Patient information about new breasts with implants
WHY CHOOSE TO GET BREAST IMPLANTS?
By inserting silicone implants, you increase your breast size by one or more bra sizes. There may be several reasons for choosing breast augmentation, including the desire to:
- Change the size of the breasts if they are too small for you
- Create more volume or restore lost volume in the breast after weightloss or breastfeeding
- Make the breasts equal in size, i.e. create more symmetry
Breast augmentation surgery primarily increases the size of the breast from the body, i.e. the cleavage, nipple position and breast fold do not change.
WHAT TYPE OF IMPLANT SHOULD I CHOOSE?
At AK Nygart, we primarily use silicone implants from Motiva, Mentor and Silimed. Silicone implants come in different shapes and softness: Round (slightly firmer) implants, anatomical (teardrop-shaped) implants and Ergonomix, (extra soft and round) implants. In collaboration with our plastic surgeons, you will find the manufacturer and size that suits you best.
Motiva implants with chip (Q-ID)
Motiva implants contain a small chip. Should your implant card be lost, you carry the identification of the implant in the small chip. You will be able to have MRI scans even if you have this. During an MRI scan, there may be a slight heat change of approximately 1.5-1.8 degrees around the chip. This temperature change will not affect the lifespan of the implant.
See more product information about the implants used by AK Nygart – read more here.
CONSULTATION – WHAT DO I NEED?
Before the surgery, you will first have a preliminary examination with our plastic surgeon. Here you will talk to the surgeon about your expectations, the surgeon will assess what will best suit your body type, and you will be given a thorough review of your options – and the risks that are always involved in surgery. Finally, the surgeon will ask about your health to make sure you are fit for the procedure.
Based on your expectations and the surgeon’s recommendations, you will plan your surgery and the size and profile of the implant. Please note that by law you can only give your consent to the surgery and have the surgery after you have had 7 days to think about it after the preliminary examination.
Only during the surgery itself can the surgeon see exactly how the implants fit with your anatomy. Therefore, it is important that you understand that in rare cases, the surgeon may need to reduce the size of the implants during the surgery in order to achieve the best possible result and symmetry of your new breasts.
We recommend that you leave your children at home for the preliminary examinations with the plastic surgeon. We have often experienced that the client has difficulty concentrating when the children are present. At AK Nygart, we pride ourselves on providing the most thorough professional and personal guidance possible.
You are welcome to bring a friend, family member or your boyfriend/girlfriend to the examination, where we will give you the oral information.
Remember that there can be a maximum of 2 people at the examination at any one time. If there are several of you who would like an examination, and to bring a relative with you, you must book independently.
WHAT TYPE OF ACCESS CAN I CHOOSE FOR THE IMPLANTS?
We can choose between three different approaches when placing breast implants in the breast: either through an incision in the outer edge of the nipple, through an incision in the armpit or – most commonly – the implants can be inserted into the fold just below the breast.
The location of the scar depends on the technique available for your anatomy and your wishes for your new breasts. The most straightforward method is to insert the implants through the breast crease under the breast. It also offers the least risk of post-operative bleeding, capsule formation, infection and of damaging the sensitivity of the nipples.
Placement via incision in the edge of the nipple can be a good option if you form nice scars, as the scar will then be camouflaged by the color change between breast and nipple. However, if you do not have a nice scar, it will be very visible.
When placed via the armpit, there will be no visible scar on the breast because the scar will be in the armpit. The armpit cannot be used if you want anatomical implants. Be aware that you cannot use the armpit access again if you need surgery later on.
SHOULD THE IMPLANT BE PLACED ABOVE OR BELOW THE MUSCLE?
In many cases, it is best to place the implant under the pectoral muscle, including in women without sagging breasts. In other cases, the silicone implant is placed under the mammary gland but on top of the muscle. This is an option, for example, for slightly sagging breasts that need to be lifted slightly at the same time as augmentation. If the breast is very saggy, an additional breast lift may be necessary.
The final choice is made in consultation with the plastic surgeon.
ARE THERE RISKS ASSOCIATED WITH THE SURGERY?
When a well-qualified plastic surgeon performs breast augmentation surgery, complications are few. However, there is always a risk associated with any type of surgery.
