When considering breast enhancement surgery, a thorough consultation is necessary.
Breast Augmentation is by far the most popular procedure requested by women around the world. Irrespective of anything you may have heard to the contrary, there are absolutely no medicines or exercises that are currently available to increase the size of the breast permanently, evenly, and safely.
At present, the only recognised technique for increasing breast size is to insert an implant into a space created behind the person’s own breast tissue. During the recent years fat transfer is also being used to increase the size of a breast, however, the results seem to be short-lived, and the procedure would need to be repeated at least a few times to obtain a more long-term result.
When considering breast enhancement surgery, or any other surgery or procedure for that matter, a thorough consultation is necessary, you should be able to discuss your concerns and goals with wanting surgery, and be fully assessed and be informed of your options, the implications of surgery and whether or not you are a suitable candidate.
Although nothing can take the place of a one-to-one consultation with an experienced Plastic Surgeon, Mr. Rezai a leading Consultant Plastic and Reconstructive Surgeon of Harley Street, London shared with us some of the questions he commonly hears from patients considering breast enhancement surgery.
Q: Can I Choose What Implant and Cup Size I Want?
It is your anatomy along with factors such as your height, width of your shoulders, the width of your hip and chest size which determines the size of an implant suitable for you. In my practice, following a thorough assessment, I offer my patients a range of sizes they can choose from, the size range is based on the above factors and will provide them with natural looking results. You will also be able to try the various sizes within the range in a non-padded, non-wired bra and decide which one you prefer.
In terms of Cup size, as you know these are commercial sizing and there is no standard cup size and if you went shopping you would find that the cup size varies with every shop or bra make. The objective, therefore, during the examination and sizing will be to determine what look you are trying to achieve with the surgery and not cup size.
Q: Can I Decide What Implant Placement to Have, i.e. over or under the muscle?
No. There are various factors in your anatomy that determines the positioning of the implant and the decision should be with your plastic surgeon. Saying that some surgeons do prefer one placement over the over, which in my opinion is NOT right. This should not be a one size fits all situation, every person’s anatomy and lifestyle is different, hence it is important for the treatment plan to be made in accordance to the anatomy and circumstances for each individual patient.
Q: Over or Under the Muscle, Which Placement Would Help Me Achieve a More Natural Look?
If the Positioning and Size of the implant is chosen based on your anatomy and chest measurements, then both sub-muscular (under the muscle) and sub-glandular (over the muscle, under the glands) placements should provide you with natural results. The placement of the implant should be based on the right indications.
Q: Is Having the Implant Under the Muscle More Painful?
Yes, it usually is and the recovery period is also longer when having sub-muscular placement. However, NONE of these should be the determining factors in the decision making. Pain can always be controlled with pain relief medication and the recovery and healing process is something that all patients must go through. I always advise my patients to try and return to their normal activities after one week regardless of the type of implant placement. But wait 4-6 weeks before resuming exercise and strenuous activities. The degree of Pain following surgery varies greatly between individuals, but everyone finds it tolerable and almost all my patients stop taking pain relief medication at day 4 post-op.
Q: Is It True That Anatomical (Teardrop shaped) Implants Give a More Natural Result?
Both Yes and No. It all depends on the preference of the individual, the Size and Placement of the implant and how much volume you would like to achieve on the upper breast pole.
In cases where the breast tissue is significantly more in the lower pole of the breast, round implants would provide better aesthetic results, the reason being that anatomical implants already have a fuller lower pole projection.
Many of my patients have little or no breast tissue and they all ask for natural results. Many of them are under the impression that the round implants would give them a fake look, but that is far from the truth!
When there is little or no breast tissue present, best placement would be sub-muscular, and this means that the upper 2/3 of the implant is covered by the chest muscle, and with time, the muscles relax and give the implants a Natural teardrop shape. With the difference of having slightly more upper pole volume than the actual anatomical implant. However, this process may take up to a year for some individuals depending on how fast their muscles relax and recover post-operatively. But with Anatomical implants, you will see the results much faster, many times only within the first couple of months following surgery.
In terms of other implant placements such as, Sub-glandular (over the muscle, under the glands), Dual plane (upper half under the muscle and lower half behind the glands) and Sub-fascia (Under the fascia of the muscle) the Anatomical implant may provide a more Natural look however, it is important to remember that it is common to lose breast tissue, especially in the upper breast pole with ageing, gravity and following pregnancy, and sometimes it would be better to obtain volume in the upper pole of the breast by using a round implant.
In summary, both Round and Anatomical implants can provide natural results, IF chosen based on the right indications.
Q: Can Breast Augmentation Change the Shape of My Breasts?
Breast augmentation can increase or balance breast size, restore breast volume, or restore the breast shape after a partial or total loss of breast tissue. It can also correct breast size asymmetry. But what it CANNOT do is to correct drooping breasts, non-size related breast asymmetries and breast deformities. In these instances, in addition to using an implant other procedure such as Lift, or some form of reconstructive breast surgery may be necessary to achieve optimum results.
Q: Can Breast Augmentation Surgery Go Wrong?
All surgery carries risks. However, choosing an appropriately qualified and experienced plastic surgeon and following the advice given will keep risks of complications to a minimum. During the consultation, I discuss all the possible risks of surgery, including implant-related complications with my patients at length. It is important that you fully understand ALL the implications of surgery to make an informed decision.
Q: How Long After Surgery Can I go On Holiday?
I advise my patients to NOT book any holiday until 4-6 weeks after the operation, this will allow enough time for the initial stages of the healing to take place. But it is important to understand that the healing process continues for months and for some people up to a year after the surgery, thus it is important to follow the advice and instructions given at every stage after the surgery as this will certainly impact the end results.
Q: Will Breast Augmentation interfere with Breast Feeding?
Breast augmentation is extremely unlikely to impair lactation or interfere with breastfeeding, especially when the implants are placed in the sub-muscular position.
Q: Do Breast Implants Need to Be Replaced?
Although some breast implants come with a lifetime guarantee from the manufacturer, it does not mean that they will last forever. The reality is that no one really knows how long any breast implant will last. Most silicone implants of today are made of a cohesive gel. This gel does not leak or break down even if the outer shell is compromised. With the two implant brands I use in my practice there is no need to change them routinely, for some they can last a lifetime but for most they need to undergo further surgery at some point of their life, for either leakage, capsular contracture (hardness of the capsule around the implant), or to simply improve the size and shape of the breasts following weight loss, pregnancy or ageing. In any event, it is safe to say that if you are happy with the implants, and they are giving you no problem, then leave them in but make sure you carry out regular self-examination of your breasts and have some type of scan every 3-4 years.
These were ONLY a few of the questions frequently asked by patients contemplating Breast Augmentation surgery, remember that Nothing you ask is considered as bad question. It is important that you fully understand ALL aspects of any Surgery or Procedure you are considering, so try to prepare a List of Questions before your Consultation, and Do Not be Afraid to Discuss All of them with your Plastic Surgeon.
To conclude, we asked Mr Rezai to provide a list of what he believes to be the most important considerations to be considered when contemplating Breast Enhancement Surgery and choosing a surgeon. The following was his reply in the form of a simple but comprehensive checklist: