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Well-shaped and firm breast are universally accepted attributes of beauty.

Breast Surgery

Well-shaped and firm breast are universally accepted attributes of beauty.

Reality, however, paints a different picture: often, breasts are considered too small or too big; and pregnancies, strong weight gain and loss, advancing age and last but not least gravity take their toll.

Plastic surgery offers competent solutions for all these problems. Breast aesthetics is one of the most important areas of aesthetic and reconstructive surgery.


Breast Augmentation

The era of modern breast augmentation began in 1963 in the USA with the use of silicone implants. Since then, the popularity of breast implants has consistently risen, making it one of the most prominent plastic surgeries worldwide. In 2023, approximately 304,181 breast augmentation procedures were performed in the United States alone. Patient satisfaction with breast augmentation remains exceptionally high; studies have shown that 98% of women report that the results met or exceeded their expectations.
Frequently Asked Questions
Most implants are made of a silicone-based polymer. Manufacturers grant a life-long warranty for the latest generation of products. The problem of capsular contracture has not been completely solved yet, but it has been reduced to a minimum.
After every surgery there are scars. Breast augmentation is an intervention that leaves only very small traces. A 4-5 cm long incision is sufficient to place the implants which can be inserted via the breast crease, the areola or the armpit. For this reason, the most common approach is through the breast crease which hides the scar. Depending on skin type, in some cases, the scars may remain visible.
Scientific studies have found no adverse impact.
The surgery is carried out in a clinic under general anaesthesia.

After 3 hours, patients can eat and get up. After 6 hours they can be discharged. A dressing is placed on the incision. After 2 days, patients can take a bath. On the 3rd day, they have to return to the clinic for a check-up; afterwards they can return to their normal life.

In the first three week, all physical exercises, except walking, must be avoided. During this time, the patient must wear a sports bra at all times. After 3 weeks, physical exercises are permitted, except arm and chest movements. After 6 six weeks, you are free to exercise as you please. In the first 3 weeks, the implants lie higher than normal, and the appearance is unnatural. After week three, they begin to move downward into their final position which they reach after 3 months. Further check-ups follow after 3 weeks, 3 and 6 months and one year after the operation. At that time, a control mammogram / ultrasound scan must be taken as well.

Bleedings, infections and difficult scar healing may occur in the early postoperative phase. But they are rare. The most frequent long-term problems are capsular contracture, asymmetries and aesthetic issues. Leaks and burst implants are a thing of the past, at least when you use branded products. Brands like Mentor, Motiva and Polytech come with a lifelong warranty.

Breast Reduction

The goal of a breast reduction is to balance the body-to-breast ratio. Breast reduction surgery comprises three distinctive steps: reduction and shaping, excision of excess skin, re-placement of the nipple-areola complex.

Frequently Asked Questions
After every surgery there are scars. Depending on breast size and the extent of drooping prior to surgery, there will be scars around the areolas, in the breast crease, and vertically between areola and breast crease. The vertical scar is the most obvious; the others are hidden in the skin texture or under the breast. Over time, the scars fade and become even less conspicuous
Scientific studies have found no difference between comparable groups of women with and without breast reduction. With the exception of women with very large and pendulous breasts, their breast-feeding capability is as good as that of regular-sized women without reduction.
The surgery is performed in a clinic under general anaesthesia.

After 3 hours, patients can eat and get up. After 6 hours, they can be discharged. A dressing is placed on the incision. After 2 days, patients can take a bath. On the 3rd day, they have to return to the clinic for a check-up; afterwards they can return to their normal life.

In the first three week all physical exercises, except walking, must be avoided. During this time, the patient must wear a sports bra at all times. After 3 weeks physical exercises are permitted, except arm and chest movements. After six weeks, you are free to exercise as you please. In the first 3 weeks, the breasts lie higher than normal and the appearance is unnatural. Also, the vertical scar under the areola looks rippled. After week three, the breasts begin to sink into their final position which they reach after 3 months. Further check-ups follow after 3 weeks, 3 and 6 months and one year after the operation. At that time, a control mammogram / ultrasound scan must be taken as well.

The most frequent complaint concerns scars, still too large breast even after surgery, and asymmetries of breasts and nipple-areola complex. All these problems are avoidable if the operation is carried out by an expert surgeon. A specific complication associated with vertical mammaplasty is a slight bulging of the skin at the lower end of the incision. This requires correction which is usually performed 3 months later under local anaesthesia. The wound healing process may take longer than expected; this affects smokers in particular. However, the proverb that “time heals all wounds” applies here as well. Until that time, a dressing must be placed on the wounds. This complication does not affect daily activities

Breast Lift

Mastopexy is a procedure used to lift sagging breasts. The intervention comprises three main steps: excision of excess skin, re-shaping of the breast tissue and re-positioning of the nipple-areola complex. If the breasts are small, the lift may be combined with the insertion of implants.

Frequently Asked Questions

Depending on the extent of sagging, the following scars will result:

  • around the areola (periareolar mastopexy)
  • around the areola and vertically down (vertical mastopexy)
  • around the areola, vertically down and horizontally in the breast crease (“reversed T”).

If the breasts are only moderately sagging, or empty after childbirth and breast-feeding, implants may be inserted to restore lost volume. In this case, a small incision in the breast crease, just like in breast augmentation, is sufficient.

