Breast Augmentation

Breast Augmentation is performed differently by various plastic surgeons, and some have made breast enlargement their specialty, like Dr Dirk. To know what makes Dr Dirk's procedure so successful and unique, check out his signature procedure - the Split Muscle Breast Augmentation.

Women sometimes have a desire for bigger and fuller breasts - they may be inherently too small or asymmetrical, and therefore do not meet the personal ideal of beauty.

Frequently, however, loss of shape and form occurs because of pregnancy, after weight loss or change purely due to age.

Many women become discontented with this change and long for their former full, young breasts.

In these cases, a breast implant can help to restore the desired shape, and body awareness is improved significantly.

In this procedure (breast enlargement) a incision is made in the skin either in the inframammary fold down, or in the area of the nipple or in the armpit. About this section, a cavity is created in which the implant is placed. In this case, the implant can be placed under the breast tissue or between the ribs and chest muscle.

All implants used today consist of a double-walled silicone case that offers high protection against injury. The new textured surface of silicone pads significantly reduces the risk of capsular contracture. The implants are filled with salt water or with a cut-resistant silicone hydro gel. Further, there are now various forms of the implant and which implant (size, shape, filler material), which section and which positioning of the implant is the most appropriate enhancement for you will be discussed in your consultation with London plastic surgeon Dr Dirk Kremer when the procedure is explained to you.

With a breast implant you will receive a full and natural breast shape that feels quite natural. You get a permanent result but the long-lasting shape may change during the aging process and with the force of gravity over the years.

If this is the case, however, a breast lift can again restore a full, youthful breast.

Read what Dr Kremer said about sagging breasts in Glamour Magazine.

Are you interested in a London breast augmentation by Dr. Dirk Kremer?
Then please go to our comprehensive further information on breast enlargement, see below:

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  1. Capsular contracture is an abnormal response of the immune system to foreign materials. It is most discussed in the context of complications from breast implants and artificial joint prosthetics.

Types of breast implant

There are two main types of breast implants: gel-filled breast implants and saline-filled breast implants.

Gel-filled implants are filled with cohesive silicone gel that feels similar to how a normal breast feels. The major manufacturers offer implants with three different strengths of cohesion.

Saline-filled breast implants are filled with salt water. They feel less natural. These saline-filled breast implants with removable filler hose, allow your doctor, by additional filling or emptying of saline to adjust size of your implants up to six months after the breast augmentation surgery.

Implant forms:

Depending on the breast shape you want for breast augmentation, you can choose either a round or a contoured implant. Contoured implants have a teardrop shape and give the patient a more natural looking breast.

Implant surface:

Breast implants have either a textured or smooth surface. The structured surface can improve the collagen fibres attach to the uneven, rough surface. The risk of capsular contracture is significantly reduced compared to implants with a smooth surface.

Is silicone for breast enlargement safe?

A number of respected multidisciplinary expert panels evaluated the available data on silicone breast implants for breast augmentation. Below is the  Institute of Medicine (IOM)'s conclusion

The U. S. Congress mandated by the multidisciplinary expert panel with an independent assessment of past and current research on breast implants made of silicone and other materials performance.

In 1999, the IOM report found the following results:

  • Women with breast implants have no higher risk for connective tissue diseases. The risk of cancer, immunological or neurological disease in women with breast implants is not higher than that of the general population.
  • Breastfeeding is safe and beneficial to health. 
  • There are no increased risks for children of women with breast implants.

Cutting and placement options for breast enlargement

London surgeon Dr Kremer uses three different approaches to insert a breast implant for breast enlargement:

  • Periareolar: The advantage of this cut is that it is least visible but compared to the other sections it has the highest risk for future problems with breastfeeding.
  • Inframammary: This section is very popular because it is hidden in the fold beneath the breast. In this section, there are fewer problems when breastfeeding. This section gives the best overview of the created cavity implant, which provides optimal positioning of the implant.
  • Axillary: This incision is less concealed, but is an alternative for women who do not want scars on her breasts.

You can discuss with a physician (eg Dr Dirk Kremer) any cuts to be made in detail and decide on the most appropriate procedure.

Positioning of the breast implant

In breast augmentation your implants are either partially under the pectoral muscle (sub muscular) or placed on the muscle and under the breast glands (sub glandular).
The sub muscular placement of implants, the risk that your implants be felt through the skin and emerging at the top of the implant through the skin is reduced. Moreover, the probability of a hardening of the tissue around your implants (capsular contracture) is reduced as well.) Further, a sub muscular placement of your implant facilitated by a mammography can be achieved. Possible drawbacks of this placement may be an extended operation time and a longer recovery period.

When placing sub glandular however, the surgical and recovery time are shortened, and the pain after the operation will be significantly lower. A possible disadvantage might be that the implant under your skin edges is apparent. Also, a mammogram may be more difficult.

Discuss with your doctor (e.g. Dr. Dirk Kremer), which positioning most suits your personal needs and physical conditions.

Surgery and anaesthesia

Breast augmentation usually requires an overnight stay in hospital, but a day case procedure can be arranged if Dr Dirk thinks it appropriate. The procedure is performed under general anaesthesia and usually takes 1 to 2 hours. Dr. Kremer will make the cut, form the receiving pocket and insert the implant. Once the implant is positioned correctly, the incision is sutured.

Postoperative follow-up of a breast augmentation

After breast augmentation surgery, you may feel tired and in pain for a number of days. The first 24 to 72 hours after surgery is when you will experience the most discomfort. Your breasts will feel swollen and sore. It is possible that you will also feel tight in the chest, and since the muscle (at sub muscular position) there will be a period of adaptation to your new breast size. Every woman's recovery proceeds differently; generally, you should be able to engage in light work after about a week.

An important aspect of post-operative care for a breast augmentation can possibly be wearing a sports bra, girdle or pressure bandage. These are designed to give you extra support during the healing phase, so that the implant can heal optimally. As recommended by your doctor take a few days to work, and avoid strenuous activities that can lead to acceleration of the pulse and blood pressure increase for a few weeks.

When using smooth-walled implants, your doctor will also recommend a breast massage to prevent subsequent capsular fibrosis. Follow any specific recommendations that your doctor will give you. If following your surgery you suffer from a fever, significant swelling and/or redness at the operated location, you should immediately contact your doctor.

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