Breast Implants Review
When I first met with Mr Lambe, I had some pretty serious issues with breast implants I’d had for quite some time. To put it mildly, the breast implants were not fit for purpose and I was lucky to find Gerard Lambe when I did.
Not only did he remove the implants and the debris they had caused, he replaced them with high quality ones which suited my frame and made me feel human again.
Although I was dreading the whole process, the care, the attention to detail, the professionalism, the after care and most important of all, the honesty provided by Mr Lambe made it a breeze (and that’s no exaggeration).
I’m sure there are many great surgeons out there but I find it highly unlikely that they would tick all the important boxes like Gerard Lambe does.
All You Need To Know About Breast Implants
Breast Implants were invented by American Plastic Surgeons Thomas Cronin and Frank Gerow in 1961 and the first breast implant surgery was performed in 1962. The inventors of the breast implant sought to mimic the natural fatty breast tissue of a woman and give them an improved breast shape and increase their size. Many women are unhappy with the size and shape of their breasts and so there has been a huge increase in breast implant patients who wish to return their breasts to their pre-pregnancy shape (or before childbirth and breastfeeding). Other women would like to increase the size of their breasts as they have always had a small chest and long for “a cleavage”.
What is Breast Tissue Made Of?
Women’s breasts are made of specialized tissue that produces milk (glandular tissue) as well as fatty tissue. The amount of fat determines the size of the breast. The milk-producing part of the breast has 15 to 20 sections, called lobes. Within each lobe are smaller sections, called lobules that produce milk. The milk travels through a network of tiny tubes called ducts and these ducts connect into larger ducts, which come out via the nipple. The dark area of skin surrounding the nipple is called the areola. Connective tissue and ligaments support the breast and give it its unique shape. The nerves in your breast give you sensation. The breast also contains blood vessels, lymph vessels, and lymph nodes.
10 Steps to choosing the right Breast Implants for YOU
1 Research breast augmentation surgery online 2 Ask trusted friends and family about their opinions on cosmetic surgery and if it might be right for you 3 If they’ve had breast augmentation surgery, ask them would they recommend their Surgeon and if so find out who and their contact details to find out more about them 4 Do further research on the Cosmetic Surgeon you have shortlisted, either online or asking previous patients. An experienced surgeon should have a good amount of reviews on their social media accounts such as Facebook or Instagram and a range of before and after pictures on their website. Google my business can be a good source of online reviews too 5 Ring the clinic to ask any further questions and to arrange a convenient Consultation time, date and hospital to suit you
6 If you are thinking about Breast Enlargement surgery then ask them if they do 3D Virtual Reality imaging where you can be scanned and see “yourself” in virtual reality with different shapes, sizes and projections of breast implants in a range of clothes from bikinis to ball gowns so that you gain a good idea of how you could look after breast surgery. 7 Print out any photos of the “look” you are trying to achieve 8 Write out some questions for your Surgeon and take them with you along with your photos 9 If you feel nervous, it might be good to bring along a trusted friend or relative 10 Arrive at your Consultation leaving yourself enough time to spare in case of heavy traffic, finding a parking space, finding reception and arriving at your Consultation room so that you are relaxed when you discuss your cosmetic surgery.
Choosing Your Breast Implants
Now that you’ve done your research on your breast enlargement (sometimes called breast aug, breast augmentation or boob job) with breast implants and you’ve found a Cosmetic Surgeon you trust, picked your consultation date, time, hospital etc (see list above) but you aren’t sure which implants are best for you then please read below for more detail on the various types of breast implants available. There are a number of key decisions which Mr Lambe will guide you through but it is useful to get a good overall knowledge of the benefits of each so that you make the right choice for YOU. The shape of implant chosen will depend on a number of factors:-
A Your body frame
If you have a larger body frame, then you would typically need larger implants (with a greater width). Patients with a small frame (ie a small chest width such as 30 inches) will see a more obvious change with a smaller implant.
B Your height
Your breast implants would need to be longer to be in proportion to your height, ie if you have a long torso, then your implants would need to be longer to be in proportion to your natural shape.
C The width of your current breasts
If you had a large cup size in the past and are hoping to regain your previous cup size (before pregnancy, childbirth or breastfeeding) then a broader width would be more suitable for you. If you have always had a small cup size then the width of the implant would give you a top-heavy look.
