BREAST AUGMENTATION in FRANKFURT, GERMANY
Breast augmentations are often requested by patients with volume loss after pregnancy, breast feeding, weight loss or because they lack the size and shape to their breast to start with. A breast augmentation will enhance and enlarge the size and projection to your breast through the use of breast implants. Most women seeking a breast augmentation are looking for a natural, youthfully shaped breast size similar to the appearance they had when they were younger. Other women seek a breast augmentation to achieve a “fuller” breast (i.e. a push-up bra look, minus the push-up bra). No matter what group a patient falls into when seeking out breast augmentation, each procedure needs to take into account a patient’s specific desires, body and current breast shape.
AM I A CANDIDATE FOR A BREAST AUGMENTATION?
Patients requesting a breast augmentation seek out the procedure to enhance the appearance of the breast for the following reasons:
- breast volume loss after pregnancy or breastfeeding
- breast volume loss from weight changes
- age related volume loss
- increase their cup size
- create a breast “mother nature” never gave them
The “most beautiful” or “ideal” breast is UNIQUE to only you and your own tastes, body and current breast. The desirable breast size and shape, will be different from one patient to the next. It is the goal of Dr. Bianca Knoll to give you the most effective and safe operative approach to achieve your desired improvement. Most of Dr. Knoll’s breast augmentation procedures can be preformed safely in an ambulatory setting.
WHAT ARE THE DIFFERENT BREAST AUGMENTATION TECHNIQUES?
There are different breast augmentation techniques to surgically insert a breast implant. Dr. Bianca Knoll’s currently performs breast augmentations via the following incision methods:
1. IMF – INFRAMAMMARY FOLD INCISION – BREAST AUGMENTATION
This is an incision made in the crease/fold of the breast. Traditionally favored as this incision allows for direct access to a breast in creating a “pocket”/space for the breast implant, with little disruption to surrounding tissues. A very safe approach, offering a well hidden placement of the incision, for patients whose wound healing is normal.
2. AREOLAR INCISION – BREAST AUGMENTATION
This is an semilunar incision made just within the areola of the breast. Due to the thinness of the skin in this particular area of the breast, these incisions usually heal very well. An areolar approach is beneficial for women who require an adjustment of NAC height and diameter, or a minimal breast lift. For these woman, the incision will extend around the areola. If combined with a larger breast lift or breast reduction a “lollipop” incision (incision around the areola and vertical down) is usually required.
3. ARMPIT INCISION / TRANSAXILLARY APPROACH – BREAST AUGMENTATION
This is an incision made in the armpit. Traditionally called the “scar-less” incision, due to the lack of notability of the scar on the breast, and main body. The breast implant is inserted endoscopically through an incision of the armpit. Although the transaxillary incision is a nice breast augmentation approach due to its hidden scar in the armpit, not every patient will be an ideal candidate based on their anatomy, life style, and desired outcome.
4. TABA – BREAST AUGMENTATION
TABA is an acronym for Trans Abdominal Breast Augmentation. This approach can be an option for patients undergoing a mommy makeover, i.e. tummy tuck (abdominoplasty, or lipoabdominoplasty) together with breast augmentation. If a patient’s anatomy is adequate for this approach, the tummy tuck dissection will be carried out above the rib cage, reaching the IMF (inframammary fold) from underneath. The breast implant pocket will be created and the implant can be safely inserted using the Keller funnel.
5. TUBA – BREAST AUGMENTATION
This is an acronym for Trans Umbilical Breast Augmentation. This is an approach in which an incision made in the belly button. The use of an endoscope is used to help a surgeon navigate to the breast. Generally this incision is only an option for patients selecting saline filled breast implants, and is rarely requested.
All surgical approaches for your breast augmentation have their pros and cons. There is no one single best breast augmentation approach for every patient. There is only a better or worse solution for each individual situation of a patient seeking a breast augmentation procedure.
To discuss your breast augmentation options and choose the right and best one for you contact the office of Dr Bianca Knoll. Dr. Knoll and her team will be happy to provide you with further information about your breast augmentation procedure and answer your questions during your consultation in our Frankfurt office.
