Breast Augmentation

Breast augmentation is the most popular cosmetic surgery operation performed and is a relatively straightforward procedure. It is used to increase breast size and improve shape. It may also be used to correct breast asymmetry and milder forms of breast ptosis (where the breasts have dropped after breastfeeding or weight loss).

What materials are breast implants made from?

The vast majority of breast augmentation procedures performed today use silicone implants. Saline implants (filled with a saline water solution are rarely used in the UK). Silicone prostheses are filled with a cohesive silicone gel (like a jelly) which produces the most natural feel and ensures the gel doesn’t leak out if the implant is compromised.

How is the optimal implant selected and sized?

There is a wide range of implant sizes, profiles and shapes available. The exact size best suited to you depends on a number of factors including your initial breast volume, your desired breast size, and your breast dimensions which will be measured during your consultation. Your body weight and chest wall shape are also important factors to be considered to achieve the best results.

During the consultation, after a number of precise measurements of your breast are taken, you will be given a number of different breast sizers to try in a trial bra in front of a mirror, to establish the optimal breast size and shape you want to achieve. You will be advised on the optimal implant volume, shape and profile, or a number of options, to achieve this result.

Which implant shape and profile is likely to be most suited to me?

Round implants are suitable for many patients including those with well-developed breasts, a well-shaped, convex chest wall and a reasonable body weight.

Teardrop-shaped or ‘anatomical’ implants mimic the shape of the natural breast – they are thinner at the top and fuller at the bottom. They are generally more suited to patients with less breast development, a relatively flat chest wall, thin patients, those requiring larger augmentation volumes and those with chest wall asymmetry in order to achieve the most natural result.

You’ll be advised which shape and profile of the implant are most suited to you during your consultation.

What is the difference between submuscular, subglandular and dual-plane placement of breast implants?

Breast implants can be placed either above the chest wall muscle (subglandular), below the muscle (submuscular) or be partially covered by muscle over their upper half (dual-plane). I use the dual-plane technique in the majority of patients as it gives the most natural results, smoothing the upper half of the implant to look natural whilst allowing good projection of the lower part of the breast. It can prove more durable over time, particularly if a patient’s weight changes.

The subglandular technique may be used in some patients with thicker soft tissue depths in the upper chest when the implant can be adequately covered by subcutaneous tissues to produce a natural result.

How is the breast augmentation procedure performed?

Breast augmentation is carried out under a short general anaesthetic either as a day case, or some patients may prefer to stay in hospital overnight. During surgery, a small incision is made in the crease under the breast and a pocket carefully dissected to allow insertion of the breast implant.  The implant is inserted via a Keller funnel to minimise the risks of bacterial contamination and later capsular contracture.

Once the incisions have been closed, drains are placed in some patients to allow any fluid to be removed, and dressings applied.  If drains are used these are kept in place until later in the day or the following morning as required. Post-operatively the implants are strapped with elasticated support strapping for a week to keep them in the correct position.

How long does recovery take after breast augmentation?

Dressings are removed after a week, after which a plain Lycra bra (without wires or padding) is worn to 6 weeks post-op. This should provide neutral support without pressure or uplift so that the implants remain in the correct position in which they were placed during recovery. You will need 7-10 days off work depending on the type of work you do. Most sports and gym exercise will need to be avoided for around 6 weeks.

Does breast augmentation affect breastfeeding and breast screening?

Breast implants do not affect breastfeeding or breast screening. When undergoing breast screening, you should tell the radiologist you’ve had an augmentation as different screening views will need to be carried out.

Which breast implant manufacturers are used?

We use a number of breast implant manufacturers including Nagor, Sebbin, Motiva, Mentor and B-Lite. These implants are all of the highest quality with the maximum durability, the decision on which to use will be discussed with you at consultation based on a number of factors.

How long do breast implants last?

No implants last a lifetime however and they usually need to be changed after 15 to 25 years on average, although this lifespan continues to increase with advances in implant technology.

What is the implant shell made from and how is it textured?

The implant shell is made from silicone also and in most cases is textured to reduce the incidence of capsular contracture, which reduces the lifespan of the implant. Nagor and Mentor implants have a micro-textured surface, which is lightly textured to minimise capsular contracture. Sebbin and Motiva implants have a nano-textured shell with very fine texturing (almost smooth) to minimise the risks of capsular contracture and  ALCL – a rare form of lymphoma associated primarily with heavily textured implants which have now been withdrawn from the market.

Some types of Motiva implants also have a chip embedded with the implant information stored for future use.

Breast augmentation:

Time in theatre: 1-1.5 hours
Anaesthesia: GA
Hospital Stay: Day case or overnight
Dressings: 1 week
Time off work: 7-10 days
Time off exercise: 4-6 weeks

Associated procedures:

Implant Exchange
Breast Reduction
Breast Asymmetry
Tuberous Breasts
Fat Grafting to the Breast

For advice on whether a breast augmentation is the most appropriate procedure for you, book a consultation with Mr Tulley by calling 020 7183 1559 or using the contact form.