London Hair & Cosmetic Surgical Centre
The leading Plastic Surgery Clinic in London
Breast Augmentation FAQ
Breast augmentation is one of the safest cosmetic operations in the UK. However no surgical procedure is without risk. The surgery is a day case general anaesthetic and no drains are required. Tissue based planning is used to make sure the correct size and shape of implant is used to fit your frame.
Implant size is best selected with tissue-based planning principles. The patient’s implant is selected using her personal measurements as well as her desired “look” to select the appropriate implant. All women have different breast types, shapes, and sizes: there are no two breasts that are exactly the same. The measurements of your breast will determine the implant size that fits your breast the best. The goal with selecting the appropriate size is not only to produce a natural and appropriate look but also to help with lowering risks of complications and give you longevity.
I routinely use Mentor implants for my breast patients in the NHS. Mentor is an American company who manufacture their implants in Europe. Mentor have had their implants approved by the Food and Drug Administration (FDA), which has stronger regulation than the European authorities. Their implants have been rigorously studied by independent researchers and have the best ten-year follow up results available.
The tissue plane of breast implant placement is dependent on the amount of breast tissue present and tissue laxity. If there is plenty of breast tissue a ‘subglandular’ approach is used. However if there is little breast tissue an option is to place the implant partially under the muscle and breast tissue , a so called ‘dual plane approach’.
The procedure takes 1-2 hours. You will be in recovery until you are safe to be discharged back to the ward. You will feel some discomfort after the local anaesthetic has worn off. Drains are not used in primary breast augmentation, in some revision cases drains are used. You will go home on the day and it is best to get someone to drive you home or take a taxi. Wounds are checked at 1 week in the dressings clinic, you can shower 48 hours after the surgery.
Research studies have shown that breast implants do not increase the chances of breast cancer. If you are 30 and over and have a strong family history of breast cancer it is advisable to get a mammogram before and after your breast augmentation. This will serve as a baseline assessment. Recently there have been reports of a rare lymphoma (ALCL) - Anaplastic Large Cell Lymphoma (ALCL), which is a type cancer involving cells of the immune system. This has been associated with macrotextured implants and these have been taken off the market. Although very rare, the reported risk is 1:30000 and patients should be aware of this condition. It can present with late redness and swelling of the breast and the treatment is implant and capsule removal.
No, a breast augmentation will not routinely affect breast feeding and a silicone breast implant will not affect breast milk and it is safe to breastfeed your child.
Mr Nikkhah offers a cooling off period before you decide to go ahead with a breast augmentation. Breast augmentation is a lifetime commitment. Therefore it is essential that you are making the appropriate choice and understand all the possible complications of the surgery. You may need revision surgery as the years go by and you need to be prepared personally and financially for this. Nobody needs an urgent breast augmentation. If you are not offered a cooling-off period, or you are put under pressure to proceed, you should walk away and look elsewhere.
List of possible complications:
Infection - this is rare in primary breast augmentation, if infection does not respond to antibiotics the implant will have to be removed and replaced at 3-6 months
• Bleeding - may result in a return to theatre
• Changes to sensation in the breast
• Wound breakdown
• Asymmetry between breasts
• Implant rupture
• Implant wrinkling
Capsular contracture - 10% at 5 years this occurs as the body responds by scarring around the breast implant. In severe cases capsular contracture can result in distortion and pain
List of possible complications:
Infection - this is rare in primary breast augmentation, if infection does not respond to antibiotics the implant will have to be removed and replaced at 3-6 months
• Bleeding - may result in a return to theatre
• Changes to sensation in the breast
• Wound breakdown
• Asymmetry between breasts
• Implant rupture
• Implant wrinkling
Capsular contracture - 10% at 5 years this occurs as the body responds by scarring around the breast implant. In severe cases capsular contracture can result in distortion and pain
Breast Reduction FAQ
It's sometimes possible to reduce problems caused by having large breasts without the need for surgery.
The following measures may help:
• If you're overweight, losing weight can sometimes help reduce the amount of fatty tissue in your breasts
• Professional bra-fitting service – for many women with problems caused by large breasts, getting a professional to fit a correctly-sized bra can reduce discomfort
• Physiotherapy– exercises from a physiotherapist can sometimes help with aches and pains caused by large breasts
• Psychological support and treatment – this can help if your large breasts are causing emotional or mental health issues.
The following measures may help:
• If you're overweight, losing weight can sometimes help reduce the amount of fatty tissue in your breasts
• Professional bra-fitting service – for many women with problems caused by large breasts, getting a professional to fit a correctly-sized bra can reduce discomfort
• Physiotherapy– exercises from a physiotherapist can sometimes help with aches and pains caused by large breasts
• Psychological support and treatment – this can help if your large breasts are causing emotional or mental health issues.
