Breast Implant Surgery
Breast implants or augmentation can be achieved using silicone breast implants. Our breast implant surgery in Glasgow is chosen by women who desire larger breasts, who wish to correct a size discrepancy between the breasts, or to replace breast tissue lost after pregnancy. In some cases, implants can also be used after a mastectomy to restore the breast.
Elanic is one of the largest Breast Augmentation practices in the Country. To see a range of before and after pictures click here.
What is breast augmentation?
Breast Augmentation is an operation to increase the size of your breasts. The most common way to do this is by using silicone breast implants, however, the new technique of fat transfer can lead to increase in breast size without the need for implants
Your surgeon will assess you and let you know if a breast augmentation is suitable for you.
However, it is your decision to go ahead with the operation or not. This document will give you information about the benefits and risks to help you make an informed decision.
If you have any questions that this document does not answer, you should ask your surgeon or any member of the healthcare team.
Is a breast augmentation suitable for me?
You are most likely to benefit from a breast augmentation if one or more of the following conditions apply to you.
You are self-conscious about the size of your breasts
Your breasts have become smaller and less shapely because of pregnancy or from losing a lot of weight.
You have one breast noticeably smaller than the other (breast asymmetry)
Your surgeon will carry out a detailed assessment before deciding if surgery is suitable for you.
This may include taking photos for your medical records. They will examine your breasts and ask you questions about your medical history.
Your surgeon will also ask you if you are planning to lose a lot of weight. It may be better to lose the weight first before having surgery.
You should let your surgeon know if you are pregnant or planning to get pregnant in the future. Pregnancy can change the size and shape of your breasts and may affect the long-term results of surgery.
What are the benefits of surgery?
Following your breast augmentation your breasts should be larger and have a better shape. Most women report that they feel more comfortable with their appearance and more confident in the clothes they wear.
Fat Transfer Breast Augmentation
Over the last few years the use of fat grafting to the breast has been investigated extensively across the World. The technique involves gentle liposuction to obtain fat from one area of the body, typically the tummy or thighs, processing of this fat and then reinjection into the breasts. Following extensive investigation this technique has now been authorised for use in the UK. Mr Sivarajan has been involved in some of the initial research on this technique as part of a European wide trial.
Fat transfer is ideally suited to someone wanting a modest increase in bust size of between one to two cup sizes and a natural result. After each treatment approximately two thirds of the fat injected will pick up a new blood supply and a third will disappear. These percentages are averages and some people will get more fat survival than others. For this reason it may be necessary to repeat the injections and this would be done not less than three months after the initial injection.
Breast Implant Surgery
What kind of breast implant should I choose?
At the Elanic Clinic we choose only to use FDA approved breast implants. These are authorised for use in the United States and have passed a rigorous safety and testing programme. The vast majority of breast implants do not meet these demanding standards and so we will not use them.
We use Silicone breast implants in most cases. Silicone has been used for 50 years now and has been shown to be safe in numerous world-wide research studies. We also recommend textured breast implants which have a fine pattern on the shell of the implant. This has been shown to reduce the risk of hardening of the implants.
We use both round and shaped breast implants, depending on the type of look you want from your breast augmentation.
Your surgeon will discuss the options with you and will recommend the most appropriate type and size for you.
Is silicone safe?
Silicone is useful for healthcare products because it does not dissolve in water or react easily to changes in temperature or to substances in the body.
Silicone is used to make heart-valve replacements, facial implants and tubes used to give people medication.
Many studies have been carried out to find if silicone breast implants are safe. There is no evidence to suggest that women who have silicone breast implants are at a higher risk of getting any diseases including cancer and arthritis.
General Anaesthetic or Local Anaesthetic with sedation – what is the difference?
Traditionally breast augmentation surgery is carried out under a general anaesthetic where drugs are given to make you unconscious, a tube is place down your throat and a machine assists your breathing. At Elanic, we are one of the few centres in the UK offering breast augmentation under local anaesthetic with sedation. In this technique a Consultant Anaesthetist places a line in your hand and gives you drugs to make you very tired and for pain relief. The breast is then injected with local anaesthetic and the operation is then performed. The advantages of sedation anaesthesia are:
- As you are not having a general anaesthetic you do not need to stay in hospital overnight
- You experience less nausea as you are given less drugs
- Your risk of deep vein thrombosis and pulmonary embolus is lower
- Some people don’t like the idea of the loss of control which comes from general anaesthesia
We give you a choice of whether you wish to have your breast augmentation carried out under local anaesthesia with sedation or general anaesthetic in hospital.
What does the operation involve?
The operation usually takes between an hour and an hour and a half.
