Breast Augmentation
Breast Enlargement Surgery
Breast enlargement or breast augmentation surgery is the process of making the breasts bigger using breast implants or using enlarging the breasts using fat injection or fat transfer to the breasts. Breast enlargement is sometimes referred to as a “boob job” or as breast augmentation using “gummy bear” implants. The breast augmentation procedure is preformed under a general anaesthetic but it can in some instances be preformed under sedation and for fat transfer can be preformed under local anaesthetic. We provide consultations for breast augmentation in London, Manchester, Birmingham, Reading, Doha and Beirut. The costs of a consultation for breast augmentation and the price of a breast enlargement procedure are displayed below. We will walk you through our breast enlargement journey with us from beginning to end on this page. Should you have any questions about breast surgery please get in touch with us.Â
Only after a thorough history and a physical examination by a plastic surgeon can we determine and advise you on the best implant or amount of fat needed to a achieve the result you want. It is possible to combine a breast augmentation with a breast lift (mastopexy), breast reduction, or other plastic surgery procedures.Â
Breast asymmetries or other breast deformities related to tubular breasts, polland’s syndrome or other chest wall deformities can be corrected using a breast implant or breast fat transfer or a combination of both. It is also possible to combine a breast augmentation procedure with additional layering using collagen dermal matrix to help achieve a better cover for a breast implant in cases were the breast skin is too thin to cover the implant.Â
Choosing the right Plastic Surgeon
The first step in achieving your goals is to choose the right surgeon. Plastic surgeons are not only trained in breast surgery, but also in aesthetic surgery. This means that a plastic surgeon will be able to preform the procedure of breast augmentation using aesthetic principles to achieve the best results for you.Â
consultations options
We offer 3 consultation options. Virtual consultations are useful for those only wanting information or live far. We cannot do physical examinations but we can review photos. Mini consultations are suitable for those wanting to know their options. Full consultations will give you all the information you need allowing you to make an informed decision. Before proceeding to surgery, all patients will need a full consultation.Â
Breast implant sizing
We will size you for the breast implant in our office. We use a dedicated sizing kit system that is extremely accurate in predicting breast size according to your desired bra size and allows you to see your new breast shape in your own clothes. The system we use allows for sizing from 50 cc to 900 cc giving you the range needed to achieve your breast goals.Â
Breast IMPLANTS-How to choose
The choice of the breast implant is one of the first questions asked about in breast enlargement and one of the most important questions for the woman seeking breast implant surgery.
Most breast implants we use in our surgeries in London or Manchester are silicone based implants. Silicone implants are pre-filled with silicone gel — a thick, sticky fluid that closely mimics the feel of human fat. Most women believe that silicone breast implants look and feel more like natural breast tissue. The silicone implant has an elastomer silicone shell pre-filled with viscous silicone gel. We are now implanting the 7th and 8th generation of silicone breast implants. The newest silicone implants have a slightly higher fill (96% fill versus the previous generation’s 85% fill) and more cross-linking of the silicone molecules. The higher fill and more cross-linking allow for an increase in the cohesiveness of breast implants, as compared to past generations of implants, in which the folds of the silicone implant could be visible through the skin.
