Breast Augmentation

Breast enlargement (augmentation) is a frequently performed procedure to correct hypoplasia (underdevelopment of breasts) or ptosis (droopy breasts).

Why do women seek surgery to enlarge their breasts?

Women whose breasts are abnormally small often say that they do not feel feminine and are ashamed of the boyish appearance of their chests. They are unable to wear underclothes or swimwear of their choice and inhibited about going out on beach holidays or swimming. They feel self-conscious while wearing eveningwear or strappy summer clothes. They state that they lack confidence both in the work situation and in their personal relationships and wish to have surgery to correct the problem. Women who have had children and have breast-fed or have lost significant weight are unhappy about the loss of volume and emptiness in the upper part of the breast.

Can I choose the cup size that I want?

It is advisable to discuss with your surgeon what is a reasonable size in terms of your height and body shape and your expectations before you undergo surgery. It is not possible to predict with absolute accuracy the cup size that an individual patient is likely to be after this procedure. Your surgeon will endeavor to give you a result, which is appropriate for your height, and build keeping your preferences in mind.

What does the operation involve?

Breast enlargement is performed under general anaesthetic and may involve one on two nights in hospital. In some patients it may be possible to carry out the procedure as a day case. Most patients have a tube drain inserted into each breast to remove any blood of fluid that may collect around the implant. This tube drain is normally removed within 24 to 48 hours and the patient is allowed home in a supportive soft brassiere.

Following surgery there is some discomfort, which is more than adequately treated by painkillers. The breast can be bruised and swollen and appears larger in the first few days after surgery than the eventual size. In approximately 6 weeks the swelling and bruising settles to a large extent and the final shape of the breast becomes evident.

What is the normal post-operative course?

A small dressing is applied to the suture line in the crease underneath the breast. Most patients are able to shower and change the dressing themselves at home every day. An outpatient appointment is made for removal of sutures approximately 1 week after surgery. A review appointment is usually offered one to three months after the operation.

What level of activity can be carried out in the weeks following the operation?

For the first couple of weeks patients can experience discomfort while lifting weights or stretching the arms above the head. It is advisable to have help around the house and with young children during this period. The majority of patients quite comfortable and are able to return to work two to three weeks after surgery. It is usually possible to return to normal exercise schedules including gym, aerobics and swimming four to six weeks after surgery.

What specific issues should be discussed in the preoperative consultation?

Your surgeon will discuss with you the different shapes and types of implants that are available, whether the implant will be placed above or below the pectoral muscle in the chest and the long-term implications of having a breast implant such as capsule formation, leaks and ruptures, future mammograms, implications for pregnancy and breast-feeding and the possibility of revision surgery in the future.

What are the complications of this procedure?

Breast enlargement surgery can have complications just like any other surgical procedure. These include bleeding, haematoma (blood clot under the skin or in the substance of the breast ), infection, visible scar, asymmetry, loss of sensation in the nipple and long-term problems such as capsule formation, leaks or ruptures.

Very rarely does an implant have to be removed due to a severe infection following surgery. If this happens the breast is allowed to settle and a new implant is put in three to six months after the operation.

What of the guarantees about the lifespan of an implant?

No implant manufacturer guarantees an implant for life but 10 to 15 years is considered a reasonable timeframe for implant survival. Patients are invited to return for an annual review to check the integrity of the implant and for significant capsule formation. If there is a suspicion of a leak or rupture the surgeon may advise you to have an MRI scan or an ultrasound examination to check on the integrity of the implant.