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Guide To Cosmetic Surgery - Breast Enlargement

Breast enlargement surgery

More commonly known as a ‘boob job’. This is the number one cosmetic procedure for women and involves the insertion of synthetic implants to increase the size of the breasts.

Why do so many women choose this procedure? There are a variety of reasons for this. There are women who feel that their breasts are too small or unbalanced (also known as asymmetry). Other women find that their breasts have lost size and shape following childbirth or excessive weight loss.

Other reasons include a congenital deformity, reconstruction following a mastectomy (breast cancer) and an overall unhappiness with the size of their breasts.

The breast implants are soft, silicone shells which are either filled with a silicone gel or saline solution. The choice of these will depend on your personal preference, your body shape and the surgeon’s advice. This equally applies to the method of insertion during surgery.

Suitability for breast enlargement surgery

This depends on a variety of factors such as age, health, emotional stability and motivations. Women who are not pregnant or breastfeeding will also be considered. 

A note about age: a great many teenage girls want breast enlargement surgery. They see this is a way of improving their appearance and emulating the models or celebrities seen in the media.

Surgeons usually prefer to operate on patients aged 18 upwards as they are likely to have finished puberty. The problem with performing surgery on younger girls is that they are still growing which means that their breasts are still developing. So, there is every chance that these will increase in size irrespective of surgery.

It is usually better to wait until this age but exceptions can be made. Surgery has been carried out on girls aged 16 and 17.

The rule in general is for girls to wait 3 years after the start of their periods before considering surgery.

If your surgeon decides that you are not suitable or you do not want to undergo a surgical procedure then there are several
‘non-surgical’ alternatives. These include breast pumps, breast feather lift, ‘Caci’ bust treatment and Microlane.

Preparing for surgery

The surgeon will advise you on how to prepare for this procedure. This will include advice about stopping smoking (if you are a smoker), what medications you can take, what to eat and drink beforehand (the time of your last meal) and preparation at home.

This preparation means getting things ready for when you return home after your operation. The last thing you want to do is to have go food shopping, do the washing or any other household task. The idea is to plan this well in advance. All you have to do then is to rest and recover from your procedure.

Everyone is different in regard to what to get ready at home but here are a list of things that can apply to every patient:

• Obtain an ample supply of painkillers, dressings, extra medications (if you need them), antibacterial soap, gauze and scar reducing creams. Also include moisturisers and petroleum jelly which can help to soothe and cleanse surgical incisions.
  
• Obtain Bromelain and Arnica Gel. These are homeopathic remedies which can help to reduce bruising and swelling. Check with your surgeon first though.
  
• Cook meals in advance and freeze these. Another option is to purchase ready prepared or microwave meals. Buy plenty of fruit and vegetables though as these contain essential vitamins and minerals which will aid with your recovery.
  
• Buy bottled water. Purchase several smaller bottles and those that have a ‘sports style’ top rather than those ‘zeppelin sized’ 2 litre bottles!
  
• Make sure that you have completed all your essential jobs such as cleaning, taking out the rubbish, laundry etc. Ask your partner or a member of your family to help with these if need be.
  
• If you own a pet such as a dog or cat then it’s a good idea to ask someone to look after it until you are well enough to do so.
  
• Place a small table by your bed. On that table have a night light (useful for those night time trips to the bathroom), your medications and painkillers, a bottle of water, a few light snacks such as crackers, a phone and the TV remote control.
  
• Wear loose comfortable clothing such as jogging bottoms, baggy tops or nightwear. Have a dressing gown and slippers to hand. It is also a good idea to keep a few blankets handy as patients are often prone to chills after surgery.
  
• If you don’t have one already then buy a seamless, sports bra or one that fastens up at the front.
  
• Prepare some ice packs. These are handy for reducing any swelling after surgery. Good ice packs are packets of frozen vegetables or special gel packs which can be bought from a chemist.
  
• If you do smoke then give up at least a fortnight before surgery, and do not resume until two weeks after surgery. You will find that the surgeon would prefer you to give up completely and can help with this. But, it can be difficult and in the meantime, make sure that you stop smoking for these timescales.
  
• At home, make sure that all the things you normally use such as crockery, pans, tins and bottles are at hip level. These equally apply to any bathroom items. Have them close to hand so that you don’t have to bend or stretch for them.

The main thing is to ensure that you don’t overstrain yourself or place any stress on your surgical wounds.

Your preparation should also include arranging a lift to and from the clinic/hospital. It is a god idea to arrange for your partner, a member of your family or a friend to come and help you out for the first two to three days.

The breast enlargement procedure

This procedure involves a series of incisions in the natural crease underneath the breast. This is the usual method of entry although there are other options such as the armpit or the areola (the brown circular area around the nipple).

The implant is then inserted in that incision and positioned. There are two choices of position:

Submuscular: the implant is placed beneath the major muscle of the chest.

