Treatments

The following are some common reasons why you may want to consider breast augmentation:

• You believe your breasts are too small for your body.
• You feel self-conscious wearing a swimsuit or form-fitting or low-cut tops.
• Clothes that fit your hips are too large at the bust line.
• Your breasts have become smaller or less firm after you’ve had children.
• Your breasts have become smaller due to weight loss.
• One of your breasts is noticeably smaller than the other.

Causes of small breasts

The size of breasts is genetically determined. Once developed, the breasts may fluctuate in size in response to changes in weight, pregnancy and breast feeding.

The aging process causes the shape of the breast to change so that they gradually droop (called ptosis). This effect is greater following pregnancy, breast feeding and in particular after a large weight loss. Most women have breasts of slightly different sizes, but occasionally a very marked difference may develop.

Breast implants

A breast implant consist of an outer shell and a filling material which is most often silicone gel or sometimes salt water (referred to as saline). Some implants are round and others are shaped more like a natural breast referred to as tear drop or anatomical implants. Either can give excellent results. The manufacturers life expectancy of breast implants is 10 or more years, although implants can stay in without problems for a much longer time.

The following options are available, depending on your medical history, body shape and aesthetic goals.

Saline-filled breast implants are filled with sterile salt water. They may be prefilled at a predetermined size or filled at the time of surgery to allow for minor modifications in implant size.

Silicone-filled breast implants are filled with soft, elastic gel and are available in a variety of shapes. All silicone breast implants are pre-filled and may require a longer incision for implant placement.

Cohesive gel silicone implants, also known as “gummy bear” or “form stable” implants, are filled with a cohesive gel, made of crosslinked molecules of silicone, which makes them a bit thicker and firmer than traditional silicone implants. This enables them to hold their shape better. Approved by the FDA for use in the United States in 2012, these implants have been available in much of the world since 1992.

Autologous fat transfer removes fat through liposuction from an area of your body in which there are abundant fat cells, such as your thighs, abdomen and hips. After a process of preparation and refinement, the fat cells are injected into your breast. This is a less common method than breast implant augmentation and is still undergoing clinical studies and research for safety and effectiveness.

Your plastic surgeon might combine any of these breast augmentation options with a breast lift if there is any sagging or drooping of your breasts.

Your anatomy and health profile as well as your personal preferences will help you and your surgeon determine:

• The best type of surgery for you
• Your optimal breast size
• The type of implant and incision location that will best fill your needs.

Factors that influence the size and type of breast augmentation recommended for you include:

• Your medical history
• Your goals for breast enhancement
• Your existing body frame and mass
• Your existing breast tissue
• Your preferences related to size and incision placement.

The goal of your aesthetic plastic surgeon and staff is to help you achieve the best results and to make your surgical experience as easy, safe and comfortable as possible.

Possible complications

If you are contemplating having breast implants, you should make sure you are aware of the potential risks.

Some of the problems that can occur as a result of having breast implants fitted include:

• Infection or bleeding after surgery
• Scarring
• The shrinkage of scar tissue around the implant (capsular contracture)
• The implant splitting (rupturing)
• The implant becoming creased or folded
• Temporary or permanent changes to nipple sensation
• In some cases, further surgery may be needed to treat problems that develop.

Breast implant surgery is usually carried out under general anesthetic, and takes between 60 and 90 minutes.

During the operation, a cut (incision) will be made in the skin next to the treated breast(s). Your surgeon will discuss with you the location of the incisions beforehand so you’re aware of where the scars will be.

After the incision, the implant is positioned between your breast tissue and chest muscle, or behind your chest muscle. Once the implants are in place, the incision is stitched and covered with a dressing.

You’ll usually be able to go home the same day you have the operation, or you may need to stay in hospital overnight. When you return home, you’ll need to take things easy at first, before gradually returning to most of your normal activities within the next four to six weeks.

You may be worried your breasts look unnatural at first, but this is normal and in most cases temporary. Your breasts will usually start to look and feel better within a few months.

Recovery

You will experience some pain, swelling and bruising immediately after breast implant surgery. Your chest may feel tight and your breathing may be restricted. This is normal and your symptoms will start to improve over the next few weeks.

You will usually rest at the hospital or clinic in a semi-upright position. This will help keep you comfortable and minimize swelling. You will be given painkillers if you need them.

After returning home, you can continue to take over-the-counter painkillers, such as paracetamol or ibuprofen. However, you should not take ibuprofen if you have stomach, kidney or liver problems, or if you’ve had them in the past. If you have asthma, ibuprofen may also be unsuitable for you.

Going home

After having breast implant surgery, you may either be allowed home the same day or you may need to stay in the hospital or clinic overnight. On returning home, you will need rest to give your body time to recover. Avoid excessive use of your arms and chest area as it may cause irritation and bleeding.

After surgery, your breasts may feel hard and you may experience some painful twinges or general discomfort. These symptoms will sometimes persist for a few weeks.

Aftercare advice

To get the best results, follow the aftercare advice of your surgeon. You may be asked to attend some postoperative appointments so your surgeon can monitor your recovery.

Your surgeon will be able to give you specific advice about any activities you need to avoid and for how long, but generally you should take a week or two off work and avoid heavy lifting or strenuous exercise for at least a month. You will usually be able to return to most of your normal activities within six weeks, although you should keep the incision sites out of direct sunlight for about a year because the skin in these areas is more delicate.

Some surgeons also recommend wearing a well-fitting sports bra 24 hours a day for up to three months after breast surgery.

Note your implant details

Make sure you keep a record of the details of your breast implants. You should make a note of the:

• manufacturer
• style
• serial number
• batch number (also known as lot number)

If your surgeon does not provide you with this information, you should ask for it and keep it in a safe place.

When to seek medical help

Contact your GP or the clinic where the operation was carried out as soon as possible if you have any unexpected symptoms or if you experience severe pain. Possible warning signs include:

• severe pain in your breast(s)
• redness of the skin of your breast(s)
• an intense burning sensation in your breast(s)
• unusual, unexpected or excessive swelling in or around your breast(s)
• deflated breast(s)
• a smelly or coloured discharge from your wounds
• a high temperature (fever)
• any lumps or aching causing you concern

Results of surgery

Although most women are pleased with the eventual appearance of their breasts after surgery, the results can vary and depend on your circumstances.

For example, the appearance of your breasts after the operation may be affected by:

• your age
• your overall health
• your ability to heal
• your existing breasts
• the position of your nipples
• your skin texture

After having breast implant surgery, you may be worried your breast implants look unnatural. This is normal, and to begin with your breasts are likely to feel quite taut or rigid. You may also experience changes in the way your breasts feel, with different areas becoming more or less sensitive than they used to be. In most cases, any changes in sensation will be temporary, although they may occasionally be permanent.

Your breasts will usually start to look and feel more natural within a few months of surgery, as the breast tissue, muscle and skin stretches to accommodate the implants. Having realistic expectations and making a considered and informed decision will help ensure you are happy with the results of your operation.

You should expect that the feel and look of your breasts will change as you get older, and implants will not stop your breasts from sagging.