Why do people have breast surgery?
This form of surgery uses artificial implants to increase the size and shape of the breasts. Many women choose augmentation because they feel that their breasts are too small or that their shape is unattractive. Often this is as a result of childbirth, weight change or age. Breast augmentation is one of the commonest forms of aesthetic surgery and has been carried out on more than four million women during the past 30 years.

Realistic expectations
You must have realistic expectations about what breast augmentation can achieve for you. It will not change your personality or make people treat you differently. Everyone is individual and surgery will not transform you into someone else.

It is critical that you spend time thinking about what you want to achieve from surgery and talk about your hopes with your surgeon. You should not have breast surgery to please anyone else but yourself. Everyone’s skin and breast type is different and the surgeon will discuss what you can realistically expect to achieve.

What happens during consultation?
The surgeon will examine your medical history and discuss how you want the appearance of your breasts to be changed. The surgeon will need know why you want a specific procedure to gain a complete understanding of what you want to achieve from the surgery. It is important that you are completely honest.

During the consultation the surgeon will explain the procedures before, during and after surgery as well as discuss the details of breast augmentation and explain what can be realistically achieved.

Getting the most out of your consultancy
Often in cases where clients are unhappy with the results of surgery it is because they did not discuss their expectations thoroughly or were afraid to talk about the outcome or risks.

You have to make an informed decision before signing the consent form so ask plenty of questions. You want to feel relaxed, confident and completely understand what will happen during surgery.

You may want to know:

• About the surgeon’s qualifications.
• How many operations of your procedure are carried out each year.
• How you prepare for the surgery.
• What realistic results can be expected and when.
• How long the results will last.
• About side effects and possible complications.
• How long it will take to recover.
• About the extent of scarring and how it will change in time.
• What happens if anything goes wrong.

Preparation for surgery

• Avoid alcohol, aspirin, garlic and food oils a least a week before surgery as they can cause excessive bleeding.
• Do not eat or drink anything six hours before your general anaesthetic.
• The surgeon and anaesthetist need to know your medical history and if you are on any medication.
• You will be advised of any health checks or X-rays required before your procedure.
• Prior to surgery you will be met by your surgeon who will assess you and discuss your queries.
• Try and give up smoking a couple of weeks before your procedure as it interferes with healing processes.
• Bring an overnight bag for your stay and leave your valuables at home.

What happens during breast surgery?
This depends on the type of procedure you require. However, in all cases you will be placed under general anaesthesia and treated as an inpatient.

Normally a silicon implant ‘shell’ is inserted through a five-centimetre incision on the crease under the breast. Another method may involve making an incision in the armpit and inserting the implant beneath the chest muscle.

In both cases a pocket will be created in your breast and implants centred beneath your nipples. The incision is closed with dissolving stitches and covered with a dressing. Which procedure is best for you and how long the operation takes will be thoroughly discussed with your surgeon.

After surgery

• Your first day is likely to be spent in a recovery room bed being cared for by nursing staff. Your surgeon will visit and advise you when you can leave.
• The reshaped breasts will have to be dressed and may have to be drained after surgery to speed up healing.
• Enjoy plenty of rest (you will feel more comfortable sleeping on your back) and avoid any energetic activity that raises your blood pressure.
• You should not drive for two days after the anaesthetic.
• If you have had a drainage tube inserted it will be removed within two days. Bandages are normally taken off after one to five days.
• Avoid alcohol, aspirin, garlic, food oils and smoking. All of these can interfere with the body’s healing processes.
• Any discomfort, bruising or swelling should be treated with a mild analgesic like Paracetamol. Do not use aspirin.
• Your breasts will feel tender for a several days and it is important that you restrict all arm movements (and not drive) during the first 48 hours to help the healing process.

Road to recovery

• Continue taking painkillers if you need them.
• Your breasts are likely to feel firm during the first couple of weeks, but the sensation will settle after about a fortnight.
• Do not be alarmed if one breast initially drops lower than the other. Both breasts will find their natural position in time.
• The ‘bubbling’ sensation that some women experience is due to the settling of the implant. This is perfectly normal and will soon disappear.
• You will need to wear a bra or crop top night and day after the operation for at least 10 days. It should only be taken off when you shower.
• Your surgeon will tell you when you can return to normal sunbathing activity.
• Scars may initially appear noticeable, however in time they will take on the normal skin colour.
• It is important to understand that breast implants do not last forever. It is recommended that you change them every 10 to 15 years. You should discuss this thoroughly with your surgeon.
• Inevitably there will be some drooping as you continue to age.
• You must contact your doctor if you suffer from an abnormally high temperature, severe pain that is not treated with Paracetamol or if you experience severe bleeding.
• If you are in doubt about any of the postoperative effects speak to your surgeon.

All surgery carries an element of risk
Most people believe that the benefits of breast augmentation far outweigh the risk. However before you sign the surgery consent form you should be aware of any possible complications and side effects.

Complications associated with any type of surgery include problems healing, the danger of infection and the potential formation of clots that may be life-threatening. Excessive bleeding or bleeding under the skin, known as a haematoma, may require a return visit to the surgery. Some patients may also have an allergic reaction to anaesthesia. In a minority of cases there may be a problem with fluid loss or an excessive build up of fluid that needs to be drained.

Deciding on breast augmentation
It is important that you take your time to make an informed decision about surgery. Complications are extremely rare as this is a very common operation, however you must consider any potential outcome.

• After a successful operation you may feel sick due to the anaesthetic and bruises formed by the procedure may take several weeks to heal.
• There will be scars left by the incisions. Scars usually fade but do not necessarily disappear completely. This depends on your skin type.
• In some cases scars may be irritable and red for several months.
• There may be numbness around the incision, which may be permanent.
• Infection of the breast may require the temporary removal of the implant to allow the area to heal.
• Healing tissue may put pressure on the implant and cause some pain. In rare cases you may require further surgery.
• Occasionally implants leak. This can be caused, for example, by an injury. If a leak occurs the implant will deflate over a period of hours and the implant’s saline (salt water) will be absorbed by the body harmlessly.
• There is no evidence that implants cause cancer, affect fertility or your ability to breast-feed.
• When you have a mammogram (for the detection of cancer) you must inform the technician as additional views may have to be taken.

Complications are rare and depend greatly on individual circumstances such as a person’s health and skin type or the extent of the procedure. Your surgeon will be able to explain how the risks apply in your circumstances.