Whether the placement is retromammary or partial retropectoral, a patient will be able to feel a portion of their implant. Patients who are lean, with low body fat, who can easily feel their ribs, are more likely to feel the outer shell of their breast implant used, no matter the placement. The material consistency of some breast implants are quiet soft and feel natural, almost like own breast tissue. Therefor most patients are not bothered by palpating their implant, and do not perceive the implant as unnatural. There are some special considerations for patients working out vigorously, who are very muscular with minimal body fat, or who are body builders. These women need special considerations regarding breast implant choices, surgical approach, and surgical technique. These breast augmentation patients my benefit from additional lipofilling to smoothen out the breast implant contour. Adding lipofilling, or fat transfer will support a natural appearance, resulting in a natural appearing transition of the breast implant to the patients body. However, this requires that a patient will have enough fat to be harvested by liposuction, allowing the fat transfer.
The success of a breast augmentation procedure is clearly dependent on the meticulous planning, a patient’s realistic expectations and compliance, aesthetic sense of your surgeon, and skilled surgical performance of your surgery.
Round or Teardrop, Smooth or Textured
which  Implant to take?
Almost every patient who comes in to see Dr Bianca Knoll for a breast augmentation consultation has some information and ideas about breast implants. Patients can spend a significant amount of time in online forums debating which implant they should choose regarding size and shape. It is often overlooked, that an implant of specific size, shape, and firmness may lead to one result in one patient, but a completely different result in another based on body size, breast shape, tissue quality, and desired outcome. A better way to think about choosing a breast implant for your breast augmentation, to consider the breast implant as closing the gap between the anatomy and appearance of a patient’s breast and desired outcome. Therefore it makes much more sense choosing the implant and surgical technique that will get you closer to the desired outcome regarding shape, volume, and how they feel. The degree of firmness and form stability of the cohesive gel of the breast implant can have an impact on both, shape and feeling of the breast after a breast augmentation. For these reasons we are very fortunate to be able to choose from a broad variety of implants by different manufacturers, and benefit by the advancements in of technology made. Together with her patients Dr Knoll will find the best and safest choice for their breast augmentation procedure.
To discuss your breast implant options and choosing the right and best one for you for your breast augmentation procedure contact the office of Dr Bianca Knoll. Dr. Knoll and her team will be happy to provide you with further information about breast implants and your breast augmentation and answer your questions during your consultation in our Frankfurt office.
What Happens during the Surgery?
Breast augmentations, and the advancements made in this field of aesthetic plastic surgery has undergone many new developments over the years. Due to Dr. Bianca Knoll’s training in aesthetic plastic surgery in the United States (Yale University), a new perspective was offered on breast augmentation. Your breast augmentation procedure will be performed under general anesthesia. Knowledge about well defined anatomical dissection planes, your surgery can be conducted with minimal trauma to the surrounding tissue, which will result in minimal to no bruising. Electrocautery dissection is a technique using an electrical current to cut tissue, and coagulate (stop) bleeding vessels simultaneously. The preference of this method is attributed to a surgeon’s ability to see, the accuracy in which to dissect, and less time in the operating room. This technique in a primary breast augmentation, rarely requires the use of drains post-operatively. During your breast augmentation procedure several steps will be undertaken to reduce the risk of biofilm development. Biofilm contributes to the development of capsular fibrosis and contracture. Due to these additional steps taken during your breast augmentation surgery the risks of developing capsular contracture can be significantly decreased, letting our patients enjoy their outcomes after their breast augmentation.
Dr Bianca Knoll’s breast augmentation procedures can be performed safely in an ambulatory setting. Depending on your general health, and your personal comfort, an overnight stay in the hospital might be preferred.
