Breast enlargement

Breast enlargement or augmentation ss one of the most popular aesthetic procedures. Enlargement of the breasts can be achieved, either with implants, which is the most popular method or by fat transfer, which is a newer technique. Many women are psychologically troubled by breast asymmetry or breast underdevelopment, which breast enlargement surgery can help to correct.

Breast implants have been in use since the 1960s. During this time they have undergone many modifications to improve their longevity, aesthetic characteristics and to reduce the associated risks of surgery. Breast implants are not actually put into breasts. They are either put underneath the breast or underneath the breast and chest muscle. I use both techniques. The technique I use for an individual patient depends on their anatomy. I tend to recommend placing implants underneath the chest muscle if a patient is very slim, such that the implants may otherwise be visible. For the majority of patients I recommend placing implants on top of the muscle to avoid any risk of distortion of the breast that can occur with muscle contraction when the implant is underneath the muscle. I use an incision in the “inframammary fold” which is the crease underneath the breast as this conceals the scar. Other incisions are possible but are rarely indicated.

Surgery is generally undertaken as a day case under general anaesthetic and takes up to an hour. I use dissolving stitches under the skin. I recommend you wear a supportive bra for six weeks after surgery. This can either be a sports bra or you can purchase a special surgical bra from Macom using my surname Baker for a 15% a discount code.

You should expect some discomfort after surgery, particularly if the implants are under the muscle. Pain tends to ease towards the end of the first week. It's important not to lie on your front for up to three months. Avoid excessive motion of the arms, including using the gym, for six weeks after surgery. If the implants are placed underneath the muscle they often move upwards before sinking back down into a better position over the coming weeks.

Most people have asymmetrical bodies, including their chests. This asymmetry may affect the shape of the rib cage, position of chest muscles and breast size and shape. Implants can correct volume asymmetry and shape asymmetry to some degree, but they cannot correct asymmetry of the chest wall, for example. Therefore, there may be persisting asymmetry after surgery. You may also find that overtime the size and shape of the breasts change. Our tissues become less resistant to gravity as we get older so the implants or breast tissue will sag with ageing. Pregnancy and weight gain also dramatically affect the size and shape of the breasts to such an extent that you may want further surgery in the future.

The risks of breast implant surgery are: bleeding, infection (if an implant becomes infected, it may well have to be removed before replacement at a minimum of six weeks later with asymmetry of the chest during this time); fluid collection (seroma); problems with healing, change in sensation of the nipples; pain around the chest that usually subsides but may be permanent; changes in the shape of the breasts overtime; movement of the implants; unsatisfactory aesthetic result (sometimes necessitating revision surgery); capsular contracture, which means hardening of the scar tissue around the implants which can affect current up to 1:5 patients with smooth implants and occasionally requires further surgery); rupture of the implants necessitating replacement and lastly blood clots in the legs (this risk is minimised by avoiding ny hormonal treatments such as contraceptives or hormone replacement therapy for 4 weeks before and after surgery).

There are two further risks that require special mention. Firstly, “breast implant associated illness” (BIAI) which is a constellation of symptoms such as brain fog, fatigue, joint pains and hair loss that some women believe are cause by their breast implants. This condition is under scientific investigation. Currently there is no biological proof that these symptoms are caused by implants.

The second condition you should be aware of is “Breast implant associated anaplastic large cell lymphoma” (BIA-ALCL) which is a very rare tumour that can occur in the capsule (scar tissue) that normally forms around breast implants. It doesn’t occur in patients who have had exclusively smooth implants which is why I offer these implants to my patients. In the Mentor textured implants the risk is 1:30,000 patients.

Despite this list of possible complications, you should remember that millions of women have breast implants every year and that the vast majority have no complications and are very happy with their outcomes.

Fat transfer breast enlargement involves liposuctioning fat from the inner thighs or tummy, for example, and injecting it into the breasts. The advantage of this is that it avoids putting implants into the body. Because not all of the fat survives the injection process, it often requires more than one procedure to achieve the desired volumes and symmetry. However, it is becoming more popular and I would be very happy to discuss it with you if you’re interested.