Breast Augmentation London

Breast augmentation surgery

Breast implants are used to increase breast size using silicone implants. Breast augmentation is suitable for women who have:

• Naturally small breasts since puberty.
• Breasts have become deflated and ‘saggy’ following pregnancy and childbirth, weight loss or with general ageing. A breast uplift may also be needed in some cases to lift up the nipples, remove excess skin and improve breast shape. 
• Breast asymmetry where different sized implants can even up the size.
• Tubular breasts where breasts are narrow, small or uneven and the areolas are quite large.
• Breast reconstruction after cancer surgery.

‍

What type of breast implants are there?

The most commonly used implants in the UK are round textured silicone implants but a variety of breast implants are available worldwide:

‍

Implant contents: the inside of an implant can be filled with either ‘saline’ (i.e. sterile salty water) or ‘silicone gel’ (i.e. thick, clear silicone gel). 

‍

Implant surface: the surface of the silicone shell can either be ‘smooth’ or ‘textured’. Capsular contracture formation (thickening and scar formation around the implant causing pain and breast deformity) is lower in textured implants compared to smooth implants. 

‍

Implant shape: implants can either be ‘round’ and ‘anatomical’ (commonly called a ‘tear drop’ shape).

‍

Base diameters and projection: the width of the implant generally increases as the size and volume of the implant increases. The projection (how much the implant projects from the chest) also varies from low to high.

‍

Round versus anatomical implants: which should I choose?

Very natural results can be produced using either round and anatomical breast implants as long as appropriate sized implants are used for your frame. 

‍

If you choose to have anatomical (teardrop) shape implants, you must bear in mind that there is a risk of ‘rotating’ within the breast pocket. This will lead to a change in the shape of your breast and potentially additional cost to you to reorientate the implant. 

‍

Round implants do not have this risk of rotation and also provide more cleavage in the upper part of the breast compared to the anatomical implants. 

‍

How do I choose the size of my breast implants?

It can be difficult to choose the size of implants you wish to have. During your consultation, you will get a chance to go through the implant options available and try on sample sizer implants with various test bras. To confirm your choice of implant size, we recommend you do a ‘Rice test’ at home. Please see our ‘Rice test leaflet’ for more information.

‍

Does breast implant surgery require an overnight stay?

Breast augmentation surgery usually takes 60 to 90 minutes. It is performed under general anaesthetic and you will be able to go home the same day.

‍

How are breast implants placed in the breast pocket?

During the procedure, a small incision (5 to 6 cm wide) is made in the breast fold. In most women, the scar heals well and is not usually visible. A pocket is then made within the breast for the implant to be placed. Any bleeding is stopped using cautery and the pocket is washed out with an antiseptic solution. The implant is then placed in the created pocket and the wounds are close. There are no drains and all the stitches are absorbable and do not require removal. 

‍

Should I have implants above or below the muscle?

The breast pocket for an implant can be created above the muscle (called ‘sub-glandular’) or under the muscle (called ‘sub-muscular’). The positioning of the implants will depend on how much breast tissue you have and whether the implants will have sufficient overlying breast tissue. Traditionally, the ‘Pinch Test’ is used to decide on the positioning of the implants.

‍

Above the muscle: 

• This pocket is the most commonly used. 
• It is made just under the breast gland and above the pec muscle. 
• If there is a good amount of breast tissue (>2cm thickness when pinching the upper part of your breast over the ribs), the implant can be positioned above the muscle.

‍

Under the muscle: 

• This pocket is less commonly used. 
• It is made just under both the breast gland and the pec muscle. 
• If you are very slim and have less than <2cm of breast tissue with the ‘Pinch Test’, the implant will need to be positioned under the muscle to give more tissue coverage over the implant at the top of breast and give a more natural appearance. 
• Implants under the muscle can be more uncomfortable initially but this subsides with time.
• Prone to developing a ‘Waterfall Deformity’ over time this is where the implants stays high on the chest and the breasts droops and falls off below the implant.

‍

When do I need to change my breast implants?

There is no fixed time when breast implants need to be removed. Some ladies believe they have to exchange their implants at 10 years but this not true. It is only necessary to remove or exchange implants if there are concerns with the breasts. So, the breasts may be swollen, enlarged, deflated, distorted or uncomfortable signifying that the implants are either ruptured or there is capsular contracture. If there is simple implant rupture, the implants will need to be exchanged and if there is capsular contracture, the capsule needs to be removed and new implants placed within the pockets. 

‍

What are the risks of breast implant surgery?

Although breast augmentation surgery is uneventful, you should always give serious considerations to the potential complications that may occur. To minimise the risk of some complications, if you are a smoker, you stop smoking 2-3 months ahead of surgery. Also, ensure other diseases such as diabetes are well controlled, eat a healthy diet and follow the instructions set out by your surgeon.

‍

The risks are listed below and more details can be found in our information leaflet.

‍

Short term risks

• Permanent scarring and poor scarring (with thick, lumpy scars or stretched scars).
• Wound infection.
• Implant infection requiring removal of the implant.
• Blood collection (haematoma) around the implant: requires return to theatre for drainage of the blood.
• Poor wound healing or wound separation.
• Reaction to stitches (stitch abscess).
• Need for further surgery.

‍

Long term risks

• Inability to guarantee a cup size after surgery.
• Altered sensation to breast skin or the nipple.
• Asymmetry of breast shape / size or nipple position / size / shape.
• Need for further surgery.
• Changes to breast shape with ageing with need for further surgery.

‍

Implant associated risks

• Implant infection requiring removal.
• Implant rupture requiring exchange or removal.
• Capsular contracture: thick scar formation around the implant leading to distortion of the breast or discomfort. Surgery to remove the capsule and put in new implants is needed.
• Palpable implant edge or rippling of the implant (especially if you have little of your own breast tissue).
• BIA-ALCL: rare blood cancer (lymphoma) around the implants that requires treatment in the NHS with removal of the implants and surrounding capsule.
• Implant rotation and change of breast shape if you have anatomical implants.
• Breast screening: implants can make visualisation of breast tissue more challenging.

‍

‍What is the recovery after breast implant surgery?

Following the surgery, you will be seen in the dressing clinic at 10 to 12 days to check on your wounds. The sutures are all dissolvable and so there are usually no stitches to remove and no drains. You will need to wear a specialist post-surgery bra day and night for 6 to 8 weeks after the procedure. 

Your return to work depends on your occupation. If you feel able, it should be possible to work from home a few days after surgery. If you are unable to work from home, then we recommend you take 2 weeks off work. You should be able to drive also after 2 weeks as long as you are pain free and able to make an emergency stop. After 6 to 8 weeks, you will be able to return to full, normal activity e.g. high intensity exercise, swimming, lifting heavy weights.  

What is the cost of breast implant surgery?

The surgery cost depends on the type of implants you choose, the procedure you have and the hospital where you have your operation. The cost of breast implant surgery starts from £6000.00 – this package price includes the surgery itself, pre-op tests and dressing clinic and follow-up appointments after surgery. 

‍

View our gallery to view pre- and post- op photos.