Breast Enlargment (Augmentation)

What is a breast enlargement (augmentation)?

A breast enlargement is performed by inserting a breast implant behind a woman's natural breast tissue. The inserted breast implant pushes and projects the natural breast tissue forward, giving a fuller and larger breast appearance. This procedure is performed on women within a broad age range who wish to improve their breast size and shape for the following reasons:
 

• A dissatisfaction with their original breast size
• A desire to regain or improve breast shape and size following significant weight loss or child birth
• A wish to correct uneven breasts (asymmetry)
• Correction of a congenital deformity of one or both breasts

Breast augmentation surgery can provide both physical and psychological benefits. who have undergone a procedure of this type report that they feel more feminine and personally confident about their new body image and can experience improved self esteem as a result of having surgery.

How is this procedure performed?

Breast enlargement surgery is generally performed under general anaesthetic. The procedure takes around one hour to perform and patients may be able to go home the same day.

Breast augmentation surgery is performed by making a fine incision in the crease-line beneath the breast itself (sub-mammary route), or through the armpit (axillary), or around the underside of the nipple area (periareolar). In the UK the sub-mammary incision method is generally favoured, though any decision is made on the basis of a patient’s personal preference, in conjunction with the surgeon’s advice and judgement. The implant can be positioned in one of two places within the breast cavity in order to push the breast forward and to enlarge the original breast volume.

The two potential sites are:

a) In front of the pectoral muscle. This route is typically chosen when a patient has sufficient skin and breast tissue to give good natural looking coverage over the breast implant.

b) Behind the great pectoral muscle. This route is typically chosen when a patient has insufficient skin and breast tissue to give a natural looking coverage over the breast implant. This method is often favoured for very slim or particularly flat chested women.

What are the results like?

This procedure can provide excellent results in women wishing to improve and increase their breast shape and size. This corrective procedure should be performed in order to obtain the best possible breast shape and size and should only be undertaken by a Consultant Plastic Surgeon who is fully qualified and well experienced in this type of specialist breast surgery. The final result will be obscured by swelling, which nearly always develops following this type of surgery.

It can take up to 14 days for initial swelling and bruising to settle to an acceptable appearance, but residual swelling will settle down gradually over several months. Typically the fine incisions and subsequent scars that are made by performing this procedure are well hidden in the natural breast crease, or arm pit, or in the pigmented margin (areola) surrounding the nipple area. Every surgeon's breast augmentation procedure technique can differ slightly and wounds can be sutured (stitched) with either dissolvable or removable fine line sutures, or by surgical glue. Sutures are typically removed 10-14 days following surgery.

How will you feel after a breast augmentation?

Most women experience some discomfort following breast surgery and take analgesic tablets (pain killers) for up to one week following surgery. It is important to allow for a natural period of healing to take place and for women who lead busy lives to abstain from strenuous activity or from heavy lifting for six weeks following surgery.

Initially, breasts will be firm and swollen and they will take at least six weeks to soften to a more natural appearance and feel. Breast swelling will settle down completely after several months.

Patients will always be advised to take a specific amount of recovery time away from work, dependant on the type of work they perform, but it is usual to take 10 to 14 days away from work to rest and recover at home following this type of procedure.

Are there any risks involved having a breast augmentation?

All surgery involves an element of risk from developing complications. However, cosmetic surgery is usually undertaken voluntarily and only when a patient is in good health. Therefore, the probability of experiencing complications from this kind of surgery are substantially lower than those who undergo surgery due to ill health.

General risks such as bleeding, infection and asymmetry and scarring will be discussed openly at consultation, as well as our scrupulous efforts to manage and minimise these risks to their lowest possible potential. However there are also specific risks to this procedure that need to be considered. These are:

Capsular contracture (hardening) - Modern day implants have ensured that the risk of capsular contracture has never been so low; however, capsular contracture is still the most common complication experienced by women following breast augmentation. Capsular contracture occurs when the human body puts a wall of scar tissue (fibrous capsule) around an implant. This scar tissue can then thicken and shrink and is noticed by the patient as an apparent hardening of the breast implant. Where a capsular contracture becomes noticeable or unsightly to the patient, remedial surgery to correct this problem can be performed.

Rupture rates and life expectancy of breast implants - Recent advances in implant technology and manufacture mean that breast implant ruptures are highly unlikely. A true evaluation of the life expectancy of modern-day implants is difficult to predict accurately, as new implants may have the potential to last a lifetime, but they have not been in use for long enough to produce proof to substantiate such a claim. Consequently, the Department of Health asks manufacturers and plastic surgeons to advise women that they may need to consider renewing their implants after a ten-year period.

Scarring - Scars resulting from breast augmentation surgery are typically fine and insignificant once the healing process is complete. However, very occasionally a scar may heal abnormally and become thick, raised and painful (hypertrophic). This condition can be treated with a special dressing or with anti-inflammatory injections or occasionally with corrective surgery, although results cannot be guaranteed.

Infection and rejection - It is important that all patients quickly recognise any signs of infection, such as excessive pain, fever or offensive wound discharge. Antibiotics given during your operation will help reduce this risk to a minimum, as will meticulous attention to your personal hygiene. On very rare occasions a patient’s body may be unable to cope with the introduction of a foreign body (such as a breast implant) and a resulting infection may lead to a total rejection of the new breast implant.

Changes in breast sensation - It is typical for most patients to notice an alteration 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 in the long term following surgery.

Palpability - Women with very little natural breast tissue should be advised that the rim of the breast implant may be visible or detectable to touch (palpable). Your surgeon may recommend placing an implant behind the pectoral muscle to minimise this effect if he believes that the implant ridge would appear unsightly.

General issues

Implants do not interfere with a woman’s ability to breast feed. There is no known association between breast cancer and breast implants.
 

Mammography - Women with breast implants should inform any future radiographer that they have breast implants, so that the most appropriate method of breast screening and mammography can be performed.

Travelling at high altitudes - Breast implants are not subject to strain, pressure or rupture when travelling in an aircraft or at high altitudes.

Smoking - Heavy smokers may be precluded from having breast implant surgery due to their increased risk of infection and rejection complications.

What next?

At Vive we believe that it is important for all prospective patients to have realistic expectations of the improvements that can be achieved through breast augmentation surgery. Your Consultant Plastic Surgeon will take into account your age, skin texture, and the existing shape and position of your breast tissue and nipples when predicting the outcome of your results. It is therefore essential to have a thorough consultation with a surgeon who specialises in breast surgery before you make a decision to go ahead with a procedure.