Any questions about breast augmentation surgery?
Breast augmentation surgery - technically known as augmentation mammaplasty - is a surgical procedure to enhance the size and shape of a woman's breast. You may choose to undergo breast augmentation surgery for a number of reasons:
- To enhance your body contour and enlarge your breast size
- To correct a reduction in breast volume after pregnancy
- To balance a difference in your breast size
- As a reconstructive technique following breast surgery
The following frequently asked questions and answers (FAQs) will give you a basic understanding of the breast augmentation surgery procedure - when it can help, how it is performed, and what results you can expect. These may not answer all of your questions, since a lot depends on your individual circumstances. Your surgeon will be able to help you with any further concerns you have about how the procedure will affect you personally.
What should I consider before having breast augmentation surgery?
Breast augmentation surgery can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
The best candidates for breast augmentation surgery are women who are looking for improvement, not perfection, in the way they look. If you are physically healthy and realistic in your expectations, you may be a good candidate.
What type of implant is used for breast augmentation surgery?
A breast implant is a silicone shell filled with either silicone gel or a salt-water solution known as saline. By inserting an implant behind each breast, surgeons are able to increase a woman's bustline by one or more bra cup sizes.
Other materials have been used to fill breast implants, but as yet none has proven as reliable as silicone or saline. At LPSA we generally prefer to use silicone implants, because of the better shape they provide.
The safety of silicone implants has been extensively investigated over the past decade, and much of the controversy that previously appeared in the media has now been resolved.
You can obtain a free booklet that explains the risks and benefits of silicone breast augmentation by telephoning or writing to:
The Silicone Gel Breast Implants Independent Review Group
Elephant & Castle
London SE1 6TQ
Telephone: 0207 972 8000
How do I plan my breast augmentation surgery?
At your initial consultation, your surgeon will evaluate your chest and general health, and explain which surgical techniques are most appropriate for you. For instance, if your breasts are sagging, your doctor may also recommend a breast lift. Be sure to discuss your expectations frankly with your surgeon. He should be equally frank with you, describing your alternatives and the risks and limitations of each. Be sure to tell your surgeon if you have a family history of breast disease, if you smoke, and if you are taking any medications, vitamins, or other drugs. Your surgeon will also provide explanations about general anaesthesia, the hospital where the surgery will be performed, and the Practice Manager will go over the costs involved. As most insurance companies do not consider breast augmentation surgery to be medically necessary, they do not generally cover the cost of this procedure.
How do I prepare for surgery?
Your surgeon will give you instructions to help you prepare for surgery. These may include guidelines on eating and drinking, not smoking, and taking or avoiding certain vitamins and medications. While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.
Where will my breast augmentation be performed?
The surgery is performed at one of several of London's best private hospitals, according to your preference and the availability of operating time. You will usually be admitted on the day of surgery, and stay overnight. You will need a friend or relative to accompany you home after your stay in the hospital.
What type of anaesthetic will be used?
Breast augmentation at LPSA is usually performed under a general anaesthetic, so you'll sleep through the entire operation.
What takes place during the surgery?
You will need to discuss the pros and cons of the surgery with your surgeon beforehand to make sure you fully understand the implications of the procedure he recommends for you. The method of inserting and positioning your implant will depend on your anatomy and your surgeon's recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola (the darker skin surrounding the nipple), or in the armpit. Every effort will be made to ensure that the incision is placed so resulting scars will be as inconspicuous as possible. Working through the incision, the surgeon will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath your chest wall muscle (the pectoral muscle). The implants are then centred beneath your nipples. Some surgeons believe that putting the implants behind your chest muscle may reduce the potential for capsular contracture. Drainage tubes may be used for several days following the surgery. This placement may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue. Placement behind the muscle may, however, be more uncomfortable for a few days after surgery than placement directly under the breast tissue.
How long will the surgery take?
Breast augmentation surgery usually takes one to two hours to complete. Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to help with healing.
What can I expect after my surgery?
You are likely to feel tired and a little sore for a few days following your surgery, but should be up and about in 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by your doctor. Within several days, the gauze dressings, if you have them, will be removed, and you may be given a surgical bra. You should wear it as directed by your surgeon, who will sometimes place it at the end of the operation to avoid a dressing change. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades. Your stitches will come out in a week to ten days, but the swelling in your breasts may take three to five weeks to disappear.
How long will it take for life to return to normal?
Depending on the level of activity required for your job, you should be able to return to work within a few days. It is best to follow your surgeon's advice on when to begin exercises and normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually three to four weeks after surgery. Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely. If you are in the appropriate age group, routine mammograms should be continued after breast augmentation, although the mammographic technician should use a special technique to assure that you get a reliable reading (please see 'Does breast augmentation carry any risk?').
How will I feel about my new look?
For most women, undergoing breast augmentation is a satisfying, sometimes even exhilarating, experience. Regular examination by your plastic surgeon and routine mammograms (if you are in the appropriate age group) at prescribed intervals will help ensure that any complications, if they occur, can be detected early and treated. Your decision to have breast augmentation is a highly personal one that not everyone will understand. The important thing is how you feel about it. If you have met your goals, then your surgery is a success.
Does breast augmentation carry any risk?
Breast augmentation is relatively straightforward. But, as with any operation, there are risks associated with surgery and specific complications associated with this procedure. While the majority of women do not experience these complications, it is best to discuss each of them with your physician to make sure you understand the risks and consequences of breast augmentation.
- The most common problem is called capsular contracture. This occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant. This problem seems to occur to some degree in one out every ten patients.
- As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.
- A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant may then be inserted.
- Some women report that their nipples become oversensitive, under-sensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear with time, but may be permanent in some patients.
- There is no evidence that breast implants will affect fertility, pregnancy, or your ability to nurse. If, however, you have nursed a baby within the year before augmentation, you may produce milk for a few days after surgery. This may cause some discomfort, but can be treated with medication prescribed by your doctor.
- Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the man-made shell to leak. If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be absorbed - without harm - by the body. If a break occurs in a gel-filled implant, however, one of two things may occur. If the shell breaks but the scar capsule around the implant does not, you may not detect any change. If the scar also breaks or tears, especially following extreme pressure, silicone gel may move into surrounding tissue. The gel may collect in the breast and cause a new scar to form around it, or it may migrate to another area of the body. There may be a change in the shape or firmness of the breast. Both types of breaks may require a second operation and replacement of the leaking implant. In some cases, it may not be possible to remove all of the silicone gel in the breast tissue if a rupture should occur.
While there is no evidence that breast implants cause breast cancer, they may change the way mammography needs to be carried out to detect cancer. When you request a routine mammogram, be sure to go to a radiology centre where technicians are experienced in the special techniques required to get a reliable x-ray of a breast with an implant. Additional views will be required. Ultrasound examinations may be of benefit in some women with implants to detect breast lumps or to evaluate the implant.