The advantages of this method are less risk of capsular contracture, easier to perform a mammogram (breast x-ray) plus the implant is deeper rooted and has more ‘padding’.

The disadvantage is that the breasts may feel too firm.

Subglandular: the implant is placed above the major muscle of the chest. 

The advantages with this method are less post-operative pain, a natural looking position and quicker healing.

The disadvantages are higher risk of capsular contracture plus it is more difficult to check via a mammogram. The implant is also easier to see and touch.

The stitches or ‘sutures’ are closed and a supportive bandage is wrapped around the chest area to aid with recovery.

The surgery is conducted under a general anaesthetic and takes around 1 to 2 hours to complete. It usually involves an overnight stay in hospital although it can be performed as a day case in a few exceptional situations.   

Types of breast implant

There are four types of implant:

• Saline (salt water) filled shell
• Silicone gel filled shell
• Cohesive silicone gel filled shell
• Hydrogel filled shell
  

The saline or salt water filled variety is very popular. The advantage with this type of implant is that if it breaks (which is rare) then the sat water solution will be absorbed by the body.

If it ruptures then it will deflate very quickly and will become very noticeable as it does so!

This implant is composed of an outer silicone shell and comes in two types of surface – smooth and textured.

The saline implant tends to last for 12 to 14 years.

The silicone gel filled version is soft, pliable and extremely safe. There have been some media reports which question the safety of this filler and studies have been carried out to see if there is a link between this type of implant and a range of health problems.

These include questions raised about silicone gel and ‘connective tissue disorders’. Other concerns include a link between implants and breast cancer but it is important to state that there is no concrete evidence to support this.

This type of implant is natural looking and has a textured surface which reduces the risk of hardening or capsular contracture.

The cohesive silicone gel type of implant is very similar to the normal silicone gel type. The shell if comprised of several textured layers and the filler material itself is a thick, cohesive gel. In the unlikely case of the implant breaking the gel will not spill out and the implant itself retains its shape.

This is a soft and pliable implant with a decreased risk of ‘rippling’ or folding.

The hydrogel implant is as safe as the saline version and has the added benefits of the gel version. It simulates the look and feel of the breast and is very safe. If it does rupture then the gel will be absorbed, safely, by the body.

Breast implants come in two shapes – round and ‘teardrop’ or anatomical. They are also smooth or textured. There are pro’s and con’s of both.

Round shaped implants are cheaper than the anatomical type and last just as long. Contrary to opinion they do look as natural as the teardrop version. These can be smooth or textured.

Anatomical or teardrop shaped implants lend a natural look to the breast. As a result of their shape there is the risk of them ‘turning’ in the breast pocket but the textured surface helps to prevent this.

Smooth implants have thinner shells and although they last longer there is a greater risk of capsular contracture. There is less risk of this happening with the textured variety but they do have a higher rupture rate.

What exactly is capsular contracture? This is the name given to the condition where the capsule around the implant tightens and so squeezes the implant. The capsule is the body’s normal reaction to the presence of a foreign body. When the implant is inserted the body reacts to this by forming protective scar tissue or a ‘capsule’ to enclose the implant.

This is normal but problems arise when the capsule enlarges and thickens which then compresses the capsule. This will make the implant feel hard and distorted in appearance.

There are several causes of capsular contracture. These include smoking, infection and haematoma.

Capsular contracture is treated by further surgery. An incision is made and cuts made in the capsule. This will release any tension. The implant is removed and then replaced after this release. This is successful but there is always the risk of this happening again.

Recovery

It is normal to feel tired, sore and bruised after this surgery. Your chest will feel stiff and swollen but this will ease. Painkillers will be prescribed to control any pain or discomfort.

The recovery period is a time of rest and taking things easy. Give your body time to heal and do overtax yourself. Have someone on hand to help you during this time. Follow the instructions given to you by your surgeon carefully.

Your progress will be monitored via a series of regular check ups. A mammogram (breast x-ray) will be performed.

Recovery can take 1 to 2 weeks although a complete recovery can take up to 6 weeks.  

You should be able to return to work after a couple of days. If your job is physical in nature then give yourself a couple of weeks.

Benefits of breast enlargement surgery

The majority of women are very happy with the outcome. They feel that their new breasts are in balance with the rest of their body and that they are more ‘feminine’ as a result.

Risks of breast enlargement surgery

This is a relatively straightforward operation and is performed countless times by experienced surgeons.  But like all surgery it carries a small amount of risk.

The main risks are capsular contracture, excessive bleeding, infection and asymmetry. There is also the risk of the nipples becoming under-sensitive, over-sensitive or losing sensation altogether. If there is any numbness it will improve over time but there is the slight chance that it be permanent.

There are other risks which apply to all forms of surgery. These include an adverse reaction to anaesthetic and dissatisfaction with the results.