Why do women choose breast augmentation?
There are various reasons for choosing breast augmentation with silicone, but for many women, breast augmentation is a good solution when:
- Breasts are small by nature
- Loss of breast volume and shape after breastfeeding or weight loss
- There are different breast sizes (asymmetry), tubular breasts, or natural differences in proportions that you want to correct.
- The aim is to increase volume and change shape.
- Correct the breasts so that the breasts are as they were originally
Briefly about breast augmentation and the consultation
Breast augmentation is one of the most common plastic surgery procedures and one that has a very high satisfaction rate. Depending on your starting point, the shape of your breast and glandular volume, and what kind of result you want - there are a number of choices to consider. Therefore, a consultation with our plastic surgeon will be of great value, where you will receive a recommendation, have different options explained, try on and feel different sizes, and have the opportunity for 3D simulation. Together we will go through your expectations and the desired result of the procedure. This is important to us so that you as a patient are satisfied.
During the consultation, we take measurements of the width of the upper body, the height of the chest, the thickness of the glandular tissue that is there, and the stretching of the skin, and compare this with the desired fullness in the cleavage, the shape and projection of the breast implant, the degree of hardness, different types of gel and texturing. We look at projections and concepts such as the difference between medium and high profile which will result in different sizes. We need to consider whether the placement of the implant should be above or below the muscle. In addition, we will look at whether it is necessary to perform a breast lift and where the scar can best be placed. You will have the opportunity to look at many before and after photos, with different sizes, brands and shapes of prostheses, round, anatomical, moderate and high profile. Good planning is essential for a good result.
Many different terms are used interchangeably to mean many of the same things: breast enlargement, breast augmentation, silicone implants, silicone prostheses, silicone nipples, breast implants, breast prostheses (breast implants). In the USA, saline implants were previously widely used, but the safety of silicone implants and the fact that they feel much more natural, as well as the development of the shell around and the gel in the implant, mean that today, in practice, silicone implants are almost exclusively chosen.
What look do I want, natural or surgical? What are the benefits of breast augmentation?
There are many advantages to breast augmentation with silicone prostheses. A lot depends on what you want and how you feel your breasts should be for your well-being. A rule of thumb says that about 100 cc constitutes a cup size, but will vary according to the height and width of the upper body. Some people want it to look as natural as possible, while others want it to look a little more surgical. We can adjust the breasts, possibly the nipples at the same time, we can correct asymmetry, and you can get a more lifted and fuller profile. Whether the result looks very natural or more surgical depends on the size, shape and placement of the implant. What women want is individual, so it's important that you think about what result will make you happy.
In general, the benefits can be:
- Increased volume and fullness.
- Improved breast shape.
- More defined breast profile.
- Correction of lost volume, shape and lift.
- Corrected any asymmetry.
What types of breast implants are there to choose from?
There are many suppliers and many implants, so which implant should you choose? This depends on your physical conditions, i.e. the starting point of the breast, and what kind of result you want.
Different silicone prostheses offer different benefits. Some are very soft and feel and move like a breast. These will often be good in primary breast augmentations in those who have little glandular tissue. Others may have more glandular tissue and want more projection and may benefit from a stiffer implant that gives more fullness in the cleavage, in which case an implant that is too soft may be too natural. Others have a breast that benefits from an anatomical implant, for example, a low-sitting breast that needs more lift of the lower part or if you have prominent ribs at the top that will give too much fullness at the top compared to the bottom. Which implant is most suitable for you depends largely on your wishes and your physique (anatomy-based planning).
The role of the implant depends, among other things, on the plane in which it is placed and how much glandular tissue you have, as well as how they feel. Some say that only one implant is best, but there are many different implants with different advantages and disadvantages. In most cases, several implants may be appropriate, and you can try them in a bra, feel them, look at sizes and also do a 3D simulation of what they will look like. There will also be a price difference between some of the implants that may be a deciding factor for some.
