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 cosmetic 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) or over the muscle (=subglandular). Teardrop shaped implants look more natural but can rotate. Rough implants last longer (=less capsular contracture) but have a small cancer risk (BIA–ALCL). Implants under the muscle last longer (=less capsular contracture) and look more natural but surgery takes longer and causes more bruising. Breast implants last 10–15 years in average.
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 don’t use drains routinely. The wounds are repaired with sutures under the skin which don’t 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 Cosmetic, 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), Cosmetic 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, Anaplastic large cell lymphoma (BIA–ALCL), Rippling
Fat transfer: Contour irregularities, Donor morbidity, injury to nearby structures, fat embolism
N.B. Most complications are unlikely and serious risks are rare
Risk factors Smoking / contraception / flights within 6 weeks of surgery, overweight, high blood pressure, bleeding tendency, 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

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