Breast augmentation is a popular plastic surgery operation designed to both increase the size
of the breasts and also improve the shape. It’s performed under general anaesthetic
and the majority of patients go home on the same day. During the operation, a small incision
is made underneath the breast in the natural breast fold. The implant is inserted either
above the muscle or just below the muscle. The incisions are closed with dissolving absorbable
sutures and a simple tape is applied to the incision.
There are many different shapes and sizes of breast implants and the breast implant
is matched to your goals for surgery, in other words, what sort of look you’re hoping for
and also your natural anatomy. At the end of the operation, a support bra is used to
support the breasts but there are no other dressings and no drains. The patients often
go home on the day of surgery and I recommend that they take a week off work.
Breast augmentation is a routine procedure and the vast majority of patients come through
without any problems whatsoever. However, there are some complications you need to be
aware of and these include general things such infection or bleeding. These are actually
very rare in breast augmentation surgery occurring in about 1 in a hundred patients, but may be
a reason why you have to return to theatre. There are complications relating to the implant.
The implants we use nowadays are very durable and robust but in a minority of cases, they
may rupture or get scar tissue formation around them that deforms the breast. This is termed
capsular contracture and is one of the more common reasons why patients undergo a revision.
There are some things which are common to all patients. These include having some degree
of nipple numbness of numbness of the skin around the breast. This usually improves over
a period of six weeks to six months. There will also be swelling and this takes several
weeks and months to settle down. Another common issue is that the breast implants
often sit quite high early on and they take some time to settle down into their natural
position. This process is called fluff and drop. In a minority of patients, bleeding
after the procedure may result in swelling in the breast pocket around the implant and
require further operation to remove the blood clot. About 15% of patients who have breast
augmentation surgery will have a revision within 10 to 15 years.
The scar is very small, around 4cm or so and it’s placed directly
in the fold underneath the breast. Overtime,
the scar fades and because of its location becomes very inconspicuous.
Pain is very subjective and it varies from patient to patient. The majority of patients
require regular pain killers for the first four or five days. By day four or five, most
patients are relatively pain free, moving comfortably and not requiring any further
analgesia. The implants often sit high and it takes time
for them to settle into a more natural position. This process takes around six months. I usually
recommend patients take a week off work and it’s four or five weeks before they
can return to strenuous exercise such as lifting weights, running, and swimming.
This is a very common question and an important issue. I tell all my patients that they have
to expect to have another operation at some stage in their life. However, if there are
no issues with the implants and patients are pleased with the shape of their breasts, then
there’s no need for revision or to have the surgery redone. Having said that, about
15 to 20% of patients will have a revision procedure within 10 to 15 years. The most
common reason for this is scar tissue around the implant which can deform the breast shape
and make it hard. This is called capsular contracture. Another but less common reason
is that the implant may rupture and sometimes patients just want a change in the size of
their implant or a further breast reshaping procedure such as a lift.