Breast enlargement (augmentation mammaplasty) is a surgical procedure to enhance the size and shape of a woman’s breast.
A woman may have a number of reasons for wanting breast enlargement surgery. Many people fail to appreciate the significance that breasts play in the average woman’s life. A woman with small breasts often feels physically inadequate, even if she has achieved significant things in her life. A breast enlargement procedure is much more than just wanting ‘Page 3’ breasts, it is about feeling feminine and sexy.
Breast enlargement is a relatively safe procedure. However, like any surgical procedure, there are certain risks and specific complications associated with this procedure that you need to discuss with your surgeon.
There has been no evidence (that we are aware of) that breast implants will affect your fertility, pregnancy or ability to breast feed. However, some people have reported difficulty with breast feeding, so keep this in mind if you plan on having children after your surgery.
There has been a lot of media attention since 1988 on the safety of silicone implants due to leakage of silicone from the implants into the body. They have been banned from use in the United States since 1992, but they are still available in the UK.
Breast implants also make it difficult to have accurate mammograms, and special mammogram views or extra examinations by Ultrasound may be needed for patients with breast implants.
The average cost of the Breast Enlargement procedure in the UK is £3000 to £4000, depending on the type of implant you choose.
TYPES OF IMPLANTS
In the UK, there are several types of implants that can be used for the augmentation, the most common are: Soya-oil filled implants (Trilucent), Hydrogel (sugar, salt and water) implants, salt water filled implants known as Saline implants and Silicone Implants.
The Soya-oil implants (Trilucent) have an outer shell of silicone and are filled with a soybean gel. They feel very similar to silicone implants. The advantage with soybean implants is that should the silicone shell rupture, the soybean gel filling is absorbed by the body and is naturally flushed out as it is not a toxin. The makers of the Trilucent soybean oil implants claim that their implants do not block the natural breast tissue on mammogram x-rays (they are radiolucent). Trilucent implants have been available in the United Kingdom since 1995 and we have not heard of any problems associated with them.
There is a very new type of implant called the Hydrogel. It is filled with solidified sugar, salt and water and it is said to feel just like natural breast tissue. It is too new to be able to access the safety and suitability at this time. These implants are between £250 to £1000 more expensive than the other types of implants.
The Saline implants are perhaps the safest type and the least expensive, but there have been complaints from women that there is a very visible “rippling” that can be seen when they are bending over. The other major complaint is that they can deflate a bit over time and in some cases they completly deflate, which requires the implant shell to be removed and replaced with a new implant.
Silicone implants are now available in the form of a cohesive gel (a thicker gel form that will not break down). The advantage of cohesive gel silicone over the older silicone gel is that if there was a rupture, in theory, the cohesive gel will stay in the same place and will not be able to travel around the body as was the case with the more liquid silicone implants.
The safety of Silicone implants is still under debate. They have been banned in the US since 1992 (also banned in France and Australia) because of ill effects women have suffered from the silicone that seeped from their implants. The UK has not concluded that they cause illness and thus they are still available. A British Medical Journal report on implant safety in February 1998, entitled “Do silicone breast implants cause connective tissue disease? There is still no clear evidence that they do”. This report goes over the research findings from numerous studies and concludes that there is no link between breast implants and connective tissue disease.
A UK medical panel reviewed silicone implants and their safety in June 1998. The panel concluded that they could not find evidence linking silicone implants with the types of illnesses women with implants said were caused by silicone leakage. Therefore, the silicone implants are still available in the UK and should be for the foreseeable future.
round implants teardrop (anatomical) shaped implant
There are also different shapes of implants available. The most common type is the round shape, which is a flat, circular shape. The second and less common type is an “anatomical” shape, which is more like a tear drop. It is said that the anatomical shape gives a more natural ‘drooped’ appearance. This is probably more of a consideration if you have very little breast tissue and you are afraid of the “Pamela Anderson” look.
SIZE OF IMPLANTS
The size of the implant is obviously a personal choice. However, if you ask your surgeon to put in an implant that is too large for your body frame, don’t be surprised if he/she won’t do the surgery.
The implant sizes start around 230 cc for a small augmentation or for someone who already has a lot of breast tissue. They go up to 800 cc or so and they can be custom made larger than that (like Lolo Ferrari from Eurotrash (Channel 4) with her 52 inch breasts).
