Breast augmentation is one of the most common cosmetic surgical procedures performed on women in the UK.
The breast is one of the most important attributes of female beauty – a symbol of attractiveness and desire. Many women are not completely happy with the size and shape of their breasts – particularly when the contours of their bust changes due to pregnancy, breast-feeding, weight fluctuation or the menopause. As they age, a woman’s breasts tend to droop, losing some of their roundness and fullness and today women who are unhappy with their breasts have many options which include breast augmentation.

 To increase self confidence and enhance self image.
 To enhance the body contour of a woman who feels her breasts are not in harmony with the rest of her figure
 To correct a reduction in breast size maybe after pregnancy and breast feeding
 To balance a difference in breast size
 To use as a reconstruction technique following breast surgery
 To balance a reduction in size of breasts after weight loss

The best candidates for breast augmentation are women who are looking for improvement in their body, are physically healthy, psycologically stable, preferably do not smoke and are realistic in their expectations about the procedure and results.. Breast augmentation, mammaplasty is generally not to develop an unnaturally large dream bust, but to enhance the natural contours of the existing breasts. Most women want naturally augmented breasts that fit in harmony with the rest of their figure. Any discussions with the surgeon will include appropriate new bust size and shape, the outcome, any side effects of treatment and expectations.

Prothesis
Prothesis come in many different shapes and sizes from high profile to low profile and from a textured surface to a smooth one, and also the kinds of materials they are filled with. The new silicone implants are considered to be more natural than saline filled implants.
The protheses exterior is made of thin, tough silicone elastomer, and or concentrated gel and they are either classic – round in shape (filled with liquid silicone gel or concentrated gel) or tear drop shape or so called anatomical implants. Both are available in various sizes. Silicone – approved since November 2006 for women over the age of 18 is approved for implants.
Prothesis (implants) come in different sizes and shapes with the exterior made of thin tough silicon elestomer. They can be filled with silicon gel or physolic salt solution. There are classic round implants or tear drop (called anatomical implants), which you may prefer,
Round implants are able to move while in position without distorting the shape of the breast and show a pronounced upper edge but if there is a moderate amount of breast tissue can also offer a natural look while anatomical implants were developed for a more natural sloping breast. If a patient is very slim and has minimal breast tissue a tear drop implant may give a more natural shape.

The advantages of saline filled implants are:
• In the event of a rupture the saline is absorbed by the body
• They are not as durable as silicon ones
• They have a higher risk of visible folds and ripples
• They feel firmer than silicone implants
• Deflation is not uncommon

The advantages of silicone filled implants are:
• They look and feel more natural
• They maintain their shape
• The risk of dispersal, should it rupture, is minimized as it is not liquid.
Implants do not interfere with mamography but you should inform the radiographer you have them. They also do not interfere with breastfeeding but should not be considered until approximately 6 months after finishing.
For technical medical and ethical reasons approximately 2 weeks before the operation procedure no medication containing asprin should be taken. Paracetemol may be taken as a painkiller if required.

Pre-visit and during consultations the surgeon will try to evaluate your physical-mental health and any medical conditions. In order to obtain the best results it is important that you are honest with the surgeon, that you advise any previous surgeries, if you are taking any medications, herbal supplements, vitamins or other drugs and if you smoke. Be sure to discuss your expectations and goals. The surgeon is here to guide, advise and explain to you how the surgery will be performed, possible alternatives that may offer better results, the risks and limitations of each as well as details of follow up and after care.

The Procedure

Firstly marks on your skin to show the contours of the new breasts will be made (these are not incisions).
Silicon breast implants come pre-filled and cannot therefore be inserted by a TUBA incision through the belly button unlike implants which are empty when the protheses are being inserted. There are 3 alternative incision sites available:
 In the armpit
 In the crease below the breast
 Around the lower edge of the areola (the dark skin around the nipple)
The breast skin and tissue will be lifted and depending on its condition the protheses will either be inserted between the mamary gland and the pectoral muscle or between the pectoral muscle and the chest. It will then be centred behind the nipple. (subglandular/submuscular).
Round implants are often criticised for giving a less natural looking result than anatomical implants, however many say they take a natural shape of the bust when held vertically into position in the body. If the patient has a reasonable amount of breast tissue the more pronounced upper edge is not so prevalent.
Anatomical implants have been designed to create a more natural looking (a gently sloping breast).
Silicone is the second most common element on the planet after oxygen – so all of us almost certainly have some in our bodies where it does no harm. It is a cohesive gel and has the property of sticking to itself strongly making breaks virtually impossible and the implant shells are slightly thicker making ruptures unlikely. For more information see Swiss Federal

Office of Public Health. www.thecosmetic-surgery-director.com.
When a patient is very slim and has very little breast tissue a tear drop implant may give a more natural shape and if a very large implant is used disproportionate to the patient’s body size this will look unnatural.

The day after the operation drain tubes will be removed and you will be able to leave the hospital. You will have to wear a compression bandage around your bust usually for 24 hours. Then this can be replaced by a sports bra which should be worn both day and night. Any scar cut in the armpit, below the breast or around the areola will be about 4-5cm long and will be dark and firm for up to 6 weeks but should fade after a few months. Depending on your occupation you should allow for at least 4 days and after 6-8 weeks when all signs of the operation have healed you will be able to return to normal. You can take some light exercise, such as walking after 7 weeks from the operation date. Other more exertive sports should be left until after 6-8 weeks.
Initially you will feel a slight pressing sensation which may last up to two weeks and some patients have said that they have had the sensation of a foreign object in their bodies but this passes. It is important to keep the breast area stable to allow the implant to settle in as soon as possible. All instructions given by your specialist should be followed exactly.
There is no evidence that breast implants will affect fertility, pregnancy or the ability to breast feed although a space of approximately 6 months should be left before surgery is considered after breast feeding. If you are having breast screening you should advise the radiographer.
Most patients are extremely happy with their breast augmentation – there is an increased amount of self esteem and self confidence.
It is not known how long exactly implants will last in the body and may not last a lifetime. Breasts will droop with gravity, ageing and weight loss, the average lifespan of a breast implant is 16 years before replacement or extraction.
In the body the wall of the implant may be weaker and become disrupted but this is more likely when there is an impact injury such as from the steering wheel of a car or a fall.
If you decide to have implants removed permanently this can be accomplished but you will probably require additional surgery to tighten the skin and breast tissues which have stretched to accommodate the implants.

to learn more about any risks and complication . 

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