Rarely we will use Polyurethane implants in selected cases. Microthane® is a micropolyurethane foam coated shell surface for breast implants. They are particularly useful for cases with capsular contracture. The main disadvantage of Polyurethane implants is that they are difficult to remove as they integrate into the breast tissue.Â
Round implants are essentially the same diameter and have a circular base. They are ideal for a full rounded augmentation with good upper pole fullness and maximum projection.Â
Shaped breast implants are egg shaped. They tend to have less upper pole fullness and deliver a more “natural breast” with a fuller lower pole. They are great if you want the most projection in the lower breast. The biggest risk with shaped implants is the risk of rotation of the implant within the pocket of the breast.Â
The more the projection the more the breast will be pushed forward.Â
Medium projection will have an impact on this, but little impact on lifting the breast up at the same time.Â
High projection implants are by far the commonest choice along with round implants within our patient groups. This implant will give the maximum side push for the breast and will also give some lift to the nipple improving its position. Â
Finally there is the volume. The volume of the breast implant tends to be one of the most important decision makings for the patient. The volume in the breast enlargement surgery determines the overall fullness of the breast. The larger the volume the larger the breast to be. The breast implant volume has a direct impact on bra cup size
As an estimate, each 150cc increase in breast implant volume reflects in a single increase in cup size in a bra. However as every woman knows, bra sizes vary from shop to shop, and so this is only an estimate.Â
Textured means that that implant has a roughness on its surface. Studies have shown that this improves the longevity of the implant by reducing capsular contracture rates after a breast enlargement surgery. Unlike smooth-surfaced implants, their surface adheres to the tissue that surrounds them, preventing them from moving around within the implant pocket, especially beneficial for tear-drop shaped implants to prevent rotation within the pocket. There is different ways of texturing and different types of texturing. You might hear the terms macro-textured, micro-textured, and nano-textured. Texturisation techniques are also different with imprinting, the use of salt crystals, or chemicals.
As an estimate, each 150cc increase in breast implant volume reflects in a single increase in cup size in a bra. However as every woman knows, bra sizes vary from shop to shop, and so this is only an estimate.Â
BIA-ALCL is a rare and highly treatable type of lymphoma that can develop around breast implants. BIA-ALCL occurs most frequently in patients who have breast implants with textured surfaces. This is a cancer of the immune system, not a type of breast cancer. The current lifetime risk of BIA-ALCL is estimated to be 1:2,207-1:86,029 for women with textured implants. When caught early, BIA-ALCL is usually curable.
Common symptoms include breast enlargement, pain, asymmetry, lump in the breast or armpit, overlying skin rash, hardening of the breast, or a large fluid collection. If you are experiencing any symptoms related to BIA-ALCL you should consult your surgeon.Â
Treatment of BIA-ALCL
- Once diagnosed the woman is referred for a PET/CT scan to look for any disease spread. Â
- The patient is referred to an oncologist.
- For patients with BIA-ALCL only around the implant, surgery is performed to remove the breast implant and the scar capsule around the implant.
- Lumps in the armpit may be disease that has spread to the lymph nodes or may still be a normal enlargement of the lymph nodes. Additional tests may sometimes include blood tests and a bone marrow biopsy.
- Some patients with advanced cases may require further treatment with chemotherapy and in rare cases include radiation therapy and/or stem cell transplant therapy.
- Following removal of the disease, patients are commonly followed for two years with imaging tests such as PET/CT scans in three- to six-month appointments. Disease re-occurrence is rare after surgical removal for early disease.
Breast implant illness (BII) is a term that refers to a wide range of symptoms that can develop after having a breast implant, regardless of the type of implant. Symptoms can include:
- joint and muscle pain
- chronic fatigue
- memory and concentration problems
- rashes and skin problems
- anxiety
- depression
- headaches
- hair loss
- gastrointestinal problems
Some people who have BII also get diagnosed with a specific autoimmune or connective tissue disorder.
Implants can be placed under the breast tissue and above the pectoralis muscle of the chest wall. This is by far the most popular way of doing breast augmentation in the world. It tends to be less painful than other techniques and has less risk of bleeding. To benefit from this though you will need to have good pre-existing breast tissue and the breast in a good position on the chest wall. As a guide, we would say you will need around 2 cm of existing breast tissue to get a good result. Otherwise there is the risk of developing rippling, the effect of the breast implant showing through the thin breast.Â
Dual plane involves placing the upper portion of the implant under the pectoral muscle, while allowing the lower half of the implant to sit directly under the breast tissue, over the pectoralis muscle. This achieves coverage of the implant on the top with the muscle, which is considered the most vulnerable part of the implant. Dual technique though goes a bit beyond, as it allows for control of the position of the breast on the implant. Â
Placing the implant under the pectoralis major muscle gives more coverage on the upper pole and reduces the chances of developing rippling that is visible. Placing the implant under the muscle reduces the risk of developing a capsule contracture by a further 5%. The main draw backs of going under the muscle are animation of the implant (it will move if the muscle contracts), more painful initially, higher risk of bleeding initially.
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