Breast enlargement
More photographs of this treatment can be found here » fotos/borstvergroting.
For whom is this treatment intended?
There are two important patient groups in my practice. First of all there are the young women from the age of 18 years onward and who feel that they do not have enough breast forming. Then there is the category of women who are about 30 - 40 years old, whose breasts have become less firm and smaller after pregnancy and breastfeeding. Of this last category there is a smaller group of women between the ages of 50 – 60 years old who would like to have the treatment done.
Minimum age
The government and the European Union would like to establish the minimum age of 18 years. For the time being I have set the limit at 17 years.
Time to think
It is nice when one of the parents accompanies a younger person. I can assure parents that it is not a life threatening operation. When it concerns a younger person I will give them a few weeks to think it over so that I will be certain that the decision is sound.
Fat injection or lipo filling is not a good technique for breast enlargement
It is unlikely that you can enlarge breasts by fat injection. Injected fat survives only in small quantities and in tissue with a good blood circulation. In a breast enlargement a large quantity is needed and the breast tissue has only a small amount of blood. Therefore the injected fat will die and cause an infection as a defense reaction. Antibiotics will not combat this.
The danger of leakage
The implants are modernized: the filling has become thicker, which prevents the gel from leaking out even in the hypothetical case of a tear in the implant. The wall of the implant is so much thicker nowadays that a tear really can be dismissed. In a recently published brochure from the Ministry of Health there is a statement that silicone breast implants can cause problems. The Dutch Association of Plastic Surgeons (NVPC) has assisted in producing this brochure and acknowledges the negative aspects. The most important negative aspect is the possible shrinkage of breast tissue around the implant, which can cause complaints of pain and a change in the shape of the breast. In my practice I encounter this problem in a severe form only in 2% of my patients.
Life expectation of the implant and guarantee
At the moment it is still uncertain how long the integrity of the present generation of silicone implants is guaranteed. This will probably not be a lifetime, but for sure they last at least several decades. Most manufacturers will give some kind of guarantee on their implants. As with other medical implants, a 100% safety can not be guaranteed. Please see also my article on guarantee.
Planning for surgery
It is not advisable to smoke, because this may cause problems with the anesthetic, like coughing while waking up from the anesthesia. Of course you have to be nil by mouth due to the anesthetic and the use of blood thinning medication like Ascal or aspirin must be avoided.
The surgery
The operation will last an hour and you will remain in the clinic or hospital for a day. In our hospital, patients will stay one night after breast enlargement. In Clinic Zestienhoven we look at where the patients live. If they live in the neighborhood they can go home at the end of the day. Do they live far away; they will stay in a neighboring hotel for one night.
In a breast enlargement, I place the silicone implant in front of or behind the breast muscle, depending on the amount of your own breast tissue. In the event of a very small breast (see picture above) it will be better to place the implant behind the muscle. If your own breast is a little larger or less firm or sagging (pictures below), then it will be better to place the implant in front of the muscle, so that the breast will become firmer.
After surgery
Sometimes after the operation there will be little tubes or so-called drains in the breasts, which will be removed a few hours later or the following day. The first day after surgery will be rather painful. You have to prepare yourself for pain, even though you will get painkillers for this. “It feels like someone has been jumping on your thorax.” I have heard people say. After three to four days the bandage will be removed. Two weeks later I will pull the stitches out by hand – one breast at a time. You have to wear a bra day and night for two weeks and are not allowed to do any muscle exercises. So no lifting, rowing or moving house. After four weeks the implant will have settled into place.
Silicone implants and breast cancer
One in nine women will encounter breast cancer. Silicone breast implants themselves do not cause breast cancer. Large epidemiologic researches in the U.S.A. have shown that the incidence of breast cancer doesn’t increase by breast implants.
Self-examination of the breast has become easier. Examination of the breast for breast cancer with the aid of an X-ray, also known as mammography, is more difficult with silicone implants. The population screening as we know it in the Netherlands is really not appropriate for women with breast implants. The mammography can be a very painful examination for them. Although there is no chance that the implant will rupture, sometimes there are several images necessary for a good view. Therefore I advise patients with breast implants to have the X-rays taken at the radiology department of a hospital.
Apart from that, research has indicated that women with breast implants, in whom breast cancer has been discovered, do not have a worse prognoses then women without breast implants and that breast cancer is not diagnosed in a later stage.
If you have had several incidents of a (benign) little lump in your breast or there is breast cancer in your immediate family, in other words breast cancer examination is extremely important to you, I will advice against a breast enlargement.
