery. Material: Thick silicone gel in a double-walled, roughened or smooth silicone skin. There are round, drop-shaped and shaped like a breast implants, which are used depending on the desired shape. Advantages: proven material. Feels natural and looks like this. Disadvantages and risks: The entire implant can be painfully encapsulated. Even leaked silicone droplets are encapsulated by the connective tissue to sometimes noticeable nodules, which are not visible and do not hurt. Silicone gel is impermeable to X-rays and therefore complicates mammography.
Alternative implant materials
Of the alternative implant materials so far none has been able to hold its own.The cushions filled with soybean oil had to be taken off the market after a short time, because the casings were not tight, the rancid oil could smell through the skin and be carcinogenic. Even hydrogel implants (a water-sugar-based gel in a silicone sheath) will not be sold for the time being, after the manufacturers could not prove that they are really compatible. But even silicone implants are far from perfect: in about six to ten percent of all surgeries, so-called capsule fibrosis occur, in which the tissue around the implant hardens and hurts. A gentle surgical technique and a roughened surface of the implants reduce the risk. In addition, the implant must be located precisely so that it does not have too much play or be compressed. And clearly: At some point it has to be replaced. After about nine years, the manufacturer's warranty expires.
Zoom in with saline or titanium
Material: saline filled silicone cases. Advantages: For the insertion only minisnuts are necessary. The implant size can be adjusted individually, because the empty sheath is only filled in the chest by tube. The material is well tolerated. Spilled saline is broken down by the body without side effects. Disadvantages and risks: do not feel as natural as silicone gel pillows. An under-filled pillow will cause visible wrinkles and it will glisten when you move. The implants become flabby and can leak completely, according to statistics this happens every 10th pillow.
Material: Silicone pads, which are additionally coated with a wafer-thin, only 30 nanometer thin titanium layer. Advantages: The super fine titanium net acts as a protective shield for the plastic silicone. The body should be distracted so that it no longer reacts to the silicone. Experts hope that in the future hardening and encapsulation can be excluded. Disadvantages and risks: There are so far only a small range of titanium-coated implants, little different pillow sizes and hardly any experience, since they are only since autumn last year on our market.
Cut in the skin fold under the breast
Technology: In the fold under the breast is made about 4 cm long cut. First, a kind of "cavity" is created in the chest into which the surgeon carefully inserts the implant. If the pillows are placed correctly, the cuts are sutured and taped with a sterile plaster. Drainage tubes allow the wound fluid that forms after the operation to drain faster. The drier the wound bed, the lower the risk of encapsulation. The operation is usually in general anesthesia, rarely in local anesthesia with twilight sleep.
Advantages: The safest method is considered to be because the doctor can insert an already filled implant in full view with optimal hemostasis.
Disadvantages and risks: Surgical risk. And the scar is visible when you lie.
Duration of operation: about 60 minutes.
Healing process: After 1 to 2 days, when the drainage hoses are pulled, you can leave the clinic. The first few days prevented a support bandage that the implants slip. Then, a fixed bra must be worn for 6 weeks. The pain is low, arm movements are initially uncomfortable. For the first time stretching movements are forbidden upwards, the implants could slip. Costs: from 6,500 euros
Cut through the armpit
Technology:In the so-called "axillary" approach is the 3-5 cm long section in the armpit. From there, the tissue pocket for the implant is prepared in the chest, often with an endoscope (miniature camera). The implant is then advanced into the thoracic cavity. The operation is usually in general anesthesia, rarely in local anesthesia with twilight sleep. Is good for saline implants that are filled in the chest first.
Advantages: The breast remains without visible scars. The axillary incision is visible only with raised arms.
Disadvantages and risks: usual OP risk. Promoted by sweat bacteria, broad scars (keloids) often form in the armpit. The preparation of the implant cavity and the hemostasis become more difficult. This increases the risk of encapsulation. This technique is particularly painful immediately after the procedure. Inserting the implants requires great skill from the surgeons. It becomes difficult with roughened pillows that do not slip and must be forced into the chest by force.
Duration of operation: about 60 minutes.
Healing process: After 1 to 2 days, when the drainage hoses are pulled, you can leave the clinic. The first few days prevented a support bandage that the implants slip. Then, a fixed bra must be worn for 6 weeks. The pain is low, arm movements are initially uncomfortable. For the first time stretching movements are forbidden upwards, the implants could slip. Costs: from 6,500 euros
Implant under the pectoral muscle
Technology: The skin is first cut open using one of the techniques described.Then the pectoral muscle is detached from the underlying thorax and the implant is pushed under the muscle. The operation is usually in general anesthesia, rarely in local anesthesia with twilight sleep. Advantages: demonstrably less capsule fibrosis. Even with very slim women, the implant does not distinguish itself under the skin. Disadvantages and risks: at first painful, because the muscle has to stretch first. Usual surgical risk. Duration of surgery: about 60 minutes. Healing process: After 1 to 2 days, when the drainage hoses are pulled, you can leave the clinic. The first few days prevented a support bandage that the implants slip. Then, a fixed bra must be worn for 6 weeks. The pain is low, arm movements are initially uncomfortable. For the first time stretching movements are forbidden upwards, the implants could slip. Costs: from 6,500 euros
Implant over the pectoralis muscle
Technology: A tissue pocket is created between the mammary gland and the pectoral muscle, into which the implant is placed. The operation is usually in general anesthesia, rarely in local anesthesia with twilight sleep.