A good way to determine the best size for you is to take sandwich bags and fill them with water from a ml measuring cup. Put the sandwich bag into your bra and see how it feels (don’t use a push up bra as it does not give you an accurate feel for the implant size). Each cc=1 millimeter (ml) or 31cc=about 1 ounce. Therefore, 250 ml=1 cup and 500 ml=2 cups.
I can’t stress enough the importance of knowing what size implants to get, before your surgery. Don’t just tell your surgeon you want to be a ‘C’ cup or a ‘D’ cup, you need to know the cc’s.
The number one complaint women have after surgery is that they didn’t get big enough implants.
BEFORE THE SURGERY
There are many things you can do to have your body in optimum condition before your surgery. Read our Health Booster page to find out.
Make arrangements before your surgery to either stay in hospital for 2 days or at least 1 day in hospital and then have someone to take care of you. You will not be able to do anything for the first 48 hours at least!
Breast augmentation is usually performed in a surgery centre or a hospital facility. Either local or general anaesthesia can be used for this procedure, but general anaesthesia is the norm. The incision will be made in such a way to make it as inconspicuous as possible, around the areola (nipple), in the armpit, in the crease where the breast meets the chest, or by using Endoscopy to place the implant through a minimal incision (More information on endoscopic surgery is available). The surgery usually takes one to two hours to complete. Most of the patients will be able to return to work within a week, depending on the nature of their job.
Your surgeon should make every effort to position the incision so resulting scars will be as inconspicuous as possible. Please note that if you opt for the Trilucent implant, a larger incision of 2-2 ½ inches is required and that placement through the areola is not likely to be available if you have small areolas.
Working through the incision, your breast tissue and skin will be lifted to create a pocket, either directly behind the breast tissue or underneath your chest wall muscle (the pectoral muscle). The implants are then centered beneath your nipples. Putting the implants behind your chest muscle may reduce the potential for capsular contracture (scar tissue forming around the implant making it go hard). The behind the muscle placement may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue. Placement behind the muscle however, may be more painful for a few days after surgery than placement directly under the breast tissue.
Drainage tubes will probably be used for several days following the surgery and they may leave a very slight scar.
AFTER THE SURGERY
The pain can be quite intense for the first 24-48 hours, although the intensity is different with every person. The surgeon will prescribe pain pills (make sure you fill the prescription before the surgery).
Make sure you have plenty of pillows in your bed for support. You will not be able to sleep in any position other than propped up in a semi-sitting position or flat on your back for 7-10 days.
Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage will be applied over your breasts to help with healing.
Within several days, the gauze dressings will be removed and you may be given a surgical bra, if not, you should buy a bra (prior to your surgery) that will give you very firm support in your anticipated new breast size. If you have your incision placed in the crease of your breast, do not wear a support bra with underwires (until your breasts heal) as they will cut into your incision.
For the first few days after the surgery, your breasts will be almost ‘rock hard’ with the swelling. Don’t worry, they will become much softer around 4-5 days after the surgery.
Some women also experience a burning sensation in their nipples (ranging from a slight annoyance to wanting to scratch them off) for about two weeks, but this will subside as bruising fades.
Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear.
Also, don’t be alarmed at the position of your breast implants when the bandages come off. They will be sitting higher up on your chest for the first few weeks and then they will gradually settle into place.
Follow your surgeon’s advice on when to begin exercises and normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually three to four weeks after surgery. Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.
Starting from about the second or third week after your surgery, you should do a deep breast massage daily. This can help prevent scar tissue around the implants from forming (capsular contracture). This massage should be kept up daily for the first six months, and then weekly thereafter.
Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although as previously mentioned, the mammographic technician should use a special technique to assure that you get a reliable reading.
Please note that this information is offered freely to individuals considering cosmetic surgery. No rights are granted and it is not to be reprinted or copied without the prior written consent of Cosmetic Surgery Net – UK . Beware that although efforts have been made to assure accuracy, many of the issues discussed here are a matter of professional opinion. Consultation with a Qualified Plastic Surgeon should be obtained to answer more detailed questions and advise you based on your personal circumstances.