Silicone Breast Implants Disturb While Sleeping on the Back

A patient asks us regarding her silicone breast implants:

I am 28 years old, presently having silicone implants for nearly 5 years, which I want to “get rid of” and then fill up the gap with my body’s own fat, so that the difference in appearance isn’t too great. The thing I really cannot stand is in particular the foreign body sensation of the silicone breast implants. The feeling of the breast while lying on the back is uncomfortable for me as well.

Silicone Is an Artificial Foreign Body

Although silicone is generally well tolerated, a silicone implant is always a foreign body that irritates a lot of women. In many cases it takes several months before women notice that they are somehow feeling uncomfortable with the silicone implants in their breasts. For example, because they find the breast implants disturbing while sleeping on the back.

Then they are thinking about a removal of the implants, but are hindered by the fear of having breasts that may look even more sagging. Removal of the silicone implants is often resulting in excess skin, which leads to a sagging breast if the place the implant took remains empty. Autologous fat is a natural filling material that can be used to restore natural breast volume.

Natural Breast Reconstruction After Removing Breast Implants

We offer the treatment in two variants, which only differ in one essential step. They are both starting with a gentle manual liposuction (liposculpture) to obtain the needed autologous fat. The liposuction is performed with very thin microcannulas. This approach is very gentle to the tissue and the risk of dent development after the procedure is minimized.

The process differs in the next step: The fat used for a breast augmentation with stem cells (Cell-Assisted Lipotransfer, CAL) is additionally enriched with precious stem cells before it is injected into the breast. Due to stem cell enrichment the durability of the transplanted fat is improved. Thus usually one treatment is sufficient to reach the desired outcome. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

In standard autologous fat transfer without stem cell-enrichment (lipofilling) the autologous fat is injected into the breast tissue immediately after its extraction. However, with this technique lower levels of sustainability can usually be achieved compared to the first-mentioned method including stem cell enrichment. For this reason it is recommendable to undergo at least a second round of surgery. Furthermore this variant is more suitable for women who have sufficient excess fat deposits.

In both cases we achieve an augmented breast that looks natural both in rest and in motion and feels like this as well. This is the great key benefit over artificial silicone implants, which can often be recognized even from large distances. The patient can also be spared unpleasant scars and general anesthesia, because breast augmentation with autologous fat and stem cells is performed on an outpatient basis and under local anesthesia. Thus the patient can go back home the same day of surgery and is already able to work the following day.

For all women who are – for whatever reason – dissatisfied with their breasts and at the same time refusing foreign bodies natural methods for breast augmentations provide the ideal way for optimization of their breast shape.

DDr. Heinrich, MD

Is It Possible to Balance Differences in Breast Shape Using Autologous Fat?

A patient with quite uneven breasts wants to know:

My concern is to adjust shape and volume of both of my breasts. The left one is much smaller than the right one. Do you think we have to fill a bit of the body’s own fat also into the right bigger one to achieve the same shape and thereby remove the asymmetry?

Whether we have to treat only one or both breasts depends on the specific shape dissimilarity. If there is only a difference in size, we recommend wearing a suction bra several weeks prior to the procedure and then filling autologous fat only into the smaller breast. Owing to the suction bra breast tissue is stretched and therefore the breast is more flexible and more receptive for the autologous fat injected later on. As an alternative to the suction bra the breast tissue can also be pre-stretched by the use of repeated saline solution injections, by which the breast is temporary swelling up and making the tissue more flexible.

Exactly as in breast augmentations with autologous fat or stem cells liposuction is performed as well at the beginning of a correction of breast asymmetry in order to obtain the autologous, natural “filling material” – a portion of the body’s own fat. Fat is mostly harvested in the areas of thighs, buttocks, hips, or the belly. When using extra thin tissue-conserving microcannulas the risk of post-operative dent development is reduced to a minimum. After the fat extraction the autologous fat is injected right into the breast for reasons of balancing the asymmetry either in stem cell-enriched form that involves an elaborate procedure or without further treatment. Stem cell enrichment allows for breast volume that is usually retained on the long-term. Thus there is – contrary to standard fat transfer – no need of repeat treatments in most cases. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

Because we only work with local anesthesia in our clinic the aftercare is considerably simpler and more comfortable. The patient is discharged home immediately after the treatment and already able to work a few days later. After the procedure it is recommendable to wear compression clothes or (depending on the breast type) possibly a sport bra for several weeks.

