Breast Augmentation Surgery

NEWS
Cosmetic Surgery Answers Issue 2 2006 - The benefits and disadvantages of having the breast implant put either over or under the muscle' CLICK HERE
GP Liaison Magazine - Tubular Breast Deformity CLICK HERE

What is a breast augmentation?
Breast augmentation surgery is performed to increase the size and shape of the breasts by the insertion of an implant beneath the breast tissue. This operation will enhance the body contour of a woman who, for personal reasons, feels her breasts are too small. It will also help to restore loss of breast volume following pregnancy and breastfeeding.

Breast Enhacement and Shaping with Macrolane, for further information please CLICK HERE

What does the operation involve?
Breast augmentation surgery is performed under general anaesthesia or under local anaesthesia with total intravenous sedation. Some patients may prefer an overnight stay in hospital after the operation, but this is not strictly necessary. The operation is carried out through short incisions (4-5 cm), most commonly in the crease underneath the breast. These incisions usually heal very well and the scars will fade with time into very fine lines.

The implants may be placed under the breast (submammary) or under the pectoralis major muscle (submuscular). There will be bruising and swelling which is greatest in the first week and initially, the implants will feel quite firm and appear to sit quite high on the chest. Over time however, as the swelling subsides, they will soften and descend to a more natural position.

What types of implants are used?
Cohesive silicone gel implants are used, which provide excellent shape with a very natural feel. There are many different options available as no two women’s breasts are alike. For the majority of women, round implants produce a natural looking breast shape but for other women, tear-drop shaped implants may be more appropriate. Every case is approached on an individual basis and the implant and surgical technique will be chosen to suit each patient.

During your consultation, you will have chosen the size and shape of implant that best suits you, and your bra cup size after the operation will reflect this. Your final bra cup size, however, cannot be guaranteed.

Are breast implants safe?
Many studies have been conducted to establish whether silicone breast implants cause certain diseases. As a result of these studies at present there is no evidence to suggest that silicone breast implants are harmful. More detailed information can be obtained from:

Silicone Gel Breast Implants Independent Review Group
Website:         www.silicone-review.gov.uk

Is it right for me?
Most women seeking breast augmentation have naturally small breasts or have lost volume following a pregnancy or weight loss. Some women simply wish to have larger breasts.

However, implants alone will not address significant sagging of the breasts (ptosis). An uplift (Mastopexy) can be combined with implants to tighten the skin envelope and lift the breasts, restoring a youthful shape as well as volume.

What are the risks and long term implications?
Complications are RARE, but you should be aware of them so that you can make an informed decision.

Every operation carries with it the risk of bleeding, infection and delayed healing, all of which may require urgent or early reoperation. In addition, there are risks that are specific to breast augmentation. If the implants themselves become infected, they may have to be removed and not replaced until a much later date. There may be malposition of the implant and/or asymmetry. There may be loss of nipple sensitivity.

In the longer term, the body forms a shell of scar tissue round the implant. This is normal. However, in a minority of women, this shell or ‘capsule’ can contract to deform the implant and consequently the breast may become round, hard and painful. The implant itself may leak or rupture. These conditions are not harmful, but further surgery may be required to remove the scar capsule, or to replace the implants.

In some patients, the implants may be felt or may become perceptible through the substance of the breast tissue. If the implants have been placed under the pectoralis major muscles, they may also move whenever the muscles contract. These phenomena are not harmful, but may be disconcerting unless you have been made aware of them.

Future pregnancies and breast feeding may affect the size and shape of the breasts, and further surgery may again be required. Finally, future screening for breast cancer is still possible with breast implants in place, but do inform the person performing the mammograms.

What should I expect following surgery?
Following surgery, you may find your breasts swollen, bruised and uncomfortable. The pain is usually mild and oral painkillers, prescribed following your surgery, will control any discomfort you have. The recovery period may last between 2 to 4 weeks. You will be able to move around at home in the first week, venture out in the second week, and gradually adopt your normal routine again in the third and fourth weeks.

During the recovery period it is necessary to refrain from heavy lifting (including small children) and reaching up to high shelves, as well as driving until you are confident you can perform all necessary manoeuvres safely.  You are required to wear a soft, stretchy sports bra with no underwiring for the full recovery period.  

Our practice nurse will keep in close contact with you whilst you recover at home. Generally, you will have a follow up appointment at the clinic at one week and one month postoperatively. However, if there are any problems or concerns, you will be seen more frequently than this, or as often as you wish. In the longer term, you are welcome to see Mr Ng for a check up at any time. All follow up appointments are free of charge whether they be at 2 months or 2 years post operatively.