Breast Augmentation or Breast Enlargement, in medical terminology called Augmentation Mammoplasty or Mamma Augmentation, is a surgical intervention to enlarge the female breast. The augmentation and shaping of the breast can be achieved both by surgical procedures with silicone implants as well as by gentle, natural methods based on the transplantation of the patient’s body fat.
A well-shaped, aesthetic breast is widely regarded as a symbol of femininity. Women who are not satisfied with their breasts often wish for an optimization. Small breast size, the loss of breast volume due to long breastfeeding, asymmetry of the beasts, or other breast deformities are common reasons for women’s dissatisfaction.
The appearance of the breast is mainly congenital, that’s why changes of the adult breast’s size and shape can hardly be achieved by means of sports or diet. An exemption is the intake of food with hormone-like effects (e.g., phytoestrogens). Many affected women suffer from problems in love life as well as problems in daily life such as avoiding wearing body-hugging clothes or swimwear. This situation can cause mental and emotional suffering.
Nowadays, aesthetic surgery offers many options to optimize the female breast, including augmentation, shaping, and correction of breast asymmetries. Besides the conventional surgical methods many women prefer natural alternatives to breast implants.
Breast Augmentation with Silicone Implants
The most popular and frequently performed method of breast augmentation is the enlargement with silicone implants. Silicone implants are inserted into the breast to give it more volume. The implants are intended to remain in the patient’s body for a long time. In order to place the implant a small incision is necessary. This incision will lead to visible scars, even when the procedure is performed carefully.
There are several surgical techniques: In case of an inframammary access the incision is placed along the underside of the breast in the newly formed breast fold. The transaeolar incision is made around the areola of the nipples and transaxillary access is made with an incision in the armpits.
Another possibility is making an incision in the umbilical area (transumbilical). This incision is mostly used for implants that are going to be filled with saline solution. The type of incision going to be made is decided on before the surgery by the doctor together with the patient.
Additionally, there are different ways to place the implant: In case of very thin women the most common placement for breast implants is submuscular. This means that the implant is positioned partially or entirely under the pectoral muscle, in contrast to the subglandular placement, in which the implant is put under the breast gland but on top of the pectoral muscle.
The advantage of breast augmentation with silicone implants is the possibility of an exact planning of the enlargement’s dimension. Moreover, the shape of the breast can be changed by either using round or drop-shaped implants.
However, surgery under general anesthesia is an extensive intervention and in addition to possible damage of the breast implants there also is the risk of foreign body sensation and visible scars that last the rest of the life. Moreover, this kind of breast augmentation also requires staying in the hospital for several days.
Breast Augmentation with Autologous Fat and Stem Cells
Breast augmentation with autologous fat makes use of the body’s own resources only. In the beginning of the procedure the required fat is gently harvested with liposuction. During the same procedure the fat gets injected into the breast either non-treated or after undergoing certain treatments (e.g., centrifugation, filtration, stem cell enrichment).
The implanted fat provides additional volume to the breast. In case of breast augmentation using standard fat transfer (lipofilling) usually a part of the volume is being lost in the time after the procedure. Therefore repeat treatments might be necessary. However, in case of stem cell breast augmentation (Cell-Assisted Lipotransfer, CAL) one procedure is normally sufficient. Within a single surgery appointment an enlargement from half a cup up to two cups can be achieved.
The procedure is carried out on an outpatient basis under local anesthesia. Therefore the patient is spared the risks of a general anesthesia. Since no incisions with the scalpel are necessary, the patient is discharged home on the same day the procedure was performed. Also, the aftercare is much simpler than after a surgical breast augmentation.