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Breast augmentation

Breast augmentation

If you are considering changing your breasts, then you are certainly not the only one. Many women find their breasts too small or find that their breasts are not in good proportion with the rest of their body. You can feel more confident when your breasts have the desired volume and firmness in combination with the breast shape that suits you. A breast augmentation is one of the most performed aesthetic operations. It is a safe procedure that lasts an hour on average. The treatment takes place under general anesthesia and you can go home the same day.

Our plastic surgeon will inform you in detail about the breast enlargement procedure during an initial consultation. Our goal is that you have realistic expectations of the possibilities, risks and aftercare. During this conversation we listen to your wishes and discuss the possibilities. No woman is the same and that is why it is also important that you, together with the doctor, look at the different fillings, shapes, sizes and surface material of the prostheses. In consultation with the surgeon, you make a choice that meets the desired result.

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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 of her own choosing. A breast augmentation in general is not the solution to any social or sexual problems. A breast augmentation is particularly useful when the breasts are underdeveloped, but in general is not performed under the age of 18. The volume of the breasts may sometimes reduce after pregnancies or slimming diets, which then can be augmented with prostheses. Sometimes an asymmetry can be corrected by placing a larger prosthesis in the smaller breast. Some women have breasts that are in proportion, but they want to be even bigger. When breasts 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 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. Therefore, a consultation with a plastic surgeon is always the first step.

A rarely reported complication with breast prostheses is BIA-ALCL (Breast Implant Associated Anaplastic Large Cell Lymphoma). This is not breast cancer, but a type of Non-Hodgkin lymphoma (lymph cancer) that can develop in the capsule and the fluid around the prostheses. ALCL is completely curable when the diagnosis is made early and treated accordingly. In 2018, ALCL was researched in women with breast prostheses in the Netherlands. It was found that women with breast prostheses have a higher risk of developing ALCL than women without breast prostheses. By the time women with prostheses reach the age of 50, the chances of developing ALCL is 1 in 35000. By the age of 75, that could be 1 in 7000. As in other international studies, it appears that ALCL occurs more often with prostheses with rough texturing i.e. macro textured prostheses. It is important to note however, that it appears that ALCL can develop in the presence of smooth and less rough textured implants too. The healthcare regulator of the Netherlands has indicated that breast prostheses comply with the rules and regulations and that breast implants do not need to be removed. A similar statement has been issued by the FDA. As a result of this publication, it is expected that follow up studies in Europe will be issued to substantiate the present recommendations.

Like any other surgical procedure complications can occur after a breast augmentation. A wound may start bleeding or an infection may occur. In rare instances the prostheses may be extruded. The chances of a complication occurring is always present, although infrequent. The scar can become red and thick after the procedure. A complication of the wound healing process may result in a widened scar. When a prosthesis hardens and becomes deformed it may be an indication that the prosthesis is broken and needs to be replaced. Furthermore, there are the anesthetic risks which are similar as in any other procedure. The anesthetist will discuss this with you.

A breast reduction is a safe and reliable surgical procedure. By far most women are pleased with the results, but sometimes the result is less favorable. There will always be scars, although seldom noticeable. You will be treated to the best of our ability, but a guarantee of a perfect result or complete symmetry cannot be given. Sometimes a second operation is necessary to obtain an optimal result. This may bring about additional costs, which will not be covered by any insurance.

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After (Dr. Karel Taams)
After (Dr. Karel Taams)
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After (Dr Karel Taams)
After (Dr Karel Taams)

After the procedure the breast may feel tense and painful. This should subside in a couple of days. After discharge, a follow up appointment will be made at the doctor’s office. If present, the drains will be removed the next day. The stitches will all be dissolvable and do not need to be removed. It is sensible to organize help at home for the first week. In the first four weeks after the procedure it is advised to wear a bra without underwires which is comfortable and supportive both day and night. All movement that is painless is allowed. For the first six weeks after the operation you should not go horse riding, jogging, or do any other sport that causes the upper torso to shake. Walking, swimming and cycling on the other hand can slowly be increased after two weeks.

The procedure lasts on average one hour and takes place under general anesthetic as a day case. Most of the time the prostheses are 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 this is done less often because of the increased risk of capsule contracture. The prostheses can be placed between the breast and the muscle or between the muscle and the chest wall. The plastic surgeon will discuss the most appropriate method in your case. Sometimes small drains will be placed and connected to two small vacuum bottles, so any fluid that may accumulate in the breast can then be drained.

Prostheses are made up of a casing made of silicone filled with either silicone gel or saline. There are misunderstandings on the use of silicone prostheses. Scientific research has never found silicone to cause breast cancer. 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 years. The reason that prostheses need to be replaced is because of contracture of the capsule around the prosthesis, which results in hardening and eventually deformation of the prosthesis into a ball shape and the breast as a whole. Factors which play a role in capsule contracture are related to the patient, leakage of the prosthesis or subclinical infections. Due to improvement of prostheses over the years leakage is far less common than in the past. 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 plastic surgeon will discuss the advantages and the disadvantages of a 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 to obtain a better result. Future investigation of lumps or other abnormalities will continue to be possible after a breast augmentation. In general, a balance between your breast size and your figure is considered. Bra sizes vary greatly between different brands and often it is not clear what size of prostheses need to be placed. 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 plain white T shirt works best. After the procedure the nipples may be hypersensitive or less sensitive. This will normalize within a couple of months to what they were before the procedure. The possibility of breast feeding is not affected by a breast augmentation.

Before
Before
After (Dr Karel Taams)
After (Dr Karel Taams)
Before
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After ( Dr Karel Taams )
After ( Dr Karel Taams )
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After (Dr Karel Taams)
After (Dr Karel Taams)
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After (Dr Karel Taams)
After (Dr Karel Taams)
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After (Dr Karel Taams)
After (Dr Karel Taams)
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After (Dr Karel Taams)
After (Dr Karel Taams)
Before
Before
After (Dr Karel Taams)
After (Dr Karel Taams)