Breast augmentation refers to surgical procedures designed to enhance the size and shape of the breast by increasing the volume of the breast either by placing an implant behind the breast tissue or using fat grafting. Sometimes both (implant in combination with fat grafting) can be used to achieve enhancement of the shape and size (composite breast augmentation). 

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Most commonly patients request breast augmentation to improve the appearance of the underdeveloped  breast, breast asymmetry, constricted shape or because they have lost breast volume and shape as a result of hormonal changes associated with pregnancy, aging or weight loss. 

 

Evidence shows that effects of surgery can not only improve the physical appearance, but can also enhance self-esteem and quality of life.

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Consultation will allow assessment and detailed discussion about what is possible taking under consideration personal circumstances and desires. There will be an opportunity to discuss alternatives, long-term implications and risks of surgery. 

 

Breast augmentation is designed to enhance and improve the appearance of one's own breast, but is not designed to completely change one's own natural breast characteristics in order to perfectly match the ideal. 

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The information below will provide basic explanation about what is involved in surgical procedures used for breast augmentation. If you have more questions, please do not hesitate to get in touch. 

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Before arranging a consultation, it is important to think carefully about what one would like to achieve to be able to discuss specific concerns and desires in detail with the surgeon. 

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What to expect from the consultation

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During the consultation, you will be asked about your desired size and anything related to the appearance of the breast that you feel is important to you. This will help the doctor to understand your expectations and determine whether they realistically can be achieved. You will be asked about your medical history, current medications, drug allergies, smoking and history of breast disease including family history. You will also be examined and the doctor will consider factors such as size, shape, nipple position and skin quality. If your breasts are sagging you might consider having an uplift in addition in order to achieve enhancement. You will try implant sizers and you might consider having 3D simulations in order to determine the size you wish to have. Medical photographs might be taken as well. You will receive a letter summarizing the consultation along with surgery fees. Typically, minimum 2 consultations will be required in order to allow time to absorb information and agree on the size prior to surgery. 

Clinical psychology consultation might be suggested in order to better assess your expectations and the degree the problem is affecting you. Joined effort from multidisciplinary team helps to improve the overall outcome of surgery. If you are are over 40 years old, you would be required to have a screening mammogram before surgery. 

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What does the surgery entail

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Silicone breast implants are typically placed behind the breast tissue or in dual plane (behind the muscle) depending on the amount of breast tissue you have and your anatomy. The surgeon will discuss this in detail during the consultation. Incisions will also be discussed. Every effort will be made to ensure the incision is placed so that the resultant scar is as inconspicuous as possible. 

Through the incision, the breast tissue is carefully lifted to create symmetrical pockets under the breast or behind the muscle (the pectoralis major). The surgery usually takes 1-2 hours and sutures used will dissolve. You will need a front-fastening surgical bra which will help to support the breast, reduce the swelling and provide comfort. 

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Recovery takes 4-6 weeks. You will require a nurse appointment a week after surgery and consultant appointment in 4 weeks or earlier if required. 

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Fat grafting to the breast  is a very natural way of achieving enhancement of the breast size and shape whilst at the same time we can sculpt the areas of the body where women typically tend to accumulate fatty tissue. Fatty tissue is obtained via  liposuction typically to the hips and flanks. Fatty tissue is then carefully processed and carefully injected into different planes of the breast tissue in order to allow maximum fat graft survival. It is expected that 50-70% of fat graft will survive at one time. Depending on the desired enhancement required, you might require several stages of fat grafting in order to gradually build up the desired size and shape. 

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Recovery also takes 4-6 weeks. You will require a nurse appointment a week after surgery and consultant appointment in 4 weeks or earlier if required. Scars for liposuction are situated in the groins. They are typically very small (approximately 5-10mm) and stitches will dissolve. You will need a front-fastening surgical bra which will help to support the breast, reduce the swelling and provide comfort. 

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Risks and implications will be discussed in detail during your consultation. 

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Regarding future breast cancer screening, in patients with breast implants special views (Eklund views) are typically required to visualise the breast tissue in front of the implant. If you have any concerns regarding implications of breast augmentation surgery on future breast cancer screening it would be recommended to see a Consultant Breast Surgeon or Clinical Oncology Consultant to discuss this in detail. 

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