The method with autologous fat and stem cells is suitable for breast augmentation for aesthetic reasons, correction of asymmetry, and breast reconstruction after tumor removal. For women who attach importance to naturalness, autologous fat treatments can be seen as an appropriate alternative to artificial silicone implants, which not only look unnatural but also cause undesired scars.

DDr. Heinrich, MD

Breast Augmentation with the Body’s Own Fat and Stem Cells

There are often women coming in our clinic who have always wished for more bust size or who were originally happy with their body shape, but, for example, have lost breast volume completely through breastfeeding and are now suffering a lot from the consequence.

Patients are also frequently consulting us because of dissatisfaction with their breast implants, an upcoming “implant replacement”, or because they have complaints. Some patients perceive the foreign body sensation as unpleasant or they suffer from complications such as capsular fibrosis.

Those women wish for a natural alternative to silicone and artificial fillers.

Stem Cell-Enriched Body Fat – The Natural Alternative to Silicone

Patient before and after stem cell breast augmentation

The after photo shows the result actually achieved by the treatment. To protect the anonymity of the depicted person individual physical characteristics (e.g., moles, tattoos) might have been removed. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

Breast augmentation with autologous fat and stem cells allows for gentle breast forming. The augmented breast feels completely natural and looks absolutely “real” in any posture, whether lying or standing.

An enlargement from about a half up to two cup sizes can usually be achieved. For larger augmentations additional rounds of surgery might be required. In case of breast reconstructions (such as after breast cancer) there are multiple procedures necessary. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

My team and I are gladly at your disposal for a comprehensive and individual consultation. If you are interested kindly contact us and arrange a consultation appointment.

DDr. Heinrich, MD

Am I Too Slim for a Breast Augmentation with Autologous Fat?

A patient asks regarding a breast augmentation with autologous fat:

We have heard about your excellent references for breast augmentation with autologous fat on the Internet. My friend and I recently had a consultation appointment in Cologne. The doctor there was of the opinion that my fat deposits are definitely insufficient. Is that right? Would it be possible to make a statement in advance, for example, based out on a photo or is it necessary to travel from Germany to Vienna?

Even prior to the actual personal consultation the patient can send photos by e-mail or arrange an informative appointment with webcam via Skype, before she has to undertake a quite long journey to Vienna. In fact we can almost always find enough fat, all the years we rarely had to reject patients because of too little fat. All we can say is that we are specialized in finding enough fat, even in women who have already been rejected as “too slim” by other doctors.

Prior to the surgery pre-stretching of very tight breast tissue can be recommendable, where appropriate. This can be achieved by using a mechanical suction bra (e.g., BRAVA system) or through injection of saline solution. This way the tissue will be loosened up and new space for the fat to be injected is created. Consequently, a more extensive augmentation can be achieved. But in fact most patients decide not to perform pre-stretching.

The actual procedure of breast augmentation with autologous fat starts with a liposuction with thin microcannulas.

Particularly in slim women it is important to choose a special method of liposuction: For the fat extraction we are using thin microcannulas, which have a diameter of only 1 to 2.5 millimeters. With these “fine tools” we can achieve much higher precision than in common liposuctions where regular cannulas are used. This is why we can obtain fat even from regions where liposuction normally is not performed. Tiny prick sites already disappear a few weeks after the procedure.