D Your breast tissue
If your skin is loose (you can test this by pinching the skin – if there is a lot of excess skin then your skin can be described as loose) you could a hold a larger implant either shaped or round. However, if your skin is thin (and quite translucent) then perhaps a smaller shaped implant would be more suitable for you.
E Your breast enlargement goals
Do you want a Natural looking breast enlargement, or do you want to achieve a more noticeable outcome? Do you want to have a prominent cleavage which is more obvious?
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Breast Implant Shapes
What shape of Breast Implants should I have?
Implants can be round or shaped (also known as anatomical or teardrop). It is important to know that both of these are able to achieve a natural look. However, it all depends on the “look” you are going for and how much breast tissue you start with.
A Round Breast Implants
Round breast implants are the most popular choice of breast implants used for breast enlargements. They look like a perfectly symmetrical sphere which has been cut in half with the curved part facing outwards from the chest wall. The Upsides of round breast implants: 1 Round implants are able to rotate without causing any problems as they look the same at the top, sides and bottom so hold the breast shape. 2 They can look as natural as teardrop shaped implants as the filling settles on the lower part of the implant due to gravity. 3 They look more natural when lying down as the filler evenly disperses outwards as it would with natural breasts. 4 The cost of round breast implants is typically less than shaped breast implants. 5 Round breast implants can give more volume at the top of the breast if you use a firm gel, therefore you can create a great cleavage with the right bra. This area is called the “upper pole” and does not normally have much projection unless you have breast implants. The downsides of Round Breast Implants 1 They may look “fake” (if incorrectly placed over the muscle in thin patients). 2 May not be suitable for reconstruction of the breast after breast cancer surgery as the tissue coverage over the implant is usually exceptionally thin.
B Shaped (or Teardrop) Breast Implants
Shaped breast implants are made to mimic the shape of natural breasts which have a higher volume around the bottom of the breast and are tapered upwards towards the neck. They are usually filled with a silicone gel that is more rigid than the gel in round implants and allows them to keep their teardrop shape. Mr Lambe mainly uses textured, shaped implants which adhere to the chest wall and stay in position and are symmetrical therefore avoiding rotation of the breast implant which could make them look asymmetrical (ie uneven). Typically older ladies who are having breast reconstruction following breast cancer choose this type of shape as it is more likely to mimic their own natural breast. The benefits of having shaped breast implants 1 Shaped breast implants are sometimes the best choice in slimmer patients who want more projection but want natural looking breasts 2 These breast implants are great for a more subtle breast enhancement, Risks of shaped implants 1 They can sometimes rotate which would make the breast look “out of shape” but this can be corrected by replacing the breast implants with round ones 2 They are firmer gel and may need a slightly larger incision for insertion but this depends on the size of the implant.
What size breast implants should I have?
size and weight of the implant placed under your skin. This is one of the factors to be decided on, along with projection, shape and texture of outer shell.
This is important to determine the right size for your body shape which takes into account the width of your natural breasts. A large difference between the natural width of your breasts and the breast implant will result in unnaturally shaped breasts.
Round breast implants are always the same height and width. Shaped breast implants are available in low, medium and tall heights and are chosen to take into account your own body frame, height and natural breast tissue as well as your breast enlargement goals.
What Projection Of Breast Implants Should I Choose?
This is the term for the amount the breast implant sticks out from the chest wall. It is sometimes called the breast implant profile or depth. A Low | B Moderate | C High
This type of breast implant can result in a more natural appearance so are typically used on patients who would like to achieve a subtle enhancement to achieve a natural look.
B Moderate Profile Breast Implants
Moderate and high profile breast implants are the most popular choices as they give a noticeable but natural result however very good results that look natural can be obtained with low height and moderate height implants also depending on the individual patient.
C High Profile Breast Implants
This type of implant results in a more dramatic result so is typically reserved for patients who want a very noticeable change or who have hollowed breasts after breastfeeding or perhaps weight loss or for breast reconstruction after a mastectomy.
