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Breast Augmentation - Overview

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What Is Breast Augmentation / Breast Enlargement?

Breast augmentation—sometimes referred to as breast enlargement, augmentation mammoplasty —is a surgical procedure that increases the size of the breasts. Most commonly breast implants are placed either beneath the chest muscles or the breast tissue. More rarely the augmentation is achieved by moving fat from another part of your body to your breasts (known as lipofilling, lipomodelling, and loop-augmentation).

Many people choose breast augmentation for various personal reasons. Some find that increasing their breast size boosts their self-assurance and body image. Others pursue this procedure as a component of breast reconstruction due to health conditions or personal circumstances.

If you are contemplating the idea of undergoing breast augmentation, initiating a conversation with a qualified plastic or breast surgeon is crucial. It is important to have a clear and comprehensive understanding of every aspect of the procedure. This includes being aware of potential risks and complications, as well as knowing what to expect during the recovery period.

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Ensuring you are well-informed will assist you in making the best decision for you, keeping your health and well-being at the forefront. If you are ready to start your journey, get in touch with our skilled team of London-based plastic surgeons today. 

Why People Choose Breast Enlargement

Breast augmentation is a popular option for individuals looking to alter the size and shape of their breasts. The procedure has the potential to boost your self-image and enhance feelings of confidence. However, maintain realistic expectations and understand that this surgery won't deliver perfection.


In addition, your breasts will naturally continue to age even after undergoing augmentation. Changes in your body weight can also affect how your breasts appear over time. If you are unhappy with these changes, additional surgery might be necessary.


Before you decide, weigh the benefits against the potential changes and challenges. Ensure your choice is informed and tailored to your personal needs and circumstances. Opting for breast augmentation could be beneficial for several reasons:

Improving Appearance:

  • This procedure is a viable option if you believe your breasts are too small or if you're experiencing asymmetry that affects your choice of clothing and the type of bra required to address the imbalance.


Adjusting Post-Pregnancy or Weight Loss:

  • Augmentation can help restore breast size that may have reduced following pregnancy or a significant drop in body weight.


Balancing Asymmetry:

  • If you've undergone breast surgery for other medical reasons and are left with uneven breasts, this procedure can help create a more balanced appearance.


Enhancing Self-Confidence:

  • Many find that enhancing their breast size positively affects their overall self-esteem.


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Types of Breast Implants

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When it comes to breast augmentation, understanding your options is crucial. There are mainly two types of implants available: silicone and saline. Although previously used, saline implants are increasingly less common in the UK.


Silicone implants are popular and many prefer them because they offer a more natural feel and are less prone to wrinkling. However, if a silicone implant leaks, the gel may remain in the implant shell or escape into the breast implant pocket, possibly leading to complications such as lumps.


On the other hand, saline implants are filled with sterile salt water. They're slightly more prone to folding and rupture compared to silicone implants. However, if a saline implant were to leak, the saline would be safely absorbed and naturally expelled by the body.


Engage in a detailed discussion with your surgeon about the pros and cons of each implant type. Considerations should include:


  • Implant material (silicone or saline)

  • The preferred size and shape of the implant

  • The placement location


By weighing these factors carefully with professional guidance, you can make an educated decision that aligns with your expectations and comfort.

Types of Breast Augmentation Surgery

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Breast augmentation surgery varies in its approach, with the main distinction being the placement of the implants.

Sub-Glandular

  • This method involves positioning the implant directly behind the breast tissue and on top of the chest wall muscle.

  • It typically results in less post-surgery discomfort.

  • It may be an excellent option for individuals experiencing a slight sag in their breasts, providing a lift and enhancing the overall appearance.

Sub-Muscular

  • The implant is placed behind both the breast tissue and the chest wall muscle.

  • This technique offers additional padding around the implant, which can be particularly beneficial for those with a slender build or limited breast tissue, minimising the chances of the implant being felt or seen.

  • Though this method may involve a longer recovery time, the end result tends to look more natural, especially in the upper breast area.

  • Keep in mind that implants placed behind the muscle may shift during muscle contractions, a phenomenon known as animation. This is a normal response and is to be expected.

Dual Plane

  • This innovative approach combines the benefits of both sub-glandular and sub-muscular placements.

  • The implant is positioned partly behind the breast and partly behind the muscle.

Your surgeon will help you choose the most suitable approach for your unique needs and body type. Open dialogue and a clear understanding of the procedure are key.

Preparing For Your Breast Augmentation

The initial step involves a thorough discussion with your plastic surgeon to express your desires regarding the size, texture, and overall appearance of your breasts.

  • In-Depth Consultation:

Engage in a comprehensive dialogue with your surgeon, exploring the various implant options available, such as silicone versus saline, round or teardrop-shaped, and smooth versus textured surfaces. Additionally, consider the potential surgical methods best suited for your needs.

  • Educational Resources:

Take the time to read through any informational materials provided—especially those from the implant manufacturer—and ensure you keep a copy for your personal records.


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As you consider moving forward with the procedure, reflect on the following key points:

  • Breast Sagging:

Implants do not counteract sagging. Your surgeon might suggest a breast lift to address any drooping.

  • Impact on Mammograms:

Having implants requires additional specialised imaging during mammograms.

  • Breastfeeding:

While many can breastfeed post-augmentation, it might pose challenges for some.

  • Potential for Additional Surgery:

If you ever decide to remove your implants, you may need further procedures to enhance the appearance of your breasts.


