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Step-by-Step Guide to Breas...

Step-by-Step Guide to Breast Enlargements: From Your Initial Consultation to Recovery

By Adel Y Fattah PhD FRCS(plast), Consultant Plastic & Aesthetic Surgeon,

Breast enlargement surgery is the most popular cosmetic surgery in the UK with around 30,000 women choosing to have the procedure done every year. Choosing to have breast surgery is a major decision and one which should not be taken lightly. However, advances in cosmetic surgery techniques and the quality of implants available now mean that the results look more natural than ever before. In this article, we take a look at what happens at every stage of the breast enlargement process.

 

Why do people choose to have breast implant surgery?

 

Women choose to have breast implants for many reasons, most often because they are unhappy with the size or shape of their breasts. In some cases, such as after childbirth or after a significant amount of weight loss, breasts can lose their shape and look deflated. In this case, women may choose to have a breast uplift as well as implants. Breast implants also form part of the reconstructive surgery required after a mastectomy to restore the breasts to their former shape.

What to consider before booking your breast implant surgery

 

How much does breast surgery cost?

It’s estimated that only 15% of breast implant surgery is carried out on the NHS, this is because it is classed as a cosmetic surgery and there are no medical benefits to having breast implants. However, for many women, the size of their breasts can make them feel self-conscious and even lead to anxiety and depression. For this reason, many women choose to have the procedure done privately.

The cost of surgery varies but at Pall Mall Medical we are open and upfront about our costs and you can expect to pay £3,500 for a breast uplift, £4,200 for a breast enlargement procedure and £5,500 for both the enlargement and uplift.

 

What type of surgery is right for me?

Breast enlargement surgery – Women who are unhappy with their breasts, either because they feel they are too small or because they feel one is larger than the other, may choose to have breast implants.

Mastopexy (breast uplift surgery) – Women who opt for uplift surgery tend to have sagging breasts as the result of breastfeeding or from losing a large amount of weight. During breast uplift, surgery excess skin from underneath the breast is removed and the nipples are repositioned. Breast implant surgery can often be done in the same operation as a breast uplift.

Breast reconstruction surgery – Women who have had a mastectomy due to breast cancer may choose to have breast reconstruction to restore the shape of their breasts. This type of surgery is either done with implants or by using the patient’s own tissue from their buttocks, thighs, back or stomach.

What size is right for me?

Breast implants are categorised in different profiles and consist of low, moderate, moderate plus and high profile. Your surgeon will be able to talk you through the difference in each, once you have discussed your expected outcome. Each profile creates a different ‘look’ to the breasts in terms of the height and diameter of the breast. For example, high profile implants have a smaller base but are ‘higher’ and therefore can create a larger appearing breast than moderate profiles.

Breast implants are measured in cubic centimetres (cc³) and the greater the cubic centimetres, the larger the breast implants. As a rough guide, around 200 cubic centimetres is the equivalent of an increase in one and a half cup sizes and breast implants tend to contain at least 200cc³. The size of implants you choose is a big decision and your surgeon will be able to discuss this with you in relation to what results you can expect to see after your surgery.

Ultimately, the breast size you choose is up to you but a good surgeon will choose implants which are the same width as your natural breast ‘base’ and which complement your frame. Having implants fitted which are too large for your frame can cause a range of problems including trouble with physical activities and your breasts may look out of proportion to the rest of your body. Not to mention stretch marks on the skin and a higher rate of wound breakdown.

 

What type of implant shall I choose?

Silicone or saline implants are the main two options for breast enlargement surgery. Saline breast implants are inserted underneath the skin and muscle of the chest and then filled with sterile salt water when in place. Silicone implants are filled with silicone gel and are inserted pre-filled. Silicone implants are generally the preferred implant as they look and feel very natural.

A further decision you will need to discuss with your cosmetic surgeon is the shape of the implants you would like. Implants come in two different shapes:

  • Round – These implants provide a fuller look with more volume in at the upper breast compared to teardrop implants which mean they can enhance the cleavage area. Round implants are filled with saline or silicone.
  • Teardrop – Teardrop implants are shaped like a teardrop with most of the volume being towards the bottom of the implant so the breast slopes downwards. These are also known as “gummy bear” implants and are filled with silicone.

An alternative to implants is breast enlargement through fat transfer injections. During this treatment, fat is removed from the buttocks, thighs or abdomen before being purified and injected into the breasts. Although the results of this procedure are very natural looking breasts, it can only really offer a moderate increase in breast fullness and size so wouldn’t be appropriate if you are expecting a dramatic difference in the size of your breasts. To achieve this the procedure would need to be repeated a number of times.

Your initial consultation

 

The first step in your breast implant journey is to speak to a cosmetic surgeon and discuss your expectations from the procedure. Some cosmetic surgeons will give you a free consultation, whereas others will charge for their time, at Pall Mall Medical, a consultation with a cosmetic surgeon is free. You may want to discuss your procedure with more than one consultant so you can choose which cosmetic surgeon you feel most comfortable with. You will no doubt have your own questions you want to discuss with the surgeon but below are some you might want to include in your list:

  • What qualifications and experience do you have?
  • How many similar procedures have you carried out this month/year and what were the results?
  • Do you have any before and after photographs I can see?
  • Do you have any testimonials from past patients I can see?
  • Are you registered in the UK and do you have a specialist qualification in cosmetic surgery?
  • How many of your patients have had complications during their procedure? What were these complications and how did you deal with them?
  • Where will the incisions be made and what scarring can I expect?
  • What aftercare is available and for how long?

