Procedures » Breast » Breast Enlargement
BREAST ENLARGEMENT / AUGMENTATION / “BOOB JOB”
Why choose us for Breast Enlargement?
Am I a good candidate for breast augmentation/enlargement?
Your surgeon will discuss with you in an unhurried manner your reasons for considering breast augmentation.
Breast enlargement is for ladies who:
Silicon implants have been in use for many years. In the 1990s concerns were raised about the use of such implants. Consequently, many large international studies were undertaken and it has been shown that there is NO association with breast cancer or with connective tissue diseases. For further information on these studies and others please consult the Department of Health website below:
http://www.mhra.gov.uk
What types of implants are available?
Implants vary according to content (silicone or saline), shape (round or teardrop), surface (textured or smooth), projection (low, medium, high profile).
Where will the breast implants be placed?
Your surgeon will make a detailed assessment at the time of your initial consultation as to where your implant should be positioned (i.e which pocket). Generally, there are 3 locations:
Subglandular:
This means "on top of the muscle" but “underneath the breast (gland)”. This is used when there is sufficient breast tissue to cover the silicone implant. On occasion it may be used to produce an enhanced look.
Subpectoral:
This means "under the pectoral muscle". This is used in women who have insufficient breast tissue and therefore the muscle provides soft tissue coverage of the silicone breast implant which makes it much less noticeable in everyday life.
Dual Plane:
The dual plane technique is a combination of subpectoral and varying degress of subglandular pockets. It involves releasing the muscle partially at the appropriate point so that you can have the benefits of having some of the implant above the muscle and some of the implant below it.
What size should I have?
Cosmetic Surgeons London provides a comfortable setting in which you may trial various sizes of implants. We use an advanced BioDimensional Analysis System where specially developed sizers are placed in your bra. This allows you to get an idea as to what size is right for you. The surgeon will guide you on implant size with regard to your body proportions but ultimately the choice of size is up to you, the patient! It is important time and care is taken at this important stage and that you are entirely satisfied with the size you are chosen. Promises should never be given by any surgeon on the eventual bra size e.g. you may wear a 34DD in Bravisimo and also 34E in Victoria Secrets (the important point being that both may be comfortable for your breasts and the only thing different is the lettering). We give an idea of cup size but ideally the Biodimensional Analysis System will help give you an idea of what you will look like. It is no longer acceptable to ask a patient to stuff breast implants into her bra until she finds a size she likes.
How long do they last?
Breast implants are not permanent devices and all will need to be replaced at some point in the future. Modern day implants tend to last on average 10-12 years. Some may last more and some less. Some may need to be changed earlier due to capsular contracture or you may wish to change your implant size through personal choice.
Where will the scars be after breast augmentation?
Scars can be in a number of places. The most common placement by Mr Sojitra will be in the crease underneath your breast (via inframammary incision). Alternatively, it can be placed at the border of the nipple-areola and skin (periareolar incision).
Will I be able to breastfeed after breast augmentation?
Breast feeding tends not to be affected by the placement of silicone implants. Also there is no evidence to suggest that the baby would receive large amounts of silicone through the breast milk. There is more silicone present in the environment and the teats of feeding bottles than in the milk of implant mothers.
Will the implants interfere with mammographic screening?
Breast implants may interfere with mammography and the detection of breast cancer. It is therefore important to let Mr Sojitra know if there is a family history. When having a mammogram it is important you inform the radiographer that you have breast implants so that special views can be undertaken in order to optimize the mammographic process. Breast implants do NOT increase the risk of breast cancer.
You (the Patient’s) Journey
Before the operation
You will have seen Mr Sojitra on more than one occasion to fully answer all your questions. It is important to avoid medications, if possible, such as aspirin and non-steroidal anti-inflammatories (NSAIDs) e.g Ibuprofen (Nurofen), Sodium Diclofenac (Voltarol) for 1 week before surgery. These tablets may increase bleeding during and after surgery. It is advisable to stop smoking 2 weeks before and after surgery from both a wound healing and an anaesthetic perspective.
The operation
You will be admitted to hospital on the morning of surgery and Mr Sojitra along with his consultant anaesthetist will come and discuss the surgical plan again with you and make some marks on your skin with pen. The operation will take approximately 1-1.5 hours and you will wake up with dressings in place before being taken to the ward. In general, breast augmentation is performed as a day case procedure. You will need to have a friend or family member to drive you to and from the hospital and to look after you for the first 24-48 hours following surgery. You may need to stay in hospital overnight if your operation is done later in the day, if you feel too tired to go or if drains are used.