If you choose to have breast implants, you should be aware of the following complications associated with the surgery:
- Capsular contracture 5-10% depending on which statistics you look at. Capsular contracture is when the capsule that always forms around the implant suddenly starts to tighten around the implant. This causes the breast to become hard and, in some cases, deformed and painful. This can happen on one or both breasts. The cause is still somewhat unclear, but the consensus is that it is caused by biofilm, which is a bacterial culture found in the breast pocket that does not cause inflammation, but for unexplained reasons can cause capsule formation. If you’ve had capsule formation once, you’re more likely to get it again.
- Haematoma – in rare cases (less than 1%), bleeding can occur after surgery. This may require a repeat operation under general anaesthesia.
- Wound infection 1%. An infection of the scar that can usually be treated with antibiotics.
- Thickened and or widened scars.
- Infection around the implant up to 0.5%. It can occur at any time, but will most often be seen within the first 14 days. The infection is treated with antibiotics. It may be necessary to remove the implant for a while (about 3 months) and then insert a new one.
- Should the implant rupture, it will of course need to be replaced. If it happens within the first year, the surgery itself is free of charge. If you have Tryg 7 insurance, the surgery is free for 7 years. In case of rupture after that, you will have to pay for the surgery yourself if the implants rupture.
- Leakage: AK Nygart is part of a research project that looks at leakage (seepage) from silicone implants depending on the cutting strength (Cohesivity) of the implant. For the project, we looked at Mentor’s round implants. There are Cohesive 1 + 2, while anatomical implants are labelled Cohesive 3. The higher the Cohesivity, the less leakage and probably less capsule formation. This means that Coh 2 and 3 can probably last longer, up to about 25 years, while Coh 1 implants are recommended to be replaced after about 10-15 years to avoid possible seepage with subsequent capsule formation.
- The nipples can become more or less sensitive and in rare cases numb. The risk of losing sensation completely is up to 1.0%.
- Implant edge and rippling. Especially in very slim women with a small breast and very little subcutaneous fat, the edge of the implant can be felt and sometimes also seen under the breast and to the side. In the same slim women, wrinkles or folds in the skin above the implant can sometimes be seen. This is called rippling. The risk of this is less now that we have cut-resistant implants than when liquid silicone or saline implants were used. Rippling and noticeable implant edges are most often seen in thin women who choose large implants.
- Double fold. Sometimes it may be necessary to lower the lower limit of the chest to make room for the implant. This may cause a retraction of the skin at the top of the breast, similar to the old fold under the breast. This is called a double fold. The risk of this is small and the plastic surgeon will try to take it into account if you have a breast that is predisposed to double folding. If the double fold does occur, it can be very difficult to correct and in the worst case it can become permanent.
- When using anatomical (teardrop-shaped) implants, the risk of rotation is less than 1%. When using very “strutting” round smooth implants (Motiva), rotation can rarely occur where the implant lies with the bottom upwards.
- Swelling.
- Pain after surgery is normal. Usually the pain goes away little by little, but in rare cases the pain can be long-lasting. In extremely rare cases, the pain can become chronic.
- Stretch marks.
- Symmastia, i.e. the breast and breastbone meet in one. This is extremely rare.
- Serom 1%. Fluid accumulation, which in some cases is depleted.
- Tissue death associated with lack of blood supply to the skin. This occurs extremely rarely.
- Usually you will be able to breastfeed without problems after breast augmentation surgery.
- In very rare cases, cancers can develop in the scar tissue around the breast implant. This includes breast implant-related lymphoma (ALCL), a cancer that has only been seen in what are called textured implants, i.e. implants with a rough surface. Among these types, implants from a company we do not use clearly have the highest risk. Of the textured implants, we use Mentor and Silimed instead. ALCL has been seen in women with Mentor implants, but it is extremely rare: the incidence of ALCL in women with Mentor implants has been found by one study to be about 1 in 66,000.With Silimed True Texture implants, no cases of ALCL have been seen to date, even though it is a textured implant. Motiva is described as a smooth implant, and no cases of ALCL have been detected. ALCL manifests itself either by persistent swelling of one breast typically several years after surgery. ALCL can also be seen in nodules in the capsule around the implant or in swollen lymph glands. If you experience these symptoms, you should consult a plastic surgery clinic, such as the one where you had the surgery, or your own doctor. It should be stressed, however, that in the vast majority of cases such symptoms will be caused by benign conditions.
