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Breast Augmentation - Patrick Mallucci, BAAPS & LPSA

Breast Augmentation

Breast augmentation (enlargement) has come a long way since the inception of the first implants in the early 1960s and is now the most popular cosmetic operation in the UK with over 30,000 procedures being carried out each year. The procedure can cost anything between £4000 and £6000 depending on circumstances.

Implants today are highly sophisticated products of advanced research and technology. The modern silicone gel implant is designed to allow for more predictable shaping of the breast, less leakage, reduced hardening and greater longevity. Implants come in two basic shapes – round or anatomical (tear drop) – this gives the patient and surgeon the ability to choose the most appropriate implant for each individual. Silicone remains the material of choice for breast implants and all doubts about its safety have now been laid to rest.

Many women benefit from breast augmentation. Commonly, women fall into 3 main categories: those who have never had any significant breast development; those who have lost breast volume following pregnancy and breast feeding; and those who simply want to be bigger than they are. In each case the key to a successful outcome is good communication between surgeon and patient.
Every woman’s breasts are different in size, shape and dimension each requiring individual planning. Some women will require more than just an implant and occasionally will also need a lift at the same time in order to obtain the best result.

Breast augmentation is carried out under general anaesthetic either as a day case procedure or with an overnight stay in hospital. The implant is inserted into the breast through a small incision, which is placed most commonly under the breast fold, but occasionally can be placed under the areola or via the armpit.

The implant can also be placed in different positions within the breast – it is positioned either on top of the pectoral muscle or underneath it. Broadly speaking, those who are very slim and have small breasts will have the implant placed behind the muscle in order to provide as much ‘cover’ over the implant as possible. Those who already have a reasonably sized breast often have enough cover already for it not to be necessary to place the implant underneath the muscle.

Aftercare

In general women are advised to avoid strenuous upper body activity (swimming, moving weights) for 4-6 weeks with other activities gently being encouraged as pain and discomfort allows.

Aftercare includes advice about bra selection for support, dressings, and advice about scar care. Complications are increasingly rare – infection, bleeding, change in nipple/breast sensitivity, asymmetry, ability to feel the implant edge, longer term risks including hardening (capsular contracture) and rupture are much less common than they used to be. There is no association between implants and breast cancer, whilst breastfeeding for women who have implants is perfectly safe.

Breast augmentation can be a life enhancing procedure when done carefully in appropriate circumstances in those with realistic expectations.

Patrick Mallucci

Patrick is Consultant Plastic Surgeon at London Plastic Surgery Associates (www.lpsa.co.uk)and Member of the British Association of Aesthetic Plastic Surgeons (www.baaps.org.uk)

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