Obtaining body fat using liposuction will change the body shape on the areas where the fat gets harvested. The agreement, whether less fat is taken from many body regions or if the focus is only on shaping of “problem zones” is also a crucial point. This is the patient’s choice or rather prescribed by the body shape. In very slim women a small amount of fat has to be harvested from many different areas to reach the amount necessary for the breast augmentation.

After fat harvesting the fat can be enriched with autologous stem cells before it gets injected. By this enrichment with autologous stem cells the fat gets “more sustainable”. This allows for results which last in the long term and have to be refreshed only in very rare cases. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

Then the autologous fat is injected into the breast to reach the desired increase of volume. As a general rule an augmentation to an extent of about one cup size can be achieved. After healing of the post-operative swelling the breast appears naturally augmented. No matter if standing, sitting, or lying – the augmented breast looks natural and feels “real” as well.

The entire procedure takes place on an outpatient basis under local anesthesia, whereby the patient is spared the risks of general anesthesia. After 2 to 4 hours gently-performed manual work the patient can directly be discharged home and be pleased about her natural breast that is only augmented by her own tissue.

DDr. Heinrich, MD

Loss of Breast Volume after Pregnancy and Breastfeeding

A patient has the following question concerning breast augmentation with stem cells and autologous fat:

Since I breastfed my second child I suffer from having only a very little breast. Before the pregnancy I had cup size C, now I do not even fill up an A cup. A breast augmentation with silicone is out of the question for me.

After pregnancy, especially after a long time of breastfeeding, many women suffer from a loss of breast volume and sagging breast tissue. A breast augmentation with stem cells or autologous fat provides a remedy for concerned women who wish to regain natural volume without implantation of foreign objects into their bodies.

Both in breast augmentation with stem cells and breast augmentation with autologous fat the patient’s own fat tissue is used to “refill” the breasts. Mostly patients wish that the breast looks like before breastfeeding. In the course of the treatment an augmentation by about 1 cup size can be achieved on average. In case of sagging breast tissue augmentations by up to 2 cup sizes are often possible. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

Both treatment methods start with a liposuction. In breast augmentation with stem cells the obtained body fat is enriched with autologous stem cells and afterwards injected into the breast. In standard breast augmentation with autologous fat the body fat is injected into the breast without stem cell enrichment. The advantage of stem cell enrichment is the long-term durability of new breast volume. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

Especially women who attach value to naturalness and reject foreign bodies such as silicone implants often gladly decide for a breast augmentation based on autologous fat. We do our procedures under greatest possible tissue conservation, exclusively under local anesthesia – without general anesthesia, without scalpel, and without artificial fillers. The procedure takes place on an outpatient basis, the patient can be discharged home on the day of procedure.

In the results body fat as filler can definitely convince because it looks “real” in every position (whether you move, stand, or lie) and also feels the same way. The natural breast function (e.g., ability to breastfeed) remains in case of procedures with autologous fat.

The aftercare is quite easy: Overnight a bandage has to be worn, afterwards compression garments. If regular cannulas are used for liposuction compression garments have to be worn for 4 to 8 weeks, when using real microcannulas it is usually enough to wear it for 1 week. A sports bra has to be used for about 4 weeks. Patients are normally already able to work 1 to 2 days after the procedure. It is very important to refrain from lifting heavy weights in the first weeks after the treatment.

DDr. Heinrich, MD

Gaining Weight before Breast Augmentation with Stem Cells and Autologous Fat?

A patient wants to know regarding breast augmentation with autologous fat and stem cells:

Is it useful to gain weight before a breast augmentation with autologous fat and stem cells in order to increase the amount of fat that can be used for breast augmentation?

No, in adult women fat cells would only get filled with additional oil as a consequence of the weight gain. This oil would have to be removed again prior to the fat implantation. By using especially thin microcannulas for liposuction we are also able to obtain enough fat in very thin patients. In addition, the entire procedure becomes very gentle because the risk of development of dimples is also reduced to a minimum.