In some cases the implant will be placed under your breast. This often gives the best feel to the implant but can sometimes give an over-augmented ‘fake’ look to the final result. Whilst some women want this look, others want a more natural result. This can be achieved through placing the implant under the pectoral muscle of the chest. This will prevent the outline of the implants being noticeable. However, sometimes the breasts can be pushed apart or look flat afterwards. To get the best of both techniques a procedure called dual plane breast augmentation was invented in America and places the top part of the implant under the muscle and the rest under the breast. This technique gives a more natural result without the downsides of having the implant completely under the muscle.
The surgeon will usually place the implant through a cut in the crease under the breast (inframammary fold). Your surgeon will make the cut and create a pocket to place the implant in. Your surgeon may place a drain (small tube) in the pocket to help drain the blood or fluid. They will usually close the cut with dissolvable stitches, leaving the drain in place
At the end of the operation your surgeon may wrap your breasts in bandages for support or ask you to wear a non-underwired support bra to help mould the shape of the breasts. This must be worn constantly for 6 weeks, just being removed to take a shower.
Prior to your surgery you should continue your normal medication unless you are told otherwise.
Let your surgeon know if you are on warfarin, clopidogrel, aspirin or other anti-inflammatory drugs, as these are more likely to cause you to bleed after your operation. Follow your surgeon’s advice about stopping this medication before the operation.
What complications can happen?
The healthcare team will try to make your operation as safe as possible. However, complications can happen. Some of these can be serious. You should ask your doctor if there is anything you do not understand. Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you.
The complications fall into three categories:
1 Complications of anaesthesia
2 General complications of any operation
3 Specific complications of this operation
1 Complications of anaesthesia
Your anaesthetist or surgeon will be able to discuss with you the possible complications of having an anaesthetic, whether it is local or general. The risks from having an anaesthetic are extremely small
2 General complications of any operation
Pain, which is usually easily controlled with painkillers. You may feel sore along your breastbone, especially if the implant was placed behind the pectoral muscle. Moving your arms can be uncomfortable for the first two to three weeks.
Bleeding during or soon after surgery. This rarely needs blood transfusion or another operation. It is common to get bruising between and under your breasts.
Minor infection on the surface of the wound in the inframammary fold. This is rare and easily treated with antibiotics.
Unsightly scarring of the skin. Usually the scars will settle over time. However, if you have dark skin, the scars can sometimes stay thick and red. Your surgeon will try to make the cuts in an area that is difficult to notice even in a swimming costume. Follow the instructions your surgeon gives you about how to care for your wounds.
Blood clots in the legs (deep-vein thrombosis) which can occasionally move through the bloodstream to the lungs (pulmonary embolus), making it difficult for you to breathe. Nurses will encourage you to get out of bed soon after surgery and may give you injections to reduce the risk of blood clots. This is vastly reduced from having a local anaesthetic and sedation, rather than a general anaesthetic.
3 Specific complications of this operation
Developing a collection of blood in the pocket where the implant is (haematoma). If this happens, you may need to have another operation to remove the blood.
Developing a collection of fluid in the pocket where the implant is (seroma). This is normally not serious and usually settles on its own. Sometimes the fluid needs to be removed using a needle. If the seroma becomes large and keeps coming back (also called a pseudocyst), the implant may need to be removed and replaced (risk: less than 1 in 100). If the problem continues you will not be able to have an implant.
Infection of the implant If this happens, the surgeon will need to remove the implant. You will need to wait for about three to four months, while the infection clears and the wound heals, before your surgeon can replace it. If the skin around your scar is red and the wound in painful and swollen, let your doctor know.
Change of breast and nipple sensation. This usually gets better in the first year. However, the change may be permanent and may affect breastfeeding.
Thickening and tightening of the capsule. The risk of this is up to 1 in 10 in ten years, but varies depending on the quality of the implants you choose. This is the most common reason for needing to have implants replaced, apart from wanting to go bigger. Your body normally forms a layer of scar tissue (or capsule) around the implant. If the scar tissue thickens and tightens, it can make the breast feel hard and can cause the shape to change. In severe cases the breast can become painful and the implant will need to be removed and replaced.
Kinking and rippling, caused by a capsule forming or by natural sagging of the skin. This is less common with modern thick (cohesive) silicone implants. Sometimes it is possible to feel the edge of the implant under the skin. However, any kinking or rippling is usually only obvious if you are slim and had very small breasts.
Stiff shoulder. If you get shoulder stiffness after the procedure it is important that you keep moving it and try to go through the full range of its movement. A physiotherapist can give you exercises. Take painkillers as you are told if you need to relieve the pain.
Numbness or persistent pain on the outer part of your breast. This is caused by injury to the small nerves that supply the skin. Any pain or numbness usually settles after a few weeks. However, this can sometimes continue for many months.
Rupture or deflation of the implant. This is usually caused by the shell ageing but can also be caused by a tight capsule or trauma (where a physical force is applied directly to the breast). With modern cohesive silicone implants, the silicone usually stays in the capsule and does not cause any obvious symptoms or pain. However, most surgeons will still recommend that the implant is replaced. If the capsule ruptures too, the silicone will leak out and the implant will need to be replaced.
