Breast Enlargement

What are implants made of?

There are three main types of breast implant:

  • Silicone implants: consist of a silicone shell (outer wall) filled with silicone gel. The gel in modern silicone implants is thick, so that if the implant is cut or ruptured the gel stays together and does not run or leak everywhere. Silicone implants can be either round or teardrop shaped
  1. Round implants are a good choice if you already have enough breast tissue to give you a good breast shape.
  2. Teardrop shaped implants are a good choice if you have very little breast tissue and you need the implant to shape your breast.
  • A second type of implant is made with a polyurethane coating. These are only used in my practice, in specific instances.
What size implants should I have?

The size of implants you choose is a very personal decision, but there are certain limitations that apply. As a general rule with breast augmentation, the bigger you go the more “unnatural” the appearance of the breast becomes. If you have never had much breast tissue, the skin of the breast is usually a limiting factor and will only stretch to accommodate a modest sized implant before starting to look “enhanced”, whilst if you have lost a lot of breast tissue (after breast feeding or weight loss for example) you may need higher profile implant to restore shape.

I use a combination of techniques to help determine the ideal, shape, size and projection of the implant to enhance your breasts. We will measure your breasts and chest dimensions and also use the latest 3-D imaging “Crisalix” to fine tune the the selection process, so that you can have an idea, what the change in shape of the breasts will look like post-operatively.

Alternatively you may prefer to have a modest sized implant and combine this procedure with a surgical tightening of the skin as a breast uplift, “Mummy makeover”. You and I will decide upon the ideal implant for you together, at the time of the consultation. You should bring with you a sports bra of the size that you aspire to fill.

You will also need this sports bra after the operation to support your new breasts for comfort for the first few weeks after surgery. I would recommend that you buy either a “Marks and Spencer’s” sports bra (Impact factor 3) or a “Triumph” sports bra. The chest girth will need to be the same as the bra that you usually wear, but the cup size will vary according to what you would like to be. For example, if you currently wear a 34A bra but wish to become a C Cup, you should bring a 34 B and C sports bras with you to your initial consultation. I will then undertake measurements of your actual and ideal dimensions.

You will then put on the sports bra and we will insert a range of implants of varying size until you find one that best gives you the figure you want. You can try to do this yourself at home by filling a freezer bag with dried rice until you get the shape and size you desire. The volume of rice in the bag can then be measured using a kitchen measuring jug. If you have asymmetry of your breasts before the operation, in terms of size, shape or nipple position, it is likely to persist to some extent following breast augmentation. I will point this out to you at your initial consultation and discuss it further

How is the operation performed?

Under general anaesthetic a small incision is made in the crease underneath the breast. A pocket is created behind the breast tissue. The implant that has been chosen (round or teardrop) is then inserted into the pocket and the operating table adjusted so that you are sitting upright. This allows me to accurately determine the correct position of the implants and ensures the best shape and symmetry. The incision is then closed in layers of buried dissolvable stitches. The wound is then dressed to gently hold the implant downwards and towards the midline.

Aftercare

General Advice

You should arrange for someone to drive you home from hospital .

You will experience mild to moderate discomfort after your breast augmentation and it is recommended that you take one or two pain relieving tablets (such as Paracetamol) on a regular basis for the first week or so. DO NOT TAKE ASPIRIN OR ANY PRODUCTS CONTAINING ASPIRIN as this may prolong or cause bleeding in the early post operative period.

Your breasts will be swollen and tender and there may be some bruising initially, though this should settle by two weeks. It is important to rest as much as possible for the first three or four days after surgery and limit your arm movement for the first week or so to ensure that the implants settle down and adhere to the surrounding tissue.

I would have advised you to purchase a sports bra beforehand and it is recommended that you wear this regularly throughout the day in order to support you augmented breasts. After six weeks of wearing a sports bra, you may start wearing underwired bras again. You should avoid getting the wounds wet for the first week although you can have a light shower as the dressings are waterproof.

Post surgery meeting

For your surgery, buried dissolvable stitches have been used. These normally dissolve spontaneously in the first four to eight weeks, so there are no sutures to be removed. At one week post operatively you will be seen by the nurse in the Dressing Clinic who will remove the dressing and inspect your wound.

Exercise

It is very important in the early period after your operation that you move around your home as much as possible, setting yourself a daily walking programme and not lying in bed for protracted periods, however, you should abstain from all strenuous exercise from for at least 2-3 weeks. After a good week of rest you may commence gentle arm movements and arm exercises and by one to two weeks post operatively you should be ready to recommence light household duties.By one month post operatively you may recommence light gym work, returning to full normal activities by six weeks.

Returning to work

Following breast augmentation people feel confident to return to driving at various time periods. You should refrain from driving for the first three days. After this you may recommence driving once you feel confident to undertake an emergency stop. Until you feel confident to do this you should refrain from driving.

Smoking

I would have advised that it is important to stop smoking prior to your operation in order to reduce the risks of complications. Following the breast augmentation, the type of job that you do determines when you can return to work.

Returning to work

More physical occupations may require 2 weeks of recuperation before you feel able to return to work. The scar will take time to mature. During those first three weeks the scar will pretty much look after itself.  If you mainly confined to deskwork, you may feel able to return to work after one week.

Skin care

By week three you should commence moisturising and massaging this scar with a good moisturising cream and rubbing quite vigorously, the aim being to soften the scar and speed up final scar maturation. The delicate scar tissue is at greater risk of sunburn if exposed to the sun, therefore, you are advised to avoid sun exposure to any scar tissue for the first six weeks of healing, after this if the area is to be exposed to sunlight you should apply sun protection factor 50 sun block to exposed scar tissue.

Complications

Though most people experience uneventful post operative recovery, if you develop any of the following you should contact the ward on the telephone number printed below:

  • Temperature greater than 38.5°
  • Severe pain not alleviated by simple painkillers
  • Fresh bleeding from the wound, other than a minor ooze
  • Sudden rapid enlargement of one or other breast
Helpful Statistics

General Anaesthetic

Limited mobility: 1 day

Surgical Bra: 4-6 weeks

Hospital stay: 1 night

Washing: 48 hours

Full recovery: 4-6 weeks

Surgery time: 1-1.5 hours

Driving: 1-2 weeks

No smoking 2 weeks before and after any surgery

Off work: 1-2 weeks

Exercise: 4-6 weeks

Patient Journeys

  • I feel completely refreshed and although some people did not see why I wanted to have it done I did and it has made me feel renewed. Well done to Anthony and his team for their support and care. So recommended.

  • I feel so appreciative of my surgery and I would like to highly recommend the expertise of Mr. Armstrong and his professional and caring team.