Because we know that every woman is unique and because we know that everyone has their own personal wishes and expectations for a breast augmentation, we work with several recognized and certified breast prostheses.
Nordstrandklinikken gives you more choices
At Nordstrandklinikken, you will have several options and a breast augmentation that best meets your wishes. We therefore offer breast implants from several suppliers and have breast prostheses from Polytech, Motiva, Sebbin and Mentor with a capsule guarantee.
If you are considering breast augmentation with silicone prostheses, we recommend that you contact Dr. Vigen for a non-binding consultation. During the preliminary examination, we will go through the options available and explain the differences. You will be able to touch different breast implants so that you can feel how they feel, and you will be able to try different implants and sizes.
Every seventh patient at Nordstrandklinikken comes to us on the recommendation of one of our former patients. Dr. Alexander Vigen has been a plastic surgeon for over 10 years, and has been a senior consultant since 2016. Since then, he has mostly worked with breast reconstruction, breast surgery and body contouring surgery.
During the consultation, he will see which surgery and type of breast implant is recommended for you.
How to find the right size?
During the consultation, you will get to try different sizes and projections such as the difference between anatomical and round, moderate plus and high profile implants. We will show before and after pictures from operations with different starting points and different choices of prostheses.
In addition, 3D simulation can be performed to see how an implant will look on you. With us, you get good guidance where your wishes and needs are at the center. When finding the right size, we take your body proportions into account so that you have a realistic expectation of what size is suitable for you.
With breast augmentation with silicone implants, there will be natural limitations to how many sizes you can go up. But with our expertise and our options in breast implants, shape and methods - we are confident that we will give you the best result.
Placement of the breast implant above or below the pectoral muscle?
Breast implants can be placed either above (subglandular or subfascial) or below the pectoral muscle (partially below the pectoralis major muscle, so-called dual plane). If we place over the muscle, we usually place subfascially. A fascia is a small thin membrane that lies over the muscle and helps to hold the implant in place.
The best position for you is determined by factors such as the quality of your skin and how much natural breast tissue is available to cover the implant.
Location under the pectoral muscle
In most cases, especially for those with small mammary gland tissue, which is the majority of our patients, placement under the pectoral muscle is the preferred method of breast augmentation. This holds the implant firmly in place and provides good shape and support for the implant. It also prevents the contours and edges of the prosthesis from being visible in slender or small breasts, and provides very stable long-term results. It is best suited for those who have small breasts with little glandular tissue.
Positioning over the pectoral muscle
Placement of the implant over the muscle (subglandular or subfascial) is usually most appropriate for women who have enough breast tissue to provide coverage over the implant, usually a large B to C cup. This surgery provides good results and little pain. Placement over the muscle is suitable for those who have good skin quality and glandular tissue to hold the implant.
In cases where you don't want such large implants, subfascial placement of implants gives very natural and good results, while large implants above the muscle will often give a more "surgical look" and can more easily sag and hang more over time.
Beneficial for those who exercise the chest muscles extensively
An over-the-muscle approach can be beneficial for patients who exercise their chest muscles a lot. As this placement will limit the movement of the implant when the pectoral muscle contracts. It can give a potentially artificial appearance in thinner women with small breasts, which has led to smaller and natural/softer implants and a moderate profile and more subfascial placement.
Advantageous for those who are slim
If you have thin breast skin or a limited amount of breast tissue in the upper breast, placing the implant under the muscle will often create a more natural aesthetic and reduce the risk of rippling*. To avoid the prosthesis folding, so-called rippling, it is therefore recommended to place the implant under the muscle. There are also implants that provide less rippling, which is a good alternative for those who have had challenges with this. Several studies have shown lower capsule formation with submuscular placement. In addition, there is the option of fat transfer around the prosthesis or so-called lipofilling in cases where there is already rippling if you do not want to change the prosthesis.
It is important to consider that the choice of implant type and method must be assessed individually.
- Rippling is when the edges of the implant fold and you can feel it.
