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Dr. Pierre ALBRECHT from Marbella Clinic- Aesthetic surgery of young breast
Since ancient times the female breast is accepted as a unique sym bol for femininity , seduction and fertility even in very distinct cultures all over the world . Apart of its cultural role the female breast has even gained more importance in our modern society when we have a loo k at fashion , music and media , were the perfect bust nearly sems to be a key element for suces .
>>>Apart from its cultural role, the female breast has gained even greater importance in
our modern society.
Speaking only of the societies based on western ideals of beauty, the image of the “ideal†female breast changed a lot during the last century following the great changes in social life like sexual liberation in the late sixties, upcoming feminism, the new femininity of the eighties and the androgyny of the nineties which substantially influenced the self-confidence of especially the young woman regarding her looks as well as her outer image in society, media and fashion. The new millennium, in spite of its obvious futureorientated acceleration and progression of all aspects of life, actually recreated a female look and style that is reminiscence to the times when a full breast was an important part of any woman’s sensual and seductive femininity.
>>>The breast of the young woman between 18 and 30 years of age has totally different needs from those of a woman of over 30 years who has maybe already had a baby.
This reborn image being transmitted by topmodels at the current fashion shows, by young female stars in the movies and by famous pop stars is reflected in every aspect of fashion and social life and makes more and more younger women to undergo plastic surgery to achieve the bust line that they feel belongs to them but accidentally was not given to them by nature.
From a plastic surgeons view, the female breast is something very delicate to change because in has an evident impact on the patient’s life and contrary to the image created by many so called “Aesthetic surgery businesses†you can not seriously offer a one price-one technique solution to achieve excellent aesthetic results. The very complex composition of the female breast consisting of glandular (milk-producing) tissue, fatty tissue and numerous fibre-like bands which hold the breast in its natural form demands anatomical expertise and individual techniques which take in consideration the age-related changes of the breast tissue. The breast of the young woman between 18 and 30 years of age has totally different needs regarding the type and shape of the implant, the position of the implant and even the position of the scars than a woman over 30 years with children. It is important to know that the tissue composition of the female breast isn’t static, but tends to change regarding the relation between glandular tissue and fatty tissue which subsequently affects firmness, elasticity and shape of the breast.
Therefore, the operating technique must be carefully adapted to the age of the patient taking in consideration the following elements :
Contrary to most women who did give birth, young women with small breasts mostly don’t have any or only minimal sagging of the breast, so the fold under the breast is not very accentuated and may even be absent. This fact diminishes the advantage of placing the implants via an incision in this fold, because the scars are not automatically hidden by the normal form of the breast like in older women. So the alternative access placing the implants via a small incision below the areola can provide excellent results with a scar even less visible and therefore needs to be considered carefully together with the treating surgeon. After a decision for the placement of the future scars has been taken, the position of the implants in the breast needs to be evaluated. Basically, a breast implant can be placed directly underneath the gland overlying the pectoral muscle or it can be placed underneath the muscle. Besides the patient’s expectations regarding the desired shape of the enlarged breast the age and the actual shape of the breasts play a very important role in making that decision. In a young woman presenting no or minimal sagging of the breast, a good elasticity of the skin and a normal breast shape, placing the implant underneath the muscle provides excellent aesthetic outcome, a better protection of the implant through the muscle and more satisfying long term results because the muscle prevents the implant from sagging.
Also if the breast is very small and the desired augmentation is more than one size, the position behind the muscle is advisable, as the glandular tissue would not cover the implant, and the result would not be natural.
>>>Today’s market offers a broad variety of different implant shapes and sizes.
On the other hand, if the patient is older and maybe has already given birth and gone
through a period of breastfeeding, the shape of breast may require the need to put the implant directly underneath the gland to provide enough volume to fill up the skin stretched by sagging.
The last important point to consider together with the treating surgeon is the style or shape of the implant. As in all other areas of life, science and technology provided a steady and remarkable improvement of breast implants during the last 10 years. Modern silicone implants have a highly resistant shell covering a soft, gel-like core, therefore providing a soft, natural feeling never achieved before while offering implant life expectations of 15 years and more. Today’s market offers a broad variety of different implant shapes and sizes which allow for an individual solution for almost every patient. Any responsible plastic surgeon should thoroughly discuss the different types of implants with the patient, and should provide the possibility to touch them, to know how they feel and to try out different shapes and sizes by wearing them inside a bra.
>>>Therefore, the operating technique must be carefully adapted to the age of the patient.
Based on his experience, the surgeon will suggest a certain range of implants that will suit the individual needs of the woman, but in most cases there will be the possibility to choose between a more rounded breast form with a little bit more volume in the upper part or a more natural, tear shaped form; or to decide between different degrees of implantsoftness referring to the patient’s individual taste.
There is no unique breast shape that can be taken to be “the ideal breast†for every woman; the most important thing when it comes to deciding about the size and shape is to give every woman her own very unique shape that suits her body and style. The seduction evoked by a perfect bust line is not only related to volume, but to an individual harmony in the relation between the breast and the chest.
This kind of harmony, that can be achieved at any age, is what we always aim to create in our patients.
Taking care of the individual needs of the woman’s anatomy and taking into consideration the elements mentioned above, the breast augmentation with silicone implants is a safe and reliable procedure with excellent and long lasting aesthetic results, especially when performed on younger women.
The following interview with a 29 year old patient is an example of the results that can be achieved with implants in a patient who has slightly saggy breast but does not want a correction with an additional uplift. The excellent results achieved by breast augmentation in a patient who has small breasts without any sagging are illustrated by photos of another 26 year old patient.