Recovery
You will experience varying degrees of bruising, swelling, and some tenderness all of which improve by the day. Breast implants placed under the muscle are associated with a little more discomfort than when placed under the breast tissue only. Our consultant anaesthetist will prescribe you adequate medication to take home to alleviate any discomfort you may experience. You will be up and moving on the day of surgery. It is important not to get the dressings wet after surgery and you will be advised on showering. Depending on your type of work, you may return to work between 7-14 days after your procedure. No heavy lifting or strenuous exercise for 6 weeks. It will take approximately 3 months before the swelling completely subsides and the final size seen. The scar will continue to improve for up to 18 months and you are encouraged to firmly massage the scar after 4 weeks. Your surgeon will see you 1 week after surgery at which point the dressings will be reduced and again at 2 weeks. At 2 weeks the stitches, which are dissolvable, will be trimmed flush with the skin so they cannot be seen. All dressings will be discarded at this stage. Your surgeon will closely follow your recovery to ensure you are able to resume normal exercising and activities. It is suggested you wear a sports support bra for 6 weeks.
Safety and potential complications?
Scars
Scarring on the whole is not problematic. A scar will always exist and will be hidden in the curve underneath the breast or at the junction of the areola and the skin. Certain individuals e.g. afro-carribean races and red haired individuals are at a higher risk of forming excess scar tissue (keloid or hypertrophic scars). Should these scars develop excellent advice and treatment will be provided by Mr Sojitra.
Infection
This is an uncommon event and occurs in perhaps less than 1% cases. If it does occur and the implant gets infected then the implant may have to be removed and remain out for 3 months. Once everything has settled a fresh implant will be replaced into the breast. Antibiotics are given during induction of anaesthetic and a short course of tablets afterwards.
Bleeding
Rarely, small blood vessels that have been cauterised during surgery open up afterward. This results in a collection of blood (haematoma) that needs to be removed. This involves a return to the operating theatre where the breast implant is removed, the blood collection washed out and the implant replaced. There are no permanent side effects due to this occurrence should it occur.
Capsular contracture
When a foreign material (silicone breast implant) is placed inside the body, the body’s natural response is to react against this and to form a layer around the implant known as the “capsule”. This is entirely normal and in the majority of patients this capsule is soft and cannot be felt. In a minority of patients, this capsule is much thicker and can cause discomfort and alter the shape of the breast. These patients may require further surgery to correct this.
Asymmetry
Most ladies have breasts which are slightly asymmetrical. The surgeon will point out any small differences between the two breasts to you before your surgery as often these small differences become more apparent following surgery.
Nipple sensation
Most ladies experience some alteration in the sensation around the nipples following breast augmentation. They may become over or under sensitive. In the majority of patients sensation becomes normal over time.
Rippling/Wrinkling of the implant
Breast implants can become palpable over time if the soft tissues become stretched over the implant with time and if the skin is relatively thin. At the same time rippling can also be seen in certain ladies.
Implant rupture & silicone leakage
Modern day silicone breast implants are made out of a “cohesive” gel which resembles the texture of jelly. If such implants leak the silicone does not leak like a runny fluid (as was the case in the older implants 20 years ago) but rather it stays near its original position. This potentially minimises that spread of silicone around the body.
Deep Vein Thrombosis (DVT)
Any general anaesthetic procedure is associated with a small risk of DVT which can potentially move to the lungs (Pulmonary Embolus). Here at Cosmetic Surgeons London we attempt to minimise this risk by the use of compression stockings before and after surgery, use of pneumatic compression devices during surgery and motivating the patient to mobilise as soon as possible after surgery.
Useful Sources of Information for Breast Augmentation
http://www.baaps.org.uk/docs/Breast_Augmentation.pdf
http://www.bapras.org.uk/cms_subcat/339/Breast-Enlargement.htm
http://www.plasticsurgery.org/patients_consumers/procedures/
AugmentationMammoplasty.cfm
Summary
Cosmetic Surgeons London always puts your comfort and safety first!
BREAST ENLARGEMENT / AUGMENTATION / “BOOB JOB”
Why choose us for Breast Enlargement?
- You will be seen and operated on by a fully qualified BAAPS/BAPRAS Consultant plastic surgeon.
- Our breast implants come with a lifetime guarantee.
- Our prices are competitive and represent outstanding results.
- We provide a personal and holistic service to our patients
- We put you safety first!