- Placement of scars
There are three primary incision locations that Nordstrandklinikken performs; the scar goes either under the breast, which is most common, around the nipple or through the armpit:
Under the breast fold: A small horizontal incision is made along the natural contour of the breast fold. The incision is between 3-5 cm long, depending on the size and type of implant, and becomes almost invisible over time.
Periareolar: The incision is made around the lower edges of the areola (the colored area around the nipple/mammilla)
Transaxillary / through the armpit: The incision is made along a natural fold in the armpit. The advantage of this is that there is no visible scar on the breast.
What is the recovery time after breast augmentation?
Since all patients are given a pain blockade at the end of the operation, most patients experience little pain after the procedure. This anesthesia lasts for several hours and you may experience some more pain in the evening. You will have pain for a couple of days before it starts to subside, so you will be given prescriptions for painkillers that you pick up before the operation - and you can also take some stronger painkillers home with you after the operation.
After the operation, you can eat and drink at the clinic and recover before going home about 1-2 hours after the operation. You can stay as long as you want that day, but most people feel fit enough to go home after being observed for an hour or so after surgery.
What do I need to consider after breast augmentation?
Your breasts will feel quite "cracked" for the first few days, which will subside in the first week. For the first few weeks, you should lie on your back after a breast augmentation. You also need to be careful not to use your arms or bump your breasts. Keep your upper arms close to your body when using your arms. If you have small children, you should get help at home 1-2 weeks after the operation. You should also be careful with heavy lifting in the first period after surgery.
You must wear preferably a good compression bra that we sell at the clinic for 6 weeks, 3 weeks day and night and then 3 weeks during the day. We do not recommend a sports bra as it must be pulled over the head and it is recommended not to put your arms over your head for the first time. For submuscular prostheses, we recommend a chest band or so-called press-down band for the first 2-3 weeks.
You can shower after 4 days. The tape on the wound can then be dried with a hairdryer. This tape can be changed for the first time after about 10-12 days. It should be changed weekly for 3-4 months to keep the scar as clean as possible.
After a breast augmentation with silicone implants, you will not be able to drive yourself and must be driven home, and you will continue your recovery in your own environment.
Patients who have lighter physical work, such as office work, are usually back at work after a few days. If you have heavier physical work, you should expect 2 weeks before you can be in almost "normal operation". You can exercise after 4-6 weeks. Much of the swelling will go down after 4 weeks. But the final result will be seen 3-6 months after surgery. Breast size does not provide grounds for sick leave.
Can you breastfeed after breast implants?
The prosthesis is placed behind the mammary gland or behind the muscle, and a small membrane forms around the implant so that there is no contact between the implant and the mammary glands and should not affect breastfeeding. In rare cases, if the nerve pathways are unusual, you may experience reduced nipple sensation or problems with breastfeeding, but this is extremely rare. In most cases, the lack of breastfeeding is not related to the prostheses. If you are considering having children in the near future, we would recommend having a breast augmentation after breastfeeding - hence you may find that you get a little more sagging in the breast after breastfeeding and may need another implant and sometimes a breast lift.
Can I have a mammogram after breast implants?
Man kan også utføre en mammografi med brystproteser, men gjerne oppi denne informasjonen til de som skal utføre undersøkelsen. Dette fordi da vil undersøkelsen utføres mer varsomt med mindre trykk når man tar bilder og at det må utføres flere bilder. I noen tilfeller vil man også få tilbud på å undersøke brystene bedre med ultralyd eller MR.
Which breast implant suppliers do we use?
We use prostheses from Polytech, Motiva, Sebbin and Mentor, which are the world's largest prosthesis suppliers. Most clinics have chosen one brand, which makes it easier logistically, but we believe that you should be able to choose the implant you want based on anatomy, tailor-made measurements regardless of brand. They have slightly different projections (different heights based on a certain width). During a consultation, we can show the difference between them and look at which one we think is best suited for you.