The risk of all the above complications increases as the size of the implant increases.
REGARDING NEW BREASTS AND BLOOD CLOTS
At AK Nygart, we put safety first. There are certain things that increase the risk of blood clots, especially in the legs and lungs, during surgery. That’s why some customers are recommended prevention with a drug called Fragmin, Klexane or Innohep.
If you need Fragmin, Klexane or Innohep, it will be given as an injection into the thigh or abdomen by a nurse in the recovery room.
In extremely rare cases (special risk patients), you will receive a prescription for blood-thinning medication electronically.
The first dose is given on the day of surgery, when a nurse in the recovery room shows you how to do it.
ASYMMETRICAL BREASTS
By nature, all women’s breasts vary in symmetry. This means that no two breasts are the same. Therefore, breast augmentation surgery will not be able to completely correct for this innate difference. But implants can take you a long way towards your goal of a more symmetrical chest.
SHOULD I CHOOSE A REASSURANCE PACKAGE FOR MY NEW BREASTS?
At AK Nygart, the price includes a security package for the first year. This covers all surgical costs in the unlikely event of any problems with the implants during the first year. Since capsular contracture rarely occurs during the first year after surgery, but typically in the following years, most people choose to purchase the extended coverage package, which covers for 7 years after surgery. With this extended coverage package, you will also be covered if other problems with the implants arise, such as bottoming out, rotation, rupture, etc.
Read more about what the assurance package covers here.
HOW LONG WILL MY NEW BREASTS LAST?
When we talk about how long the results of your breast augmentation surgery will last, there are two things you need to be aware of.
- The implant: Different manufacturers have different warranties. Regardless, all experience shows that as the years go by, implants become more fragile, which reduces their stability and increases the risk of sudden failure. It’s a clear recommendation to have your implants replaced before they break, but no one can predict exactly when that is. We recommend that you have your breast implant checked after 10-12 years, possibly with an ultrasound scan. You are also always welcome to visit us for a check-up.
- Your own ageing Even if you achieve a satisfactory result from the surgery, your body and tissues will continue to age. This means that the shape of your new breasts will change over time. How quickly this happens depends on your genetic disposition, how you live, whether you smoke, as well as the overall weight of your breasts and the position of the implant. Note that your breast tissue will become particularly lax after pregnancy and breastfeeding, and this will also affect the appearance of your breasts.
If you are overweight, there is an increased risk of complications from anesthesia. If your BMI (Body Mass Index) is over 30, we cannot offer you breast augmentation surgery. Calculate your BMI here.
If the final result does not meet your expectations and those of the surgeon, it is up to the surgeon to decide whether a re-surgery can improve the result.
HOW BIG CAN THE BREAST IMPLANTS BE?
Over the last 3-4 years, we have seen that our surgical customers increasingly want larger and larger implants in their breasts. Of course, we would like to accommodate these wishes if possible. On the other hand, the surgeon’s professional judgement also depends to a large extent on the possible complications of larger implants. These include an increased incidence of capsule formation and rippling.
At AK Nygart we want complete satisfaction. That’s why it’s important that you think about the information you receive during the preliminary examination and that you are able to reconcile yourself with the recommendation the surgeon makes. If you are in doubt about the size or profile of your new breasts, we always ask you to contact us before the surgery.
HOW ABOUT FUTURE BREAST EXAMINATIONS?
Most women with breast implants can be screened by mammography, but there may be technical obstacles. Therefore, you should always inform the mammography staff that you have implants in your breasts.
If the breast implants are placed behind the pectoral muscles, mammography screening can usually, but not always, be performed without problems.
In women where the implants are placed in front of the pectoral muscles and in women with heavy capsule formation around the implants, mammography screening will often be less suitable or not possible at all. This is because X-rays cannot penetrate the implants.
If there are symptoms of changes in the breast, a so-called clinical mammography is always performed, which includes several X-ray images (mammography) supplemented by an ultrasound examination and cell and tissue tests.
