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Breast augmentation

What is a breast augmentation?

A breast augmentation is a surgical procedure that enlarges the breasts by the insertion of silicone implants underneath the breasts.

Why have it?

Women undergo breast augmentation to enlarge the size of their breasts because they feel they are too small, and to enhance their body contour. Other reasons are a loss of volume following pregnancy or weight loss; a significant difference between the size of the breasts or following surgical procedures for various breast conditions where breast tissue has been removed.

Reasons not to have it

Breast augmentation is contraindicated in those who have had radiotherapy treatment, are undergoing chemotherapy or are immunocompromised, have an active infection anywhere on the body, have an untreated breast cancer, or have medical conditions that increase the tendency to form deep vein thrombosis. As a general rule patients should be 18 years of age.

Women with breasts that are 'sagging' or have lost skin tone and elasticity may be inappropriate for breast augmentation alone and may require additional surgery to lift and reshape the breast (mastopexy).

Being overweight and smoking can increase the incidence of complications from surgery. It may be wise to delay surgery until smoking is stopped or cut down, and a proportion of excess weight lost.

Aspirin increases the risk of bleeding by preventing blood from clotting. If you are taking aspirin you will be asked to stop this for at least ten days before the procedure.

Further information

Consultation

When Mr Roblin assesses you for a breast augmentation, he will examine the breasts for any suspicious lumps. He will then look for the proportion of the breasts as compared with the body as a whole and the symmetry, size and shape of the breasts. Mr Roblin will also assess the degree of body fat that you have, as this will determine the level of the placement of the implant.

Before the consultation you should have an idea of the size of the breasts you would like. Mr Roblin will give you some implant samples in the clinic, which can be used to estimate the exact size of the implants to be used.

You will be asked about your general health, particularly information regarding heart disease, diabetes, and deep vein thrombosis (clots in the leg). Mr Roblin will want information about your medical history and any previous surgical procedures.

Procedure

The incision used on the majority of the procedures is in the outer end of the crease underneath the breast, which ensures that the scar is well concealed. Occasionally an incision around the nipple is used, particularly if an augmentation is to be combined with a mastopexy (breast lift).

The implant is placed either under the breast tissue or underneath the pectoralis muscle on the chest wall. The implant is placed under the muscle when the patient has smaller breasts and only a small amount of subcutaneous fat. This is because in these cases, placing an implant underneath the breast tissue alone increases the likelihood that the implant will be palpable or its outline visible. A drain will be inserted and is usually removed the following day.

Anaesthetic

The operation is performed under general anaesthesia and takes approximately 1 hour.

Length of stay

1 night following the operation

Risks/Possible complications

Early (1-2 days):

Frequent
  • Bruising
  • Swelling
  • Numbness
Infrequent
  • Bleeding (haematoma)
  • Infection

Later (after one week):

Infrequent
  • Scars - can be lumpy, may stretch and widen. Scars continue to improve and mature for up to a year
  • Capsule formation
  • Rippling
  • Change in nipple sensation
  • Asymmetry
  • Permanent (very rare) numbness
  • Implant leak
  • Implant rupture
General anaesthetic
  • Deep vein thrombosis
  • Chest infection
  • Allergic reaction to drugs or tape

Please refer to the Department Of Health website on the use of Silicone Implants.

http://www.silicone-review.gov.uk

Recovery

Immediately after the operation
  • You will feel bruised and sore and there will be some swelling
  • Pain is usually moderate and controlled with standard painkillers
  • A drain will be in placed in each breast that is usually removed the next day
After return home
  • Socialising with friends 1 week
  • Return to work at 2-3 weeks
  • Driving at 2-3 weeks
  • Swelling and bruising up to 6-8 weeks
  • Wear compression/support bra garment for 6 weeks
  • Return to gym and strenuous activity 6-8 weeks
  • Final result 3 months

Future routine mammograms can be undertaken effectively as part of a breast-screening program.

Permanence of results

Permanent. The breast, as with normal breasts, will droop with increasing age.