Cosmetic problems. It is difficult to predict exactly how particular implant will make your breasts look. The size and shape of your breasts will change over time. The implants can take up slightly different positions and they can make natural differences between your breasts more noticeable. Sometimes it is not possible to create a cleavage. Larger implants are also heavier and can speed up age-related sagging that also happens in natural breasts.
What can I do to help make the operation a success?
Lifestyle changes
If you smoke, try to stop smoking now. Stopping smoking several weeks or more before an operation may reduce your chances of getting complications and will improve your long-term health.
Exercise
Regular exercise can reduce the risk of heart disease and other medical conditions, improve how your lungs work, boost your immune system, help you to control your weight and improve your mood. Exercise should help to prepare you for the operation, help with your recovery and improve your long-term health.
Before you start exercising, you should ask your GP for advice.
What is the recovery process like?
After the operation you will be transferred to the recovery area. Your breasts will look discoloured and feel firm and swollen. You will be observed for 3 hours.
You should be able to go home the same day or the day after, if your operation was under general anaesthetic in hospital. If you do go home the same day, a responsible adult should take you home in a car or taxi, and stay with you for at least 24 hours.
If you are worried about anything at home please contact us for advice. You will be given out contact details on your discharge.
Returning to normal activities
Most women return to normal activities within two to three weeks. The bandages can be removed after a few days as long as you have a soft bra that fits comfortably. You should not wear underwired bras for the first six weeks.
You should be able to return to work after the first week, depending on your type of job. For the first six weeks after the operation, do not lift anything heavy or do any exercise. You should be able to do a limited amount of activity, such as lifting young children, after about two weeks.
You should avoid sex for the first three weeks and then be gentle with your breasts for at least another three weeks.
Do not drive until you are confident about controlling your vehicle and always check with your insurance company first.
The future
Your surgeon will arrange for you to have follow-up visits to check on your progress.
It usually takes a few weeks for your breasts to look and feel more natural. The results of a breast augmentation usually last for a long time. However, even if the operation is a success, you may need to have further surgery at some time in the future to have them replaced or removed. The manufacturers say that breast implants last for a minimum of ten years. Also, gravity and the effects of age will change the shape and size of your breasts.
You should not have any problems breastfeeding. However, many women with or without implants cannot to breastfeed.
Implants placed behind the breast may interfere with a mammogram (breast x-ray used to detect breast cancer). You should let your doctor know that you have had an implant and additional views or the use of an ultrasound or MRI scan may be recommended.
First Steps
A breast augmentation is a cosmetic operation to make your breasts bigger, and usually to improve their shape. It is only suitable for certain women. You should consider the options carefully and have realistic expectations about the results.
Surgery is usually safe and effective. However, complications can happen. You need to know about them to help you make an informed decision about surgery. Knowing about them will also help to detect and treat any problems early.
Vivek's Philosophy
I perform different types of breast implant operations depending upon the wishes of the patient. At the Consultation I like to get an understanding of the type of augmentation the patient is looking for. Some women are looking for a natural look, whereas others want a more augmented or 'fake' look and others just want to replace the breast tissue they lost through pregnancy. After examining the patient and understanding the type of look they want I will recommend either above or below the muscle implant placement and whether round or teardrop shaped implants would be better. When I place the implants under the muscle I like to do whats called a 'dual plane' augmentation. I think this gets round some of the traditional problems with under the muscle implants such as wide spacing; it also allows me to very slightly alter the nipple position to get the best look and correct any asymmetry.
In patients wanting a 'natural look' I will recommend either tear drop shaped implants or dual plane round implants, depending on the size and look they want, the condition of their breast tissue and their nipple position. I will explain all this in much more detail in the clinic.
The type of breast implants i prefer are Allergan Natrelle or Mentor implants and I like to show patients the implants and different sizes so that they can choose.
I admit the patient on the day of Surgery and the operation takes about an hour under General Anaesthetic. I infiltrate local anaesthetic as well to minimise pain after the procedure. Once the implants are placed i use dissolving stitches and a water-proof dressing so the patient can shower normally. I do not usually use a drain and i do not usually use bulky dressings. I give my patients speciofic instructions on the size of bra to buy and use this to help mould the shape. I like to have my patients in a bra a little big for them for the first few days whilst the swelling settles and then into a well fitting non-underwired support bra that they must wear constantly for the first six weeks, just removing it to have a shower.
I see the patient back a week later to check everything is healing well and then at 6 weeks and 6 months.
For more information on breast augmentation, or to book your consultation or discuss whether you might be suitable for a breast augmentation, please call us on 0141 332 5106
Book your consultation now to find out more.
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