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OUR OPERATING TECHNIQUE

The Plastic Surgeon makes an incision in the skin and then creates a pocket where the implant is placed. The location where the incision is made is either in the crease beneath the breast (the most common method), in the armpit, or on the edge of the nipple. As previously mentioned, Akademikliniken developed a mathematical method to accurately determine the best position of the implant. This technique was first described in 2002 at Akademikliniken. Since then more than 600 surgeons each year from around the world travel to Akademikliniken to learn the technique.

The main advantages of the method is that the results are now more predictable after surgery and the scars are accurately hidden in the fold under the implant. Because the incision is made under the breast, the surgeon has better visibility than with an endoscopic technique via the armpit. The implant can be placed either above or below the large pectoral muscle. Which position is best in each case is discussed prior to surgery.

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Download our guide: Breast augmentation – Important questions you should ask ››

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After Breast Augmentation

In most cases you can go home the same day the surgery is performed. The pain after surgery can be intense during the first 6-8 hours and occasionally analgesic injections are required. Thereafter, common painkillers are usually sufficient. For support purposes a sports bra needs to be worn continuously for three weeks then during the day only for a further three weeks. If an implant with a smooth surface is used, it is recommend that your breasts are massaged every day by a method which will be explained prior to your discharge. This reduces the risk of capsular contracture. Normally however, a textured implant is used, and massage of the breasts is not required or advised.  The first few days after surgery the breasts will feel tense and swollen.  This is normal and it is important to remember that it may take up to several months before your breasts achieve their final form.

Read more about how your breasts may be affected after a breast augmentation operation.

When you are going home after an operation, you will always get a return appointment with phone numbers to the clinic and the appropriate Consultant Plastic Surgeon so that you can reach us day and night.

If you have additional questions, please contact us.

AK Method

What is the Akademikliniken Method and what makes it better than any other method used for breast augmentation?

The Akademikliniken (AK) Method is a mathematical calculation that involves pre-operatively determining a more precise positioning of your breast implants.

The placement of implants is today often based arbitrarily on a surgeon’s experience and feeling and not based on careful analysis and measurements. Often the incision is placed in the armpit or around the areola where the risk of infection and implant malpositioning is much higher and the visibility into the implant pocket very limited. The optimum site to place the incision is on the chest exactly at the lower margin of the new implant - where the scar is best concealed.

The Akademikliniken planning system was the first real mathematical method for breast augmentation presented. The first draft of the method was released in 2002 and since then doctors from all over the world have travelled to Akademikliniken to study it. 


Good planning and careful analysis are a prerequisite for obtaining a good end result. There are a variety of pre-operative methods of breast augmentation surgery, but these are often relatively arbitrary and not mathematical. 


The two facets of the Akademikliniken method are as follows:

1. Vertical positioning. Where is the implant placed in relation

     to the nipple?

2. The skin. How much skin is needed in the lower half of the

     breast?

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How does it work?

Two fundamental observations were made in mid-1990. First, a correctly performed breast augmentation will elevate the nipple vertically. The second observation was that you can draw a straight line from the elevated nipple position to the sternum (breastbone). We have chosen to call this line the NS line.

The elevated nipple position is the result of increased projection of the chest. However, if the implant is misplaced, the result is not the same and the nipple is displaced distally or proximally relative to the starting position. The best results are achieved when half the implant is placed above the nipple and half below. The distribution should be 

Where is the implant placed?

772_bccf679a-300x60Knowing the end result before surgery facilitates this calculation and provides the opportunity to insert the implants in the perfect vertical position.

After careful evaluation of hundreds of patients Akademikliniken noted that nipple elevation can be simulated by the arms raised in a 45-degree angle (hands placed on head). After this is done the following calculation is made: we mark out the NS line (nipple-sternal line) and then measure vertically straight down half the length of the implant. This provides us with the position for the ILP-line (implant lower pole).

The two lines NS and ILP provide very valuable guidance during surgery. If revision or further surgery is performed, we do not make a new NS line as the nipples are already elevated.

The vertical positioning of the implant has a major impact on the appearance of the upper chest. When we solved the first concept of the preoperative planning, we came to consider the second facet in the preoperative planning of breast augmentation surgery.

 

How much skin is needed between the nipple and the lower chest where the lower border of the implant will be situated?

The important factor here is not the base of the implant, but:

  • The width and projection of the implant
  • The thickness of the breast tissue
  • The skin's character (elasticity)

Now, a new calculation is made. The distance between the ideal projection point of the nipple on the implant to the lower border of the implant (the position in the breast fold where the incision is) is calculated. This measurement obviously depends on the size of implant selected and this length is then added to a measurement of the breast's glandular tissue. 


 

How do we know then how much breast glandular tissue is present in the patient?

There are three methods to calculate this:

  1. Measure the ILP-line (hands on head) and subtract half the  height of the implant
  2. With the help of special instruments (callipers) to measure the thickness of the breast and divide by two.
  3.  Use of a general table for small, medium or large breasts.

After these measurements are taken, the final component of the Akademikliniken method is undertaken which is to consider the elasticity of the skin. The position of the incision from the nipple (both above calculations added together) is marked out with the skin stretched to simulate the effects on the skin after the implant is inserted.

Many surgeons find these calculations to be too complicated. However when using our method you have, a better opportunity to more accurately predict your results, faster surgery, fewer complications, and no re-operations for incorrect implant positioning. It leads to more satisfied patients.

 

Choice Of Implant

There are a wide variety of breast implant manufacturers in the world but there are two main types of breast implants, namely, silicone and saline implants. At the Aesthetic Institute we use only breast implants made of a case of silicone gel as these are of the highest quality and have shown the best results in clinical studies.

The difference between these two types of implants is that silicone gel is a viscous gel that has the advantage of providing a more natural texture to the breast, whereas saline is a liquid that makes up two thirds of the human body. There is also a silicone gel with a firmer shape and texture known as so called jelly implants (cohesive implants).

Over the past ten years Akademikliniken has performed more than 8000 breast Augmentations with these so called jelly implants and no other clinic in the world has an experience that comes close to this.

Implants suited to the individual

In recent years, breast implants have been developed with a teardrop, anatomical shape to produce the most natural breast as possible. Anatomical implants with the firmer silicone gel are also manufactured in a matrix system with nine different shapes and sections of each implant size. This system allows us to personalise the implants according to your preferences and your body shape. Akademikliniken has the largest overall experience in the world of teardrop-shaped silicone implants.

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About Breast Augmentation

Breast-feeding and mammograms

There is no evidence to show that breast implants adversely affect the ability to breastfeed. Similarly, mammography and breast examinations can in most cases be performed in the usual way. Occasionally a more thorough mammogram is necessary to obtain an accurate result.

Replacement of implants

There is no medical reason to replace or change the implants after a certain time. In some situations with older implants there may be reasons to change them after 10-20 years if their outer shell has worn to more modern implants. A large number of scientific studies now exist regarding the risks of silicone in the body and have not been able to show an association between the use of silicone implants and serious medical disorders.

Capsular Formation

A capsule is something that occurs when a thickened connective tissue layer forms around an implant possibly making the breast feel hard.  The textured surface of the implant is designed to reduce this risk. Capsule formation in itself is not dangerous but may impair the shape and texture of the breast. In the event of a severe capsular contracture it is necessary to have an additional operation. The capsule is incised and usually partially removed through the old skin incision so that your breasts feel soft again; a so-called capsulotomy.

If you have additional questions or concerns, please visit our forum for questions and answers or contact us.