A breast augmentation procedure or enhancement, also known as a ‘boob job’, is a treatment that surgically alters the size and shape of your breasts. Breast implants come in all shapes and sizes so whether you want a subtle or more noticeable change this procedure could be right for you, providing you have thought about it carefully and consulted with a plastic surgeon.
Only a qualified cosmetic surgeon can determine whether breast augmentation is right for you, but providing you are fit and healthy and have realistic expectations of what can be achieved then surgery can be a great way of giving you more confidence in the way you look.
Women undergo breast enlargement surgery for a number of reasons. If you have any of the following concerns, then you could be a candidate for surgery:
- Naturally small breasts
- Asymmetrical breasts (where one is a different size or shape to the other)
- Reduced firmness and sagging as part of the ageing process
- Drooping or sagging breasts after pregnancy or breast-feeding
- Removal of all or part of your breast following cancer treatment
While breast enlargement can be the right choice for many people, for others it is not suitable. People suffering from certain illnesses or serious psychological issues connected with body image, such as body dysmorphia, are not suitable candidates for surgery. You should also never consider having surgery if you are being pressured into it by someone else. Undergoing surgery, even if it is for cosmetic reasons, is a serious decision that should be carefully thought about.
Teenagers are not usually suitable for breast implants and most cosmetic surgeons would not operate on someone under the age of 18, because their breasts have not finished developing. There are some rare exceptions to this rule but if you are under 18 and desperately want surgery then it is worth consulting with a surgeon and being counselled through your options. In the majority of cases you will get a better result if you wait until your body has finished developing in your twenties. You may also have a different perception of how you want your breasts to look when you are slightly older and rushing into surgery may result in the need for further corrective treatment or removal of the implants.
Heavy smokers are also not ideal candidates for any type of cosmetic or plastic surgery as they are at more risk when undergoing general anaesthetic. If you do smoke, you’ll be asked to stop at least two months before your breast enlargement procedure, as smoking can also delay the healing process. You can learn more here about breast augmentation risks and complications.
For many women, the size and shape of their breasts has a huge impact on the way they view themselves. Having small, saggy or asymmetrical breasts can make you feel self-conscious, unattractive and insecure about your body. Breast enlargement can have enormous benefits. Providing you have thought about it seriously beforehand and are happy with your decision then having the surgery can really boost your self-confidence and self-esteem and give you a better-proportioned figure. It can also open the door to a more varied choice of clothing. If our figure was disproportionate then having implants can add balance, meaning that clothes will fit you better and you will feel more confident in what you wear. Results differ from person to person however, so you need to make sure you have reasonable expectations of what the surgery can do for you.
Although there are many benefits to breast augmentation, there are also a number of risks involved, which should be carefully considered before you make the decision whether or not to go ahead. The risks include infection, capsular contracture, loss of or increased nipple sensation, rippling, displacement and ruptured implants. Infection, scarring and bruising are common side effects of any surgery however there are specific side effects related to having an implant inserted in to your breast as your body can see it as a foreign object and react to it. The risks of these complications occurring can be minimized by carefully picking your surgeon, following the post-surgery recovery instructions and the type of implant you choose.
Swelling is very common following any breast augmentation surgery. The combination of increased volume from the breast implant and swelling from surgery may cause your breasts to feel large, heavy, and tight. The swelling can also extend downward into the abdominal area. The swelling in your breasts can take three to five weeks to go completely and wearing your recommended supportive surgical garments will help.
Bruising is fairly common after any surgery although not everyone will experience it. The amount of bruising you get will depend on how the implant is placed, its size and shape and the individual patient. While bruising is usually very minimal, if you have any large, firm, painful areas of bruising, contact your surgeon immediately as there is the possibility of developing a hematoma, which is a more serious type of bruise that will need treatment. However normal bruising should subside in one to two weeks.
Infection can occur with any type of surgery. It usually happens within one to six weeks of surgery. In the majority of cases an infection can just be treated with antibiotics, however in some cases the implant may need to be removed. Symptoms of infection include fever as well as severe tenderness, redness, and swelling. To avoid getting an infection, make sure you keep the area around your stitches clean and avoid putting creams or deodorants near it. You should also not submerge yourself in a bath or swimming pool during the recovery period.
Capsular contracture is a hardening of the tissue around the implant, caused by a natural reaction to a ‘foreign body’. A layer of scar tissue forms around the implant as it heals. When the scar tissue contracts it creates pressure on the implant, which can cause pain, hardening of the breast, and distortion of the breast shape. This usually only happens within the first few months after surgery although it can occur at any point after surgery. Recent advances in implant technology, such as the development of textured implants, have minimized the risk of this happening.
Nipple sensation can be affected by surgery. Increased sensitivity or numbness/loss of sensation in the nipples can be a permanent side effect, particularly in surgery where the nipple is removed and replaced. It is important to remember that this is very common as a temporary side effect however and, in most cases, the sensation in your nipples will return to normal after a couple of weeks or months. Your breasts will return to being as sensitive as they were previously. It is estimated that one in seven women experience loss of or a lessening in nipple sensation after breast enhancement but this is only permanent in a small percentage of cases.
Rippling occurs when the filling of the implant moves and causes a bump or ridge to appear in the outer shell. Rippling is most common with saline implants and is not common with smooth-surfaced implants, silicone gel implants, and implants that are placed beneath the chest muscle. Additional surgery would be needed to correct this problem.
Displacement occurs when the implant moves from the place it was inserted. This is extremely rare and will usually only happen within a couple of days of surgery. It can be corrected with additional surgery.