COMBINED PROCEDURE: BREAST AUGMENTATION AND BREAST LIFT
It is essential to define your wishes and expectations pre-operatively in order for us to recommend and perform the right surgical procedure for you. Some patients need to undergo a combined procedure, having a breast augmentation and breast lift performed at the same time. Depending if the breast implant is being placed above or below the breast muscle (pectoralis muscle), the recovery will be faster or lengthier. Performing a simultaneous breast lift and breast implant augmentation carries some specific risk related to wound healing, asymmetry, shape, biofilm, capsular contracture, and potential revisions. A combined breast lift and breast augmentation can be performed safely and successfully. If you would like to learn more about a breast augmentation combined with a breast lift, please contact the office of Dr. Bianca Knoll to set up your consultation.
WHAT ARE THE DIFFERENT BREAST IMPLANT PLACEMENT OPTIONS?
Placement in breast augmentation refers to the choice of location for the breast implant. Every placement location has it’s benefits and trade offs in a breast augmentation procedure. No surgical option is perfect for every breast augmentation patient, and the choice of breast implant location is mainly based on the thickness, quality and quantity of breast tissue a patient currently has.
- Retromammary / Subglandular Placement: This placement refers to placing the breast implant behind your breast tissue, but INFRONT of your pectoralis muscle.
- Partial Retropectoral Placement: This placement refers to placing the breast implant PARTIALLY UNDER the pectoralis muscle. The upper portion of the implants is covered, whereas the lower portion of the implant is not covered by the muscle, the so-called dual plane technique.
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 “TEAR DROP-SHAPED”, “SMOOTH” OR “TEXTURED” BREAST IMPLANTS FOR YOUR BREAST AUGMENTATION?
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 WHEN UNDERGOING A BREAST AUGMENTATION?
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 RISK 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, Leakage
Although 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 Contracture
A 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.
HOW WILL THE SCARS OF A BREAST AUGMENTATION LOOK?
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.
BREAST AUGMENTATION CONSULTATION IN FRANKFURT
Most patients seek a consultation with Dr Bianca Knoll because they would like to achieve a natural looking breast enhancement. During your consultation you will learn about every aspect of the breast augmentation procedure including:
- Your individual anatomy related to your goals
- Differences, Pros and Cons of placing the breast implants (above, i.e subglandular or below, i.e. submuscular)
- Differences, Pros and Cons between different available breast implants
- Pros and Cons between the 5 different available surgical approaches
- Newest scientific information about capsular fibrosis and contracture, biofilm and ALCL
- Associated risks with a breast augmentation procedure
- Guidelines before and after the breast augmentation surgery to reduce the risk of complications
- Considerations on the longterm after a breast augmentation procedure
Your consultation will be very comprehensive. Please plan enough time for your visit. Some of our patients bring a list of questions to their consultation, which Dr Knoll will be happy to go through with you.
We understand that it can be impractical for some of our out of town/international patients to travel to Frankfurt for an initial consultation. For this reason, Dr. Knoll’s office offers online consultations. By submitting a series of photographs, information about your desired outcome, and a little about yourself, we can start to determine if you are a good candidate. Though a virtual consultation starts the conversation, it does have it’s limitations and does not replace the need to be seen in person for a traditional consultation to finalize plans for a procedure.
BREAST AUGMENTATION COST
We understand that costs are always and issue. Over the years we noted with patients, who we have seen in our office after their procedure was performed, who were shopping for the “best deal”, and that “great deal” did not turn out to be so great. Revisional surgeries ended up being quiet costly, and in some cases the ideal result could not be achieved anymore by revisional surgery. Our fees are considerate regarding expertise, quality and safety. The cost of a breast augmentation is depending on surgical technique used, length of procedure and the details involved. There are three different cost associated with surgery: the surgeon’s fee, hospital fee and anesthesia fee. Dr. Bianca Knoll’s office in Frankfurt will provide you with a detailed cost proposal including all these 3 different costs after your consultation. The best thing to do is to come in to see Dr. Knoll for a consultation. You will be thoroughly examined and provided with all the information you will need to make an informed decision. You will also receive further information about any pre-operative testing required and additional information about your breast augmentation procedure.
If you would like to learn more about a breast augmentation options, please contact the office of Dr. Bianca Knoll in Frankfurt. We will be happy to assist you!