An initial consultation with a cosmetic surgeon is an opportunity for you to discuss your expectations of the procedure. The surgeon will ask about your previous medical history and discuss the potential risks with you. You can also discuss the size and shape of breast implants you would like and what results you can expect from these.

Just before surgery

 

Once you’ve decided which cosmetic surgeon you feel most comfortable having the procedure with, you can then book your surgery date and begin to prepare for your procedure. Your cosmetic surgeon will advise you of exactly what you need to do before surgery but preparation usually includes:

  • Giving up smoking if you are a smoker for at least two weeks before surgery. This is for two reasons:
  1. Nicotine constricts blood flow in the tissue so giving up smoking is particularly important for breast implants and uplifts as restricted blood flow to the nipple or skin flaps, for example, could result in the tissue not healing correctly or even dying. For this reason, nicotine can also delay the healing process and can worsen scarring.
  2. Smoking can also increase the risk of complications with anaesthetic as some of the substances in cigarette smoke cause respiratory problems and can restrict oxygen intake.breast implants
  • Don’t drink any alcohol for at least 24 hours before your operation.
  • If you take any herbal remedies or vitamins speak to your consultant or a nurse. Usually, you will be asked to stop taking these at least a week before your operation as the effect they have on anaesthetic is unknown.
  • Eat well and take gentle exercise in the weeks leading up to your operation. A breast enlargement operation takes at least a couple of weeks to recover from and during this time you’re likely to feel tired and sore. Preparing your body beforehand will give you the best chance possible of recovering well and feeling as well as you can after surgery.
  • You will have to fast for a minimum of six hours before your operation and you will be given instructions on what you can eat and when you can eat it before your surgery.
  • Breast enlargement procedures are generally carried out under general anaesthetic which means just before the procedure you will speak to the anaesthetist who will be with you throughout your procedure. They will ask you your medical history and whether you’ve had any previous problems with anaesthetic.

 

During Surgery

When you are ready for surgery, a nurse or hospital porter will collect you and you will be taken to theatre. Once in theatre, you will be asked to confirm your details before the anaesthetist puts you to sleep by administering anaesthetic via a vein in the back of your hand.

 

A breast enlargement procedure takes around an hour and a half to complete. During the procedure, your surgeon will create incisions under your breast or near your armpit to enable them to insert the implants. Once the implants are in place, your consultant will stitch the cut closed and apply a dressing to the wounds.

 

After surgery

When you wake up from your operation your breasts are likely to feel and look much bigger than you anticipated, this is because of the post-op swelling and is completely normal. Your breasts are likely to feel painful and hard and look bruised as well but again, this is completely normal and these symptoms will subside.

You should be allowed to go home the same day as your operation and before you leave, your surgeon will reiterate their recommended aftercare advice. Your surgeon or a nurse will give you a doctor’s note enabling you to take time off work to recover from the procedure.

It will usually take around six weeks for you to return to your normal activities and during this time you can slowly increase your movement levels but should avoid doing anything too strenuous for at least a month after your procedure.

 

Before you leave the hospital, ask for details of your implants including the style, serial number, batch number and the manufacturer. At Pall Mall Medical, we only use breast implants manufactured by Nagor, a British brand which offers breast implants with a lifetime guarantee that covers you against implant rupture and contracture.

If you’d like to find out more about breast enlargement procedures at Pall Mall Medical or if you’d like to book your free consultation with one of our cosmetic surgeons, contact the team today.

 

Glossary

  • Asymmetry – There is a difference in shape, position and size of the breasts.
  • Augmentation – An operation to increase the size of the breasts by using implants.
  • Implant – The artificial substance used to increase breast size.
  • Mastopexy – A breast uplift procedure where the breast is reshaped to look more firm.
  • Cubic centimetres – How the volume of the liquid inside implants is measured.
  • Implant profiles – The level of projection of the implant from the base of the implant e.g. a breast implant with a higher profile will create a more prominent shape.
  • Round implant – A circular, flat shaped breast implant which provides more fullness at the top of the breast.
  • Teardrop implant – A breast implant which slopes downwards to create a teardrop shape.
  • Saline implants – Saline is a substance made from salt water. Saline implants are put in place and then filled with saline.
  • Silicone implants – Silicone is a thick plastic gel with a similar consistency to human fat.

 

Further Resources

For more information on breast enlargement, uplift and asymmetry correction for surgery for Pall Mall Medical visit our breast enlargement page.

If you are thinking about having your breast implants removed or replaced then find out how Pall Mall Medical can help with our breast implant removal and replacement page.

To find out more about breast cancer risk factors and how to perform a breast examination, read Dr Jenna Burton’s blog Breasts and Their Bobbly Bits.