In rare cases implants can also rupture or leak. This happens when the outer shell of the implant tears and can happen with both saline and silicone implants. If a saline implant is ruptured or leaks your breast will deflate within a day or two. In most cases the implants can be replaced and there is no evidence to show the leaked solution causes any harm. If a silicone implant leaks, which is even more rare, you may not notice as the silicone gel is very thick and can still remain inside the implant. Although scientific studies have shown there is no link between silicone implant leaks and cancer or autoimmune diseases the fact that the leak happens so slowly means it will not be easily detected like it would with a saline implant.
There is also always a risk associated with undergoing general anesthetic. You can experience side effects from anesthesia, such as a sore throat, headache, dizziness, nausea, vomiting, shivering, or muscle pain but these are usually temporary. It is very important that you let your surgeon know if you have experienced any reactions to anesthesia in the past.
Scarring will occur with any kind of surgery. The locations of your scars will depend on the technique used by your surgeon. Your scars will be firm and pink for approximately six weeks and will fade over the next few months but never disappear completely. Various topical medications are available to help minimize the appearance of scars.
Serious side effects and complications with breast augmentation are very unusual, however it is important to remember that if you do suffer complications you may require additional surgery to repair damage or remove the implants and could be left with scarring.
Some people are concerned about the link between breast implants and cancer. There is no evidence to show that this is the case, however there is a possibility they could interfere with cancer detection during routine mammograms. If you are going for a mammogram it is very important to tell your doctor and the screening technician that you have had breast augmentation. This will not only insure that they avoid placing excessive pressure on the implants but will enable them to get a more accurate reading by taking the fact you have implants in to account.
Before making the decision to undergo breast augmentation, you should find out as much information as possible about the procedure, the surgeon and hospital you are being treated at.
Always discuss the procedure with your clinic or hospital first and then go away and think about it before making your decision. You should also have a consultation of at least an hour with your surgeon before going ahead. Do not be afraid to ask any questions and make sure all of your concerns are addressed before you sign on the dotted line. The most important thing is to make an informed decision that you feel confident about. During your consultation your surgeon should take a thorough medical history and give you a consent form to sign to make sure you fully understand the possible risks and complications. It is very important that you read this form carefully.
Preparing for breast augmentation surgery:
- Avoid taking aspirin or anti-inflammatory drugs for a period of 10 days before your surgery, because they cause the blood to thin and make surgery more dangerous.
- Give up smoking at least two months before the procedure, as it increases the risks and can delay the healing process.
- On the day of your breast augmentation surgery, you should wear loose-fitting clothes that can be removed and replaced easily.
You should also consider when, and if, you want to have children. If you are considering trying for children in the near future, it is advisable to wait before having surgery. Breast augmentation should not interfere with breast-feeding, but there is a risk of breast implant revision if you get pregnant after having implants. Pregnancy and breast-feeding can dramatically change the size and shape of your breasts so it may have an impact on the look of your implants.
During breast enlargement surgery, you will be put under general anesthetic while the surgeon makes the incisions and inserts the implants. The type and size or your implants and where the scars will be placed will have been discussed at your consultation. In some cases, you can have the operation done while you are awake, using a combination of a local anaesthetic and sedative.
Incisions are most commonly made under the breast using a technique called inframammary incision, so that the scars can be hidden in the natural skin fold beneath the breast. Implants can also be inserted through the nipple, known as periareolar incision, which creates a tiny scar around the edge of the pigmented area surrounding the nipple. In the case of saline implants, they can also be inserted through the armpit, known as transaxillary incision or belly button, known as the TUBA technique, although this technique is not commonly used in the UK.
The implants can either be placed under the muscle, known as submuscular, or on top of the muscle just behind the breast tissue, known as subglandular. Benefits of submuscular placement may include decreased risk of capsular contracture and less interference with mammography. However, breast implant surgery with subglandular placement can take less recovery time and may involve a lesser amount of post-operative pain.
The operation usually takes between one and two hours but can be as little as 40 minutes. Nowadays breast augmentation does not usually involve an overnight stay in hospital so you will be able to go home the same day.
After breast augmentation surgery, you will most likely be drowsy and sore for a day or two so it is a good idea to have a friend or relative drive you home and help you for a couple of days until you feel a bit better. Although you should be up and around after about 48 hours, there may be some side effects which can last for a couple weeks to a month so you should follow your surgeon’s instructions closely during this healing period.
You can be quite swollen and bruised after surgery and your implants may seem too big or hard, but this is normal. Your breasts may also be quite sensitive and tender for a few weeks.
You will usually be sent home with bandages and a surgical bra, which will be removed after a couple of days. If you haven’t had absorbable sutures, then your stitches will also need to be removed after seven to 10 days. You will then need to wear a sports/support bra and refrain from exercise or any other strenuous activity for at least four weeks but should be able to return to work after a week, but for some people it may be longer. Don’t attempt to rush your recovery however as it may have the reverse effect and prolong things. If you need to take more time off work, do it.
Your scars will look quite pink and raised in the weeks following surgery but should fade. The position of your scars will depend on how the implant was inserted. They will never disappear completely however a skilled surgeon will be able to hide them well so they will not be noticeable. To make sure your scars heal as well as possible, make sure you stick religiously to the recovery instructions given to you by your surgeon.
It will take up to a couple of months for your implants to settle down so you need to be prepared for them to feel a little odd for a while. You will not really be able to judge the final result until then but if you have any concerns about the look and feel of your implants, discuss this with your surgeon.
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