Breast augmentation

Information on Breast Augmentation : Forum Klinik Köln (Cologne)

Depending on your individual anatomic situation differnt techniques may be advisable for breast augmentation. We like to present the most common, including our speciality, the virtually scar-free augmentation via an axillary approach, endoscopically performed. 

As a new technique we introduce breast augmentation with autologous fat cells as a very natural augmentation, suitable for selected patients

1. Axillary approach - endoscopic breast augmentation - our speciality

We take advantage of a technique originally invented by Henry Delmar, Cannes. Via an axillary approach high up in the axillary fold the dissection is meticulously performed with a specially designed endoscope. Haemostasis is easily achieved and dissection of the implant recipient site can be performed to a standard of precision not seen before the endoscopical era. Placement of anatomical implants, if desired, is not an issue. The dissection and implant placement can be either in front or behind the pectoralis muscle, depending on the anatomical preop situation. The main advantage is the inconspicuous scar. Not only the placement of the scar is inconspicuous, it is also the scar quality in the upper axillary fold that makes the scar ideally invisible after one year. Nevertheless exceptions to this cannot be ruled out.

Endoscopical transaxillary breast augmentation is ideal for patients without a preexisting submammary fold, like those who have little or no breasts, or medium sized, firm breasts. In those patients a scar under the breast would always be visible. Furthermore, the younger the patient, the greater the risk of bad scar formation (keloidal or hypertrophic scar). The older the patient, the more preexisting damage the skin has (irradiation, age, smoking), the BETTER the scar will be. As a conclusion, if you have preexisting skin damage (good scars) and have a submammary fold, the classic technique will be very suitable. If you do not have a submammary fold and are more at risk for bad scar formation or simply dont want a scar on your breast, the endoscopic technique is best for you.

2. The Classic techniques

As mentioned before, these techniques may still be very suitable for selected patients.

The submammary approach is excellent for patients with a preexisting submammary fold and a history of good scar formation. The periareolar approach is preferred if there is a history of good scar formation and additionally to augmentation breast lift or a correction of the areola in size and position is planned.

Implants: We use anatomical and round Implants, all from Allergan, formerly Inamed McGhan. The results with these 4th generation implants are excellent. Low visibility, natural look and feel and a very low rate of capsular fibrosis stand out. In most cases anatomically shaped implants are used. All implants have highly cohesive silicone gel filling and five outer membranous shields including a barrier membrane. There is no safer implant on the market.

Over or under the pectoral muscle? This entirely depends on the preop anatomical conditions. Patients with scarce subcutaneus tissue and very small breasts are candidates for "under the muscle" placement to prevent any unnatural show of the upper pole of the implant.

How big? One of the questions that needs in-depth pre op discussion and simulation. Most patients want the natural look and don´t want the augmentation to be visible at all. We have to evaluate the tissue amount and firmness, elasticity, nipple position, asymmetries, etc and then evaluate carefully the "wants". Matching the "wants" and the "cans" is clue to patient satisfaction. The size does neither influence the technique nor the price. News is that we make use of the computer assisted BioDynamic Sytem to evaluate the proper size in appropriate cases. There is a word of caution, however: the quality of the computer-generated result depends on the quality of data fed into the computer. Basically, the computer can only be of assistance finding the best size; surgical experience and in-depth discussion of patient needs and wands is crucial.

3. Autologous fat cell tissue transfer - the most natural way to enlarge the female breast

Since long, fat transfer has been recognized as a reliable technique for volumetric corrections in different parts of the body. But the female breast has been spared as a recipient site for free fat tissue transfer in the past.

Since now more than five years free fat transfer has been extensively used as an alternative technique for breast enlargement with safe and predictable results. Concerns have been possible microcalcifications that could mimic breast cancer. According to new data, this risk seems to be reasonably low.

We are happy to introduce Dr. Konstanze Warbanow. Mrs Warbanow has extensive experience with fat grafting and liposuction. She runs her own consultancy office in the rooms of our clinic as an associated Plastic Surgeon.

We kindly invite you to schedule a consultancy appointment in the Forum Klinik Köln (Cologne).

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