Breast Augmentation
Breast augmentation is an aesthetic surgical procedure for those who wish to increase breast volume and achieve a fuller, more proportionate appearance. Because every patient's anatomy, tissue thickness and expectations differ, a detailed assessment is carried out before surgery.
This assessment examines many parameters together: the structure of the rib cage, the position of the breast on the chest wall, any curvature of the spine (scoliosis), existing asymmetry, the position of the inframammary fold and tissue thickness. These findings are then weighed against the patient's personal expectations to decide on the most suitable implant type, the pocket in which the implant will be placed, and whether additional procedures (such as fat grafting) are required.
Alongside clinical measurements, three-dimensional simulation (Vectra XT) and external sizers are used during the decision process, so the patient can evaluate the likely result visually before surgery.
Implant Placement Options
When the upper breast tissue is of sufficient thickness, the implant may be placed over the pectoral muscle. Where tissue thickness is insufficient but this placement is still preferred, the upper tissue can be reinforced with the patient's own fat. In physically active patients, over-the-muscle placement is favoured wherever possible in order to preserve chest muscle function.
When the upper breast tissue is thin, or the chosen implant volume is not suited to over-the-muscle placement, the implant is positioned beneath the muscle. The aim here is to increase the thickness of tissue covering the implant by including muscle, making the transition at the upper pole of the breast softer and more natural.
The Preservé Technique
Preservé is a tissue-preserving approach that changes how the implant pocket is created. Where classical methods separate tissue by cutting, the Preservé technique uses a special balloon dissector to expand the tissue gently and in a controlled way — without cutting — to prepare the space for the implant.
In this approach the implant is placed not under the muscle but between the layers of the breast tissue itself (subglandular) or beneath the thin fascial layer over the muscle (subfascial). The pectoral muscle and the natural ligaments supporting the breast are therefore preserved, and distortion of shape with muscle movement (animation deformity) is not seen. For this reason it can also be a suitable option for people who use their chest muscles actively or who lead an intensive sporting life.
Minimal incision, reduced tissue trauma and less bleeding are among the defining features of this technique, which generally results in a more comfortable recovery. Whether Preservé is appropriate for a given patient is determined after examination, evaluating breast tissue thickness, the desired volume and overall anatomy.
Augmentation with Fat Grafting Alone
A marked increase in volume is usually not achievable with fat grafting alone. In suitable patients, however, fat grafting on its own may be preferred to correct asymmetry or to fill the upper pole of the breast slightly. For more detail, see the Fat Grafting section.
Recovery After Surgery
- With over-the-muscle placement, most people return to daily life within 3-4 days.
- With under-the-muscle placement this may extend to 7-10 days.
- Avoiding strenuous physical activity and chest exercises is advised for the first 6-8 weeks.
- A support bra is recommended for 2-3 months after surgery.
These timings are a general guide; individual recovery varies according to the examination and the surgical plan.