Breast Implants (Augmentation)

What is it?

For some women, the size or shape of their breasts is a cause of unhappiness. The problems can be exacerbated by natural body changes due to pregnancy, weight loss or ageing.

Breast augmentation is a surgical procedure that uses breast implants to enhance the shape or increase the size of a woman’s breast. It is the commonest cosmetic procedure undertaken in the United Kingdom. It is performed by placing a breast implant either immediately behind the breast or behind the muscle that lies deep to the breast or both (dual plane). The implant then pushes the natural breast tissue forward to give the appearance of a fuller breast.

Implants can either be round or anatomically shaped (more of a tear-drop shape). Round implants provide a fuller appearance higher up on the breast, along with a more defined cleavage. Anatomical implants create a more natural look with less volume at the top.

Varying degrees of projection (the degree the nipple moves forward after inserting the implant) are possible, depending on chest wall measurements. The necessary breast implant volume that is suitable for you can be estimated by using a temporary implant placed in your bra, over your breasts. Various volume sizes can be placed in this way, to assess breast appearance. Another method is the rice test, which your surgeon can explain to you. This enables you to test out beforehand what size of breast you would most like to have.

What to expect

Breast augmentation surgery is performed under a general anaesthetic. It takes around two hours and you will normally stay in hospital overnight. Occasionally, your surgeon may need to insert a drain, which could prolong your hospital stay by a few days.

A small incision is made in the fold, under the breast. This creates a “pocket” into which the implant is inserted. The implant is positioned either in front of the pectoral muscle or behind the muscle. Your surgeon will discuss the pros and cons of each with you prior to surgery.

The benefits of breast augmentation are noticeable immediately after surgery, but the final result is often not really seen until the swelling and bruising have subsided. The scars are well hidden in the natural breast crease and gradually fade over a year. Dissolvable sutures are used, so they do not need to be removed.

What results can be achieved?

Increasing your breasts to the desired size and shape can have a positive impact on your body image and self-esteem. It can help you to achieve the body shape you want and enable you to wear the sort of clothes you would like to wear.

Possible Risks

All surgery carries risks and cosmetic surgery is no exception. Breast augmentation is a commonly performed procedure and the risks tend to be small.

After surgery

After breast augmentation surgery you are likely to experience:

  • Mild discomfort, which should be easy to manage with painkillers. Wearing a sports-bra for around six weeks can offer extra support and help with your recovery.
  • Swelling – this will have gone down sufficiently within three months for you to be measured for a bra.

You should refrain from physical exercise for six weeks following surgery. Your surgeon will talk to you about showering and getting the incision sites wet.

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Common risks

The risk of most types of cosmetic surgery is similar and these will be discussed with you during your consultation. You can help to minimize certain risks by following your surgeon’s advice and instructions after surgery. Some of the common risks include:

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  • Minor pain and discomfort – this can be treated with over the counter painkillers.
  • Swelling and bruising – your surgeon will advise you how long this will last based upon your individual procedure.
  • Inexact cup size or shape – The final size and shape of your breasts after breast augmentation surgery is unpredictable, but your preference will be taken into consideration during the planning stages. Initial post-operative swelling will take time to settle – normally around three months – and it is only after this time that you will be able to get an accurate idea of the shape and size of your breasts. The breast is a glandular organ that changes throughout your life. Ageing, pregnancy and weight loss or gain can affect the final result.
  • Asymmetrical breasts – Nothing in our body is naturally symmetrical and this includes our breasts. Breast augmentation surgery is not an exact science as it relies on the artistic eye of the surgeon. As such, some level of asymmetry is inevitable after surgery.
  • Changes in nipple sensation – It is common for patients to notice a change in breast sensation following surgery. These changes usually subside when the breast has fully recovered from surgery. Occasionally, patients report that their nipples or breast skin remain either more or less sensitive than it was before surgery. There is often a little numbness directly above the scar.
  • Scarring – initially any scars will be red but they will fade over time to be virtually invisible.
  • Dissolving skin stitches not holding properly – if this occurs the stitches may need to be removed under local anaesthetic.
  • Stitch granuloma – sometimes a tender lump or abscess can occur at the stitch site. This is generally more common where the skin is thinner, such as in front of or behind the ear. The stitch may need to be removed or it may be treated with antibiotics.
  • Dissatisfaction with the way the breast feels – Women with very little natural breast tissue will normally be advised that the rim of the breast implant may be visible or detectable to touch after surgery. Your surgeon may recommend placing an implant behind the pectoral muscle in order to minimise this effect.
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More serious risks
The symptoms listed above are normally temporary or without serious consequences. There are some more serious risks associated with cosmetic surgery, which will be discussed with your surgeon as part of the initial consultation.

Plastic surgery alone cannot change your life but it can give you the confidence to make those changes for yourself.

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