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Breast augmentation is enlargement of the breast. This is usually done by inserting an implant beneath the breast to make it look larger. It will enlarge breasts that have always been small, but can also be used to fill out breasts that used to be larger. 

The implants are usually inserted using an incision placed under the breast at the crease, but can also be put in via an incision in the armpit or around the nipple. 

Implants can be placed either directly behind the breast (known as sub-glandular placement), or behind the breast and chest wall muscle (known as sub-muscular placement). 

Behind the Breast

The insertion of implants behind the breast is considered to be the simplest of the available enlargement procedures, and less likely to cause significant discomfort. This route is also effective for patients with slightly drooping breasts. 

Behind the Muscle

The insertion of implants behind the breast muscle provides more padding, which is a key consideration for slender patients and those with very little breast tissue where the edge of an implant may be detectable through the skin. The muscle provides extra cover and helps to hide the upper half of the implant, and so is often recommended for those who have very little breast tissue and whose ribs may be visible through the skin. 

What Type of Implants ?

The outer layer, or shell, of all implants is made of silicone. Some implants have an additional polyurethane coating. The shell can be filled with either silicone gel or saline. We use Mentor or Allergan cohesive gel silicone implants. 

Implant Size 

Implants are supplied by volume in milliliters or weight in grams. It is not possible to just pick a cup size and ask the surgeon to supply that. At your preoperative consultation the surgeon will assess your chest wall, your existing volume of breast tissue and how much skin is available to accommodate the implant. The surgeon will be able to give you an idea of what implant size is appropriate for you. Your own view is also important since in most patients a range of possible implant sizes could be used and it is helpful if the surgeon knows if you would tend towards the larger or smaller end of that range. The surgeon will not be able to guarantee you a cup size. In general the larger the implants that are used and the slimmer you are the less natural-looking your breast augmentation will be. The implant will be less obvious if it is not oversized and if you have a reasonable amount of your own tissue to cover the implant. 

Implant Shape

Implants can either be round or teardrop- shaped (otherwise known as anatomical). Round implants provide a bigger volume at the top of the breast, and by design are the same width as they are tall. With either of these options, there are varying degrees of projection, depending on whether the desired effect is to look subtle or more noticeably pert. In general the surgeon will advise the best shape option to fit your frame and your desired outcome. 

Are Silicone Implants Safe ?

Breast implants are made from medical grade silicone. This is a polymer that has been tried and tested and is used in a number of other medical devices. It is a safe material to use in the body. Silicone is inert in the body, you cannot react to it or reject it. There is no association between breast augmentation and breast cancer or cancer of any other part of the body. Neither is there any proven association with any other illness. Old types of implant shells may fail and the silicone gel may leak out. Whilst this may cause symptoms and will result in re-operation to remove and replace the implants there is not evidence that a ruptured breast implant causes ill health. 

What Does the Operation Involve ?

Breast enlargement surgery takes about 1 or 2 hours, and is usually done under general anaesthetic. The operation itself involves accessing and creating the pocket into which the implant will be placed, using one of the insertion routes mentioned above: breast-crease, armpit or nipple. Please note that, our surgeons prefer to use breast-crease incision method. Once the pocket has been created, the surgeon may insert a trial implant to check that the size chosen is appropriate. The trial implant is removed, the definitive implant inserted and the incision wounds are stitched. Our patients stay 1 night at the hospital after the breast implant operation. Postoperative pain in these procedures is easily controlled. Your chest will feel tight. Your breasts and ribs below your breasts will be tender. Patients will be mobile from day one and should be back to full exercise within six weeks. Patients are recommended to take around one to two weeks off work immediately after the operation in order to ensure you recuperate fully. 

At first your breasts may look too high and the skin appear tight. This tends to settle down over the first six weeks or so after the operation as a more natural shape emerges. Most patients are delighted with the change that has been achieved, but some find their new shape is difficult to get used to. You should be prepared for this possibility. 

The nature of the scars will depend on the technique that has been used. Scars tend to be quite red in the first six weeks, changing to purple over next three months and then fading to white. Most patients will form good quality scars over time. Abnormal scarring is rare in breast augmentation surgery. 

 

All operations are associated with risks. Fortunately, serious complications are rare with this operation. However, sometimes unavoidable complications will occur.

 

The aim of this article is to give you a general information about the surgical intervention in question. You need to make more research about possible complications and risks of this selected procedure in order to make an informed decision. Please note that complications occur more frequently with patients who are obese, smoke, and have a history or lung or other chronic underlying medical conditions.

 

Smokers are recognized to have a significantly higher risk of post operative wound healing problems with a subsequently higher potential of infection as well as operative and post operative bleeding. Patients should discontinue smoking for two weeks before and two weeks after surgery. Although it helps to stop smoking before and after surgery, this does not completely eliminate the increased risks resulting from long­ term smoking. Smoking also has a long term adverse effect on the skin and ageing process.

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