Bust at its best
Beautiful, shapely breasts are a dream for many women, and sometimes their self-confidence even depends on them. No wonder, then, that breast surgery was once again the undisputed leader among aesthetic surgical procedures last year. A conversation with plastic surgeon Dr. Christian Lenz from Munich about modern breast implants and safe surgical techniques for breast augmentation.
If you add up the reports from implant manufacturers, up to 50,000 women in Germany last year had their décolleté boosted with the help of silicone. However, many women are unsettled following the scandal surrounding PIP implants. Education and critical questioning are more important than ever!
Are silicone pads actually always the method of choice for breast surgery?
“When it comes to breast augmentation, implant placement remains the most commonly performed surgical technique.”
What are the different types of implants?
“There is an infinite range of implants. Roughly speaking, there are silicone gel implants and saline implants. Today, however, the use of silicone implants is the general standard.”
At the latest after the scandal about the defective French PIP implants, patients have become uncertain. What do you tell a patient who is afraid?
“There are now a variety of really safe implants, for example silicone implants with a particularly resistant surface structure and barrier technology. This ensures that a blue-colored barrier layer minimizes the leakage of silicone into the body and, because of its coloring, can be checked one hundred percent for damage in the event of a breakthrough. I personally like to use so-called monoblock implants. They consist of one silicone block, so leakage is virtually impossible.”
What other differences are there in silicone pads?
“There are microtextured and macrotextured implants. I prefer to use the macrotextured ones. They grow in behind the pectoral muscle like Velcro, so there is no uncomfortable foreign body sensation when you move. The tight fit also means that asymmetries very rarely occur, whereas the microtextured implants tend to slip, in my experience.”
What role does the consultation play in your practice?
“The first consultation is extremely important and I take a lot of time for it. After all, it is about very intimate and personal wishes. How big do you want the breasts to be? Which breast shape best suits the overall figure? With which procedure, with which type of breast surgery do we achieve the desired result? And finally, information about possible risks is also very important.”
Capsular fibrosis is particularly feared? What can cause it?
“Even a high-quality and perfectly implanted silicone cushion is perceived by the body in some cases as a disturbing factor. Up to ten percent of patients develop capsular fibrosis after breast surgery: the body resists the implant, gradually encasing it in a sheath of connective tissue – with the result that it has to be removed again.”
What can be done about it?
“Capsular fibrosis also occurs mainly when there is a bruise around the implant after surgery. In that case, the bruise is also broken down, but a small residue remains, like a “film” on the implant. This “film” can then lead to a two-dimensional scar that envelops the entire implant. This lays the foundation for capsular fibrosis. An experienced plastic surgeon who frequently performs breast augmentations knows the exact course of the muscular structures and blood vessels. This makes breast augmentation possible without any blood loss or bruising. The choice of the surgeon should therefore fall on someone who mainly deals with this subject. In this way, the risk of capsular fibrosis and other risks can be reduced to a minimum.
Do implants actually have to be replaced again after ten years?
“That was actually the case in the past. The modern, innovative silicone cushions are practically no longer replaced. Provided they have been professionally implanted by a specialist who specializes in them.”
How many breast augmentations have you personally performed?
I can’t say that exactly. In the last 20 years, it was about 250 breast augmentations per year. Meal a little less, sometimes a little more.
What are the biggest risks and side effects?
“First of all, in addition to the capsular fibrosis described above, there are the usual surgical complications, such as bleeding, bruising, risk of thrombosis, infections and wound healing problems. With poor implant quality, potential implant wearers must also consider that replacement may be necessary years later.”
How much does breast augmentation with implants cost?
“The cost of breast augmentation in my practice ranges from 5,200 to 5,800 euros, depending on the choice of implants and anatomical conditions.