Breast Augmentation

I advise patients on whether breast augmentation would be appropriate, the lifetime implications of the surgery, and on the optimal operation and implant choice.

Before coming to see me to discuss surgery patients have found it helpful to look at available information on-line. The BAPRAS website has good information the different types of implants and the different techniques for surgery.

https://www.bapras.org.uk/public/patient-information/surgery-guides/breast-augmentation

The BAAPS website includes information about Breast Implant Associated Anaplastic Large Cell Lymphoma (BIAALCL). There is more information on the government MHRA website. BIAALCL is estimated to affect about 1 in every 7500 women who have breast augmentation.

https://baaps.org.uk/_userfiles/pages/files/biaalcl_information_1.pdf

https://www.gov.uk/guidance/breast-implants-and-anaplastic-large-cell-lymphoma-alcl

The BAAPS website also has information about a condition currently given the title of “Breast Implant Illness”.

https://baaps.org.uk/_userfiles/pages/files/bii_information.pdf

I most commonly use implants manufactured by Mentor. These implants are FDA approved and have a warranty against premature failure. I will discuss with you the pros and cons or smooth or textured implants, and round or anatomical implants. Most patients chose anatomical textured implants between 245 and 325 cc in volume.

If you are coming for a consultation, it can be helpful to bring a sports bra and a tight-fitting top with you. This can help us to work out the best implant for you by allowing you to see the effect of a silicone implant of different volumes.

Needless to say, if you can have a lateral flow test before coming to the hospital for you consultation it would be reassuring and helpful.

Planning breast augmentation surgery

I take a series of measurements from the patient, and match these to the specific dimensions of different implants. This enables me to accurately choose the right implant and the right technique to get a consistent result for each individual patient.
I use external-sizers in the preoperative consultation to allow prospective patients get a clear understanding of the effect of implants of differing volume. I do not hurry this initial consultation and encourage patients to return for a second visit (at no charge) if there are unanswered questions. Prospective patients can review the before and after images of women who have previously had this operation.

The operation

I use the dual-plane technique. At the end of surgery the upper part of the implant sits below the lower fibres of the chest muscle, this helps to make the implant less visible. The operation is under general anaesthetic, and usually lasts between 80 and 100 minutes. I do not routinely use drains. Patients usually stay in hospital for one night.

After-care

Patients wear Micropore™ tape across the infra-mammary crease for the first week after surgery. Most patients are confident to shower and freely mobilize, comfortably lifting their arms above their heads. I ask patients to avoid lifting heavy objects for three weeks after surgery. Most patients will wear a sports-bra continuously for four weeks after surgery. I will give specific individual advice before surgery on when and how quickly to return to sport.


Before Surgery	Marking for surgery anatomical 325 CC implant

First morning after surgery with Micropore™ tape support	One month after surgery

Risks

The most immediate risk is of bleeding requiring a return to the operating theatre. This should happen in less than 3% of patients.
In the days and weeks after surgery there is a risk of infection. Most infections can be treated with antibiotics.
In the medium and long term there is a risk of asymmetry, discomfort, movement of the implant, changes in nipple sensation, and tender or lumpy scarring.
The risk of deep venous thrombosis and pulmonary embolism is minimized by the use of thrombo-embolic stockings, and early mobilization of the patient after surgery (getting out of bed as soon as fit enough to do so with the support of the nurses).
Patients who experience a rapid onset of calf pain, or shortness of breath in the weeks after surgery, need rapid assessment (usually best carried out by a local hospital emergency department) to exclude the possibility of a deep venous thrombosis (a clot in the calf veins) or a pulmonary embolism (a blood clot obstructing a lung blood vessel.
The risk of sepsis after breast augmentation surgery is extremely low, however, any patient who develops a fever and feels unwell in the days and weeks after surgery, should seek urgent medical assessment and advice. This could mean attending the emergency department of a local hospital.

To make an appointment
please call 01223 550 881

Cambridge Plastic Surgery