breast augmentation

BBA

 

Indications

 

Reasons to have breast augmentation include a woman’s desire to increase her bust size, to replace volume after weight loss or child birth and to correct asymmetries.

 

Consultation

The most important aspect of all your treatment in the consultation is the time that you can let me know what it is that you want to achieve from your surgery. There are many decisions including not just size but which type of implant to use and what shape you would like. These all determine the final outcome for you and so it is very important to take the time to consider these choices and weigh up all of the advantages and disadvantages.

 

 

 

Implants

 

I use only high quality implants from major manufacturers with a strong track record and who supply a warranty to cover their implants against failure or complications. The implants are all made from a silicone shell with an inner gel also made of silicone. Implants come in different dimensions to fit each person’s chest and to provide the best final result. I use implants supplied by Mentor, Polytech and B-Lite.

 

How do I pick my implant size?

I now use ‘state of the art’ 3D imaging and Virtual Reality visors. They have been recently renamed ‘boobgoggles’ and widely featured in The Real Housewives of Cheshire, The Sun, Tge Mirror and both Capital and Heart Radio statins as well as social media.  Using an iPad I can scan a model of your chest into the system and then simulate different sizes and shapes of implants as well as how these will look when placed in different tissue planes i.e. under or over the chest muscle wall, Newer updates also allow you to see a simulation of how the breast will move when you walk and lie down. The images can be shared with you at home and updates to sizes can be made without having to come back to our clinic saving time and money..

 

Tissue Planes

 

A breast implant can be placed either behind the muscle (sub-glandular) or beneath the muscle (sub muscular) or sometimes a combination of the two known as dual plane breast augmentations.There are good and bad points to using each one of these and that is why it is important to examine you to determine which is the best tissue type plane to use to get the result that you want.

 

Subglandular placement puts the implant directly behind the mammary gland and in front of the muscle. This placement requires the least complicated surgery and yields the quickest recovery.

 

The downsides of this particular  placement are increased chance of  capsular contracture, greater visibility and vulnerability for the implant. This is because only the flesh and gland separate the implant from the outside world. Depending on the amount of available breast tissue, the implant may be seen “rippling” through the skin especially in women who have low body fat.

 

Submuscular placement puts the implant behind the chest muscle wall. The implant is placed behind the pectoralis major muscle and behind all of the supporting fascia (connective tissue) and non-pectoral muscle groups. Submuscular implants tend to be the best for mammograms, as they put the implant fully behind the area that needs to be examined. This placement has the same drawbacks of subpectoral placement but has a longer recovery time.

 

Pre-existing asymmetries

 

Most people are not perfectly symmetrical and this is also true for most ladies’bbreasts. It is not uncommon to see patients who have different positions of the nipples or slight differences on the height of the breast. Some of these can be adjusted for at the time of the operation but others will still be present after and at your consultation I will show you the difference that can and cannot be corrected through breast augmentation alone and those that would require additional surgery

 

Recovery

 

The surgery takes approximately 60 minutes under general anaesthesia (asleep). You will be in the hospital as a day-case meaning you do not have to stay overnight. The wounds are closed with dissolving stitches so that there is nothing to remove. The incision is covered with a splash proof dressing that will allow you to shower after 48hrs provided you do soak the dressing by keeping your back to the shower.

Complications

 

A breast augmentation is overall a very safe and predictable operation but like all surgery it does carry risks. The most frequent are bleeding, infection and in the long term, capsular contracture.

 

Capsular contracture is a complication where the normal scar that forms around the implant, known as a capsule, becomes hard and can alter the implant shape, create ripples and sometimes pain. The severity is graded 1 – 4 and for grades 3 and 4 the implant companies will cover the cost of re-operation – details can be found here and here.

 

Consent

 

A key part of all cosmetic surgery consultations is to make you aware of all potential risks of the procedure that you are interested in and this is known as informed consent. I will normally arrange 2 consultations in order that you have time to weigh up all the information provided and I will supply a written and comprehensive informed consent document that you will need to read and if you have any questions please make a note of them for your next consultation

ALCL

 

A recent rare complication (believed to be in the order of 1:50,000-300,000) of breast implants is emerging and it is an association with a cancer known as Anaplastic Large Cell Lymphoma. Full information on this treatable tumour that occurs in the scar (capsule) around the implant can be found here. The important points are that it is easy to detect due to swelling and can be treated by total removal of the scar.

 

Some Common misconceptions 1 – 10

 

1 All implants have to be replaced in 10 years

No. The warranty from the manufacturers is for 10 years but many patients have problem free implants for much longer than this.

 

2 They explode on aeroplanes

No again. This is completely untrue.

 

  1. They stop you breast feeding

No. All glands remain and ducts remain intact so breast feeding is possible.

 

4 You cannot have breast screening

Yes you can. During breast screening you should mention it to your physician who will adjust their screening to obtain some different views but it can be done safely.

 

  1. My friend had 250cc so that’s what I should have!

You are not exactly the same as your friend and so you should take time to choose what is right for you,  just as when trying on a friend’s clothes who appear to be a similar build you often find that the item looks different on you and so it is with breast implants as you have a different body shape, frame, shoulders, waist and clavicle so need to choose the type of implants that suit you.

 

  1. Silicone causes auto-immune illness.

No. A full FDA investigation has found no evidence for this. More info can be found here

 

7.All implants look fake.

No. a natural result can be obtained as seen in many of the before and after pictures on this site.

 

  1. Under the muscle/ over the muscle is best.

There are good and bad points to each and that is why your consultation is so important.

 

  1. A big implant can lift the nipple.

A small lift can be achieved using shaped implants but often a full uplift is required.

 

  1. I will lose all sensation.

Some patients do report altered sensation after an implant and this is more likely if you have very small breasts  and then have a large implant that stretches the tissues.