Mentor and Polytech and Sebbin have a prosthetic warranty, all the prostheses we use are of the highest standard in the world. Mentor and Polytech have microtextured recognized implants with a good prosthetic warranty. They also have a much wider range of different implants for different situations. Sebbin has something called semi-smooth and Motiva has so-called nano texturing which are both quite similar and have a smoother surface, in addition to the gel being somewhat softer and behaving more like a breast and having softer and more movable properties.
For those who exercise a lot
We have many patients who exercise a lot and there will then be a number of considerations to take into account both in relation to the placement of the implant as described above, but also in relation to the choice of implant. The Polytech B-lite series is a lightweight implant that is very good for those who run a lot or for other reasons want the lightest possible prostheses.
What types of implants are available?
- Silicone implants
- Round implants
- Dimensionally stable (anatomical/drop-shaped) silicone implants
- B-lite implants (from Polytech)
- Textured breast implants
- Polyurethane implants
- Smooth breast implants
Today, there are many methods and implants used for breast augmentation with silicone implants.
Silicone implants
Silicone implants have been used for decades and were first developed in the 1960s. In the 1990s, silicone was approved by the FDA and has proven to be safe for breast augmentation and reconstruction. Over the years, the technology has evolved considerably and the gel has become soft and feels like a breast. In the last ten years, silicone implants have taken a quantum leap and today provide a result that feels, acts and looks natural. In addition to feeling natural, you can drive a truck over an implant without it cracking and you can cut an implant in half without the gel running out.
Silicone is lightweight and has a feel and appearance that approximates human breast tissue. It is hypoallergenic and maintains its shape and consistency over time, and silicone implants are the "gold standard" for breast augmentation. They come in round or anatomical/drop shapes, and there are pros and cons between these as described below.
Round implants
At Nordstrandklinikken, we use approximately 70-80% round implants and 20-30% anatomical implants. In many cases, there is so much mammary gland tissue or coverage over the prosthesis that there is little difference between round and anatomical implants. Studies have been conducted in which plastic surgeons try to determine whether the implants are anatomical or round, and it turns out that in many cases, especially under the muscle, there is little difference between the two over time. Round implants provide more fullness and projection at the top - something that many people want when undergoing breast augmentation. They are also somewhat less expensive than anatomical ones.
The prostheses come in different projections or profiles that vary somewhat between different manufacturers (medium/mini, medium plus/demi, high/full, ultra high/corse) as well as different degrees of hardness - therefore you should spend plenty of time on consultation so that you can assess what shape and volume you want. If you want as much projection as possible and have some soft breast glandular tissue outside, you can choose a harder implant to provide projection. If you have less glandular tissue and want the softest possible breast, you should choose a softer implant.
Dimensionally stable (anatomical/drop-shaped) silicone implants
In our practice, we use approximately 20-30% anatomical implants. In some cases, these are the most beneficial, especially when you want the most natural result possible and where there is very little glandular tissue, or where you need to lift the lower part of the breast after breastfeeding a child, for example. A small breast lift can be achieved with anatomical implants by rotating the lower pole of the breast up and forward. Some people also have prominent ribs above the nipple, which means that round implants provide a disproportionate amount of fullness at the top compared to the bottom. Studies, including by Malucci in England, have shown that 55% of the breast volume should be below the nipple to achieve an aesthetically pleasing breast (45/55 principle). To achieve a good shape, anatomical implants should therefore be chosen in some cases.
Shaped or form-stable silicone breast implants, sometimes referred to as gummy bear, teardrop, or anatomical implants, are FDA-approved for use in patients for both cosmetic and reconstructive surgery. They have been available in many parts of the world for over 25 years. In hospital reconstructions, we have mostly used these implants in recent years with very good results. Most of our experience with these implants has been with textured shaped implants, which are not available as smooth to prevent rotation, but are also available in polyurethane, which is more fixed, does not rotate and should not cause capsule formation. They have proven to be beneficial in controlling the positioning of the implant and have little to no rippling in slender patients.
Shape stable implants have proven to be of great benefit to breast reconstruction patients, providing a better and longer lasting shape over time, less rippling and a more natural appearance in those with little or no glandular tissue.
