These figures are just a rough guide and individuals may vary depending on their height and weight.">
 

Mr Neil Toft

Consultant Plastic Surgeon

BSc MBChB MD FRCS (Plast)

 

0845 094 5657

 

 

BREAST AUGMENTATION INFORMATION


General Background

Breast augmentation means increasing breast size. This is achieved by placing silicone breast implants under the breast tissue to improve fullness and volume. Breast implants come in a range of sizes, although most women require implants in the range of 200cc to 300cc - cc is short for cubic centimetre and therefore 1cc = 1ml.The difference between one bra cup size and another is about 120cc. Therefore, breast implants of 240ccs would increase the breast size by two cup sizes (i.e A cup to C cup, or B cup to D cup). These figures are just a rough guide and individuals may vary depending on their height and weight.

Silicone implants give the most natural and realistic feel available. They are made from a silicone covering which is filled with semi-solid silicone much like the consistency of Turkish delight. Silicone implants are considered safe, and there is no evidence that they cause connective-tissue disease or breast cancer. There is actually some evidence that women with breast augmentation may have a lower incidence of breast cancer than the normal population. More information on this topic is available at the department of health website - www. doh.gov.uk. (search site for "breast implants").

Saline (salt-water filled) implants are not used often in the UK and are subject to problems such as high rupture rates, unnatural feel, and rippling of the implant. For these reasons not many UK-based surgeons will use saline breast implants. In addition, the covering membrane of the saline implants is actually made out of silicone!

Breast augmentation is a price-sensitive market, and in an effort to reduce cost some surgeons use cheap, inferior quality implants, which are more likely to leak or deteriorate. Top quality, high end implants made by Mentor, Allergan, or Nagor may cost slightly more than other implants, but are superior and less problematic in the future. Breast implants by Mentor, Allergan, or Nagor are the only type used for these reasons.

The aim of breast augmentation is to increase the volume of the breast, whilst keeping the end result looking natural. Too big implants relative to the size of the patient tend to look unnatural, and are best avoided. Good results are best achieved by using high quality silicone implants accurately placed under the breast tissue, the size of which both the patient and surgeon have agreed on before the operation.

Before the operation

There is nothing special or complicated to be done by the patient. If you are on the oral contraceptive pill you should continue to keep taking it, and inform the surgeon or anaesthetist in the hospital. If you smoke it would be a good ideal to stop for a month before and two weeks after as this will improve wound healing and your post-operative recovery. It is a good idea to buy a soft sports bra (without wire) about 2 cup sizes larger than your natural breast size and bring it to the hospital on your day of surgery. In addition, it would be advisable to stop any herbal medicines and avoid aspirin or ibuprofen-like drugs for 2 weeks before the operation.


The operation itself

You will come into the hospital on the morning of surgery. The operation is performed under general anaesthetic and takes just over an hour. The implants are inserted under the breast tissue though an incision in the natural skin crease below the breast, were the breast tissue joins the chest wall. The wounds are closed with dissolving stitches and a light dressing applied. In most cases drains are not required.


Post-operative follow-up and after care.

You are strongly advised to stay in hospital overnight. All being well, you will be discharged the following day with antibiotics and painkillers. It is import to leave the dressing alone and wear the sports bra day and night. At between 5 and 7 days you will be seen in the clinic and the dressing removed and the wound checked. It is important to rest and take it very easy for at least 2 weeks after the operation. You wound be advised to take 2 weeks off work and it is essential to avoid all sexual activity during this period. The sports bra needs to be worn day and night for a month to give the best result. Vigorous sport such as jogging or the gym should be avoided for 6 weeks. A check up clinic appointment at 3 months after the surgery will be arranged for you.


Complications

All operations carry a risk of complications, although in breast surgery these are fortunately low. There will be a scar under the breast that may be red and lumpy for a few months but this usually settles down by itself. The risk of infection and bleeding are between 1 and 2 % and precautions are taken to avoid this with antibiotics and careful operating. Many patients will notice that they have reduced sensation in the nipple. In 90% of patients, sensation returns to normal in a few weeks, but in about 10% of cases the reduction in nipple sensation is permanent. Breast augmentation should not interfere with subsequent breast feeding.
All patients develop scar tissue around the breast implant itself, and this is normal and does not interfere with the outcome. However, between 2 and 8% of women develop hard scar tissue known as a capsule. This may deform the breast tissue over a number of years and make the implants look less natural than they were. This is corrected by removing the old breast implants along with the capsule and replacing the implants with new ones.
Many patients often ask how long implants last. There is no correct answer for this question and it can vary from 10 years to over 25 years. What is certain is that the implants do not last forever and if they will probably need to be replaced at some point in a patient's lifetime. A reasonable estimate of breast implant lifespan would be about 10 to 15 years.

Summary

Breast augmentation is a relatively simple surgical procedure involving one overnight stay in hospital, and about 2 weeks off work. The complication rate is low and many patients are very happy with the final result.

Operation Time 1 - 2 hours
Anaesthetic General
Nights in hospital 1
Time off work 2 weeks
Return to normality/exercise 4 - 6 weeks