Potential Risks With Breast Augmentation
It is important for all women considering a breast augmentation to understand there are some risk associated with any surgery. Whether it be a medically necessary procedure, or an aesthetic plastic procedure, there are risk, but it is the goal of Dr. Bianca Knoll and her staff to have your best interest at heart, and will do everything they can to have your surgery go well, and your recovery proceed smoothly, safely and with the least amount of unpredictable things. During your consultation Dr Knoll will go through with you all the potential risks in detail. These are just some examples of the most common patients concerns associated with breast augmentation:
- a. Rupture, Deflation, LeakageAlthough safety and quality of breast implants have significantly improved, they are man-made devices. While most women go years with no issues, there are the rare occasions in which something does occur with breast implants. In cases of deflations with saline breast implants, the saline leaves the implant shell (think of a water balloon with a small hole… water leaves, and the shell remains), and results in the loss of volume, which is easily noted. Ruptures in silicone implant patients, are generally noticed by a patient, who notice “something different” in shape or contour of the breast. In order to diagnosis this, it is generally ordered for an outside test, such as mammogram, CT scan, or sonogram to be preformed to check on the implant shell (the outside cover of a breast implant). Leakage is generally noticed the same as a rupture. Any of these would result in the need for a secondary procedure to correct the situation. It is also important to know that from a general stand point, ruptures, leakages and deflations, DO NOT happen to both breast, at the same time.
- b. Capsular ContractureA thin collagen layer is formed by the body around the implant, the so-called “capsule”, which is a normal reaction of the body to a foreign body. A capsule can also occur to medically necessary devices such as knee replacements, pace makers and new joints. Capsular fibrosis and capsular contracture is a condition in which the scar lining/tissue that surrounds the breast implant, starts to thicken, harden and/or tighten. Although the etiology is not fully understood, research over the past decades have shown that certain triggers are involved, like biofilm (caused by bacteria) and hematoma. The risk to expose the breast implant to biofilm can be significantly reduced by choosing the placement of the breast implant under the muscle, choosing an incision that reduces the risks of bacterial translocation, applying safety measures before, during, and after the operation. During your consultation Dr Knoll will explain to you in more detail capsular fibrosis and contracture and will provide you with uptodate research in evidence based medicine. Dr Knoll has performed basic science research related to the influence of silicone on capsular fibrosis which has been presented at several international and national meetings.
- c. Uneven Appearance
It is important to realize that the goal of a breast augmentation is to enhances and enlarges the size and projection of breast through the use of breast implants. However, all breast are different prior to surgery; including the right and left breast of each patient. Although some asymmetries can be corrected or improved by your surgery, small asymmetries can still be notable post-operatively, especially if they were there pre-operatively. Each patient will experience recovery and healing at their own pace, and Dr. Knoll and her staff are here to answer questions of both the expected and unpredictable things after surgery.
Should any risk, or a concern occur post-operatively, it is always beneficial to contact the office. No surgeon can address an issue without knowing an issue exist.
Scars and your Breast Augmentation
Breast augmentation will require an incision. Patients are often concerned about the visibility of their scars after their surgery. Most scars will be barely noticeable after the healing process is completed. But, although the incisions will be closed tediously to reduce tension, in some patients the incisions still might be noticeable depending on the individuals healing and scar formation. While some surgical techniques result in less visible scars, how an individual patient heals, is unpredictable, especially if they never had any surgeries or injuries before. Despite Dr. Knoll using precise surgical techniques and post-operative wound care instructions , there are the rare occasions in which scars require treatments for unsatisfactory formations. Many steps will be taken to help decrease the visibility of a scar. However, it is important to understand that in most patients, a fine scar might be noticeable. If you would like to learn more about your breast augmentation options, please contact the Frankfurt office of Dr. Bianca Knoll to set up your consultation.
Breast Augmentation Recovery
Most patients do describe their immediate post-operative recovery as not too painful. Patients experience more pressure related discomfort and some pain, that can be controlled with the appropriate pain control regimen. Most patients feel well and are fairly active right after their surgery. However, to ensure adequate wound healing you will be limited in your physical activities during your immediate post-operative period. Most breast augmentation procedures are performed as a day procedure with no drains used, and with only a few days downtime thereafter. Each patient will experience recovery and healing at their own pace, and Dr. Knoll and her staff are here to answer questions of both the expected and unpredictable things after surgery, and guide you. Dr Bianca Knoll and her staff will have your best interest at heart, and will do everything they can to have your surgery go well, and your recovery proceed smoothly, safely and with the least amount of discomfort possible.