They produce extra fullness in the upper part of the breast (sometimes called upper pole). You should choose these implants if You would like more projection than moderate profile implants can give Your breasts have reduced significantly after weight loss, ageing, pregnancy or breastfeeding. Your natural tissue is more pliable (ie stretchy when pulled) You have little breast tissue so require larger implants You have a small or petite body frame and would like a fuller enlargement.
Where Should I Have My Breast Implant Placed?
A Under the Chest Wall (Under the Muscle)
This is where the breast implant is placed under the chest muscles and is sometimes called sub-muscular or sub-pectoral placement. The chest muscles are called the pectoralis major group of muscles and the implant can then only be partially seen so is a great way of achieving a natural looking result.
1 Reduces risk of capsular contracture
1 Longer recovery time 2 More painful as the muscles have to be manipulated during your surgery 3 Increased swelling 4 Takes longer to see the end result as the implant takes longer to drop into position
This placement gives a natural looking breast enlargement.
B On top of the Chest Wall (Over the Muscle)
This is where the breast implant is positioned between the chest muscle and the breast tissue which is also known as sub-glandular placement. The breast tissue includes the mammary gland. This type of placement is the least complicated and gives you the quickest recovery period but is only suitable if you have 2cm of tissue that can be picked on the upper part of your breast.
1 Quick recovery 2 Less complications 3 Athletic women who want their chest muscles to be prominent and separate to the breast implant
1 Easier to see the breast implant as only the skin and mammary gland in front of it 2 Slightly increased chance of capsular contracture (see below) leading to rippling
It gives a very natural appearance if the patient has enough of her own breast tissue and does not choose a large implant. In thinner patients, a fake look may be achieved by placing a firm gel implant in this plane.
C Multi-plane Placement
Offers the best of both worlds in that the implant is covered in the upper part of the breast so a natural appearance to the cleavage and upper part of the breast is achieved but the implant is able to push against the lower part of the breast and give fullness and shape that may be masked if more of the muscle was covering the implant. As with the “under the muscle” technique, the risk of seeing the implant move when activating the muscles is still present but the implant is not too high and settles quicker then purely under the muscle. The majority of my breast implant surgery is done in this way as most of my patients are slim and I find this technique gives the best balance of natural shape and low risk, with good recovery time.
Breast Implant Materials
All implants are made of an outer shell and an inner filling. The shell is made of silicone and this can be made of either a smooth or textured surface (see below). The filling I choose in my practice is also silicone and this gel can be soft or firm depending on the goals you have for the feel of your breast post surgery ie do you want your breast implants to feel firm to the touch or more natural? You may wonder how can the shell and gel both be made of silicone if one is soft and the other is supposed to be robust and stop leakage. It’s all down to the length of the chains of silicone molecules. Longer chains equal a firmer shell and shorter chains equal a soft gel feel and appearance.
Breast Implant Inner Filling?
What is the inside material made from and why?
Breast implants are typically made from either Silicone or Saline. The saline implants can then be topped up with a further incision. Silicone breast implants have a thicker filling which is made to feel more like an actual breast.
What are Diagon Gel Implants?
Diagon gel implants allow natural movement of the implant on the chest wall but also replicate the feeling of a soft breast. They are split into two halves with the base being a firmer gel which sits near the base of the breast and the less firm gel is positioned at the front of the breast to give a soft breast effect when touched. They have a unique shape with the most prominent part of the implant sitting lower than a traditional teardrop implant and this, when positioned correctly, allows the nipple to be lifted a few centimetres without any additional scars. Not everyone is suitable for this, but a good test is to raise your arms up in front of the mirror and if both your nipple and breast tissue is lifted above the fold of the breast you may be suitable for correction using this type of implant.
The “fold” of the breast is the area where the breast tissue meets the chest wall at the base of the breast. This is typically where the scar is positioned in breast enlargement surgery as it is hidden in this crease and covered by the breast itself. A combination of two types of firmness of the gels gives the “best of both worlds” as the breasts can move naturally on chest but also project to give a nice shape.
Breast Implant Outer Surface
Tear drop shaped implants come in a variety of textures which helps the implant adhere to the chest and reduce the risk of them rotating behind the skin which would not matter in a round breast implant as all sides look the same (it’s circular). Anatomical or teardrop shaped breast implants would not look right if they moved out of position as they are unevenly shaped.