A disadvantage of teardrop-shaped microtextured implants is that they may occasionally rotate. This may occur in between 1-3% of patients over a ten-year period. It is therefore important to have very precise surgery and correct pocket size, but may be less favorable in e.g. athletes or in secondary surgery as the prosthesis is more likely to rotate.
In recent years, round implants have been introduced that behave more like an anatomical implant in that the gel moves more like a breast. Motiva ergonomix is a popular implant for this and is very soft and natural.
B-lite implants (from Polytech)
In recent years, Polytech has developed prostheses called B-lite, which are very lightweight. For athletes and those who like to run and exercise, this will be a great advantage. We constantly receive reports from aerobics, fitness and other people who enjoy intensive training that they find these lighter and better than traditional implants.
This also applies to those who want large implants. For smaller implants, the weight difference will not be significant, but for larger implants, especially over 350 cc, there is a big difference. Over time, heavy implants will be unfavorable for neck and back pain, and these implants are therefore recommended where greater volume and low weight are desired.
Capsule warranty
The clinic has a capsule guarantee that follows the prosthesis manufacturer for the first 5 years after surgery, i.e. you will be covered for free reoperation by the clinic and prosthesis from the supplier if you get a capsule, as this is extremely rare.
We offer 3D simulation
What if you could look in a mirror before a procedure and see the result right then! At Nordstrandklinikken, this is actually possible with the help of Arbrea. Arbrea and their 3D technology will help you make the right choice, as you can see all the options you have to choose from in advance. Magic! And not least reassuring and educational. With Arbrea, you make the right choice. Simple, fast and secure.
Før operasjon
Om man røyker eller snuser så må man slutte med dette 6-8 uker før operasjon, avhengig av hva slags type operasjon man skal utføre.
Blodfortynnende medisiner, betennelsesdempende medikamenter og salisylsyrepreparater må ikke brukes 7 dager før operasjon.
Uken du skal få utført operasjon, så er det viktig at du har frisk. Har du symptomer på sykdom så må du ta kontakt med klinikken, slik at vi kan sette opp en ny dag. Man skal ikke utføre en operasjon når man har symptomer på sykdom.
Before surgery, you will be given a prescription for medication, with information on which tablets to take and what preparations to make at home.
Hva skjer operasjonsdagen?
På selve operasjonsdagen så faster man 6 timer før operasjon. Da er det også viktig at man ikke tygger tyggegummi eller pastiller, snuser eller røyker. Man skal ikke bruke parfyme, deodorant eller sminke - og piercinger og neglelakk må fjernes.
It is always a priority for us that you feel well cared for with the very best expertise, in safe and comfortable surroundings. You will be welcomed by a nurse who will go through a checklist with you. You will also meet our anesthesia staff who will look after you during the operation. You will then be taken to the surgeon for registration and a preoperative consultation. During the operation, you will be given general anesthesia and a local anesthetic to limit the pain.
The surgery takes about 1 hour.
Finally, a pain blockade is administered to reduce pain after the operation. You will receive a prescription in advance and painkillers to take home with you after the operation.
På postoperativ blir du fulgt opp av våre sykepleiere, der du blir liggende minimum 1 time etter operasjonen er ferdig. Du får mat og drikke og smertestillende etter behov.
Bestill en uforpliktende konsultasjon
At the consultation, Dr. Vigen looks at your wishes and looks at different options in relation to your anatomy and what options are available. We have 3D simulation so that you can take a picture of your upper body and simulate how the different implants he recommends will look on you and compare it to what you want. It will then be easier to understand whether you want a moderate or high profile, for example, and see what the different volumes will look like. We carry most implant types and can show these during a consultation at the clinic and explain the benefits of the different types and find something that suits your needs. You get to try different volume sizers and inserts so that you can get an impression of the size of the implant inside the bra. We have at the clinic but you are welcome to bring a bra without inserts or a sports bra to the consultation.