For a breast augmentation the obtained fat can be injected into the breast either untreated or enriched with autologous stem cells. The first, the so-called lipofilling, is especially suitable for patients who have enough fat deposits which can be used for fat harvesting for an additional round of treatment after some time. Stem cell-enriched autologous fat (Cell-Assisted Lipotransfer, CAL) in contrast normally enables results which are durable in the long-term in only one surgery appointment. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

No matter which of both options you choose – as a result you always get a naturally shaped breast that looks “real” and feels the same way. Through the gentle approach – liposuction performed by hand and breast augmentation through injection – there are no visible scars remaining and general anesthesia is superfluous. The procedure is done on an outpatient basis in local anesthesia and takes about 3 to 4 hours.

Liposuction with microcannulas and breast augmentation with stem cell-enriched autologous fat enable a natural breast augmentation even for most slim patients. Therefore you can definitely waive a gain in weight before the procedure.

DDr. Heinrich, MD

To What Extent Can the Breast Be Augmented with Stem Cells and Autologous Fat?

A patient wants to know regarding breast augmentation with stem cells or autologous fat:

Which maximum cup size can I achieve at a breast augmentation with stem cells or autologous fat during one surgery appointment? I am 1.64 meters tall and I weigh 57 kilograms.

Usually we can achieve a breast augmentation by about 1 cup size. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given. As a general rule: The more sagging the breast tissue (e.g., due to volume loss after breastfeeding), in other words, the more “space” we have for the injected fat, the bigger the possible increase can be. If there is a desire for additional augmentation or if the breast tissue is rather tight, pre-stretching the breast is recommended to “make more room” for additional volume. This pretreatment happens with the help of a suction bra and/or with the injection of saline solution.

The process of a breast augmentation with stem cells or autologous fat is the following:

At the beginning fat is taken from the patient’s body, usually from the bottom, thighs, and belly, by the means of liposuction. We carry out liposuctions manually with real microcannulas. This kind of liposuction (liposculpture) performed by us is, by the way, substantially more tissue-conserving than the common mechanical liposuctions with ultrasound, laser, vibration, or jet-assisted ones. Thus the aftercare is considerably easier (compression garments for only 7 days).

The obtained body fat is then injected into the patient’s breast either in untreated form (so-called standard autologous fat transfer/lipofilling) or after special preparation (so-called stem cell-enriched autologous fat transfer/lipofilling). The advantage of a fat preparation through stem cell enrichment is that in the contrary to standard autologous fat transfer of untreated fat long results can be achieved which are sustainable in the long-term. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

The whole treatment is performed on an outpatient basis and takes between 3 and 5 hours. The patient is allowed to go home on the day the surgery is done. Instead of general anesthesia we exclusively work under local anesthesia. We do not use scalpels at all, so no scars visible with the naked eye develop in case of normal healing conditions. Unlike as in breast augmentation with foreign bodies such as silicone implants, breasts augmented with autologous fat tissue look natural in every position and feel “real” as well in any body position.

DDr. Heinrich, MD

When Is Doing Sports Allowed after Breast Augmentation with Autologous Fat/Stem Cells?

Compared to breast augmentation with silicone implants breast augmentation with autologous fat or stem cells is a considerably more gentle and less invasive procedure.

Body fat obtained by a liposuction performed by hand (liposculpture) is an autologous filler, which enables a breast augmentation up to an average of one cup size. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given. Depending on the method the harvested body fat is injected into the breast either without further processing or after stem cell enrichment. Repetitions of the treatment are possible. If the breast is tight and small, pre-stretching of the breast (for example, with a mechanic suction bra) might be recommendable. In this way the breast can be “prepared” for the augmentation by creating sufficient room for the additional volume.

Instead of general anesthesia we exclusively work under local anesthesia. We also completely refrain from using scalpels so that no scars visible with the naked eye are developing in case of a normal healing process.

Because this treatment is considerably gentler compared to breast augmentation methods in which a foreign body (mostly silicone or saline) is surgically implanted, the aftercare is also easier: Already one to two days after the procedure you can perform moderate kinds of sports like walking or bicycling. Strength training that also stresses the chest area can be usually done after about 4 weeks.