Breast reduction is a surgical procedure to reduce the size of the breasts, patients often seek this procedure if they have pain and discomfort from heavy breasts. It is a functional operation that can significantly improve quality of life in patients. The breast is also lifted and the shape of the breast can be improved.
Even in large reductions I use a superomedial technique to complete the breast reduction and can safely remove up to 1 Kg from each breast. The nipple is lifted superiorly in this technique whilst still attached to glandular breast tissue, the remaining inferolateral portion of the breast is removed. Patients will have an inverted T shaped or anchor scar. In smaller reductions < 500g I do not use drains.
When you wake up after surgery, you'll have dressings on your breasts and drains attached. After 1 to 2 days, the drains will be removed and you'll usually be able to go home.You will be sent home pain with painkillers. your breasts will be swollen, and may feel tender and lumpy after surgery. The swelling may last for around 3 months. You will not see what your breasts look like until the swelling has gone down.
In most patients the scars fade and can take up to a year to fully mature. The scar extends around the nipple complex and continues as an inverted T shaped anchor scar. In some cases patients may experience Keloid or Hypertrophic scars, these may need steroid injections to improve the scars.
• Infection
• Haematoma - often occurs in the first 24 hours and will necessitate a trip back to theatre to stop bleeding
• Inability to breastfeed
• Loss of nipple sensation
• Nipple loss/necrosis (rare)
• Fat necrosis
• Altered size and not achieving desired cup size on reduction
• Asymmetry requiring further surgery
Wound breakdown (often occurs at the T junction) - managed with dressings
• Haematoma - often occurs in the first 24 hours and will necessitate a trip back to theatre to stop bleeding
• Inability to breastfeed
• Loss of nipple sensation
• Nipple loss/necrosis (rare)
• Fat necrosis
• Altered size and not achieving desired cup size on reduction
• Asymmetry requiring further surgery
Wound breakdown (often occurs at the T junction) - managed with dressings
Breast Lift FAQ
This is a cosmetic uplift procedure that reshapes the breast. The internal tissues of the breast (parenchyma) are rearranged to make a more fuller and youthful breast. Unlike breast reduction surgery where tissue is removed and volume is reduced uplift surgery repositions the tissues. The procedure can be combined with implants (Mastopexy Augmentation). Mr Nikkhah routinely performs this surgery in his NHS practice for women who need symmetrisation surgery after microsurgical breast reconstruction.
Mastopexy can be carried out by a number of different techniques and the scars will differ accordingly. Most commonly you will be left with a scar around the nipple complex and a T shaped scar or vertical scar beneath the nipple complex.
The wounds are checked 7 days in the dressing clinic and women are advised to wear a well fitted sports bra.
In most instances there is no need to use a surgical drain.
Infection, Scar, Nipple sensation loss, Pain, Fat necrosis, Revision surgery ( up to 25 % risk) in Augmentation Mastopexy.
Implant Replacement FAQ
Access to the implant is made through the same incision, the implant is removed with a capsule of scar tissue that covers it (Total Capsulectomy). In some instances it is not possible to remove all the capsule around the implant (Partial Capsulectomy). A new implant is placed and a drain is placed to prevent seroma formation and the wound is closed in layers. The procedure will take about two hours to perform. It is performed as a day case procedure, so you will be able to return home on the same day with a well fitted sports bra, once the effects of the anaesthetic have worn off.
• Infection - resulting in implant loss
• Haematoma - return to theatre for bleeding
• Delayed healing
• Seroma
• Asymmetry
• Haematoma - return to theatre for bleeding
• Delayed healing
• Seroma
• Asymmetry
Male breast reduction FAQ
It is important to take a thorough past medical history as Gynaecomastia can have a number of underlying causes.
Obesity - this is because being overweight can increase levels of oestrogen, which can cause breast tissue to grow. If you're overweight you're also more likely to have excess fat that can enlarge the breast tissue
Puberty - Many teenage boys have some degree of breast enlargement. Gynaecomastia at puberty usually clears up as boys get older and their hormone levels become more stable.
Older age - As men get older, they produce less testosterone. Older men also tend to have more body fat, and this can cause more oestrogen to be produced. These changes in hormone levels can lead to excess breast tissue growth.
Other causes may include side effects of medications, cannabis, alcohol misuse.
