What surgical procedure can help this?
There are 2 mainstream options that can help with this. Breast implants or the use of your own autologus fat.
There are patients who are naturally flat-chested, and they would like to enhance their breasts just to be in proportion with the rest of their body. Often it can be even more noticeable that someone is lacking in the chest area. These patients often want to be discreet and perhaps go up one or two cup sizes. Patients that have had several children will also notice that their breast area has shrunk and are not what they once use to be especially in the upper half of the breast which creates a sagging look. The implants used by the Viel brothers are highly cohesive silicon implants – if you cut the implants in half the silicon remains within its casing, which removes the concern of leaking silicon implants.
Breast augmentation using fat AKA ‘The Organic Boobjob’
Fat transfer to breast area was formally approved by The American Society of Aesthetic Plastic Surgery in April 2006, in Orlando, Florida. This technique is used in patients with smaller busts or women whose breast have reduced in size or drooped, after having children. The average increase in bust size volume is one-cup size. Since it is the patient’s own fat, there is no risk of rejection and no possibility of allergic reaction.
There are certain patients who are afraid of of the idea of implants or to have a foreign object in their body. For whatever personal reasons, they would prefer their own fat to create this new volume. Many mums choose this procedure that have lost volume on the upper half of their breast and who just to top-up what has been lost from breast-feeding but may have put on extra weight on their lower half. They do not wish to change size of their breast but to return to their original volume before children.
An ideal candidate would be those with sufficient fat on the lower halves of their bodies (abdomen, thighs), and who only wish to be organic and natural, but this procedure is limited to increase only about 1 cup size. Patients who wish to have larger breast would still need to consider breast implants instead.
What sort of consultation do you give for this operation?
Dr Maurizio Viel or his identical twin brother, Dr Roberto Viel will initially listen to what the patient wants, and then advise accordingly. There will be a physical examination so the surgeon can explain what will occur during the surgery, where the incisions will be made, and what results the patients can expect.
Also, the surgeon will discuss the types of implants available to the patient. There are large choices of implants available in the UAE, but the most common ones used are Naturelle by Allergan (US – FDA Approved), Mentor (US – FDA Approved), Cereform (France). Natrelle and Cereform, for example, now provide lifetime warranty on their highly-cohesive implants. At our clinic, we choose only these implants from highly-reputable companies such as Allergan who are also the producers of Botox and Juverderm (brand of fillers).
Finally, Dr Maurizio Viel prefers to recommend that patients choose a size of implants that looks natural. This means choosing the right implants to suit the body frame, and also not stretch the skin too much where you can actually see the implant.
2) During the consultation, the surgeon will assess the patient to see if they have sufficient fat for the procedure, and to assess which area of the body the fat should be harvested from. Usually the surgeon may take it from the abdomen, inner or outer thighs. Most patients are delighted that fat is removed from one part of their body and literally added to another, contouring their body shape. The surgeon will always remove more fat than required for future top-ups as the body will reabsorb some of the fat, and the patient may return for another injection to the breast area performed under local anaesthesia.
What is involved in the operation itself?
The procedure takes 1 hour under sedation, which is not the same as general anaesthesia, and the patient goes home the same day. Generally, Dr Maurizio will recommend the incision, which is only 3.5cm, to be placed on the breast fold at the bottom of the breast rather than through the aerola. Findings show that entry of implants through the aerola show higher risk of capsule contraction.
The procedure takes approximately 2 hours and it is a one-day procedure done under sedation, which is not to be mistaken with general anaesthesia. Sedation is a mid-point between local and general anaesthesia, and the patient will return home a few hours after the procedure. Once the area of fat harvest has been agreed, the fat is removed during the surgery with the patient under sedation, and the fat is prepared, and reinjected into the breast area
Do you have any follow-up consultations after the operation?
Applicable to both implants and fat harvest to breast area
After the initial post-op check ups, at our clinic we see patients every month for the first 3 months, then followed by a check-up at 6 months and then 1 year. Following that we recommend that patients come once a year just for a regular check-up or at any point they have any discomfort or are worried.
What are the risks involved in this operation?
As with any surgery, there are also risks. For breast implants, there is always the risk of a capsule contraction, which can occur to anyone – this is if the scar tissure tightens around the implants. This squeezing of the soft implant can cause the breast to feel hard. This can be treated in several ways with a simple procedure. As with any surgery, there are also risks of infections and blood clots.
How long is the recovery time?
1) The patient can take 3 – 4 days off work, and the bandages are removed after 1 week, and the stitches are removed after 2 weeks. We advise patients to do only lower body exercises after 2 weeks, and light upper body exercises after 4 weeks, and most patients can resume normal activities after 6 weeks.
2) The patient can expect some slight swelling and bruising for the first 48 hours but most normal activities within reason can be performed except for driving due to the sedation and upper body exercises or heavy lifting will not be allowed during the first two weeks. The bruising and swelling will then subside over the next few weeks.
Dr Maurizio Viel & Dr Roberto Viel
London Centre for Aesthetic Surgery Gulf, Dubai Healthcare City, 04-375 2393,