Am I a good candidate for breast augmentation/enlargement?
Your surgeon will discuss with you in an unhurried manner your reasons for considering breast augmentation.
Breast enlargement is for ladies who:
- Want to enhance the size of their breasts
- Want to increase cleavage
- Want to correct the effects following pregnancy and breast feeding
- Want to correct differences in size between both breasts
- Want to correct uneven or deformed breasts
- Want to correct an absence of breast tissue due to a congenital (birth) problem
- Want to boost self-esteem and self-confidence.
Silicon implants have been in use for many years. In the 1990s concerns were raised about the use of such implants. Consequently, many large international studies were undertaken and it has been shown that there is NO association with breast cancer or with connective tissue diseases. For further information on these studies and others please consult the Department of Health website below:
http://www.mhra.gov.uk
What types of implants are available?
Implants vary according to content (silicone or saline), shape (round or teardrop), surface (textured or smooth), projection (low, medium, high profile).
Where will the breast implants be placed?
Your surgeon will make a detailed assessment at the time of your initial consultation as to where your implant should be positioned (i.e which pocket). Generally, there are 3 locations:
Subglandular:
This means "on top of the muscle" but “underneath the breast (gland)”. This is used when there is sufficient breast tissue to cover the silicone implant. On occasion it may be used to produce an enhanced look.
Subpectoral:
This means "under the pectoral muscle". This is used in women who have insufficient breast tissue and therefore the muscle provides soft tissue coverage of the silicone breast implant which makes it much less noticeable in everyday life.
Dual Plane:
The dual plane technique is a combination of subpectoral and varying degress of subglandular pockets. It involves releasing the muscle partially at the appropriate point so that you can have the benefits of having some of the implant above the muscle and some of the implant below it.
What size should I have?
Cosmetic Surgeons London provides a comfortable setting in which you may trial various sizes of implants. We use an advanced BioDimensional Analysis System where specially developed sizers are placed in your bra. This allows you to get an idea as to what size is right for you. The surgeon will guide you on implant size with regard to your body proportions but ultimately the choice of size is up to you, the patient! It is important time and care is taken at this important stage and that you are entirely satisfied with the size you are chosen. Promises should never be given by any surgeon on the eventual bra size e.g. you may wear a 34DD in Bravisimo and also 34E in Victoria Secrets (the important point being that both may be comfortable for your breasts and the only thing different is the lettering). We give an idea of cup size but ideally the Biodimensional Analysis System will help give you an idea of what you will look like. It is no longer acceptable to ask a patient to stuff breast implants into her bra until she finds a size she likes.
How long do they last?
Breast implants are not permanent devices and all will need to be replaced at some point in the future. Modern day implants tend to last on average 10-12 years. Some may last more and some less. Some may need to be changed earlier due to capsular contracture or you may wish to change your implant size through personal choice.
Where will the scars be after breast augmentation?
Scars can be in a number of places. The most common placement by Mr Sojitra will be in the crease underneath your breast (via inframammary incision). Alternatively, it can be placed at the border of the nipple-areola and skin (periareolar incision).
Will I be able to breastfeed after breast augmentation?
Breast feeding tends not to be affected by the placement of silicone implants. Also there is no evidence to suggest that the baby would receive large amounts of silicone through the breast milk. There is more silicone present in the environment and the teats of feeding bottles than in the milk of implant mothers.
Will the implants interfere with mammographic screening?
Breast implants may interfere with mammography and the detection of breast cancer. It is therefore important to let Mr Sojitra know if there is a family history. When having a mammogram it is important you inform the radiographer that you have breast implants so that special views can be undertaken in order to optimize the mammographic process. Breast implants do NOT increase the risk of breast cancer.
You (the Patient’s) Journey
Before the operation
You will have seen Mr Sojitra on more than one occasion to fully answer all your questions. It is important to avoid medications, if possible, such as aspirin and non-steroidal anti-inflammatories (NSAIDs) e.g Ibuprofen (Nurofen), Sodium Diclofenac (Voltarol) for 1 week before surgery. These tablets may increase bleeding during and after surgery. It is advisable to stop smoking 2 weeks before and after surgery from both a wound healing and an anaesthetic perspective.
The operation
You will be admitted to hospital on the morning of surgery and Mr Sojitra along with his consultant anaesthetist will come and discuss the surgical plan again with you and make some marks on your skin with pen. The operation will take approximately 1-1.5 hours and you will wake up with dressings in place before being taken to the ward. In general, breast augmentation is performed as a day case procedure. You will need to have a friend or family member to drive you to and from the hospital and to look after you for the first 24-48 hours following surgery. You may need to stay in hospital overnight if your operation is done later in the day, if you feel too tired to go or if drains are used.
