Breast reconstruction with silicone implants for gender incongruence

Overview

In breast augmentation with silicone implants, the breast is enlarged by inserting high-quality silicone implants above or below the pectoral muscle. Silicone implants are available in various shapes and countless sizes. Breast augmentation can be combined with genital sex reassignment surgery for patients with gender dysphoria. According to WPATH guidelines, we recommend breast reconstruction after one year of sex reassignment hormone therapy in order to assess the hormonally induced growth of the breast.

The use of silicone implants allows us to respond to the different expectations of patients. Basically, our goal is a beautifully contoured and natural-looking breast.

Preparation for the operation

Prior to the operation, we will discuss your ideas with you in a detailed consultation and determine the appropriate technique (incision, implant position, implant size and shape). In the 14 days before the operation, you should refrain from taking painkillers that affect blood clotting (e.g. aspirin). We also recommend abstaining from nicotine consumption for two weeks before and after the operation.

Breast reconstruction procedure

Breast augmentation is performed either as a day-case procedure or as part of a 1-2 day hospitalization under general anesthesia. A small incision is made in the underbust crease to create a space for the implant. Alternatively, incisions can also be made at the edge of the areola or in the armpit area.

Access in the underbust fold for the insertion of breast implants.

The implant can be inserted either on or under the pectoral muscle during breast augmentation. The choice of implant position depends on various factors and your wishes. After the implants have been inserted, the skin is sutured with absorbable sutures. A supportive bandage is applied in the operating room.

Which implants are used?

Modern breast implants consist of a silicone shell and a cohesive silicone filling, which means that even if the shell is damaged, the silicone cannot leak.

A basic distinction is made between round and anatomical (teardrop-shaped) implants. These are each available with different projections and in many sizes.

After the operation

• Wear a sports bra and the chest band for 6 weeks day and night.
• No sport for 6 weeks
• No lifting of loads over 5 kg, no overhead movements for 6 weeks
• Avoid mechanical pressure on the breasts
• Normal posture, no relieving posture, especially in the shoulder girdle area!
• We recommend showering from the 3rd postoperative day at the earliest if the wound is dry
• After suture removal (between 10-14 days) scar care with scar ointments, silicone plasters etc.