Breast augmentation is more commonly known as breast enlargement. This procedure is one of the most commonly performed plastic surgical operations worldwide. The most common technique for breast augmentation involves the use of breast implants.
Breast Enlargement Using Breast Implants
Alternative methods of breast enlargement also include fat transfer or lipomodelling. The aim of this surgery is provide volume to the breast. Some patients may also require an uplift of the breast and this may require a mastopexy or breast lift procedure.
Frequently Asked Questions
A breast augmentation is performed under a general anaesthetic and is usually performed as a day case although occasionally an overnight stay maybe required. The operation involves placing an incision in the natural crease underneath the breast. A pocket is then created for the breast implant. This pocket may be underneath the breast tissue (subglandular) or beneath the pectoralis muscle (submuscular). The dual plane technique involves placing the implant partly under the muscle and under the glandular tissues. The decision on where the breast implant is placed is dependent on your breast characteristics and will discussed during your consultation with Mr Nassab. Once the breast implant is placed in the pocket the incision is then closed with sutures and dressings applied.
Breast implants can be classified according to their shape, composition or coating. The shape of the breast implant may be either round or anatomical, commonly referred to as teardrop. The round implants tend to produce a fuller cleavage and upper pole of the breast. The anatomical implants produce a more subtle result.
In the UK, most breast implants are filled with silicone whilst in the US some surgeons use saline filled implants. The silicone gel is termed as cohesive meaning that it retains its shape even when cut.
Breast implants can also have differing coatings that are either smooth, textured or polyurethane.
Breast augmentation surgery has been performed for many decades and there have been numerous studies looking at the safety of silicone breast implants. These studies, which comprise of several thousands of women, have not shown any links with diseases such as autoimmune disorders, connective tissue diseases or cancers. There has been much news recently regarding PIP breast implants, which were made of industrial grade silicone rather than medical grade silicone. Mr Nassab has never used PIP implants in his practice.
There is currently no evidence that breast implants cause an increased risk of breast cancer.
Breast augmentation like any surgery may result in potential complications although these are uncommon. The main complications following breast augmentation include:
Bleeding and haematoma formation
A haematoma is a collection of blood that may form in the pocket of the implant and this may require surgery to wash the pocket and stop any bleeding.
The risk of infection is rare. You will normally be given some antibiotics during the procedure to reduce this risk further. Most infections occur soon after surgery although they may happen many years after the initial surgery as well. If the infection is severe then the breast implant may need to be removed. The cavity is then washed and closed. Usually we would then need to wait a number of weeks to months before replacing the implant.
There will be a scar from the incision to insert the breast implant. The scar is most often place in the crease beneath the breast. Scars can sometimes become raised or lumpy and this is referred to as a hypertrophic or keloid scar. This may need further treatment in the form of silicone dressings or creams and possibly a course of steroid injections.
Change in Nipple Sensation
Most women will notice an alteration in the sensation to the nipple following breast augmentation. Most often there is reduced sensation although some women may notice increased sensitivity after breast enlargement. This is often temporary although some permanent changes may occur.
All breasts have some degree of asymmetry and even after breast augmentation there may be some minor degree of asymmetry. There are occasions when minor asymmetries preoperatively may be exaggerated postoperatively. There main also be differences in terms of nipple position after breast enlargement.
The main long term complication with breast implants is the formation of a capsular contracture. When an implant is placed into the breast the body forms a thin capsule around it. In some women this capsule can become thickened and cause discomfort and distortion of the breast. This may require further surgery and the risk of it recurring is high if you have already had a capsular contracture.
Changes with Time
When you age or have children, there will be changes in your breast shape and volume. Generally, the skin loses its elasticity and thins resulting in drooping of the breast, known as breast ptosis. This may require an uplift procedure or mastopexy to correct. Thinning of the skin and tissues covering the breast implant may result in the implant becoming palpable, show signs of rippling or wrinkling.
The majority of women are able to breast feed after breast augmentation. It has also been shown that the breast milk in women with breast implants does not contain any significant amounts of silicone. In fact, silicone is commonly used in baby products such as bottle teats and soothers.
I would recommend waiting for 6 weeks before flying long haul. This is to ensure that everything has settled and there are likely to be no problems prior to flying. You may be able to travel short haul after 2 weeks but you will still need to wear your support bra for 6 weeks following surgery.
The normal recommendation is 6 weeks for strenuous physical activity. Exercising earlier may cause increases in blood pressure and heart rate that may increase the risk of bleeding. Patients that have the implants under the muscle will also find that they will have more discomfort initially.
Patients are advised to wear a support bra for the first 6 weeks following breast implant surgery. The support bra should ideally have a zip at the front for easier changing. After the 6 weeks, you should be able to wear normal under-wired bras again.
Almost all patients will have their scar in the breast crease just underneath the breast. A small number of patients may have the scar around the areolar. I do not perform breast augmentation using an armpit or axillary incision.
I use the highest quality Mentor breast implants that are owned by Johnson and Johnson. These are breast implants with a high safety track record that have been on the market for over two decades. They are one of the only brands with long term published clinical results.
I have never used PIP implants in any of my patients. I see many patients that have had PIP implants previously that I have removed or replaced. I believe in only using the highest quality implants with long term safety data.
ALCL stands for Anaplastic Large Cell Lymphoma. This is a very rare form of cancer that can develop around the implants. The relationship with breast implants is not fully understood yet although a various factors have been reported. It is thought to occur in about 1 in 300000 breast implants. Patients that have had implants for several years that develop sudden onset swelling should be investigated to exclude this.
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This patient desired breast augmentation to increase breast size and restore volume.
This is the result shown at 6 weeks following augmentation with 250cc High Profile Dual Plane (Under the Muscle).
I can't thank my surgeon Dr Reza Sedghi Nassab, he's been fantastic, answered all my questions, made me feel at ease & felt in safe hands. He's a very good surgeon with a lovely bedside manner.DMBreast Augmentation
Such a professional service was offered, with care and patience and I was very reassured during the whole process. I would highly recommend Reza Nassab as a Plastic Surgeon.AFBlepharoplasty
Reza Nassab is a great surgeon. From our very first meeting to the last 6 week check he has been professional, friendly and helpful. So happy i went with him for my operation.RGBreast Augmentation
I can not thank reza nassab for the amazing work he has done on my tummy tuck,he has given me my smile and confidence back which I haven't had for years.LBTummy Tuck