| BBA | Breast Augmentation Surgery |
|---|---|
| Procedure | Breasts enlargement (=breast augmentation / "boob job" / "breast aug" / breast implants / augmentation mammoplasty / augmentation mammaplasty) can be achieved with silicone implants or own body fat. Women over 50 or women with a strong family history of breast cancer should have a breast cancer screen prior to aesthetic surgery. MTF transgender patients will require a psychiatric referral letter and a second supporting letter by a psychiatrist according to RCS guidelines. Breast implants come in different volumes and projections (=profiles), can be round or teardrop-shaped (=anatomical / contoured), have a rough (=textured) or smooth surface and can be placed under the muscle (=dual plane / submuscular / subpectoral) or over the muscle (=subglandular / subfacial). Teardrop shaped implants look more natural but can rotate. Rough and smooth implants have a small cancer risk (BIA-ALCL, BIA-SCC). In rough implants this risk is higher, but they last longer with less capsular contracture, a more stable position and less "bottoming out". Implants under the muscle develop less capsular contracture and look more natural shortly after surgery, can but can result in a wider cleavage, a "breast animation deformity" or a "waterfall deformity" over time. Implants over the muscle can make the breasts droopier and be more visible under the skin. Breast implants last 10-15 years in average. To find the desired size, implant sizers can be used in clinic and the rice test can be used at home (= fill the mid-portions of old tights with a measured volume of rice, tie the ends, and conform these to the breasts in a bra – adjust volume as per preference). For enlargements less than 200ml, fat can be transferred from the abdomen, thighs or flanks into the breasts with a process similar to liposuction through tiny holes. Some of the fat can disappear within 4 months. The remaining fat will stay. I do not use drains routinely. The wounds are repaired with sutures under the skin which do not require removal and dissolve within four months. A support garment following surgery is recommended. |
| Scars | 5cm in new breast fold for implants. 5mm cuts for fat transfer |
| Operation time | 1.5 hours |
| Anaesthesia | General |
| Hospital Stay | Day Surgery > (Overnight) |
| Benefits | Aesthetic, Psychological |
| Risks | Bleeding, Infection, Scar problems (stretched, thick, abnormal pigmentation, red, retracted etc.), Skin discoloration, Wound separation, Necrosis, Slough, Pain, Numbness, Bruising, Swelling, Overcorrection, Undercorrection, Asymmetry, Droopiness (short or long term), Aesthetic imperfections (Higher risk after subsequent pregnancies / weight changes / menopause), Seroma, Shoulder problems, Pneumothorax, Lung injury, Skin penetration, Need for further surgery (including implant removal), Allergic reaction, Chest infection, Heart attack, Stroke, Blood clots in legs & lungs. Implants: Capsular contracture, Implant rupture / Leak (silicone granuloma / lymphadenitis), Implant extrusion, Implant displacement / rotation, Rippling, Waterfall deformity, Breast animation deformity, Bottoming out, Wide cleavage, Misplacement etc. In most patients, breast implants do not cause medical disease but there is a small risk of developing cancer (e.g. BIA-ALCL or BIA-SCC) and other not yet known diseases in future. Fat transfer: Contour irregularities, Donor morbidity, injury to nearby structures, fat embolism. N.B. Most complications are unlikely. Serious risks or death are rare |
| Risk factors | Smoking / contraception / flights within 6 weeks of surgery, overweight, high blood pressure, bleeding tendency (Stop herbal products or supplements for two weeks before surgery), diabetes |
| Optimising factors | Diet rich in Vitamin C and protein, plenty of fluids, fresh air, scar massage, sun protection, support garments, breast band and breast massage (only if advised by me) |
| Discomfort | 1 - 2 weeks |
| Bruising | 2 - 3 weeks |
| Recovery | Light activities 2 weeks, Driving 3 weeks, Physical work / sports / sex 6 weeks, Unrestricted 3 months |
| Acceptable appearance | 2 - 4 weeks for most patients (This is subjective) |
| Final result | 6 - 18 months |
| Alternatives | No Surgery, Bra enhancers |
Anstey Hall
Maris Lane
Cambridge
CB2 9LN
