Plastic surgery on the breasts

Many women are not satisfied with the shape or the size of their breasts. Therefore, they decide to undergo a breast enlargement or reduction. The related plastic and cosmetic surgery include breast lifting, breast implants or breast reduction plasty. They are all explained below.

Women usually want a breast reduction if the weight of their breasts causes them discomfort, such as pain in the spine or the shoulders. Or simply because they do not like how their large breasts look.

Breast enlargement with implants is the most common cosmetic breast surgery. Many women who are dissatisfied with or distressed by their small breasts decide to undergo the surgery.

Breasts lose their firmness as women age or as a result of pregnancy. The result is often hanging breasts. It is difficult to wear clothing which emphasises the décolleté, and the women are often very dissatisfied with how their breasts have sagged. Breast lifting, known as mastopexy, can be of help here. Breast lifting is often also combined with breast implants.

What preparations are carried out before the procedure?

Intensive consultations are carried out before a cosmetic breast operation. The patient's expectations and wishes related to the breast correction are discussed in depth. The advantages and disadvantages of the different procedures are explained. In this way, patient and surgeon decide which is the optimum procedure.

All the usual pre-operative assessments are required, such as a blood test, blood pressure measurement and an ECG. All blood-thinning medication must be discontinued prior to surgery. The operation is carried out under general anaesthetic and the patient must have an empty stomach.

How is the operation carried out?

Breast enlargement

A silicone implant is usually used for a breast enlargement. Sometimes an implant filled with saline is used as an alternative to a silicone implant. The shape of the breast and the selected implant determine where the incision for the implant will be made in the skin. Three locations are usually possible: The incision is commonly made in the skin fold under the breast (infra-mammary). It is less common around the areola or in the armpit.

The implant is placed either directly under the mammary gland over the breast muscle, or under the breast muscle. If it is placed over the breast muscle, the breast muscle does not have to be injured. The surgical wound thus heals faster than planned. However, in the case of women with very small breasts with limited breast tissue, the implant must be set under the breast muscle for the most part. The surgery takes approx. one and a half hours.

Breast reduction

The form and the size of the breast will determine where the incision is placed for a breast reduction. During the procedure, skin fat and lymph tissue is removed. The nipples must usually also be reduced in size and adjusted. The procedure takes two to three hours.

Breast lifting

During a breast lift, incisions are made in the skin around the nipples. Any excess skin is removed and the nipples are lifted (mastopexy). Depending on the initial situation, the breast lift can be accompanied by a breast enlargement or a breast reduction. The procedure takes approx. two to three hours.

What is the success rate of this procedure?

After cosmetic breast surgery, women are generally very satisfied with the result. Transparent consultations before the procedure and the correct follow-up treatment.

What are the possible complications and risks of this procedure?

Breast enlargement, breast reduction or breast lifting are low-risk routine procedures and usually occur without complications. As with all surgery, the operation may lead to infections, post-operative haemorrhaging or blood clots (thromboses) in rare cases. The silicone implants used nowadays are very stable. The previously observed complications such as leakage of silicone into the breast tissue are now absolute exceptions to the rule.

Depending on the procedure, the residual scars will be more or less visible. During mastopexy, visible scars are unavoidable.

What happens after the operation?

After the surgery, the patient is monitored during the recovery phase as they wake up from the anaesthesia. It is usually possible to leave hospital one or two days after the operation. You should avoid lifting heavy objects and major physical exertion for some time after the surgery.  It is recommended that you only sleep on your back for the first three weeks after the surgery. Sauna visits and direct sun on the breast should be avoided for six months.

After a cosmetic breast operation, a special sports bra must be worn for six weeks. The follow-up care is decisive for the success of the surgery as a capsule made of connective tissue forms around the implant which supports the breast with the implant during this time. The final results can only be assessed four to six months after the surgery at the earliest.