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Breast Enlargement

Breast augmentation also known as augmentation mammaplasty is a surgical procedure performed to enhance the size and/or shape of the breasts through the placement of breast implants. It is the most popular cosmetic surgical procedure with 7732 operations being performed in the United Kingdom in 2016.

FAQ's

Are there different types of implants?

Breast implants come in a variety of types and sizes. All implants are made of an outer casing of silicone, but may be filled with either a silicone gel or salt solution called saline.

Some are round and some are more of a teardrop shape. The round ones are used when the breast already has shape, but you are looking for an increase in size or volume. The shaped implants are good for people who are flat chested, wanting to add both shape and volume to their breasts.

Implant sizes are measured in cubic centimetres or (cc) and most implant sizes range from 200 to 350 cc with a range of 150 to 750cc. A person with a large frame or build will need to have a larger size implant (in cubic centimetres) in order to achieve the same cup size as a person with a smaller frame. Implants need to be sized in proportion to your build. Different sized implants can be implanted if one breast is larger than the other.

 

How do I choose my size of implant?

During your consultation, Mr Henley will discuss in detail the look you wish to create; some people are looking for natural results - a subtle enhancement - whilst others are looking for “big” rather than “balance”. Finding the right size implant involves taking into consideration not only final size, but also your physical build, the width of the chest wall, skin texture, the amount of natural breast tissue you have already and your overall figure. You will be provided with inserts to ‘experiment with’ in order to identify the most appropriate size.

How big to go is not an easy decision and certainly one that should not be rushed. In Mr Henley’s practice, this sizing process has resulted in a 99% satisfaction rate with the increase in size of the breasts.

The text that you have in this section should have the heading “How long does it take to perform the operation.

 

How are the implants inserted?

Breast implants can be inserted in a number of ways and the approach used will depend upon the type and size of implant chosen, your body shape and your preference. A cut (incision) can be made in the crease underneath the breast (called an inframammary incision), or in the armpit (a transaxillary incision) or around the lower edge of the nipple (the periareolar incision), although this particular approach is not favoured by Mr Henley. A fourth technique involves using an endoscope (like a small telescope) to insert inflatable implants through a small incision in the tummy button (the umbilical incision). This method is controversial and is not a technique used by Mr Henley either.

Breast implants are pushed through the incisions and positioned either in front of (subglandular) or behind (submuscular) the chest muscles. Once the implant has been adjusted to the right position, the incisions are closed with stitches.

 

What are the risks and side effects of surgery?

In the hands of a skilled surgeon, complications are infrequent and usually minor. However, as with any operation, there are risks associated with surgery and specific complications associated with this procedure.

The greatest risk with this sort of operation is that the breast will feel harder than normal, a complication known as capsular contracture. This may develop in the first year or two after surgery. Regardless of the implant selected, the body will naturally form scar tissue around the implant. If this scar tissue shrinks or contracts, it can cause anything from a mild firmness to extreme hardening that can cause a visible deformity of the breast. This may develop in the first year or two after surgery and occurs in around one in 10 women. However, the risk is much less likely with the textured implants in use now rather than the smooth implants which used to be inserted.

Approximately 1 in 7 women complain about changes in nipple sensation with either a reduction or complete loss of sensation. This may take up to six months to settle and very occasionally, can be permanent. An unpleasant oversensitivity can also occur, particularly when clothing rubs against the nipples, and this takes a similar period of time to settle.

Scars result from any incision but breast augmentation incisions are usually well hidden in the breast crease or the armpit. However, there is a small risk that the scars may become red, raised and lumpy and this complication can take a long time to improve.

Implants can rotate or shift position after surgery and they can also weaken and rupture. Implant rippling or wrinkling can also occur.

Other risks include bleeding, delayed healing, wound infection, chest infection and blood clots in the leg known as a deep vein thrombosis, although all these risks are uncommon.

There is the possibility that there may be a link between breast implants and an extremely rare type of immune system cell cancer called Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Due to the rarity of a diagnosis of ALCL (believed to be in the order of 1 person out of 50,000-300,000 people) a worldwide collaboration is required to provide robust data to investigate the link.

BIA-ALCL presents with late onset (at least one year after implantation), rapid swelling of one breast. It should be noted that ALCL is extremely rare and treatable by surgery and other therapies recommended by the cancer specialist team.

 

How soon will I be able to resume my usual schedule?

You will probably experience swelling and soreness for a few days after the operation, but you should not feel any severe pain. At the end of the operation, minimal dressings will be applied and your sports bra fitted. You will normally go home the day after surgery and should rest for one week. It is important that you undertake no strenuous activity at all for the first few weeks, allowing the body the time it needs to heal. However, you still need to get up and move around every hour or so to avoid post-operative complications. Refrain from driving for the first week as well. Your dressing will be removed about a week after surgery. Mr Henley uses internal stitches and glue to close the wound so there are no stitches to take out. Apart from bathing, you should continue to wear a sports bra to give your breasts the necessary support for four to six weeks.

