Since ancient times the female breast is accepted as a unique symbol 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 look at fashion, music and media, were the perfect bust nearly seems to be a key element for success.

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 future-orientated 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.

This reborn image being transmitted by top-models 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.

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.

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 implant-softness 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.

Normally in social life, we greet someone by looking them in the eyes and shaking their hand. Those brief moments already give us an impression of the person standing before us. For this reason, the eyes and the look are so important. The look…is not only the eyes themselves, the colour of the iris, the uniformity of the white and the light in the iris (things that are always touched up by computer in the photos of celebrities and models on the cover pages), but the look has to include the eyebrows, the upper lids, the eyelashes, the lower lids, the bags and shadows under the eyes, the crows feet.

When we meet someone, we always look first at his or her eyes. Our attention then passes to the mouth. These two parts of the face allow us subcon sciously to obtain information will help us to guess the approximate age of that person, and perhaps also some traces of his or her character.

If the mouth and lips are frequently the first question for a woman, the eyes are usually the object of consultation for a man. For some it is the aesthetic aspect, for others, it is a question of practicality or aesthetics, but the motive is really the increasing demand for this type of surgery.

We should try to look at it from a different viewpoint, particularly regarding the correction or increased volume of a woman’s lips. The first thing we should remember is that when we look at ourselves in the mirror, we have a tendency to focus our attention on details, slight imperfections. But other people don’t look at us in the same way, they don’t observe us in so much detail.

When we meet someone, we always look first at his or her eyes. Aesthetic surgery can be of great help to give a fresh and seductive touch. (see pictures before and after)

In our day to day life, most people we meet will greet us by looking us in the eye, to establish whether our look is deep or empty, warm or cold, straight and honest or, on the contrary, evasive, etc….Throughout the ages, the eyes have been considered to be the mirror of the soul. The brain immediately registers the forms and movements of the face, which give us an idea of the vitality and emotional state of that person.

Only the professionals, (and this can include best friends!!!), make a critical analysis of tones, texture, the skin condition, etc, in order to determine more precisely the age and the requirements for face care. Eye contact is therefore by far the most important, followed by the lips. In most cases, the need is to correct, rejuvenate and “sweeten” the look.

Patients generally understand this concept, but they immediately state that they do not wish specifically to change the expression of their look. The role of the professional is then to focus the attention on the fact that our look is not the same at all stages of our life and that maturity is sometimes synonymous with sadness, associated with a drooping of the eyelids and the outer corner of the eye.

The youngest patient on whom I have performed an eye operation was 27, and oldest was 79. Both were motivated for different reasons, but their circumstances were identical. They both had drooping eyelids which gave them a weary look and feeling, the younger patient because of her natural anatomy and the older one due to her age. The younger one, naturally, wanted not only to look younger but also to appear fresher and above all, sexier. The older patient only wanted to continue working without the feeling of tiredness.

Well, now I have used the word “sexy”. It could also be “seductive”. It’s true that drooping eyes, whether the eyelids or the outside corner (called the external canthus) do not look very sexy, but tired and even sad. Eyes that are larger and somewhat drawn out (feline) look more attractive. Throughout the centuries, women have painted their eyes to make them look larger and wider. This reminds us of Cleopatra, but apparently the men of Ancient Egypt also used to paint their eyes.

“the

LOOK”

The truth is that there is an almost magical attraction with large eyes. They are the symbol of an open vision towards others and to the world. Wide eyes are also associated with the natural shape of the eyes when we smile. They send out a message of sweetness, like a smile. In fact, there are people who are cruel and cold but who naturally have this kind of eyes, and they seem to always give a sweet smile, even when they are very angry.

It is very important to point out that the eye is closely joined to the upper and underlying structure. In fact, upper lids that are heavy and wrinkled are possibly, in the majority of cases, the result of sagging forehead skin. Lax lower eyelids, with circular rings, are often due to a loosening of the facial skin. In this way it is understood that the eyes can normally be operated on, independently from the rest of the face, whilst they should really be analysed as an integral part of a harmonious whole. This way it is preferable to create younger eyes, raising the “outer corner”, eliminating the excess skin, with a little of the muscle in the case of the upper lid, but trying to tuck in the skin without tensing the muscle too much at the level of the lower lid.

A final detail, it is possible to give a touch of embellishment to the eyes, creating or recreating at the external part of the upper lid, what Steven Hoefflin, the famous surgeon to the stars in Hollywood, calls a “beauty egg”. The study of thousands of faces has, in fact, demonstrated that the beauty of the features is almost a mathematical equation. It depends on the face having certain areas of fullness, seven for women, that are common to all of the most beautiful faces in the world. If these small areas of fullness do not exist, they can be created by fat injections, synthetic injectable products or implants.

