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Beauty Confidence Style & Satisfaction

BREAST AUGMENTATION

This is usually achieved by placing silicone breast implants under the breast tissue to improve fullness and volume. Breast implants come in a range of sizes and shapes, although most women require implants in the range of 200cc to 350cc. The difference between one bra cup size and another is about 125cc. Therefore, breast implants of 250ccs would increase the breast size by two cup sizes (i.e. A cup to C cup, or B cup to D cup). These figures are a rough guide and the actual size of an implant required to increase one cup size is a very individual matter which depends on height, weight and chest circumference. Implants come in a round or anatomical (teardrop) shape and can have different outer surfaces. The implant chosen should follow a thorough discussion between you and your surgeon. Implants are usually placed under the breast tissue but in some circumstances the implant is partly or completely placed under the pectoral muscle of the chest wall and again this decision will be taken following a discussion with your surgeon.

The aim of breast augmentation is to increase the volume of the breast, whilst keeping the end result looking natural. Large implants relative to the size of the patient tend to look unnatural, and run the risk of causing synmastia (loss of cleavage due to breasts joining in midline) which can be difficult to treat. Good results are best achieved by using high quality silicone implants accurately placed, the size, shape and position of which, will have been discussed and agreed before your operation.

Before the operation

Silicone implants give the most natural and realistic feel available. Silicone implants are safe, and there is no evidence that they cause connective-tissue disease, autoimmune diseases or breast cancer. More information on this topic is available at the department of health website - www.doh.gov.uk.

The breast augmentation market is price-sensitive, and in an effort to reduce cost some surgeons and clinics use poorer quality implants, which are more likely to rupture, leak or deteriorate. High quality implants may cost more than other implants, but are probably less likely to cause problems in the future. We only uses implants of the highest quality from leading implant manufacturers.

There is nothing special or complicated to be done by the patient. If you are on the oral contraceptive pill you should continue to keep taking it, and inform the surgeon or anaesthetist in the hospital. If you smoke it would be a good idea to stop for a month before and two weeks after as this will improve wound healing and your post-operative recovery. You should buy a soft sports bra (without wire) about 2 cup sizes larger than your natural breast size and bring it with you to the hospital. In addition, it would be advisable to stop any herbal medicines and avoid aspirin or ibuprofen-like drugs for 2 weeks before the operation.

The surgery

You will come into the hospital on the morning of surgery. The operation is usually performed under general anaesthetic, although it is possible to do the surgery under local anaesthetic with sedation. The procedure takes just over an hour. The implants are inserted under the breast tissue or chest wall muscle through an incision about 4-5cm long in the natural skin fold below the breast. The wounds are closed with dissolving stitches and a light dressing applied. Drains are not usually required.

Post-operative follow-up and after care.

You would normally stay in hospital overnight. You will be discharged the following day with painkillers. It is import to leave the dressing alone and wear the sports bra day and night. At between 5 and 7 days you will be seen in the clinic and the dressing removed and the wound checked. It is important to rest and take it very easy for at least 2 weeks after the operation. You would be advised to take 2 weeks off work and it is essential to avoid all sexual activity during this period. The sports bra needs to be worn day and night for a month to give the best result. Vigorous sport such as jogging or the gym and contact sports should be avoided for at least 8 weeks. A check up clinic appointment at 3 months after the surgery will be arranged for you.

Possible complications

All operations carry a risk of complications as described under “General risks”, although in breast surgery these are fortunately low. There will be a scar under the breast that may be red and lumpy for a few months but this usually settles down by itself. The risk of infection and bleeding are between 1 and 2 % and precautions are taken to avoid this with antibiotics and careful operative technique. Many patients will notice that they have reduced sensation in the nipple. In 90% of patients, sensation returns to normal in a few weeks, but in about 10% of cases the reduction in nipple sensation is permanent. Breast augmentation should not interfere with subsequent breast feeding.

All patients develop scar tissue around the breast implant itself, and this is normal and does not interfere with the outcome. However, approximately 10% of women develop hard scar tissue known as a capsule. This may deform the breast tissue over a number of years and make the implants look less natural than they were. This is corrected by removing the old breast implants along with the capsule and replacing the implants with new ones. There are implants which have been shown in studies to reduce the risk if this occurring and David Mowatt would be pleased to discuss the use of these implants with you.

Many patients often ask how long implants last. There is no definitive answer to this question and it can vary from 10 years to over 25 years. What is certain is that the implants do not last forever and they will probably need to be replaced at some point in a patient's lifetime.

Some patients worry about the effect of implants on breast screening and the risk of breast cancer: There is no evidence to suggest that implants increase the risk of breast cancer and there are in fact studies which suggest that patients with implants have a slightly lower risk of developing breast cancer. If you attend for breast screening you should inform the radiographers that you have implants, as they will have to account for this when positioning you for mammography.

Plastic & Reconstructive Surgery

FACTS AT A GLANCE

SURGERY TIME
1–1.5 hours

HOSPITAL STAY
Day case or 1 night

ANAESTHETIC ASSESSMENT
No

PRE ADMISSION TESTS
Possibly

SLEEPING POSITION
SSleeping on back recommended for 4 weeks.

REASONABLY MOBILE
1 day

WASHING
Shower after 1 day. Bath after 2 weeks.

DRIVING
3 weeks

EXERCISE INCLUDING GYM
8 weeks

SEXUAL ACTIVITY
Restricted activity after 4 weeks

FULL RECOVERY
8 weeks

TIME OFF WORK
2 weeks

BRAS & GARMENTS
Sports bra worn for 8 weeks. Wired bra after 2 months.