Women tend to choose breast enlargement treatments because they feel their breasts are too small, have dropped or feel ’empty’ – for instance after pregnancy, or due to ageing or weight loss. Breast implants can also be used to correct asymmetry or for reconstruction after breast cancer. Excessive sagging of the breast may require an uplift by removing excess skin, which can be performed at the same time as a breast enlargement. This procedure is called an Augmentation Mastopexy.
An alternative to the use of breast implants is fat grafting, in which fat is taken from one area of the body by liposuction and transferred to the breasts to provide a permanent, implant-free enlargement. However, the amount of breast enlargement that can be achieved in one go is much less than can be achieved with an implant. Fat grafting can be repeated several times for larger size increases and can be combined with breast implants to avoid a wide cleavage gap, or to create very natural-looking results.
When using breast implants for cosmetic cases I exclusively use silicone implants. These have been used for breast augmentation for more than 30 years and have reliable long-term data.
Breast implant size, shape and projection are decided in the clinic through a three-step process.
Firstly, we run through a detailed history of your current and desired breast size, to estimate the approximate volume increase you need.
Next, I will take measurements of your breasts and chest wall, to assess what will best fit your body. Using a 3D simulation, we fine-tune the exact size and shape you most prefer.
Finally, you wear external sizers over your breasts in a bra, to simulate the weight change you can expect and to see how your new breasts would look in your usual clothes. Most patients are very happy with their implant selection after running through this process.
I use a small incision either under the breast or around the nipple, depending on whether you would like a nipple reduction or small nipple lift at the same time. Most of my patients request a natural look, which often entails placing the breast implant beneath the muscle using the “dual plane” technique.
We are fastidious about antimicrobial precautions – not just to avoid infection, but to reduce the chance of capsule formation many years later. Precautions include covering your nipples during surgery, washing the implant cavity with an antibacterial solution, opening the breast implants immediately before they are needed, using fresh gloves to handle them and inserting them through a sterile funnel.
The sutures used to close the wound are placed under the skin and dissolve – you will never see them, so you don’t need to worry about your one-week postoperative check.
Before you decide to undergo any cosmetic surgery always do your research and find a reliable surgeon with a good reputation. Developing a rapport with your surgeon is essential. A consultation usually takes at least half an hour and it should be with the surgeon rather than a nurse or patient coordinator. I like to meet twice before surgery so you can ask all the questions you’ve thought of between meetings. If necessary I would prefer to meet more than twice before surgery than for you to have unanswered questions going into the operation.
After breast enlargement surgery, you will be asked to wear a post-surgical bra to support and protect your breasts and will be given postoperative exercises to start on the day of surgery. In this way, many patients report not needing paracetamol after a few days. You should be able to return to work after one or two weeks depending on the nature of your job.
Reasonably mobile: from Day 1
Surgical bra for 4-6 weeks,
non-underwired bra for 2 months
Hospital stay: 1 night
Washing: Shower after Day 2,
bath after 2 weeks
Full recovery: 4-6 weeks
Surgery time: 1-1.5 hours
Driving: 1-2 weeks
We advise patients to stop smoking 2 week before and after any surgery
Time off work: 1-2 weeks
Exercise: 4-6 weeks