GENERALIt's not easy to determine which women will choose breast augmentation surgery. However, many people desire larger or firmer breasts: more than 3,000 breast augmentation surgeries are performed in the Netherlands annually. Breasts can be small or underdeveloped since puberty. Sometimes breast volume decreases after pregnancy, or breasts become saggy and smaller after a weight-loss diet.
There are no clear age limits for breast augmentation surgery, but it's unlikely to be performed before the age of eighteen. It's important that you want breast augmentation surgery yourself. It shouldn't be a desire of those around you, such as your partner. Breast augmentation surgery generally doesn't solve social or sexual problems.PROSTHESIS, IMPLANTSThe simplest, most effective, and most durable option for breast enlargement is plastic implants. These implants consist of a silicone rubber pouch filled with silicone gel or another filler (e.g., water). Double-walled implants also exist. The inner volume is filled with silicone gel, and the outer volume with saline solution. There are many misconceptions about the use of silicone. However, scientific research has never demonstrated that silicone has any harmful effects on health. The Dutch Association for Plastic Surgery, of which almost all plastic surgeons in the Netherlands are members, believes that breast augmentation with silicone is a responsible medical procedure. As with any other surgery, the benefits of breast augmentation must be carefully weighed against the disadvantages and risks. These will be discussed in detail with you. The lifespan of implants can be limited. It is recommended that you schedule another appointment with a plastic surgeon at least ten years after the surgery.PREPARATORY CONVERSATIONThe plastic surgeon will discuss the size of the implant with you. The goal is generally to achieve breasts that complement your figure. The surgeon will also discuss the placement of the scars. As with any surgery, breast augmentation leaves permanent scars. Due to their location and color, they are usually barely noticeable. The nipples may be more or less sensitive after the surgery. Sensation usually returns within a few months, but this is not always the case. Function is generally not impaired. Breastfeeding remains possible. The implants are placed under the glandular tissue or under the pectoral muscle. Examination for lumps or other abnormalities remains easily feasible.PREPARING FOR THE OPERATIONIf you are taking blood-thinning medications (e.g., coumarin, marcoumar, Sinaspril, Sintrom, Ascal, APC, asprobruis, or baby aspirin), you must inform the plastic surgeon during your initial consultation. These medications must be discontinued three to ten days before the breast augmentation procedure. Your doctor will give you instructions on how to do this. Nicotine increases the risk of wound healing problems. Your doctor therefore recommends that you stop smoking completely several weeks before the procedure. Breast augmentation surgery is sometimes performed as an outpatient procedure. In some cases, hospitalization for a few days is recommended. The plastic surgeon will discuss this with you. On the day of admission, your armpits will be shaved, and the surgeon will trace the surgical pattern on your breasts. The procedure is usually performed under general anesthesia.METHODBreast augmentation surgery typically takes one to two hours. The implants are usually inserted through an incision in the skin fold beneath the breast. They can also be inserted through an incision in the armpit or next to the nipple. The implants are placed between the mammary gland and the pectoral muscle, or beneath the pectoral muscle directly on the ribs. The plastic surgeon will discuss the most suitable method with you. At the end of the surgery, the breast is dressed with a supportive bandage. Two drains (thin tubes) are usually inserted into the wound area, connected to two vacuum bottles. Wound fluid is drained from the surgical site through these tubes. The drains are removed when the fluid production has almost stopped.AFTER BREAST AUGMENTATIONAfter breast augmentation surgery, your breasts may sometimes feel sore and tense. This will subside within a few days. The drains are usually removed after one to two days. Upon discharge from the hospital, an appointment will be made for a check-up. During this visit, the stitches will be removed if necessary. It's wise to arrange for assistance for the first week after returning home. Wearing a bra day and night for the first four weeks after surgery is recommended. An elastic band above the breast is sometimes also advised. Any movements you can perform without pain are permitted. It's best to avoid sports, heavy lifting, or raising your arms overhead for the first six weeks after surgery. Gently massaging your breasts with a cream or lotion can soften the scar. Ask your plastic surgeon when you can begin this.COMPLAINTSAfter surgery, your nipples may be less sensitive, or even more sensitive. This usually resolves within a few months, but it can also be permanent. A scar may temporarily become red, swollen, and hard for a few months after the procedure. Almost all breast prostheses will wear out somewhat over time. Therefore, they may need to be replaced at some point, which would require further surgery. Such surgery is only necessary if symptoms occur.RESULTSBreast augmentation is a safe and reliable surgical procedure. Many women are satisfied with the results, but sometimes there may be some unsatisfactory results. Scars will always remain, which are usually barely noticeable. You will be treated to the best of your ability, but no guarantees can be given for a good result or complete breast symmetry. Sometimes a second surgery is necessary to achieve optimal results. This entails additional costs, which are usually not covered by insurance.RISKS AND COMPLICATIONSAs with any other surgery, complications can arise with breast augmentation. A wound can bleed or become infected. In rare cases, an implant is expelled. The risk of complications is therefore present, but small. The scars may temporarily become red and swollen after the procedure. Impaired wound healing can also cause a permanent, wide scar. The body forms a layer of connective tissue around each implant. This layer is also called the capsule. Sometimes the capsule contracts, causing the breasts to become hard and unnaturally round. It is impossible to predict in whom this will occur. It is possible that there is a difference in capsule formation between two breasts from the same patient. This complication is being extensively researched, but no cause or treatment has yet been found. However, implants with a rough surface are increasingly being used, as excessive capsule formation appears to be less common. In rare cases, a prosthesis breaks. Sometimes this is noticeable because something "snaps" or because the breast feels different or has changed shape. A broken prosthesis must always be replaced. Furthermore, there are the normal risks of general anesthesia. These risks are no greater or less than with any other procedure. The anesthesiologist will discuss these with you.COMPENSATIONSince 1991, the government and health insurers have implemented a new regulation regarding plastic surgery. Breast augmentation surgery is generally not covered by health insurers. Only in exceptional circumstances will the health insurer be willing to cover the costs. Your insurance company's medical advisor will then contact you to assess whether the surgery is eligible for reimbursement. Therefore, you should assume that you will have to pay for the surgery yourself. The plastic surgeon will inform you of the total cost of the surgery. |
