A breast augmentation can take place with a breast prosthesis or with body fat. Breast prostheses always consist of an external shell consisting of solid silicone with a rough or a smooth surface. The filling can consist of 2 different substances, namely from physiological serum or silicone gel.
1. Cohesive silicone gel:
An advantage of silicone is that it feels smoother, a disadvantage is that it can migrate in the chest at rupture of the prosthesis, although because of this is minimal compared to the older prostheses where the filling was much more fluid.
2. Physiological serum:
Advantage is absolute safety, the disadvantage is that this prosthesis can feel less natural.
There are different models in breast prostheses, namely around prostheses or anatomically shaped prostheses where the shape looks more like a drop. Anatomically shaped prostheses are usually more expensive than round prostheses. Which prosthesis will be placed is different for each individual. This is always determined in consultation with the surgeon.
The breast prostheses can be placed:
1. Between the mammary gland and the chest muscle
2. Behind the pectoral muscle and the mammary gland
This depends on the anatomical situation and varies per person. In consultation with the surgeon, the best result will be examined.
Placement for the chest muscle is less painful, but assessing a breast picture (mammography) can be more difficult. Placement behind the pectoral muscle is more painful, but usually provides better coverage and increased risk of supple breasts (less chance of contracting).
The insertion of the prostheses can be done in 3 ways:
1. via the armpit with the endoscope (axillary)
2. via an incision on the edge of the areola (periareolar)
3. via an incision in the fold under the breast (inframammary)
This is also determined in mutual consultation.
A breast augmentation procedure is an operation that gives a very nice result to the vast majority of patients. However, complications and / or disadvantages are possible with each surgical procedure. Immediate postoperative complications can be after bleeding, complication of wound healing and infection. Fortunately, these complications are rare.
Complications in the long term can be:
1. Reduced sensitivity in the nipple, although this is rare and usually temporary in nature.
2. Leakage of the breast prosthesis, although the quality of the breast prostheses is now such that they can last for at least 15 years or longer.
3. Capsular formation due to excessive scar production around the prosthesis, this may involve a hardening of the prosthesis with a non-natural position of the breast. In extreme cases, a haircut contracture can occur, in which the breast becomes a hard ball, as it were, which can also be very painful, so that the prosthesis has to be removed. The chance of this is, however, very small.
4. Malposition of the prosthesis. In a number of exceptional cases the prosthesis can start to move after a while. This is also seen very little, especially with the currently used prostheses with a rough surface.
Finally, it should be pointed out that a breast augmentation is an aesthetic procedure, for which reimbursement is almost never reimbursed by the health insurance fund and also not in the hospitalization insurance schemes.
The procedure takes place under general anesthesia. Almost a day admission can suffice, ie admission in the morning and discharge in the evening, if care is provided at home. Sometimes 1 night in the hospital may be necessary, because of postoperative discomforts, eg pain or nausea as a result of anesthesia.