This type of surgery is very satisfying to the surgeon and also to the patient, because the rejuvenating and embellishing effect is immediate in the majority of cases.

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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

A Tummy Tuck is a surgical procedure by means of which we can improve the appearance of the abdomen when there is an excess of fat and skin tissue

In the majority of cases, a tummy tuck is performed on adults over the age of 50 who are feel uncomfortable with an excessive amount of skin and have to wear loose-fitting clothes to conceal it. It can also be related to obesity problems. Generally speaking, it involves skin that has lost its elasticity, whether through several pregnancies or after a weightloss diet, and is no longer smooth and taut over the framework and muscles of the body.

There is an evident aesthetic problem and greater inconvenience with regard to clothes.

For many years, abdominoplasty has been described as a technique to eliminate a large amount of excess skin by means of an incision made from hip to hip, passing across the pubis and the navel. Several types of incisions and scar patterns are described, generally in the form of an inverted “M”. The fact of having to cut a large quantity of skin means the surgeon has to relocate the navel, making an opening higher up and stitching at that level.

During the operation it is possible to take the opportunity to stitch the abdominal muscles in cases of slackening of the stomach wall. In general it is not advisable to have a liposuction followed by an abdominoplasty because the risk of the tissue scarring badly or dying (necrosis) is much higher.

The results of a classic tummy tuck are variable. In the majority of cases patients have been very pleased at being able to dress more easily and with the image of having a new body, when clothed. When the clothes come off, then the results are not quite so satisfactory because the scar is very large and visible, which patients are somewhat embarrassed to show.

“ In the field of abdominoplasty, as in any other procedure of aesthetic plastic surgery, my concerns have always been to reduce the pain, the trauma of the anaesthetic, surgery and recuperation time, as well as the visible aspects of having undergone surgery i.e. the scars…”

My point of view

In the field of abdominoplasty, as in any other procedure of aesthetic plastic surgery, my concerns have always been to reduce the pain, the trauma of the anaesthetic, surgery and recuperation time, as well as the visible aspects of having undergone surgery. i.e. the scars… At the same time to increase the patient’s pre- and post-operatory comfort, the naturalness of the results and the discretion of the surgeon’s intervention to be able to enjoy a new life to the full.

For these reasons, I have never been fully in favour of performing a major tummy tuck, and have always tried to achieve satisfactory results with a minitummy tuck, i.e. by making only one incision at the level of the pubis that goes 2 or 3 centimetres beyond the pubic hair, respecting the original navel, or in other words, removing a crescentshaped section that is 4 or 5 cm wide.

Upper Abdominoplasty

But of course, the technique of a minitummy tuck is not enough in cases of an excess of skin, and we have to think of something additional. For this there is a new surgical option that can complement what is known as a lower abdominoplasty, and is called specifically the upper abdominoplasty. The technique, always with the aim of reducing the “visibility” of the operation and increasing the naturalness of the results, consists of lifting the skin above the navel and cutting the excess at the level of the inframammary folds. With incisions of 10 to 15 cm long, it is possible, as with the lower abdominoplasty, to remove 2 more crescents of skin of 4 and even 5 centimetres width.

NEW Abdominoplasty

(Tummy Tuck )

“…Many men ask questions, interested in this technique, particularly after the age of 55 or 60, because they do not have inframammary folds, to hide the scars”…

Many advantages The advantages of this technique are numerous : it is a far less invasive technique than the major tummy tuck, it is not necessary to touch or reposition the navel, the scars are almost invisible because they are hidden by the weight of the breast that always falls a little and covers the fold. The recuperation period is much less and more comfortable, with far less risk of skin necrosis, infections and split stitches. While it is true that this technique cannot be used in cases of extreme obesity, many patients, both men and women, are able to enjoy having a flat tummy – not only with no fat, as would be after a liposuction – but also with smoother skin. Many men ask questions, interested in this technique, particularly after the age of 55 or 60, because they do not have inframammary folds to hide the scars. It is the same as in the case of younger women with small breasts. For these cases, the solution would be to make use of a tattoo. Nowadays it is widely accepted and not considered at all strange to wear a tatoo, which can even be discreet and simple, such as a leafy branch, for example, although some people prefer the idea of a snake tattooed all along the scar. In any case, I would tell anyone who is definite about not wanting a scar in that place, that it is far more attractive than a lot of hanging skin or a scar running from one side of the abdomen to the other. It is simply a matter of mentalizing yourself and having a tattoo applied when you had never before thought of having one.

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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