Hospitalization is superfluous as well for our treatments – the breast augmentation with autologous fat or stem cells is performed on an outpatient basis; the patient is discharged home on the day of intervention.

DDr. Heinrich, MD

How Long Does Preparation of Fat for Stem Cell Breast Augmentation Take?

A patient has the following question regarding stem cell breast augmentation:

I am interested in a breast augmentation with stem cell-enriched autologous fat. What’s the purpose of “stem cell enrichment” and how long does this process take?

The breast augmentation with stem cell-enriched autologous fat is a special method of autologous fat transfer (lipofilling). The problem of common lipofilling, which is an injection of “untreated” body fat without additional stem cell-enrichment, is that typically a relatively high rate of the added volume gets lost after the procedure. This means the additional breast volume is degrading for the most part in many patients and is often lasting only for a few months if “untreated” body fat is used for breast augmentation. Repeat treatments are thus often necessary.

Results that are lasting in the long-term can basically be achieved only by the additional enrichment of the harvested body fat with stem cells. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given. In this special kind of autologous fat transfer the body fat gets enriched with autologous stem cells in a laboratory procedure and afterwards injected into the breast. This stem cell enrichment makes the important difference between various types of autologous fat transfers and allows for a significantly better durability of the result. The process of stem cell enrichment is performed immediately after fat extraction and takes about 1½ hours. In conventional autologous fat transfer there are also stem cells contained in the implanted body fat, however, in most cases considerably too little to achieve long-lasting results.

In detail the process of a breast augmentation with stem cells is as follows: First, body fat is harvested using a special method of liposuction (liposculpture). Liposculpture is performed by hand, optionally with microcannulas or regular liposuction cannulas, and is considerably more tissue-conserving than the conventional mechanical liposuctions. Immediately after the extraction of the fat this body fat gets enriched with the patient’s own stem cells and – this is the last work step – injected into the breast. Normally one surgery appointment is sufficient; repetitions of the treatment are almost always superfluous. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

The entire treatment, including liposuction, stem cell enrichment, and injection into the breast, is performed within the same procedure and takes about 4 hours. In case of standard autologous fat transfer the process of stem cell enrichment is omitted.

Because our patients’ security is of utmost priority we exclusively work under local anesthesia, we don’t do general anesthesia at all. Scalpels aren’t used as well and we perform our procedures under the greatest possible body protection. In case of a normal healing process no scars develop that would be visible to the naked eye. An inpatient stay is superfluous as well and the patient can directly be discharged home on the day of intervention.

The aftercare is easy: Compression garments have to be worn for 1 week, a sports bra is necessary for about 4 weeks.

DDr. Heinrich, MD

Where Is the Fat for Breast Augmentation with Stem Cells Taken From?

A patient wants to know about stem cell breast augmentation:

I have questions regarding a breast augmentation with stem cells: Where or rather out of which body parts do you take the autologous fat?

The fat required mostly comes from hips, buttocks, thighs, and sometimes also from the belly. In these regions the needed amount of fat is even available in very slim women. By using extra-thin microcannulas the risk of formation of dimples after a liposuction is reduced to a minimum.

In breast augmentation with autologous fat or stem cells the obtained fat is injected into the breast either untreated or in stem cell-enriched form. Due to the additional volume an augmentation by one cup size can be achieved on average. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

In case of very tight breast tissue pre-stretching could be necessary to make room for the fat. This can happen either with a mechanic suction bra (for example, BRAVA system) or through the injection of saline solution, which makes the tissue swell for a short time and thereby stretches the skin. This pretreatment has to be done a few weeks before the actual breast augmentation as required.

Both breast augmentation with autologous fat and with stem cells (Cell-Assisted Lipotransfer, CAL) are performed on an outpatient basis under local anesthesia. Thus the patient is presentable and fit for work within the next 1 to 2 days.

DDr. Heinrich, MD

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