A strange thing you may experience is a gurgling sound coming from your breast; this is caused by fluid and air bubbles forming within the implant pocket whilst the implant settles down. These sounds will stop within the first few weeks as the air gets absorbed into the body. Don’t be alarmed if this happens; it does not mean that your implant is leaking.

Depending on your occupation, you are likely to be back at work in about 10 to 14 days. After approximately four weeks you can start to increase your activities, so that by six weeks post-surgery, you have resumed your full normal physical activities. From this point onwards, you may use whatever bra you wish. Mr Henley will check that everything has settled at one year following the operation.

Over time, post-surgical swelling will decrease and incision lines will fade. The effects of your surgery should be long lasting, although future pregnancies, aging, gravity and weight gain or loss will alter breast shape.

You should be careful about having nipple piercing following this operation. There is a possible risk that bacteria can enter through the break in the skin at the nipple, causing an infection. This can spread backwards from the the piercing to the breast tissue and implants. Apart from any pain or discomfort caused by an infection, there is a possibility that your implants may need to be removed.

Implants do not interfere with the ability to breast feed and they are not subject to strain or rupture when travelling in aircraft.  However, the presence of implants does make breast health screenings, such as mammography, a little more difficult. If you are having a mammogram or other diagnostic test to the breast, it is important to let X-ray staff know that you have implants in place. X-Ray staff can then make sure that the most appropriate method of screening is used.

 

How long do implants last?

Breast implants are a long-term commitment. It is important to be aware that no implants should be viewed as life time devices and they may need to be replaced at some point, possibly in the next 15 – 20 years or sooner. The good news is that most surgeons would say that as long as there is no clinical concern or symptoms, there is no need for further surgery to replace implants. However, you will need to consider whether you are prepared to commit to the possibility of surgery in the future and its associated expense

 

Do breast implants increase my risk of getting breast cancer?

Scientific studies have repeatedly shown that there is no increased risk of developing breast cancer for women who have breast implants. Similarly, there has been no independently reviewed research that demonstrates a clear link between silicone implants and autoimmune diseases such as rheumatoid arthritis.

The NHS Choices website provides additional information on breast implants and the breast implant registry which was set up in October 2016. In addition, the Medicines and Healthcare Products Regulatory Agency (MHRA), an agency of the Department of Health of Health monitors the performance of implants in order to continually assess their safety.   Mr Henley will make sure that you are given full details of your implants: manufacturer, style, catalogue number and batch/lot number.  You are advised to keep this information in a safe place.

 

Patient A - Small Subglandular Implants

This patient started with a minimal amount of natural breast tissue. However, it was really important to her that any enhancement looked completely natural. She said "I don’t want to look like I’ve had a boob job." The implants were inserted in front of the breast (pectoral) muscle - in the subglandular position.

Before surgery

 

Six weeks after surgery

 

10 months after surgery

Before surgery

 

Six weeks after surgery

10 months after surgery

At one week post op

At one week, you can see that the implants are high up in the chest. It is not unusual for patients to become anxious at this point, believing that the implants inserted are oversized. However, it takes time for the implants to settle down into their final position.

Scar at six weeks

The scars here show that the implant was inserted through the inframammary crease. This is the most widely used incision.

Scar at ten months

At ten months, the scars have faded to an almost invisible line.

Patient B - Large Subglandular Implants

It is important to spend time at the pre-operative stage “test driving” the size you want to be. Choosing how big to go is not an easy decision. This patient wanted a much curvier look than the previous patient. This lady's implants were also inserted in front of (subglandular) the breast muscle.

Before surgery

 

Six weeks after surgery

 

One year after surgery

Before surgery

 

Six weeks after surgery

One year after surgery

Before Surgery

Seven weeks after surgery

One year after surgery

Patient C - Submuscular Implants

This patient's implants were inserted behind the breast muscle - in the submuscular postion. She was very slim and wanted a larger augmentation which did not show the implants. She accepted the risk of movement with tightening of her chest muscles

Before surgery

 

Six weeks after surgery

 

Eleven months after surgery

Before surgery

 

Six weeks after surgery

Eleven months after surgery

These views show how the breasts become distorted when the lady tightens her chest muscles.

Muscles relaxed

Muscles tightened

6 Weeks after surgery

Muscles relaxed

 

Muscles tightened

Patient D - Fat Transfer (No Implants)

This lady wanted a small to medium enlargement but did not want breast implants. The fat used to increase this lady's breast size was removed from her thigh area. The patient was delighted with her new shape - both top and bottom.

Before surgery - Fat Transfer

11 months after surgery

 

Before surgery - Fat Transfer

 

11 months after surgery

 

Before surgery - Fat Transfer

11 months after surgery

 

 

Before surgery - Fat Transfer

11 months after surgery

 

Mr Henley would like to thank these patients for allowing their photographs to be displayed for the benefit of others who may be considering cosmetic surgery.

The information provided is intended to give a brief outline of the procedure. It is not a substitute for a personal consultation with a surgeon.

Contact 0800 288 4777

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