Breast Augmentation

This operation is designed to increase the size of the breasts and also to improve their shape by the insertion of an implant between the breast tissue and chest wall. The procedure achieves increased breast volume and also produces a more natural shape and symmetry. All breast implants rely on some form of silicone shell within which a silicone gel mimics the consistency of the breast. The implants may differ in consistency, size and shape, and are specifically chosen to suit the individual. The implants can be inserted in front of or behind the chest muscle and the pros and cons of each technique will be discussed with you in full detail at your consultation. A variety of incisions may be used, the most common and highest satisfaction incision is beneath the breast. The size of your new breasts will depend on your personal choice to some extent but we do recommend the appropriate size and shaped implants commensurate with your height, build and your body weight. Breast implants vary in consistency and shape. At LCPCS our preference is for the highest quality silicone implants, with manufacturer guarantees. Either round or anatomical (tear drop) implants will be recommended, and this depends upon individual requirements, the shape of the breast and chest wall, and desired outcome.

The Operation
Breast augmentation is performed under general anaesthetic, takes 1-2 hours, and it is usually recommended that you stay in hospital for 1 night. The most commonly used incision leaves a small scar under the breast to which the implant is inserted. You will wake up comfortable with stabilising dressings and, in most circumstances, a drain from each breast. Drains are not mandatory, but the decision not to use them will be made during surgery. Drains are normally removed at 24 hours, but prolonged drainage may require them to be left in place for longer. It is acceptable practice to be discharged with drain in place to be removed later in outpatients. We do recommend that you wear an unwired post – surgical or support bra soon after surgery for comfort. Patients will normally go home on the first day. Getting used to a new shape may be uncomfortable particularly on arm movement, but is not usually painful. Arm and chest stiffness is common, but is easily overcome with gentle exercise. Appropriate medications are prescribed. Antibiotics are given peri-operatively. Early breast swelling is common, but bruising and bleeding are uncommon.

Recovery Period
The sutures dissolve and do not need removing. Stained dressings may be changed as required. Patients may shower normally but should gently towel dry the suture line, and replace wet dressings as necessary. Initial dressings will be water resistant but will not tolerate prolonged submersion. An unwired bra or close fitting ‘crop – top’ is worn for 6 weeks (day and night) and physical activity is restricted for a month until the implants settle in their new position. The best sleep position is on your back to prevent movement of the implants in position. The return to driving, household chores and professional activity is individually driven, but a return to normality takes approximately 6 weeks.

Follow up period
Patients are seen at intervals of one week, six weeks and 3 months, and then annually at their discretion.
Information on breast augmentation and breast implants:
DoH advice document: www.doh.gov.uk/bimplants Independent Review Group document: Silicone Gel Breast Implants: www.silicone-review.gov.uk