breast implants 

A thorough consultation with the plastic surgeon, taking into account your body shape, existing breasts and individual circumstances, is essential to best achieve your goals, desires and expectations. If you are considering breast augmentation, there are a number of choices to discuss with your plastic surgeon.

A) TYPES OF FILLING OF THE IMPLANTS

​An implant can be filled with different kinds of products such as silicone, saline, hydrogel,…

Plastic Surgeon Dr Nelissen prefers cohesive silicone implants because these are safe (minimal risk of leakage), feel natural and have a long life time. The silicone gel is cohesive, meaning it is pre-shaped with a viscous consistency. Because the gel is not runny or liquid in property, its use in breast implants minimises the risk of leakage problems. Many patients also find silicone implants feel softer and more like natural breasts than saline implants.

B) SMOOTH / TEXTURED / POLYURETHANE FOAM COVERED SHELL

Dr. Nelissen prefers not to use smooth implants because they generally have a greater risk of capsular contracture problems. Capsular formation is part of the normal healing process. Capsular contracture or capsular problems, on the other hand, refers to the tightening of scar tissue around the implant (abnormal healing). When an implant is placed into the breast, the body recognises it as a foreign object. In order to ‘contain’ the implant and keep it from wandering around, the body creates a capsule of collagen fibres around it, to seal it off. This is a natural process and usually unproblematic. However, if that capsule contracts or thickens, it can squeeze the implant, causing pain, distortion and hardening of the breast (capsular contracture problems).

Studies show that there are less capsular contracture problems (7 to 10% over a period of 10 years) with textured implants, compared to smooth implants, and significantly less problems (1%) with polyurethane (P-URE) implants.

Therefor Dr. Nelissen only uses textured or polyurethane implants. Polyurethane implants have a unique foam surface that significantly decreases the risk of capsular contracture. The foam covering becomes part of the capsule and makes it less prone to contracting.

An additional advantage is that anatomical polyurethane implants show a smaller risk of rotation and displacement problems because of the close interaction between the implants and the tissue surrounding them (Velcro effect). Ideal for patients predisposed to capsular contracture problems (after a former breast augmentation) or with thin/loose skin.

C) ROUND / TEARDROP (ANATOMIcally) shaped 

The shape of an implant varies from round to teardrop shaped. Both types of implants are used by Dr. Nelissen. The implants are also available in different profiles. After performing several measurements, the plastic surgeon will discuss with you what type of implant will give the most beautiful result, taking into account your personal wishes.

Teardrop shaped implants are considered to look more natural because they copy the natural shape of the breast. But also with round implants, a very natural result can be obtained, depending on the type of skin envelope and the placement technique.

Teardrop shaped implants show a greater risk of rotation, especially with bigger volumes in a loose skin envelope. This can be avoided by using teardrop shaped polyurethane implants.

d) BRAND NAME IMPLANTS 

The Belgian Authorities forbids us to mention online the trademark names of the used breast implants. However, this information can be given at specific request and will also be discussed during intake. Important to know is that Dr. Nelissen only uses so-called ‘A label’ implants, safely purchased through official Belgian pharmacies.

E) Volume / size

Your body shape, breast tissue and individual preferences are the main determinants of the desired implant size. Breast implants do not come in bra cup sizes (A, B, C, …) but are expressed in cubic centimetres (cc).

A 200cc prosthesis in a small, tiny person can give 1 BRA cup size rise but in a tall person or after some weight loss or pregnancy, more than 300cc is needed to fill the breast with 1 BRA cup size.

The desired volume will be determined based on the measurements by the plastic surgeon, fitting the implants during the intake and looking at before- and after photo’s of breast augmentations.

3d visualisation

You can also have a 3D visualisation of your breast augmentation. This simulator allows you to see yourself in 3D in your desired cup size with round or anatomic implants. This offers the perfect solution to visualize your breasts “after surgery” in 3D.

f) INCISION LOCATION

The incision in the crease under the breast (inframammary) is the most common breast augmentation incision used today and has the following advantages:

• Better visibility: the plastic surgeon has a clear view during the operation on the pocket in which the implant is to be placed so that the pocket can be perfectly tailored.
• There will be less blood loss. The risk of haemorrhage drops so that usually no drains are necessary.
• The scar is hidden in the natural crease under the breast and is less visible than in the armpit.

The incision around the nipple (periareolar) has the disadvantage that it involves cutting through breast tissue and that the sensibility in the nipple may be reduced.

The incision in the natural crease of the armpit (transaxillary) has the disadvantage that the distance of the incision from the breast can negatively reduce the surgeon’s ability to control bleeding and to position the implant correctly. If the scar in the crease of the armpit heals poorly, it is noticeable in bikinis and sleeveless tops. If capsular contracture problems occur, another incision (and scar) will be necessary for treatment.

The incision in the rim of the navel (transumbilical TUBA) can only be used for saline implants. The distance of the incision from the breast can negatively reduce the surgeon’s ability to control bleeding and to position the implant correctly.

G) LOCATION PLACEMENT OF THE IMPLANT 

The implant can be placed in different ways: before the muscle (subfascial) or partly behind the muscle (dual plane). This will be discussed during the intake with the plastic surgeon. Following the latest techniques, polyurethane implants are more frequently placed before the muscle.

Five years ago, Dr. Nelissen placed the implants in 25% of the breast enlargements under the muscle, but now this is still less than 5%! Because of this, there is a smoother recovery, the breasts look more natural and there is less chance of a 'double bubble'.

During the intake interview with the plastic surgeon, the placement of the implants (below or above the muscle) is discussed with the patient.

H) Anaesthesia

A breast augmentation is performedunder general anaesthesia under continuous supervision of our experienced anaesthesiologist. The patient will wake up soon after the anaesthesia and will be able to leave the recovery quickly after dismissal by the plastic surgeon and the anaesthesiologist.

i) FAQ

• Is breast screening still possible? Yes and even easier because the gland lies on the implant, making it more easy to detect any lumps more quickly. Mammography/MRI/NMR are still possible. You do need to report to your radiologist that you have implants.
• Can I still breastfeed with implants? Yes, nothing is changed to the gland itself.
• Can I still travel by plane? Yes. However it is discouraged to fly immediately after the procedure because of the risk of haemorrhage.

J) Safety breast implants

Read here more information about the safety of the breast implants used by Dr. Nelissen.

K) Guarantee policy for breast augmentation with implants (performed by Dr. Nelissen)

Despite all the security measures, it will sometimes be necessary to perform corrective surgery after a breast augmentation. Read more about the unique ISAPS-guarantee policy for breast augmentations.