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Breast Augmentation

A good and successful breast augmentation relies upon careful planning, a clear understanding of what it will realistically achieve in your particular case, meticulous surgery, a quality implant and appropriate aftercare.

Most women requesting a breast augmentation have an image in their mind of what they wish their breasts to look like. Sometimes it is useful to bring to your consultation pictures of the shape and size of breast that you would ideally like to aim for. Much of your initial consultation will be to make sure that I understand your aspirations. We will then discsuss the best way of trying to achieve them. To this end, after an initial discussion you will be examined and a variety of different measurements taken. In most cases an implant size and shape can be chosen based upon these measurements and an understanding of your own desires.

Breast Augmentation - Before Breast Augmentation - Before

Breast Augmentation - After Breast Augmentation - After

As far as implant size (volume) is concerned, most women have a size that is the most suitable one for them. It is possible to put in a slightly bigger implant (this would make you as big as you can safely and realistically be) and it is possible to put in a smaller one. If the ideal size of implant has been assessed in your case and you wish to be a lot bigger than that, I will refer you to another surgeon. You will always find a surgeon who will be prepared to insert oversized implants but such situations are unlikely to result in a happy outcome and will ultimately end with problems. After seeing many women with such problems, I believe they are best avoided.

Choosing the right implant

This involves not just assessing the ideal size (volume) but also the ideal height, shape, consistency and projection. There are now many different types and shapes of implants. The particular implant that is most suited to your particular case needs to be found. The differences between certain implants and the reasons why one particular implant is being recommended for you will be discussed and examples shown.

What will I look like?

It is not possible to show you the exact results of using a particular implant in your own case (although software is being developed) but in a mirror it is possible to demonstrate the extent to which individual dimensions of your breast will change. It is also possible, of course, to show you the results from other ladies for whom a similar implant has been used. Having said this, pictures of other augmentations often best serve to highlight sizes and shapes that you do or do not wish, or to illustrate the effects of different types of implant, hence guiding me towards understanding your own expectations (see examples of some of my patients in the Gallery).

The operation

A discussion will be had about the operation itself, the ideal position of the implant in your case: on top of the muscle or to varying degrees under the muscle. Some women who have a lot of natural droop to the breast benefit from a breast lift at the same time as augmentation.

Admission and aftercare

You are generally admitted on the day of surgery. You will be re-examined and the measurements used originally to choose your implant size re-checked. The site of incision will be marked. This is usually at the site of the new fold underneath the breast. The operation takes about 1 hour. Dissolvable stitches are used and special glue is spread over the wound. This makes you waterproof such that you can shower the next day. A support dressing is used for 24 hrs and after it is removed you will be fitted in a bra. Most women stay one night in hospital, although getting home the same day is possible. You will be advised to wear a support bra day and night for the first 3-4 weeks. In addition you should avoid any strenuous upper body activity (e.g. weights at the gym) for about 6-8 weeks. The scar usually heals as a fine white line. Ways in which you can maximise the chances of your scar healing perfectly will be discussed with you.

Recovery

Breast augmentation is an operation that is not associated with a lot of pain. It is however associated with tenderness that gradually settles over a few weeks. You will need to take mild pain-killers for the first few days. If your implant is placed under the muscle, discomfort and the need for mild painkillers can continue for 2 - 3 weeks. Most women are able to perform normal activities within a few days of this operation. Overall recovery and return to work will depend upon a variety of factors including what type of work you do (e.g. lifting may be unadvisable for a few weeks).

Aftercare

A full aftercare service is provided. Most implants that I use come with a lifetime guarantee. In addition the price you pay includes a post-operative check by the nurse and a final consultation with myself. It also includes the unlikely possibility of any further surgery that was necessary for any reason up to 12 months.

Complications - What can go wrong?

Any operation can be associated with infection and every effort is made to avoid this. You will receive antibiotics when you are asleep in theatre and for 24 hours afterwards. Any operation can be associated with bleeding, anaesthetic problems (nausea in particular), venous thrombosis (although precautions are taken routinely) and allergic reaction to drugs or dressings. Sometimes sensation to the nipple can be affected and very occasionally the nipple feels numb after breast augmentation. No two breasts are the same and this is true after breast augmentation - you will not be 100% symmetrical. Some people heal with better scars than others. Scars can sometimes thicken or stretch. Longer term problems after breast augmentation include the following:

  • Capsule formation

  • Implant rotation

  • Visibility

  • Infection

  • Rupture

  • Ageing

  • Mammography screening

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