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Breast Augmentation or mammaplasty is the operation where artificial means
are used to increase the size and/or shape of the breasts.
The implants can be saline, or silicone prostheses.
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Many women consider having Breast Augmentation in order to improve their breast size or shape because they think their breasts are too small, uneven in size or unattractive. Some women have breasts that do not fully develop or have significant change in size or shape after pregnancy, weight change or ageing.
Breast Augmentation can be carried out to correct drooping breasts but may require an additional uplift procedure. (See information sheet on mastopexy).
The decision to undergo Breast Augmentation should always be a personal one. You should not consider this procedure to please someone else. Like all aesthetic plastic surgery procedures, Breast Augmentation will not resolve any of life's major problems and cannot be expected to do so.
The media have voiced many individual concerns regarding the safety of breast implants. Please read carefully the information sheet provided regarding the safety of silicone implants and feel free to discuss it at length with your surgeon during the consultation.
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Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery.
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After surgery, breasts appear fuller and more natural in tone and contour. Scars will fade with time.
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Successful Breast Augmentation surgery requires careful planning to establish a personalised set of objectives that you feel comfortable will achieve the results you wish for. There are a number of points that need to be covered and it starts with deciding whether you would prefer say saline or silicone implants, and whether a round or teardrop shape is more suitable for you. You will then need to consider the size of the implant which often involves trying different size bra fillers, either implants or a self-made one.
A useful way of trying to assess the implant volume at home is to measure some rice in a measuring jug, place it in a stocking and use it as a filler in a larger cup size bra. The cup size is a difficult indicator because it represents a calculation between the circumference over the breasts and of the chest wall under the breasts.
This means that the same cup size in different for body frames represents a different volume, and so does the volume needed to jump one or several cup sizes.
You will then need to decide regarding placement of the implants, which can be either behind the breast tissue or behind the pectoral muscle and breast tissue. Finally, your choice of placement of the scars needs clarification.
The surgeon will then discuss with you are risks related to Breast Augmentation surgery and the usual recovery sequence.
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Breast Augmentation is usually carried out under general anaesthesia. There are a number of techniques of Breast Augmentation. The most popular is insertion of the prosthesis through the sub-mammary crease under the breast, via an incision approximately 5cm long. Another method is where access to the breast is gained through an incision on the lower edge of the nipple-areola, but this is less commonly used.
A third method involves an incision in the armpit and the placement of the prosthesis underneath the pectoral muscle may be preferred but this will be fully discussed with the surgeon as there are some benefits and disadvantages.
After making a 5cm incision in the breast crease, the surgeon creates a pocket under the breast tissue in front of or behind the pectoral muscle. Bleeding points are sealed and the prosthesis is inserted into the pocket. The incision is closed with dissolving sutures and covered with a light dressing. A sports bra which you should bring with you, will be put on after the operation.
A supportive bra needs to be used day and night for the first six weeks, but it may naturally be taken off for shower or bath. The initial tapes should be left undisturbed for the first week, by which time the wound will normally be healed. Subsequently, it is advisable to apply MicroporeŽ tape to the scars for another 4-6 weeks, as it often leads to a better quality scar.
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Incisions are made to keep scars as inconspicuous as possible, in the breast crease, around the nipple, or in the armpit. Breast tissue and skin is lifted to create a pocket for each implant.
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The breast implant may be inserted directly under the breast tissue or beneath the chest wall muscle.
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After surgery the breasts will be tender and swollen for a few days and it is advisable to keep limit the arms movements and take the painkillers prescribed. Most women can drive on the third day. To help decrease the swelling and bruising taking Arnica for a week prior to surgery and 2 weeks afterwards is advisable.
Postoperative haematoma (a collection of blood under the breast) may occur in the first 24 hours, which is why limitation of arm movements is advised. Should this happen, it may necessitate a return to the operating theatre but this would not affect the long-term outcome.
There may be changes in nipple and breast sensation, which are usually temporary. It is fairly common for the skin above the incision to feel somewhat numb for some months but this rarely extends to the nipple. Complete loss of sensation is more common in large volume augmentation as the severely stretched nerves have more difficulty recovering. Some patients describe increased sensation, which can last for two or three months.
Infection with Breast Augmentation is fortunately very rare and will exhibit itself by swelling and redness appearing up to three weeks after surgery. Should this complication occur, it would mean the removal of the implant and the infection allowed to clear before the re-insertion of a new prosthesis.