The Danish Breast Surgery Association recommends that women over 35 who want new breasts have a mammogram/ultrasound scan before surgery.
The Danish Health Authority writes:
“Breast implants can cause problems with mammograms, so if you choose to have an implant, it is important that you inform the staff that you have a breast implant. If the implant is behind the pectoral muscle, the examination can often be carried out anyway as staff try to push the implant so that it does not hide the breast tissue. There may be a very small risk that the implant capsule may rupture during the examination, but this is extremely rare.
Women who have breast implants in front of the pectoral muscles cannot usually be examined with mammography. If there are symptoms or suspicion of disease in the breasts, a so-called clinical mammography, which includes several X-rays supplemented by an ultrasound examination, can be performed on medical indication. However, the implants may still prevent part of the breast tissue from being seen and assessed.”
BII – BREAST IMPLANT ILLNESS
Symptoms of BII include muscle and joint pain, fever, fatigue, “brain fog”, headaches, anxiety, dry eyes and mouth, etc. Several possible causes of BII have been proposed, but none have been scientifically established. Therefore, patients with BII usually want to have the implant removed with the capsular tissue intact, also known as a bloc.
There are no diagnostic tests specific to this condition. We still don’t know exactly what it is, but now we know a lot more about what it isn’t, based on recently produced scientific studies. According to the results of these studies, BII is not an inflammatory disease, not related to heavy metal exposure and not associated with silicone gel (as BII can occur with saline implants.) BII also occurs with both smooth and textured implants.
Most women who have symptoms they believe are related to their breast implants experience improvements after the implant is removed. No one knows why, and there is no way to predict who will not improve after implant removal.
According to recent studies, it doesn’t matter how they are removed. In other words, patients’ symptoms improve whether the implants are removed with or without the surrounding capsular tissue.
HOW DO I PREPARE FOR THE SURGERY?
Before the surgery, you must:
- 1 week before the surgery, stop taking medicines containing acetylsalicylic acid (Magnyl, Aspirin, etc.). However, you must not stop taking heart medication or other blood-thinning medicines (Clopidogrel, Marevan, etc.) without consulting your own doctor or cardiologist.
- You should stop taking herbal medicines that can affect the blood’s ability to clot, such as Q10, fish oil, valerian, ginseng, ginkgo, garlic powder/ginger or vitamin E 1 week before.
- Arthritis medication (Ibuprofen, Naproxen,Diclofenac etc): take a break for 3 days, possibly after consulting your own doctor or rheumatologist.
- Avoid tattoos, piercings or major dental work such as fillings 1 month before and 1 month after the surgery. This is because tattooing, piercing and dental work can cause bacteria to form in the blood and settle around the implant.
- In addition, you need to buy Paracetamol 500 mg + Ibuprofen 200 mg for one week’s use.
- Arrange with a relative for you to be picked up 2 hours after the surgery and looked after for the next 24 hours.
- It’s a good idea to shop and cook for a week, so you only have to concentrate on recovering from surgery.
- On the day of the surgery, take a shower and wash your body and hair thoroughly with soap. Do not use body lotion or cream on the area you’re having surgery on.
- Dress in loose, comfortable clothes, preferably a zipped blouse and flat shoes.
- Jewellery and any piercings are removed and left at home.
- Take a break from smoking/e-cigarettes 6 weeks before and 4 weeks after surgery: to reduce the risk of poor wound healing, lung problems and infections during surgery, you should stop smoking at least 6 weeks before your surgery. If you intend to start smoking again, we recommend that you wait until at least 4 weeks after surgery to optimize the healing process. Smoking cessation medication (nicotine patches, nicotine gum, etc) can be used. Read more here.
- Take a break from alcohol: if you drink less than 7 drinks/week as a woman and less than 14 drinks/week as a man, you have a low risk of getting sick from alcohol during surgery. If you drink more than this, you should cut down and if you drink more than 4 drinks a day, you should stop drinking alcohol completely 4 weeks before your surgery. This will reduce the risk of complications (infections, poor wound healing, lung problems, etc.) Read more here.
Just before the surgery, the surgeon will draw your breasts and briefly go through the surgery with you again.
