Choosing to change the way you look through cosmetic surgery is probably one of the most important decisions you will make.

Why and when is a breast enlargement performed?

Choosing to change the way you look through cosmetic surgery is probably one of the most important decisions you will make. Many women find that the size and shape of their breasts affects their self-confidence. If you feel that your breasts are out of proportion with the rest of your body, or that age or breastfeeding have caused them to shrink or lose their shape, a breast enlargement operation (also known as breast augmentation or having breast implants) can help.

What can you expect?

Breast implants are used to make your breasts larger, firmer and fuller. Breast implants are available in a variety of types and sizes and their shape is either round or ‘anatomical’. They are usually made of an outer layer of silicone, filled with cohesive silicone gel. This is a soft gel, highly elastic material with the approximate density and feel of normal breast tissue. Silicone materials have “memory” ie the shell and gel components of an implant can be stretched and they will return to their normal state when relaxed.

Round implants are used most commonly and are the most reliable. In some ladies, especially if very slim, then anatomical may give a more natural result by being less ‘full’ at the top of the breast. However, they are firmer implants and can rotate in a small number of cases. You’ll be able to see different examples of breast implant and discuss the advantages and disadvantages of each before you decide which one is best for you. There are different techniques available which result in different scars either under the breast, around the nipple or in the armpit.

You will be given a further consultation in two weeks to discuss any queries you may have following your initial consultation. You can bring along your partner, parent or friend for any of these consultations. You will have to undergo an examination and may have some simple health checks such as blood tests and in some cases a mammogram. If you decide on surgery you will be required to sign a consent form giving permission for the operation. This requires that you are aware of the risks and complications involved with the procedure, which will have been explained to you.

The Procedure

Breast enlargement surgery will be performed under a general anaesthetic, usually takes about an hour and in many cases performed as a day case without the need for an overnight stay in hospital. The surgery involves placement of an implant either under the breast tissue in most cases. In some very slim patients the implant is placed beneath the muscle under the breast to help camouflage the implant. There are many different types and sizes of implant available. They all have a silicone outer layer but may be filled with silicone which in modern implants is a ‘cohesive’ gel that does not leak out in the event of implant failure.

Due to strict NHS guidelines and service restrictions, it is not always possible to perform this type of surgery under the NHS. There are strict provision criteria, such as body mass index and clinical priority, which need to be met and these should be discussed with your GP or surgeon before a decision can be made to perform such procedures.

Are there any reasons for a patient not to have this procedure?

Patients who are actively smoking or on blood thinning medication such as aspirin or warfarin have a higher risk for postoperative complications such as bleeding, wound infections and delayed wound healing. It is advisable not to consume nicotine in any form for at least two weeks before this procedure and at least two to three weeks after. Medication such as aspirin or warfarin may need to be stopped if they are not absolutely essential at the appropriate time before surgery. This should be discussed with your Consultant or GP.

BRA Meetings

Meetings are held on Tuesday afternoons either virtually via Microsoft Teams video conferencing or face to face at St Andrews Hospital outpatients department.