Breast augmentation

You should be at least 18 years old before getting a breast augmentation. This is the guideline of the Swiss Plastic Surgery Association and is observed in many countries. Although an exception can be made in special cases, such as an inherent deformity, each individual case must be examined carefully and critically.

Although every surgical operation involves certain risks, those associated with breast augmentation are relatively low. Important prerequisites for successful breast augmentation surgery are that you are healthy and that it is performed by qualified personnel as well as in a state-of-the-art operating room, such as the ones at Aesthea. The operating room should also have the highest sterility category, as is the case for heart, eye and neurosurgery and orthopedic surgery.

The risk of post-operative bleeding or infection is less than one percent. Capsule formation occurs in around five to ten percent of cases. Issues with scarring are very rare.

Sensitivity in the nipple may be temporarily impaired, especially with large implants. This is due to skin and nerves being stretched and because fine nerves are severed during the operation. Numbness or temporary oversensitivity tend to subside quickly; only in rare cases do they persist.

The specialists at Aesthea will inform you about possible risks during a personal consultation.

The ability to breastfeed generally remains intact after undergoing a breast augmentation. Since the implant is placed behind the milk-producing gland, the integrity of the mammary gland remains intact and the ability to breastfeed is usually retained.

Capsule formation/capsular contracture is caused by a natural fibrotic foreign body reaction in which the body’s own connective tissue envelops the implant. This layer sometimes thickens over the years, making the breast feel firmer. Corrective surgery is only appropriate in pronounced cases. Corrective surgery removes the capsular contracture and usually also replaces the implant.

You can expect to be unable to work for one to two weeks. This also depends on your job: most office workers, for example, can resume work after about ten days. Women with a physically demanding profession (hairdresser, cook, physiotherapist, nurse, etc.), on the other hand, should expect a somewhat longer period of incapacity to work.

Although hormone treatment can be used to enlarge the breast without surgery, this also increases the risk of cancer. As an alternative to breast augmentation using implants, the breast can also be enlarged by means of lipofilling (injections with autologous fat). The extent to which autologous fat injections contribute to the development of tumors has not been conclusively researched. We advise against bio-resorbable hyaluronic acid injections.

The implants used at Aesthea are made of silicone. The implant may be filled with a saline solution or a cross-linked (cohesive) silicone gel. The advantage of cross-linked (cohesive) silicone gel is that it is nice and soft and retains its shape. Thanks to the cross-linking of the silicone gel, implants can no longer leak today.

The mammary gland always remains accessible for a preventive examination – even with an implant. An experienced examiner will not overlook indications of possible breast cancer. We recommend that patients over 30 years of age have a mammogram/ultrasound examination before implantation; in case of familial breast cancer sometimes even before the age of 30.

No, the risk of breast cancer is not increased by having breast implants. Statistical studies have shown that patients with breast implants receive better radiological and gynecological follow-up care. Any cancerous changes in the breast are often detected earlier as a result, which can have a positive effect on the overall prognosis.

The first implants made of silicone gel date back to 1962 and the gel used today is much less liquid than back then. Should the shell tear, the risk of the silicone penetrating the mammary gland is thus very low. The anti-diffusion shells used in the latest generation of implants further limit the spread of silicone molecules.

The specialists at Aesthea will advise you on the selection of implants to suit your individual circumstances and wishes. The so-called MP implant (moderate profile) is used very often. If a woman with a narrow chest wants substantial breast volume, so-called HP implants (high profile) with a narrower base can be used to prevent the breasts from protruding on the sides. As most women are looking for nice curvature in the upper breast area, teardrop implants are rarely used anymore. There is also a risk of such implants rotating a little during the healing process, which would result in the teardrop shape slanting off to one side.

The size of the implants depends on various factors, such as the woman’s height, the weight of her breasts, her chest shape and size as well as the desired volume and shape.  Canfield’s VECTRA^® h2 3D imaging system enables Aesthea to also create realistic before/after simulations and high-definition images of the breast. 

The Aesthea specialists will provide you individual and competent advice, including with regard to implant size. In principle, the choice of implant size depends on your personal wishes. If the size you desire risks harming your long-term health, we strongly advise against it. Perform the following test at home: find a thin bra with the cup size you want. Fill two thin plastic bags with 250 ml uncooked rice each. Close the bags, place them in the bra cups and shape the “breast”. For an ideal visual effect please put on a closely fitting garment and then look at yourself in the mirror. You can then add or remove rice as you like to achieve the desired effect. Once you have determined the right size for you, please put the amount of rice in a measuring cup and note the quantity. If you are still undecided, we will be happy to provide additional advice before the operation. It is very important for us to assist you with your choice of implants so that you feel comfortable with them in the long run.

In about 70 percent of all breast augmentation surgeries, the incision is made under the breast, in 20 percent in the armpit and in 10 percent in the subareolar region. We don’t cut in the armpit. Whether the incision is made at the edge of the areolar region or the breast fold depends on your wishes on the one hand, and on the medical indications on the other. You can discuss the most suitable incision for you in your personal consultation with one of the expert surgeons at Aesthea. 