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Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery.
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After surgery, breasts appear fuller and more natural in tone and contour. Scars will fade with time.
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The most common complication following Breast Augmentation is capsular contraction. This is when the scar tissue shrinks around the implant squeezing it so that it feels firm or in some cases quite hard. Most capsular contracture stems from using smooth shell implants but with modern textured surface implants the incidence of encapsulation is low, probably around 5%. It is not known why this condition develops in some cases and not others.
Extremes in athletic activity (such as marathon running) are a definite factor but normal activities such as aerobics, badminton etc. do not appear to cause this problem. If it is necessary to relieve the firmness of a contracture it may be appropriate to surgically release the capsule under general anaesthetic. Several medications are currently under trial after having shown positive effects on capsular contracture.
Breast pain can occur after surgery in the area just like after surgery in any other part of the body. Most commonly this settles by itself in the space of a few months but in some instances it can last longer and may require specific treatment.
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On the day of surgery it is possible to go home is the degree of pain and discomfort if you experience is moderate and can be controlled with painkiller tablets. However, the more important consideration when going home the same day is that you should be accompanied by a responsible adult both through the day and the first night.
Discuss with your surgeon whether to bring with you for after surgery a supporting bra, or whether he or she will use adhesive tape for the breast and therefore not require a bra for the first week.
After the Breast Augmentation surgery, nausea and vomiting can be troublesome in some people and you should let your nurse know so you can have appropriate medication. Also, when you start drinking again, take small sips at several minutes intervals, to see whether you tolerate them well and they do not trigger nausea.
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In the last years significant effort has gone into making Breast Augmentation of comfortable experience. The level of pain and discomfort following the operation will naturally depend on individual pain tolerance. In the first few days remember to take the pain tablets regularly even if your discomfort is limited. It is also advisable to take a very gradual approach to exercise.
The fact your pain or discomfort is more limited does not imply that the healing process advances quicker in your case. The main risk with exercising too early is seroma, a collection of clear fluid around the implants, which may require drainage. As a rule, most surgeons recommend that for the first three weeks you should refrain from upper body exercise, and perhaps just take some long walks. After three weeks you can start gradual exercise, building up such that around six weeks you should be back to normal activity levels.
Driving is frequently possible after 2 to 4 days following your Breast Augmentation surgery and depending on your level of pain and discomfort. One of the considerations is that seat belts can be uncomfortable, but for your own safety it is better to delay driving and wear a seat belt than to rush into driving and not wear your belt.
A common question is how soon one can fly after the operation. This has effectively nothing to do with the breasts but rather the risks of clots in the leg veins during the longer flights. It is difficult to know with certainty what is the specific impact of Breast Augmentation surgery on the risk of leg vein thrombosis, but the most common advice is to wait for about a month after your operation, in particular for long flights. Please also consider to follow the other advice for in-flight safety, drink a reasonable amount of fluids during the flights, take short walks or exercise your legs at regular intervals and wear compression stockings in particular for long flights.
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There is no known link between silicone prostheses and increased risk of breast cancer or autoimmune disease. Please read more regarding these issues on the web page of the Independent Review Group on Silicon Breast Implants, commissioned by the UK Government.
Regular self-examination is important for every woman and is still possible after Breast Augmentation. If you find a lump you should inform your plastic surgeon immediately and although silicone causes shadows on x-rays, mammography can still be performed by an experienced radiographer and does not cause a problem.
Scars are a consideration. They are noticeable initially but will assume normal skin colour in time dependent upon the healing characteristics of the individual. Thick and lumpy scars (keloids) are fortunately extremely rare, but may require specific treatment.
There are long-term implications of a Breast Augmentation procedure. This is because it is only sensible to assume that breast implants will not last forever and may need changing. This however would be many years in the future.
Breast Augmentation is a well known, tried and trusted technique, which has been performed for the last thirty years on more than three million women worldwide. Results are very good, and the majority of women undergoing this procedure appear delighted with their figure and report both increased confidence and new quality of life.
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Order your FREE DVD
Aesthetic Plastic Surgery is producing a series of comprehensive informational DVDs offering detailed information about procedures performed by our team.
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Silicone Implants
The applications of silicone, whether used as an oil, gel or solid, are equally extensive in the medical field. Here we provide answers to some of your questions about silicones, more specifically breast implants, and to provide an overview of silicones.
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About the Procedure
Informative Brochure