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Editorial: Pier Albrecht, Pierre Albrecht, Pierre Albrecht Marbella,
Pier Albrecht Marbella, Dr. Pierre F. Albrecht, Pierjean Frank Albrecht, Marbella Clinic
Filling of fine lines, deep lines and creases. Dr. Pier Albrecht. Tansform Magazine nº 3.
Transform Magazine. Pier Albrecht. Editor
Filling of fine lines, deep lines and creases. Dr. Pier Albrecht. Tansform Magazine nº 3.
- Filling of fine lines, deep lines and creases. Dr. Pier Albrecht. Tansform Magazine nº 3.
- Filling of fine lines, deep lines and creases. Dr. Pier Albrecht. Tansform Magazine nº 3.
Wrinkles and creases in the skin are very significant during the aging process. With the passing of time, the skin loses its elasticity due to changes in its basic components such as collagen, elastin,hyaluronic acid (the filling substance containing collagen and elastin), and in glicosaminoglicans, that lose quantity and quality, etc… but at the same time the percentage of moisture is considerably reduced, meaning dehydration. These changes are both hereditary and genetic – what is known as “constitution†in Chinese medicine – and
the hygiene of life such as exposure to the sun, to the cold, to the wind, and the consumption of products like sugar, fats, cigarettes, alcohol and spices – known as the “condition†in Chinese medicine.
The dermis becomes thinner, less elastic, it separates slightly from the hypodermis, and when you smile or grimace, instead of moving to follow the movement of the underlying layers, it forms creases. The repetition of these expressions causes the dermis to break up along the creases, forming wrinkles that, at first, are fine and gradually become
more pronounced.
Also, the deepest layer of the skin, the hypodermis, which is mainly composed of fat, undergoes change, and in the majority of cases is reduced, but sometimes increases. In all cases, the fat changes position on the face due to the lack of support from the skin that has lost its elasticity. And of course, this change is a downward movement as in the case of the upper cheek, just below the eyes. Babies have practically no lower eyelid as the cheek only sags after some years have passed, pulling the skin below the eyelashes downward and thus forming the lower eyelid. When it loses its elasti-city, the skin sags, and the underlying fat with it, forming nasogenian grooves and marionette lines.
Aesthetic medicine does remedy this aging process by filling in the wrinkles and creases, restoring part of the skin’s moisture and elasticity. Two different kinds of products are basically used for this purpose :
1) Semi-permanent filling, containing hyaluronic acid in different concentrations, that fills
in the dermis between the collagen and the elastin fibres. The quality and density of this hyaluronic acid can vary according to the make, but are nearly all the same. (RESTYLANE, HYLAFORM, JUVEDERM, HYDRAFILL etc…) There are three different degrees of density, for filling in fine lines up to the deepest lines. With greater density, the hyaluronic acid can be injected into the fine lines but contains more water and dissolves more rapidly. Grade 1 hyaluronic acid, less dense, has a duration of 3 to 5 months, Grade 3, more dense, can last up to a year. RESTYLANE produces a high density hyaluronic acid for correcting volume that can be injected close to the bones and that lasts 18 months.
“ Adverse reactions to hyaluronic acid are very rare. Personally I have never seen any cases, neither amongst my patients or those of any other doctors.â€
2) There are also products for permanent filling using polyacrilamide (AQUAMID) that are safe and achieve a very good level of volume correction (lips) and creases (naso-labial furrows, for example). Polyacrilamide is a product that is used in its solid form for manufacturing contact lenses. Consequently we know that it is compatible with the human body. AQUAMID is injected deep into the hypodermis and remains in the area where it is injected. As in the case of any other permanent filler, my attitude towards AQUAMID has been to use it with great care. I started injecting only in the glabellar frown lines (between the eyebrows) for a few years to make sure it would not displace nor creat any adverse side-effects. After two years, I started injecting in the nasogenian grooves two years later
I started using it on the whole face to restore the original volume.
When someone wants to correct their wrinkles and creases, it is important to explain that the best results are achieved by correcting the same aging process.
That is to say, it is possible, but not sufficient, to correct a fine line o a deep wrinkle by filling it in with hyaluronic acid. In reality, this is only the correction of the aging process, the loss of moisture and elasticity from the dermis. To achieve the best and most
durable results, the hyaluronic acid should be injected into the dermis and a polyacrilamide into the hypodermis, to compensate the other aging process which is the loss of fat. In this way we can achieve more natural-looking and longer-lasting results.
The reality about the nasogenian folds :
It is important to mention this subject because an incorrect use of the filler products
can give rise to very unaesthetic results. It is true that aesthetic doctors tend to prescribe injections for their patients because they cannot perform surgery, but the patient should have a good understanding of the aging process in order to be able determine what is the best course for looking younger.
The nasogenian folds are the result of fatty tissue sagging from the upper cheek or malar area, this sagging is halted by the upper lip. Because of this, two grooves appear when you smile and the condition becomes worse if you sleep on your side, because it accentuates the grooves even further, breaking the dermis and creating a wrinkle inside the folds. When a patient asks for these folds to be corrected, he or she should be aware that the doctor is going to inject a product into a place where it is not really needed. That is to say, to fill in a nasogenian fold is to CHANGE the natural appearance of the face. In reality, the physiological correction would be to lift the skin and the fatty tissue upwards and outwards by means of surgery. By doing this, the grooves disappear immediately. What I am saying is that the filling in of nasogenian grooves is a TEMPORARY solution because it is an aesthetically artificial and un-natural solution to the problem of the sagging of the cheeks. This treatment can be carried out successfully, but up to a certain limit. After that we have to resort to surgery, or rather inject the cheeckbone to lift the cheeks out.
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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,
Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,
Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic