For many women, the shape and volume of their breasts are not only an important aspect of their body, but also an essential part of their self-esteem. Quite often, women are unhappy with having either too small, too large or misshapen breasts. Over time and with age, the shape of the female breast changes naturally. Loss of skin elasticity, the pull of gravity and other factors such as weight changes, pregnancy and breastfeeding all affect the shape and firmness of the female breast. Due to genetic predisposition, they may also be too small in proportion to body size.
In addition to cases of juvenile mammary hypoplasia (congenital), with or without asymmetry, we also see women who wish to change the shape of their breasts following pregnancy and/or an extended period of lactation. These events may be followed by so-called involutional atrophy of the mammary gland. Together with tissue subsidence, this also gives the impression of sagging, less plump breasts. Excellent results can normally be achieved by adjusting the breast volume with implants. In the event of a significant relaxation of the skin, it is sometimes also necessary to perform a breast lift (mastopexy) to obtain optimal results. All breast implants consist of a silicone shell which can have various types of surfaces. The implant usually contains a silicone gel. They come in various shapes and sizes. The variety of shapes of implants available today means more anatomic, natural, and long-lasting results, tailored to the individual woman. The choice of breast augmentation method will depend on your anatomy, expectations and the plastic surgeon's recommendations.
A breast lift — also known as mastopexy — is a procedure used to reposition and reshape breasts which have sagged over time. In this procedure, the nipples and areolas are often repositioned in a higher, more youthful position. Sometimes it is advisable to combine the procedure with a breast augmentation, in which the volume of the breasts is increased with an implant. Through a special procedure (LTMT mastopexy), this can be avoided in certain cases. The operation can improve the shape, texture and size of the breast. This type of procedure can also be used to correct pre-existing asymmetry. The ability to breastfeed is not usually affected. However, it should be taken into account that future pregnancies may once again lead to a sagging of the breasts. For this reason, if you plan to have further pregnancies in the short term, it is advisable to postpone the surgery. The scars are the same as those from a breast reduction: this means that there will be a scar surrounding the entire areola and a vertical scar connecting the areola with the lower edge of the breast. Depending on the method used, there is also sometimes a horizontal scar at the skin-fold below the breast, resulting in a T-shape or inverted L-shape scar.
Some women – by nature – have very large breasts in proportion to the rest of their body. Because of the size and weight of their breasts, women may have limited mobility and skin issues when playing certain sports. Overly large breasts can give rise to posture issues, as well as shoulder, neck and head pain. There may also be a psychological impact. Surgical breast reduction involves partial removal of the mammary gland, fat and skin. With this procedure, volume is reduced, and the breast becomes lighter and firmer, and shape can be improved. The areola size is also usually reduced. Thanks to this procedure, asymmetries between the two breasts may also be corrected. Your doctor may ask you to have a mammogram prior to surgery to exclude any existing nodules. This will depend on your age and family risk.
This procedure was developed at the end of the 70s and consists of mobilising, breaking down and aspirating subcutaneous fat by introducing a cannula (a few millimetres in diameter) through one or more 3-mm incisions in the skin.
It can be combined with lipostructure, for example to increase volume in a desired location such as in the upper part of the buttocks. What was once simply fat removal has now become a procedure for reshaping fat tissue to achieve the desired shape. In the event of overall excess weight, it is recommended to first reduce body weight to minimise the risks linked to the procedure and to achieve better results.
The best use of liposculpture is for localised accumulations of fat in the buttocks, hips, inner knees and abdomen. It is rarely used for more significant obesity with gynoid fat distribution. Good results can be obtained because the adipocytes removed will not form again. The surgery can be performed with an assisted local anaesthesia or general anaesthesia depending on the case. For most cases, the in-patient stay at the clinic is 24 hours.
The postoperative period involves using dedicated elastic compression stockings for at least 20 days, with which most activities can be quickly resumed. The final results are visible 2-4 months after surgery.
This is particularly suitable for correcting abdominal imperfections after weight loss or pregnancies. These cases may involve a drooping abdomen or “apron”, sagging of the rectus abdominis muscle and a stretching of the tissue between these muscles.
The skin of the whole abdomen area between the pubic bone and lower rib is firmed and repositioned as desired. A repositioning of the abdominal muscles is often carried out at the same time during the procedure. The scar runs above the pubic hair and, where necessary, may extend up to the hips. In extreme cases, where there is major abdominal scarring, extreme excess skin or significant stretch marks, it may also be necessary to make a vertical incision in the mid abdomen area. The operation is performed under general anaesthesia. It is necessary to wear an elastic belt for 3-6 weeks post surgery.
This method corrects just the region surrounding the navel and the part of the abdomen close to the pubic area. There will be no navel scars. There are several variations of this type of technique.
Where there is significant excess skin at the buttocks and the back and side of the thighs, for example after significant weight loss, the skin loses its ability to hold its position. This results in flat or drooping buttocks, skin wrinkling and sagging under the buttocks. There is a procedure similar to the tummy tuck for the back of the body. In this case, the scar will lie above the buttocks and extend sideways from where a tummy tuck scar would be. When a tummy tuck is combined with a buttock lift in the same operation, it is called a body lift.
We see significant excess skin in arms and thighs following major weight loss or skin ageing. In such cases, the lift procedure may involve removing parts of skin from these areas. These procedures may be combined with a liposuction operation. The skin incisions are on the inner arms and thighs. The appearance of these scars and the effect of the surgery must be taken into full consideration.
The term gynaecomastia refers to an overly large male breast. This can be the result of an enlargement of the mammary gland itself or an accumulation of fat in the male breast area: so-called pseudogynaecomastia. Sometimes both causes are present. The enlargement of the mammary gland may have various causes; before an operation it is necessary to rule out any hormonal imbalances as the reason for this particular shape of breast. Surgical treatment for pseudogynaecomastia consists of liposuction carried out under general anaesthesia through small skin incisions. In the case of gynaecomastia, the gland will be removed through an incision made on the lower edge of the areola. In the event of skin sagging, potential skin reduction procedures can be performed depending on the individual case.