Breast Augmentation

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