The most common breast lift method is vertical mastopexy. The result is aesthetically pleasing and the scar is not too conspicuous. With respect to permanence of the result, vertical mastopexy is superior to all other methods.

Scientific studies have found no difference between comparable groups of women with and without breast lift. The risk of reduced milk production is even smaller than after breast reduction.
The surgery is carried out in a clinic under general anaesthesia.
After 3 hours, patients can eat and get up. After 6 hours, they can be discharged. A dressing is placed on the incision. After 2 days, patients can take a bath. On the 3rd day, they have to return to the clinic for a check-up; afterwards they can return to their normal life. In the first three week, all physical exercises, except walking, must be avoided. During this time, the patient must wear a sports bra at all times. After 3 weeks, physical exercises are permitted, except arm and chest movements. After 6 six weeks, you are free to exercise as you please. In the first 3 weeks, the breasts lie higher than normal and the appearance is unnatural. After week three, the breasts begin to sink into their final position which they reach after 3 months. Further check-ups follow after 3 weeks, 3 and 6 months and one year after the operation. At that time, a control mammogram / ultrasound scan must be taken as well.

The most frequent complaint concerns scars and asymmetries of breasts and nipple-areola complex. All these problems are avoidable if the operation is carried out by an expert surgeon.

If the breast lift is combined with implants, implant-related complications may occur. The most important problem is capsular contracture around the implant. You can find more information about the issue under the heading breast augmentation.

Breast Reconstruction After Mastectomy

Breast reconstruction plays an important role in the normalisation process after cancer-related mastectomy. This radical surgery does not only leave physical traces but also causes a psychological trauma with consequences for the sufferer’s social life. A breast reconstruction can help patients to regain quality of life, rebalance the body and its appearance, and bring relief to the mind as well.

Frequently Asked Questions
Every mastectomy patient can have a breast reconstruction, provided no medical condition prevents it. In consultation with the general surgeon, the oncologist and the plastic surgeon, the patient decides about the modalities of the operation, and the method to apply
If mastectomy is performed at an early stage of cancer development, reconstruction can start immediately. If the cancer was in an advanced state, and if radiotherapy is scheduled as further treatment, reconstruction must wait until radiotherapy, and possibly chemotherapy, have been completed. On average, this means you have to wait one year. If the application of radiotherapy is not certain, a so-called tissue expander can be placed under the breast muscle already during mastectomy; this saves the patient one operation. The expander is used to stretch the tissue to prepare it for implant insertion.

The following principle methods are used:

  • Reconstruction with implants
  • Reconstruction with the patient’s own tissue
  • Reconstruction with implants and own tissue.

In general, breast reconstruction is a sequence of operations and may take up to one year. The first surgery is usually the most comprehensive and most painful. The follow-up operations are shorter and less painful.

With the first surgery, the tissue expander is implanted and the healthy breast is reduced in size. During the second intervention, the implant is placed and symmetry restored. If tissue grafting is the preferred method, this is performed during the first surgery session. The second phase is dedicated to symmetry and small-scale revisions. In the third session, the nipple-areola complex is reconstituted. This is a relatively simple intervention and requires only local anaesthesia.

The decision is based on the condition of the tissue, on the patient’s constitution, whether radiotherapy was applied or not, the status of tumour development, breast size, age, childbirth, and other factors. The advantages and disadvantages of the individual methods are evaluated jointly with the patient before a decision is taken. It is a long and rather difficult process, and after every stage surgeon and patient decide how to proceed. A successful reconstruction requires an open exchange of views and, most of all, mutual trust because there is always a risk of complications.

Gynecomastia

Gynecomastia is a composite Greek word (gyne - woman, mastos - breast) and a medical term for “women-like breasts”. The condition affects one in two men and can cause psychological trauma. The reasons for male breast formation are varied, changes in hormone levels or side effects of medication, but in many cases, the source cannot be identified.

Frequently Asked Questions

At first, the cause is determined. If there is suspicion it might be caused by hormonal imbalances, an endocrinologist must be consulted. If that is the cause, there are special treatments. Gynecomastia in young adults usually recedes after a few years.

Very often, Liposuction is sufficient. If, in addition to fat tissue, an excess of glandular tissue is present, ultrasound liposuction (Vaser) may be applied. If that does not yield a satisfactory result, excess breast tissue is removed through an incision in the areola. Excess skin is removed so that the scar is in the areola where it is less conspicuous.
The surgery is carried out in a clinic under general anaesthesia.

After 3 hours, patients can eat and get up. After 6 hours, they can be discharged. A dressing is placed on the incision. In the first 2 weeks, patients must wear a special corset because of the liposuction.

After 2 days, patients can take a bath. On the 3rd day, they have to return to the clinic for a check-up; afterwards they can return to their normal life. In the first three week, all physical exercises, except walking, must be avoided. After 3 weeks, physical exercises are permitted, except arm and chest movements. After 6 six weeks, you are free to exercise as you please.

Gynecomastia surgery is usually complication-free and the results are very satisfactory. Persistent swelling in the first few months may give rise to concern. However, they are generally only temporary. The most frequent long-term complaint concerns the extent of the surgery. In these cases a second intervention to remove extra tissue may become necessary. Liposuction may be associated with rippling or the formation of depressions in the skin. This is avoidable with careful planning.