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Breast augmentation is a surgical procedure involving the insertion of implants into a woman’s breasts. There are many types of implants available, including silicone and saline implants. Amongst other criteria, implants are selected according to the desired size and shape of the breasts following surgery.

A woman’s decision to have breast implants is an entirely personal one. Each woman will have her own preferences regarding breast size and shape when considering breast augmentation surgery. It is important to discuss your expectations fully with your cosmetic surgeon, in order to achieve a successful outcome.

Is breast augmentation right for you?
    There are many reasons why women choose to undergo breast augmentation surgery. Predominantly, women choose breast augmentation surgery in order to increase the size and improve the shape of their breasts. A woman may feel that her breast size is too small, or that the shape and fullness of her breasts has changed following childbirth or weight loss. In some cases, a woman will choose surgery to improve the symmetry of her breasts, or as a reconstructive procedure following a mastectomy, trauma, or where there is a congenital abnormality.

     For any woman considering breast augmentation, it is important to have realistic expectations about the results of breast augmentation surgery. Breast augmentation is suitable for those seeking enhancement, rather than perfection, in the size and shape of their breasts.

     Breast augmentation surgery is recommended for women with fully developed breasts, usually 18 years or older.

How is breast augmentation surgery performed?
    Your cosmetic surgeon (plastic surgeon) will determine the most advisable method for insertion of implants during your initial consultation.

     Generally, implants are inserted through an incision in the crease where the breast meets the chest, around the areola (the dark skin around the nipple), through the armpit, or via the navel.

     After the incision is made, the cosmetic surgeon will separate the breast tissue from the skin to create a pocket, either directly behind the breast tissue (sub-mammary or sub-glandular placement) or between the pectoral muscle and chest wall (sub-muscular placement). After positioning the implant, the incision is closed with stitches.

Types of implants
Breast implants consist of a silicone rubber shell, filled with either saline (salt water solution) or silicone. Implants are available in a range of sizes, shapes and textures. Your cosmetic surgeon will determine the most suitable implant, taking into account your expectations, current lifestyle and other surgical considerations.

How long does the surgery take?
Breast augmentation surgery usually takes between 1 to 2 hours and is performed under general anesthesia.

How long will it take to recover?
    It is common for patients to experience some pain and discomfort in the first 1 to 2 days after surgery. These symptoms can be alleviated by medication prescribed by your cosmetic surgeon. Stitches are usually removed 7 to 10 days after surgery. It is common to experience a burning sensation in the nipples- this usually subsides within 2 weeks after surgery.

     Your surgeon may recommend the use of a surgical bra to provide support for the breasts and assist in the recovery process.

     Swelling usually subsides 3 to 5 weeks after surgery.

     Most patients can expect to return to work within a few days after surgery. Your cosmetic surgeon will advise you when more rigorous activities, such as exercise, can be resumed.

What are the risks involved?...
All surgery carries some degree of risk, including the risk of excessive bleeding and infection. There are, however, a number of complications relating to breast augmentation surgery that you should be aware of:

A complication known as ‘Capsular contracture’ can sometimes occur. It is caused when the tissue around the implant begins to contract or tighten. Capsular contracture may require surgery to alter or remove some of the tissue surrounding the implant. In some cases, removal of the implant is required.
Changes to the sensitivity of the nipples can occur following breast augmentation surgery. Nipples can become more sensitive, less sensitive, or may even become numb. Whilst these symptoms usually improve over time, in some cases they may be permanent.
Breast implants do not usually affect a woman’s ability to breastfeed or become pregnant. However, hormonal changes to breast shape and size during and after pregnancy can alter the appearance of breasts with implants.
Rupture or leakage of the implants can sometimes occur. In the case of saline implants, deflation of the implant will be noticeable within a few hours. The salt water expelled from the implant will be gradually absorbed within the body over several hours or days. Silicone implants do not usually deflate and leakage can be hard to detect. The silicone gel may remain inside the implant shell, or may escape into the surrounding breast tissue. Women with silicone implants are advised to have their implants checked annually in order to detect any problems. A detailed screening of silicone implants is recommended every 3 years.
Mammograms may become more difficult to perform after breast augmentation. Additional ultrasound or MRI examinations may be required to ensure reliable results are obtained.
Both silicone and saline breast implants are not guaranteed to last a lifetime, and often need to be replaced or removed at some time in the future.

Your cosmetic surgeon will discuss these risks with you in full prior to surgery. In addition, you should ask to read the leaflet that accompanies the breast implants when ordered from the manufacturer. It will provide detail in relation to the features of the implants, as well as any associated risks.

Continuing care
The majority of women are deeply satisfied with their new shape following breast augmentation surgery.

However, it is important to remember to continue regular checking of your breasts for any unusual changes and schedule regular mammograms if you are in the appropriate age group. You should be sure to advise your doctor and mammographic technician that you have breast implants, so they can use appropriate screening techniques.