Recovery
You will experience varying degrees of bruising, swelling, and some tenderness all of which improve by the day. Breast implants placed under the muscle are associated with a little more discomfort than when placed under the breast tissue only. Our consultant anaesthetist will prescribe you adequate medication to take home to alleviate any discomfort you may experience. You will be up and moving on the day of surgery. It is important not to get the dressings wet after surgery and you will be advised on showering. Depending on your type of work, you may return to work between 7-14 days after your procedure. No heavy lifting or strenuous exercise for 6 weeks. It will take approximately 3 months before the swelling completely subsides and the final size seen. The scar will continue to improve for up to 18 months and you are encouraged to firmly massage the scar after 4 weeks. Your surgeon will see you 1 week after surgery at which point the dressings will be reduced and again at 2 weeks. At 2 weeks the stitches, which are dissolvable, will be trimmed flush with the skin so they cannot be seen. All dressings will be discarded at this stage. Your surgeon will closely follow your recovery to ensure you are able to resume normal exercising and activities. It is suggested you wear a sports support bra for 6 weeks.
Safety and potential complications?
Scars
Scarring on the whole is not problematic. A scar will always exist and will be hidden in the curve underneath the breast or at the junction of the areola and the skin. Certain individuals e.g. afro-carribean races and red haired individuals are at a higher risk of forming excess scar tissue (keloid or hypertrophic scars). Should these scars develop excellent advice and treatment will be provided by Mr Sojitra.
Infection
This is an uncommon event and occurs in perhaps less than 1% cases. If it does occur and the implant gets infected then the implant may have to be removed and remain out for 3 months. Once everything has settled a fresh implant will be replaced into the breast. Antibiotics are given during induction of anaesthetic and a short course of tablets afterwards.
Bleeding
Rarely, small blood vessels that have been cauterised during surgery open up afterward. This results in a collection of blood (haematoma) that needs to be removed. This involves a return to the operating theatre where the breast implant is removed, the blood collection washed out and the implant replaced. There are no permanent side effects due to this occurrence should it occur.
Capsular contracture
When a foreign material (silicone breast implant) is placed inside the body, the body’s natural response is to react against this and to form a layer around the implant known as the “capsule”. This is entirely normal and in the majority of patients this capsule is soft and cannot be felt. In a minority of patients, this capsule is much thicker and can cause discomfort and alter the shape of the breast. These patients may require further surgery to correct this.
Asymmetry
Most ladies have breasts which are slightly asymmetrical. The surgeon will point out any small differences between the two breasts to you before your surgery as often these small differences become more apparent following surgery.
Nipple sensation
Most ladies experience some alteration in the sensation around the nipples following breast augmentation. They may become over or under sensitive. In the majority of patients sensation becomes normal over time.
Rippling/Wrinkling of the implant
Breast implants can become palpable over time if the soft tissues become stretched over the implant with time and if the skin is relatively thin. At the same time rippling can also be seen in certain ladies.
Implant rupture & silicone leakage
Modern day silicone breast implants are made out of a “cohesive” gel which resembles the texture of jelly. If such implants leak the silicone does not leak like a runny fluid (as was the case in the older implants 20 years ago) but rather it stays near its original position. This potentially minimises that spread of silicone around the body.
Deep Vein Thrombosis (DVT)
Any general anaesthetic procedure is associated with a small risk of DVT which can potentially move to the lungs (Pulmonary Embolus). Here at Cosmetic Surgeons London we attempt to minimise this risk by the use of compression stockings before and after surgery, use of pneumatic compression devices during surgery and motivating the patient to mobilise as soon as possible after surgery.
Useful Sources of Information for Breast Augmentation
http://www.baaps.org.uk/docs/Breast_Augmentation.pdf
http://www.bapras.org.uk/cms_subcat/339/Breast-Enlargement.htm
http://www.plasticsurgery.org/patients_consumers/procedures/
AugmentationMammoplasty.cfm
Summary
| Operation Time | 1-1.5 hours |
| Anaesthetic | General Anaesthesia |
| Nights in hospital | Day Case / 1 night |
| How much time off work? | 1-2 weeks |
| When can I exercise? | After 6 weeks |
Cosmetic Surgeons London always puts your comfort and safety first!