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Before the procedure:

  • Medical Clearances and Adjustments:

You might require a baseline mammogram, and certain medications could be temporarily halted to reduce bleeding risks.

  • Lifestyle Modifications:

If you smoke, you’ll need to quit for a specified period before and after the surgery.

  • Post-Surgery Support:

Arrange for someone to drive you home post-procedure and stay with you during the initial recovery phase.

The procedure itself can be conducted in an operating theatre under a general anaesthetic, typically allowing you to return home the same day. 

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What Happens During a Breast Implant Procedure

Here is a breakdown of what typically happens during the breast implant procedure:

  • Choosing the Incision Site:

Your surgeon will start by making a single cut. The location of this cut can be under your breast (known as inframammary), under your arm (referred to as axillary), or around your nipple (termed periareolar).

  • Creating Space for the Implant:

Post-incision, the next step involves lifting your breast tissue and making room for the implant. This space can be either behind the chest wall muscle or in front of it.

  • Inserting the Implant:

Depending on your choice and prior discussions with your surgeon, a saline or silicone implant will be inserted. If it’s saline, it goes in empty and is filled once in place. If it’s silicone, it’s pre-filled.

  • Closing Up:

With the implant securely in place, your surgeon will stitch up the incision and apply bandages, often using skin adhesive and surgical tape to aid the healing process.

  • Duration:

Typically, the procedure lasts 60 to 90 minutes.


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Recovery After Breast Augmentation

Breast augmentation is a significant procedure, and like any surgery, it requires a period of recovery. Here’s what you can generally expect during this time:

  • Post-Surgery Movement:

Most people find they can get up and move around soon after the procedure. This is an important part of the recovery process.

  • Time Off Work:

Planning for adequate time off is essential. You’ll likely need to take one to two weeks away from work to allow your body the time it needs to heal.

  • Driving:

Avoid driving for at least the first week post-surgery.

  • Wearing a Sports Bra:

Many surgeons recommend wearing a sports bra constantly for up to three months after surgery. This helps in supporting your breasts and keeping them secure as they heal. Be sure to confirm this with your own surgeon, as recommendations can vary.

  • Restricting Activities:

For the first month following surgery, steer clear of heavy lifting and strenuous exercise.


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In terms of your recovery timeline:

  • First One to Two Weeks:

Any non-dissolvable stitches will be taken out. If you have dissolvable stitches, they will start to disappear on their own.

  • Six Weeks:

By this point, you should be able to return to most of your regular activities. Additionally, any scars should begin to become less noticeable.

  • Several Months Post-Surgery:

Your breasts should have settled more, taking on a more natural look and feel. You might also be able to stop wearing the sports bra around this time.

While recovery is ongoing, keep an eye out for any signs of complications, such as warmth and redness in the breast area, fever, shortness of breath, or chest pain. These could be indicators of an infection or other issues, and you should reach out to your surgeon right away if you experience them.

Remember, every person’s body is different. Follow your surgeon’s advice and give yourself the necessary time to heal.

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The Longevity of Breast Implants

Breast implants are durable, but they are not designed to last forever. Over time, they may need to be replaced or revised to maintain the desired aesthetic and ensure safety.

Generally, implants can last from 10 to 15 years. However, this does not mean they will automatically need replacement after this period. Some may last longer, while others might require attention sooner.

Around the 10-year mark, some individuals might consider additional surgery. This could be due to a variety of reasons:

  • Changes in personal preference regarding size or shape

  • Complications with the implants, such as rupture or leakage

  • Natural changes in breast tissue over time, altering the appearance and feel of the implants

Anyone with breast implants should maintain regular check-ups and stay vigilant for any changes in their breasts’ appearance or feel.

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Risks of Breast Augmentation

Breast augmentation carries certain risks and potential complications. These include the following:

  • Scar Tissue:

There is a possibility of scar tissue forming and altering the shape of the breast implant, a condition known as capsular contracture.

  • Pain in the Breasts:

Some people experience pain in their breasts post-surgery.

  • Changes in Sensation:

You might notice changes in the sensation of your nipples and breasts.

  • Shift in Implant Position:

The implant could shift from its original position.

  • Implant Leakage or Rupture:

The implant can leak or rupture, requiring further intervention.

  • Hardening of Breast:

This happens when scar tissue shrinks around the implant and is known  as capsular contracture.

  • Creases or Folds:

The implant may develop wrinkles or folds.

  • Abnormal Shape:

If the implant rotates within the breast, it could lead to an irregular shape.

  • Rippling of Implant:

This is when the implant is covered only by a thin tissue layer, leading to visible rippling.

  • Breastfeeding:

If you breastfeed post-surgery, you might produce slightly less milk.


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Addressing these issues could require additional surgeries, either to remove or replace the implants.

Every surgery has general risks, including:

  • Bleeding and Clots:

Although rare, blood clots can pose a severe risk.

  • Infection:

Any infection that does occur would typically be treated with antibiotics.

  • Allergic Reactions:

You might have an allergic reaction to medicines or products used during the surgery.

Breast Implant Illness


Some people have reported systemic symptoms. This is called breast implant illness (BII); however, the connection to breast implants is not fully understood.

Symptoms can include fatigue, memory issues, skin rashes, joint pain, and more. Removing the implants may alleviate these symptoms, and research is ongoing to understand this condition better.


Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)


This is a rare type of immune system cell cancer linked to breast implants. It has been found in a very small number of individuals with implants located in the scar tissue surrounding the implant.

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