For the surface material I will usually use a textured surface implant as this helps to reduce the risk of tightening of the normal scar that forms around the breast implant (capsular contracture). Smooth implants are more often used in the USA and have a higher rate of capsular contracture.
Another surface that I use is called polyurethane and this is a special coating of a “furry” material on the surface of the implant that reduces capsular contracture further (see below) and helps the implant to stay in place. There are times when this is the best choice, for example, with a patient who has large implants and this outer material plus the polyurethane will help to prevent the implant from dropping over time.
Micro Textured Implants
What is micro-textured?
This is a texture that is not rough enough to be felt by hand but it has a textured appearance under a microscope.
The Microthane coating is like a polyeurothane that minimises capsular contracture as it integrates with your own tissues and so does not make a firm capsule. It also has the ability to stick firmly in position and this makes it useful for revisional surgery or in patients who have lax skin that will not be able to support the weight of the implant over time. When combined with the Diagon gel shape, it also able to achieve a lift to the nipple as the breast can be made to stick to the implant.
The Benefits of this type of breast Implant
1 They have a low rate of Capsular Contracture 2 They are stable and stay in position once inserted, therefore the position Mr Lambe puts them in is where they will stay 3 If you have suffered from Capsular Contracture in the past and want your breast implants replaced, then a textured implant will be recommended.
The disadvantages of this type of breast implant
1 They can only be removed after a period of 6 months after your breast enlargement surgery due to the fact that they stick to the tissues in the first few months making removal very difficult until this process is complete. 2 They don’t “drop and fluff” which are the terms used for the settling in period after a breast implant operation where the implant typically moves down a bit due to gravity and settles into place.
What Is Capsular Contracture?
This is the name for tightening of the normal scar that forms around breast implants when they are inserted into the breast. It is the growth of hardened scar tissue that can feel rigid and sometimes painful to the touch. Patients who have suffered from capsular contracture in the past are recommended to have them replaced with a more textured type of breast implant that will enable the breast tissue to adhere to the breast implant and not form this type of hard scar around it. The rate of developing this complication is low and by using textured breast implants this risk is even lower which is why Mr Lambe uses textured styles when he is performing breast enlargement surgery.
Breast Implant Warranty
For your breast surgery, you want to be sure that you are getting high-quality implants made by a reliable manufacturer that supplies a warranty. I use Polytech implants as they provide a lifetime warranty for your implants that cover you against failure or severe capsular contracture (which is a tight scar around the implant that can sometimes cause pain and/or a change in shape of your breast). Another reason I use Polytech implants are that they are made in Germany where they have a high standard of quality control and use the safest precision made techniques which produce the lowest risk of failing for my valued patients. Please register here to be eligible for this warranty
Mr Lambe was interviewed for BBC Radio London regarding the PIP scandal and the low-grade quality of the silicon filling in a particular brand of breast implants manufactured in France, so if you’d like to hear more about it, then simply click below.
Breast Implant Safety
Breast implants have been used safely for many years now. However, there was a scare back in the 1990s around the safety of silicone and a possibility it may be associated with various diseases. This led to a huge investigation in the USA and the findings were that there was no evidence that breast implants cause immune disease or any other type of illness with one exception I will discuss later. There was another high profile scandal in the last 5 years regarding PIP implants and this was a case of fraud by a French manufacturer of breast implants who started using a low-grade silicone in their implant production that led to some of the breast implants rupturing and leaking. He has since been found guilty of gross negligence and this case has led to governance looking very closely at the industry and all implant manufacturers are now under very close scrutiny. This is another reason why I only use reliable and long-established manufacturers with the highest standards. There is a slight risk of developing ALCL (short for Anaplastic Large Cell Lymphoma) which this report estimates at 1:26,000 patient risk. A symptom of this disease is a rapid swelling in one or more breasts. Should this occur you should contact your doctor immediately and tell them you have breast implants. Thorough research has been done in this area with the leading research and governing bodies taking part. Full details are available here.
Breast Implant Register
Lastly, it is important that you receive the details about your breast implants and keep them safe. In response to the problems surrounding PIP you can also register your breast implants on the government database for breast implants for peace of mind. Click here. We hope this explains the many choices available and please call us if you need any further information on any of the above points. For Breast Implant FAQs InfoSheetBreastImplants
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