Before The Procedure
Breast surgery is usually performed under a General anaesthesia although it is possible to have this done under a Local anaesthesia. This can be discussed with you at the time of your consultation.
The breast implants are inserted through a small 4 to 5cm incision and the most frequently used site for placing this incision is along the crease beneath the breast, implants can also be inserted through incisions placed in the armpit and beneath the nipple- areola complex. The most suitable site for the incision will be discussed at your consultation and the choice will depend on the area your consultant feels you would get the best results.
The breast implant may be placed behind each breast, inserting it either under your breast tissue (sub glandular) or behind the muscle on which the breast lies (sub muscular) as illustrated in the diagram below. Sub muscular placement is desirable in women who are very slim with very little subcutaneous fat, the advantages being edges of the implant are not visible as they are blunted by the overlying muscle and also there is a lower incidence of capsular contracture. One of the disadvantages of sub muscular placement is that the implant may move when the woman exercises.
Immediately After The Procedure
Pain Control:
Generally after breast augmentation you should not have more than a mild pain and this usually responds well to ‘Paracetamol’ or ‘Co-codomal’. Please avoid taking aspirin or Voltarol as this may cause bleeding/haematoma formation. You will be given a supply of pain relief medications on discharge.
Antibiotics will be given before and after operation which is to minimize the risk of infection.
Wound dressings:
The surgical wounds will be covered with protective dressings and should be left undisturbed until you’re seen in the clinic which is with 7 to 10days after the operation. However if the dressing is soiled with discharge you will need to report to the hospital nurse or your GP’s practice as soon as possible for an examination and change of dressings.
Support Bra: You will need to wear a good fitting support bra day and night for 6 weeks to maximize the benefits of the operation.
Rest and Relaxation: It will be helpful to have someone with you for the first few days after returning home. You should be able to return to work within a few days, depending on the level of activity required by your job. Your breasts may be quite sensitive for two or three weeks so you will want to avoid direct stimulation. Once they are no longer sore, usually within three to four weeks after surgery, contact is fine.
Driving and work: Do not drive or operate machinery for 2 weeks.
Exercise: Resume gentle exercise after 2 weeks and avoid strenuous exercise for at least 6 weeks. Avoid stretching of upper torso and arms for a minimum of 3 weeks to prevent wound problems.
Other Things to Consider After Your Surgery
Breast feeding and pregnancy:
Silicone has never been shown to harm a breast fed baby. Implants themselves do not usually interfere with the ability to breast-feed. Breasts do enlarge as much as 3 bra cup sizes during pregnancy and breast-feeding and a very large implant will add further to the weight resulting in excessive stretching of the breast skin and sageness.
Age:
Breasts naturally change in size and shape with age. Augmented breasts will also change with age and the outcome is not predictable.
Mammography:
Silicone breast implants obscure breast tissue on conventional mammograms. It is therefore important to inform the radiographer (person who takes the x-ray pictures) if you had implants in your breasts and additional mammogram may be taken using special techniques. Breast ultrasound or MRI (Magnetic Resonance Imaging) is useful additional investigations for specific breast problems.
Sensation:
Nipple sensation is altered in about 1 in 7 women after breast augmentation. It can be reduced, heightened or lost. These changes are usually temporary but can sometimes be permanent in a small number of women.
Sexuality:
There is no doubt bigger boobs boosts confidence and self-esteem and improved self confidence tends to have a positive effect on a woman’s sexuality.
Scars:
Most people tend have a nice thin scar, but hypertrophy and very occasionally keloid change is known to occur in a very small proportion of patients.
Asymmetry:
Some degree of mild asymmetry between breasts in terms of size, shape and placement on the chest wall is normal. breast enlargement may make these mild discrepancies more noticeable. Marked degrees of asymmetry between natural breasts can be improved by the insertion of different sized implants.
Shelf life of Implants:
Breast implants have a limited life span (about 10 years) and women should be aware of the possible need for further surgery for change of implants and the future costs involved.
Visibility of implants:
With age breast tissue tends to weaken. Consequently, tissue overlying the implant becomes thinner and the edges of the implant may become more obvious. This can be best prevented by placing the implant in a Sub-muscular pocket of the implant.