Placing implants behind the large pectoral muscle has the following two advantages: it can reduce the risk of breast hardening and the muscle functions like the body’s own bra, thus providing the breast better support in the long run.

We advise you not to engage in any sports activities in the first six to eight weeks after the operation. You should also avoid raising your arms higher than 90 degrees during the first 14 days.

Yes, you can have a child with breast implants. Your breast will change just like those of a woman without breast implants during and after pregnancy.

Capsule formation or hardening of the breast may occur in certain cases. Small hematomas (bruises) may form in the implant pocket under certain circumstances. Despite all the precautions taken, a capsule may sometimes form and require a follow-up operation. You will receive a disinfectant washing lotion before surgery. This reduces the bacterial load in advance, allowing you to significantly reduce the risk of infection.

Although it usually takes about 60 minutes, the duration ultimately depends on the surgical procedure chosen for you specifically. 

You should not take any painkillers such as aspirin for the last 14 days before surgery, as this slows blood clotting. Please also avoid alcohol and sleeping pills as far as possible. Some food supplements can also increase the tendency to bleed. It is particularly important not to smoke if you want to promote wound healing and reduce the risk of infection. Please do not to apply any cream or body lotion on the day of the operation.

An anesthesiologist will inform you in detail before the procedure.

Scars are no longer reddened and are thus almost invisible around six to 12 months after surgery – except in the case of abnormal wound healing. We will discuss the location of the scars and the associated advantages and disadvantages in detail with you before the operation. We recommend follow-up treatment with silicone gel patches once the stitches have been removed.

Only the end of the suture is removed. The rest of the stitches dissolve by themselves after about three months. There may be some minor swelling in the scar during the first three months. 

Implants are usually not noticeable from the outside, except in very slim patients with little subcutaneous fatty tissue. Such patients show significant differences, depending on the choice of implants.

Although a general replacement of implants was recommended every ten years in the past, this is no longer necessary. The latest silicone implants are expected to last a very long time (about 15 to 20 years) today.

There is no reason to replace the implants unless the implants tear or there is increased capsule formation. If a saline solution implant ruptures, the breast usually flattens out within a few days. This is because the water leaks out through the tear and is absorbed by the body. If a silicone gel implant ruptures, in contrast, the breast volume remains the same. The tear is usually detected by a mammogram or echography.

We will provide you with all the necessary medication to take home, if this has not been done beforehand already.

You can live normally again without any restrictions and also do sports after about six to eight weeks.

Although minor sensitivity disorders (e.g. tingling or insensitivity to touch) may occur in the first few months after breast surgery, they tend to subside after around six months.

The clinic stay at Aesthea is usually 24 hours for breast augmentation.

As minor hematomas statistically increase the risk of breast hardening, we feel that it is important to remedy any minor bleeding that may occur during the night after the procedure.

No, you don’t need to be overweight. Everyone tends to have at least minor fat deposits on different parts of their body that can be suctioned and used for breast augmentation.

Yes, in principle, the transplanted autologous fat tissue is retained for life. Nevertheless, just as with any normal, non-operated breasts, breast shape and (depending on fluctuations in body weight) breast volume changes over the years, which is why further surgery may be desired at a later date. Some of the transplanted fat is lost over the years, which can lead to asymmetry and may make it necessary to repeat the procedure.

Both liposuction and fat grafting into the breast require minimal incisions (2 to 5 mm) in the skin. These stab incisions are made in the most inconspicuous places possible. The so-called donor areas, i.e. the parts of the body where the patient’s own fat is suctioned off, are generally located on the abdomen, buttocks and thighs. A thin needle is used to gently inject extracted autologous fat into the breast at the desired points after a special preparation.

The procedure can, in principle, be repeated several times, thus gradually enlarging the breast, even though this is usually unnecessary.

Very minor calcification occurs around the internal scars during every operation on the breast (both during implant augmentation and autologous fat augmentation, and especially during breast reduction). Only very minor calcifications occur with our method of autologous fat breast augmentation. Today’s ultrasound and mammography techniques make it possible to easily distinguish them from other microcalcifications. We recommend our patients have a mammogram and ultrasound examination before the operation in order to eliminate any uncertainties and make before-and-after comparisons at a later date. The fat should not be injected into the mammary gland during autologous fat breast augmentation as this can result in an unclear diagnosis.

Breast augmentation with autologous fat (instead of silicone implants) has hardly any risks, since the body’s own fat cells are used to enlarge the breast. However, not all cells fuse with the existing fat cells. This can lead to the formation of oily cysts if the surgeon lacks expertise or if the surgical procedure is unsuitable. Oily cysts can occur if the fat used consists of larger lumps and its core is not connected to the local blood supply and consequently dies.

A competent and experienced surgeon, as the ones at Aesthea, can largely avoid the formation of oily cysts because if the fat is injected with care, the survival rate of the transplanted tissue is significantly higher. It is nevertheless impossible to entirely avoid the occurrence of very small oil cysts and microcalcifications.

Relevant complications that could lead to unsightly breast shape or even be harmful to health have not been observed in autologous fat breast augmentation to date.