HOW DO I FEEL AFTER THE SURGERY?
The surgery itself takes about 1 hour. And you can be picked up about 2 hours later. When you wake up after the surgery, you will probably feel some pain around your new breasts. However, the pain can be relieved or reduced with painkillers given to you at the clinic.
You can hear three women talk about the pain of their breast augmentation here.
There may be some bleeding from the wound during the first 24 hours after surgery. To relieve this, press a clean cloth lightly against the wound for 15 minutes. If bleeding continues, you should contact the surgeon.
You will be given a check-up time on the day of the surgery and it is important that you follow the recommendations given to you by the recovery nurse. You will also be given information about when you can take a bath and what type of dressing you have and when it needs to be changed.
WHEN DO I NEED TO COME TO THE CLINIC FOR A CHECK-UP?
On the day of the surgery, the recovery nurse will inform you about the check-up with the nurse and the surgeon. After your surgery your surgeon will call you in the evening to check on your well-being, and a nurse will call you the next day.
We recommend that you leave your children at home for the subsequent check-ups. It is important that you can concentrate on the important information, and our experience from follow-up visits shows that children find it very upsetting to see mum or dad having their dressing changed.
If you are unsure or have questions in the meantime, you are always welcome to call us and make an appointment at the clinic.
WHEN WILL EVERYTHING BE BACK TO NORMAL?
You can expect a soft and normal breast after about 3-6 months. In some cases, ulcers and possible bruising may last up to 4 weeks. The scars may be red for up to 12 months and you should avoid sun directly on the scar for that long.
You must not sleep on your stomach or side for the first 14 days after the surgery. You must wear a supportive sports bra day and night for 6 weeks after surgery.
You should wait 3-4 weeks before taking part in sports. Then start slowly and use the supportive bra again. If you feel soreness in your breasts, stop immediately and slow down next time. Avoid swimming pools, steam baths and saunas for at least 5-6 weeks after the surgery.
Most customers are back at work 1-2 weeks after surgery, depending on how physically demanding the work is.
IS THERE A BOOKING RESTRICTION BEFORE THE SURGERY?
According to the Danish Health Authority, at least 7 days must elapse after you have received the written and oral information before treatment can take place. This gives you time to go home and think about the procedure, talk to family and friends and possibly have second thoughts – before we operate. You can only give your final consent to the surgery once the 7 days have passed.
Your consultation is valid for one year. The validity is subject to the condition that no major health changes have since occurred, e.g. major weight fluctuations or new medication, which can be an obstacle to the plan that has been made together with the surgeon. If such changes have occurred, or if more than a year has passed since your initial consultation, and you wish to have the surgery, you must come in for a renewed consultation.
YOU CAN BOOK AN APPOINTMENT IMMEDIATELY
After the consultation, you can book an appointment for surgery right away. The appointment just needs to be at least 7 days in advance. Book your appointment with us before you go – or call when you’re ready. It’s entirely up to you.
If you have any further questions about implants or breast surgery, please feel free to contact the clinic on tel. 70 27 57 57.
OTHER
In case of cancellation, future consultations and check-ups must be cancelled at least 24 hours before the agreed time. In case of no-show without cancellation, a fee of DKK 600 will be charged.
We only forward information regarding your treatment at AK Nygart to your own doctor after we have obtained consent from our customers.
On our website you will find all cosmetic reports made by the Danish Health Authority.
The reports are also available on the National Board of Health’s own website.
QUESTIONS ABOUT MY SURGERY
The Danish Health Authority has produced information on breast augmentation with implants, which we recommend that you also read: Risici ved at få indsat brystimplantat – til kvinder, der overvejer brystforstørrende operation 2. udgave ved Sundhedsstyrelsen.
You are always welcome to contact the clinic if you have any questions about the surgery, filling in the loan application, the procedure at AK Nygart or anything else. You can either write to info@aknygart.dk or call 70 27 57 57.
WHAT DOES A SURGERY COST?
You can find the prices of new breasts by clicking here.
If you want to finance your upcoming surgery, click here.
You are always welcome to contact us if you have any questions about filling out the loan application.
Patient information on new breasts with implants – version 11-04-2024