Breast augmentation

Implants
All breast implants are made of an outer layer of silicone and are filled with either silicone, sterile sea water (saline) or both. The silicone used to fill implants can be either liquid or gel. Liquid silicone and saline implants give a more natural feel, while gel silicone gives a firmer feel and is available in a wider range of shapes. There are all kinds of implants that adapt to all body shapes. For example, rounded implants add volume to the upper part of the breast for lift, while pear-shaped implants separate the breasts and make them look more youthful. It’s important to discuss the shape and appearance of implants with your surgeon, as some give a more natural look while others have more of an “oomph” effect.

Preparing for the operation
- During your first consultation with the surgeon, he will talk to you about the size and shape of the implant you want, and he might also show you photos of breasts that have been operated on.
- You’ll be asked questions about your health, medical history and lifestyle.

Procedure
The operation takes 1-2 hours and usually requires an overnight stay in hospital.

Techniques
The surgeon makes an incision, inserts the implants either underneath or above the muscle, and closes it again with dissolvable stitches. The same technique is used no matter where the incision is made. There are 3 types of incision: periareolar (made at the edge of the areola which surrounds the nipple); inframammary (made in the fold under the breast); and transaxillary (made in the underarm area).

After the operation
- You shouldn't feel any pain - just a feeling of heaviness.
- The breasts are bandaged up for one week.
- A support bra has to be worn for a month. 
- The scars need massaging with special healing cream.
- Massage your breasts daily with nourishing cream to keep the skin supple and prevent capsular contracture (a complication where scar tissue becomes tight and squeezes the implant). The more you move your breasts the better.
- You need time to adapt to your new, heavier breasts. It's advisable to wear a sports bra for several months.

Risks
There are risks linked to the anaesthesic (shock and allergies), local infections of the scarred area and swelling. Capsular contracture may also occur. This is the body’s reaction to the implant. It causes abnormal scar tissue to form around the implant. If this happens, the implant will become hard and visible, there will be painful swelling and the breast will lose its suppleness. If the operation goes wrong or if the result is asymmetrical (one of the breasts higher or bigger than the other), the procedure will have to be repeated.

The results
Impressive, right from the first week. 6 months after the operation, when the glandular and epidermal tissues have adapted to the new shape of your breasts, the result becomes definitive.

How long do the results last for?
- Breast implants have a life span of about 10 years minimum, but nowadays they’re practically guaranteed for life.
- In rare cases, an implant can crack, but silicon gel is non-toxic so there’s no need to panic! You will need to have another operation though.
- If you’re pregnant, the implants won’t get in the way, but don't have very large implants so you don’t put too much tension on the breast tissue, which is stretched quite a lot during pregnancy. Have the implant positioned under the muscle rather than under the breast tissue so it stays completely separate from the mammary gland, allowing you to breastfeed safely.

How much does it cost?
Costs vary from one surgeon to another, but on average you can expect to pay from £3,400 to £5,000.

More information
Contact either the British Association of Cosmetic Surgeons (BACS) or the British Association of Aesthetic Plastic Surgeons (BAAPS).