Advantages: shorter surgery time than under muscle storage. Then less tension in the chest than in the operation under the muscle. Disadvantages and risks: Surgical risk. Too large implants on the muscle can be palpable and become visible later. Duration of surgery: about 60 minutes. Healing process: After 1 to 2 days, when the drainage hoses are pulled, you can leave the clinic. The first few days prevented a support bandage that the implants slip. Then, a fixed bra must be worn for 6 weeks. The pain is low, arm movements are initially uncomfortable. For the first time stretching movements are forbidden upwards, the implants could slip. Costs: from 6,500 euros
T or L section
Technology: The T- or L-cut runs around the nipple, then vertically downwards and ends with a horizontal cut (T-shape) under the breast or a longer, one-legged cut (L-shape). Except for very heavy reductions (more than 3 kilos per side), the nipple remains attached to the glandular tissue for sensitivity and breastfeeding. The excess fat and gland tissue is removed from the lower part of the breast, from the rest the new breast is formed. With very much fat can be additionally sucked off.
Advantages:The scars heal smoothly. Disadvantages and risks: Surgical risk. Swelling for 3 to 4 months. In the first week it can lead to wound pain. "Squinting" nipples are a surgical mistake that occurs mainly in the L-cut. If the breasts are not the same size or asymmetrical after the reduction, it is necessary to reoperate. Operating time: approximately 2 to 4 hours under general anesthesia.
Healing process: Drains are placed for 2 days to drain the wound fluid. That's how long you have to stay at least in the clinic. For 7 to 14 days, a tight chest bandage must be worn. Once the strings have been pulled, they will be replaced by a fixed bra for at least another 6 weeks.
Costs: about 7,000 euros
Reduction with Lejour technique
Technology: Except for the cut around the nipple, only a second vertical cut down is required. After the tissue has been excised, the skin is drawn like a curtain.
Advantages: less scars with good results.
Disadvantages and risks: requires a lot of experience from the surgeons. When the skin contracts, a "mini-ruffle" is formed, which does not self-level within the next 3 months. In 20 percent of the cases, it has to be corrected on an outpatient basis. Surgical risk. Especially in the lower part of the suture it is not uncommon for wound healing disorders. Duration of surgery: 2 to 4 hours under general anesthesia.
Healing process: Drains are placed for 2 days to drain the wound fluid. That's how long you have to stay at least in the clinic. For 7 to 14 days, a tight chest bandage must be worn. Once the strings have been pulled, it will be replaced by a fixed bra for another 6 weeks. Costs: about 7,000 euros
Reduction with Benelli technique
Technology: It is cut around the areola. Excess fat and glandular tissue are removed without the nipple and glandular tissue being displaced upwards.
Advantages: the only breast reduction with only a barely visible scar around the nipple. Also suitable for women with poor scar healing.
Disadvantages and risks: Surgical risk. Only smaller reductions are possible. Rarely, an aesthetic optimal shape is achieved, usually the new breast is pancake-like flat. Often the position of the nipples looks unnatural. Operating time: approximately 2 to 4 hours under general anesthesia.
Healing process: The drains are placed for 2 days to drain the wound fluid. That's how long you have to stay at least in the clinic. For 7 to 14 days, a very tight chest bandage must be worn.Once all threads have been pulled, it will be replaced by a fixed bra for at least another 6 weeks.
Costs: about 7,000 euros
breast lift
Technology: No tissue is cut out, only the skin tightened. The possible cutting techniques are identical to the breast reduction. The nipple has to be moved. Only in 10 percent of cases, however, is a mere tightening out, usually it must be combined with a reduction. As with the reduction, the tightening is always overcorrected. That is, the breasts are initially quite tall until the tissue gradually gives way over time.
Advantages: little wound pain.
Disadvantages and risks: It can lead to bleeding, infections and delayed wound healing. By displacing the nipple, it is possible to injure nerves that temporarily or permanently switch off the sensation. The result is not permanent because the skin relaxes over time. Operating time: maximum 2 hours.
Healing process: same as with the reduction.
Costs: from 5500 euros. Conclusion: If you opt for an enlargement, an externally roughened silicone implant is the most tried-and-true material that works most naturally. If you have very little fat, you should use it under the pectoral muscle. Breast surgery should only be performed by experienced aesthetic plastic surgeons who have performed at least 100 of these surgeries and are a member of a surgeon's association. For reductions, the T-cut is the most tested.
Steffi K. * thought at the age of 19 about a breast OP after ...
Today she is 23 and is lying on the operating table.
In the preliminary talk had Steffi with cosmetic surgeon dr. Neuroth still discussed the size of the implants. 300 instead of 260 grams should be pure. Cup size 75 C is her declared goal. Dr. Neuroth reserves the right, however, to adjust the size only during the operation: "It is much more important that the curve looks good, a nice Gugelhupf equal."
Steffi's bosom is objectively small, but nice. She sees it in a different way: "For me personally, that was not enough, I was always looking for my décolleté and I did not find anything, with clothes all about the décolleté and I was tired of push-up bras."
The implants are used (300 grams have become) through the breast crease. The cut around the nipple is too risky for the surgeon. Against the armpits speaks the danger of stronger scarring. In addition, one could notice the surgical traces in the evening dress easier.
Afraid of surgery Steffi has no, such interventions she has "often enough on TV". In addition, a friend in the same clinic has the breast enlarge, and then looked "just great". According to Dr. Neuroth The biggest risk is not in the breast surgery itself, but in the misconduct of the patient afterwards. And that ranges from stumbling, exposing oneself to the sun, rash burdens, arms that are lifted too far, to the friend who wants to touch too early.
At the dressing decrease Steffi had to howl with happiness. "Like a new person" she feels and is looking forward the most "to the summer and new underwear". More self-confidence should give her the bosom. She does not want to make a secret about his artificiality. Even the colleagues knew about the procedure. * Name changed by the editor