Breast reduction surgery is not usually available on the NHS
Male breast reduction surgery is not usually available on the NHS. You'll probably need to pay to have it done privately. In some cases, the NHS may provide male breast reduction if it's causing considerable pain or distress
Obesity - this is because being overweight can increase levels of oestrogen, which can cause breast tissue to grow. If you're overweight you're also more likely to have excess fat that can enlarge the breast tissue
Puberty - Many teenage boys have some degree of breast enlargement. Gynaecomastia at puberty usually clears up as boys get older and their hormone levels become more stable.
Older age - As men get older, they produce less testosterone. Older men also tend to have more body fat, and this can cause more oestrogen to be produced. These changes in hormone levels can lead to excess breast tissue growth.
Other causes may include side effects of medications, cannabis, alcohol misuse.
Breast reduction surgery is not usually available on the NHS
Male breast reduction surgery is not usually available on the NHS. You'll probably need to pay to have it done privately. In some cases, the NHS may provide male breast reduction if it's causing considerable pain or distress
Breast reduction surgery is usually done under general anaesthesia. The operation involves making a cut around the nipple and removing excess fatty tissue in combination with liposuction. In larger reductions repositioning of the nipples may be necessary. You'll have dressings over your wounds. The operation takes about 1-2 hours and is a day case procedure.
It can take several weeks to fully recover from breast reduction surgery. You may need to take a up to a week off work. You may have sore, swollen and bruised breasts for a few weeks. You'll need to wear an elasticated compression garment day and night for 1 to 2 weeks after the operation - similar to a tight fitting cycling shirt. This helps support your chest while it heals and reduces the chances of seroma formation. After 1 to 2 weeks, your stitches will either dissolve or be removed.
Avoid stretching, strenuous exercise and heavy lifting for about 3 weeks after the operation. It will take about 6 weeks until you can return fully to your normal activities.
Avoid stretching, strenuous exercise and heavy lifting for about 3 weeks after the operation. It will take about 6 weeks until you can return fully to your normal activities.
Infection
Scar
Asymmetry
Nipple sensation loss
Nipple necrosis
Seroma Revision surgery
Scar
Asymmetry
Nipple sensation loss
Nipple necrosis
Seroma Revision surgery
Implant removal FAQ
Patients who have ruptured implants, capsular contracture, infection and unhappiness with the shape of the breast and feel they wish to have them removed.
Access to the implant is made through the same incision, the implant is removed with a capsule of scar tissue that covers it (Total Capsulectomy). In some instances it is not possible to remove all the capsule around the implant (Partial Capsulectomy). A drain is placed to prevent seroma formation and the wound is closed in layers. The procedure will take about one hour to perform. It is performed as a day case procedure, so you will be able to return home on the same day, once the effects of the anaesthetic have worn off.
PIP breast implants were withdrawn from the UK in 2010 after it was found they had been fraudulently manufactured with unapproved silicone gel, and were far more prone to splitting (rupturing) than other breast implants.
Research hasn't found any evidence to suggest that PIP implants pose a serious health risk, but they can cause unpleasant symptoms if they rupture and you may be anxious about leaving them in. If you have PIP implants, you should discuss with a surgeon whether they should be taken out.The implants don't necessarily need to be removed, but they should be taken out if they rupture or you're worried about this happening.
Research hasn't found any evidence to suggest that PIP implants pose a serious health risk, but they can cause unpleasant symptoms if they rupture and you may be anxious about leaving them in. If you have PIP implants, you should discuss with a surgeon whether they should be taken out.The implants don't necessarily need to be removed, but they should be taken out if they rupture or you're worried about this happening.
Some private clinics have agreed to remove and replace PIP breast implants free of charge, while others charge a fee. If the clinic where you had your implants fitted won't help you because it has closed or is unwilling to do so, you may be able to have your implants removed free of charge on the NHS.
However, the NHS in England won't provide replacement implants if your original implants were fitted privately, except in a very small number of cases where they were fitted for medical, rather than cosmetic, reasons.
If you had PIP breast implants originally fitted on the NHS, you may be able to have them removed and replaced by the NHS at no cost.
The operation to remove and replace PIP implants is done wherever possible through the original surgical cuts.
However, the NHS in England won't provide replacement implants if your original implants were fitted privately, except in a very small number of cases where they were fitted for medical, rather than cosmetic, reasons.
If you had PIP breast implants originally fitted on the NHS, you may be able to have them removed and replaced by the NHS at no cost.
The operation to remove and replace PIP implants is done wherever possible through the original surgical cuts.
• Infection
• Haematoma - return to theatre for bleeding
• Delayed healing
• Deflated breast requiring a breast lift
• Seroma
• Asymmetry
• Haematoma - return to theatre for bleeding
• Delayed healing
• Deflated breast requiring a breast lift
• Seroma
• Asymmetry
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