© M W PAYNE 2019

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BREAST AUGMENTATION

Breast enlargement, also known as breast augmentation or a ‘boob job’, is one of the most popular cosmetic surgical procedures in the UK.  It is used to:-

 

  • increase the size of smaller breasts

  • correct fullness lost through pregnancy, breast feeding or weight loss

  • balance asymmetrical breasts 

 

Implants are used to enhance the size and shape of the breast. The patient’s stature, breast anatomy, skin thickness and elasticity will determine the size of implant which can be used and also the positioning of the implant. 

 

The procedure will not correct sagging breasts.  If the breasts need to be lifted, an uplift procedure may be carried out at the same time as the augmentation (see Breast Uplift).

 

It should be noted that implants are a consumable item and will need to be removed or replaced at some future point so the cost of further surgery should also be taken into consideration.

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The Procedure

 

The procedure is performed under a general anaesthetic and usually takes around 1 hour.  Implants are inserted into a pocket which is made through an incision in the crease under the breast (the inframammary fold).  The implants can either be placed directly behind the breast tissue and on top of the pectoral muscle (submammary) or behind the muscle (submuscular dual plane). 

 

Risks/Complications

 

Any invasive treatment carries its own risks and complications.  Also, every procedure has limitations and the risks should be compared to the potential benefits before undergoing a surgical procedure.

 

Possible risks and complications include:-

 

  • anaesthesia risks including depression

  • scars and keloid/hypertrophic scarring

  • asymmetry in the length and position of the scars

  • skin necrosis and wound healing problems

  • asymmetry in volume, shape and submammary folds

  • infection

  • wound breakdown with an exposure of the implant

  • fluid build-up as in a seroma or bleeding as a haematoma

  • development of a blood clot as in a deep vein thrombosis, thromboembolism or pulmonary embolism

  • swelling and bruising

  • potential for a change or loss of skin sensitivity and nipple erectability

  • visibility and palpability of the implant 

  • implant rupture 

  • gel bleeding

  • displacement of implants 

  • capsular contracture

  • breasts may develop prominent veins 

  • stretch marks

  • existing ptosis will remain

  • breast feeding may be impaired

  • implants may interfere with breast cancer screening

  • need for further surgery

 

Recovery

 

Recovery time can vary between patients. Some discomfort will be felt afterwards which can be controlled by pain medication but patients should expect swelling and soreness for several weeks. The breasts may also feel tight and firm and strenuous work or exercise should be avoided for 4-6 weeks.  

 

Although fuller breasts will be immediately noticeable, the final results won’t be available until the implants have settled and the swelling has completely subsided.  The incision scars will be covered by underwear and will typically fade over several months.  

 

The results may be affected by significant weight gain/loss or pregnancy. 

 

Implants are a consumable item and will need to be removed or replaced at some future point so the cost of further surgery should also be taken into consideration.