Indications: Small or underdeveloped breasts, asymmetrical breasts, deflated breasts, breast cancer and/or mastectomy, breast deformity.

Procedure: Breast is enlarged using various sizes, shapes, profiles of silicone breast Implants inserted through an incision and placed in a suitable position. Fat transfer to Breast may also be used however, this is not a suitable option for everyone.

Operation: Takes between 45-60 minutes and is performed under general anesthetic.

Benefits: Breasts in proportion to the rest of the body. Improved confidence.

Recovery: 7-10 days depending on implant placement and patient’s anatomy.

Result: Final result is usually seen between 6-12 months, depending on implant placement and patient’s anatomy. Pregnancy, significant weight fluctuations and ageing will alter the results over time.

Notes: Treatment plan including implant size, shape, profile and placement is personalised for each patient, based on the patient’s height, width of shoulders and hips, chest measurement, anatomy and of course the patient’s wishes.

Indications: Droopy and sagging breasts, which may be genetic or a result of significant weight loss, pregnancy, certain lifestyle or simply the effects of the inevitable ageing process.

Procedure: Various techniques and incision patterns are used depending on the degree of the breast, however the common goal is to correct breast ptosis by removing excess skin and repositioning the nipple-areola hence altering breast volume and contour.

Op-Time: Takes between 60-90 minutes and is performed under General Anesthetic.

Benefits: A natural and more youthful breast shape. Improved confidence.

Recovery: 10-14 days.

Result: Result is usually seen between 6-12 months. Pregnancy, significant weight fluctuations and ageing will alter the results over time.

Notes: For added volume and size increase breast implants or fat transfer may be used.

To learn more read: 5 Things You Should Know About Breast Uplift Surgery

Indications: Large, heavy and sometimes pendulous breasts causing considerable physical pain and/or psychological distress.

Procedure: Various techniques and incision patterns are used depending on the required size reduction. The goal is to remove excess glandular tissue, fat and skin, reposition the nipple-areola and create a proportionate breast size and natural breast contour.

Op-Time: Takes between 60-90 minutes and is performed under general anesthetic.

Benefits: More proportionate breast size and improved breast shape, improved self-esteem and confidence and no more physical pain and psychological distress.

Recovery: 10-14 days.

Result: Final result is usually seen between 6-12 months. Pregnancy, significant weight fluctuations, ageing and hormonal will alter the results over time. And sometimes even hormonal changes can significantly increase the breast size.

Notes: There are limitations as to how much tissue can be removed from a breast, without causing complications. What is important is to ensure that the new breasts are symmetrical, balanced and in proportion to the individual’s frame.

To learn more read: 5 Things to Know Before Getting Breast Reduction Surgery

Indications: Under-developed breasts, narrow and elongated cylindrical shape, abnormal breast base constriction with little or no breast tissue, enlarged, bulging and herniated nipple areola complex (pigmented area around the nipple), abnormal wide cleavage due to the breasts being far apart. High located breast fold (inframammary fold), fold may be absent in severe cases. Droopy breast that looks long and constricted.

Procedure: A combination of various techniques is normally used depending on the characteristics and severity of the condition. The goal is to release the underlying constricted tissue, widen the constricted base of the breast to a normal size, lower the infra-mammary fold, increase the skin envelope, increase the size of the breast using implant or own tissue, reduce the size of the nipple-areola complex and restore breast symmetry.

Op-Time: Takes between 60 minutes to 3 hours and is performed under General Anesthetic.

Benefits: An improved and more natural and rounded breast shape and projection. Improved confidence.

Recovery: 10-14 days.

Result: Final result is usually seen between 6-18 months depending on the severity of the condition. The result keeps improving over time. Pregnancy, significant weight fluctuations and ageing will alter the results over time.

Notes: Usually in cases of severe tuberous breasts, a second minor surgery is necessary for optimum result.

Indications: Breast cancer, mastectomy, breast Injury.

Procedure: The procedure and timing for breast reconstruction depend on each patient’s circumstances and preference. These vary from the use of implants, through to the latest techniques of autologous (living) tissue reconstruction, in which the patient’s own tissue from another part of the body is transferred to the chest area to create the new breast. Sometimes a combination of implant and patient’s own tissue is required to achieve optimum results.

Op-Time: Takes between 2-5 hours depending on type of reconstruction.

Benefits: Brings balance and proportion back to a woman’s body and at the same time restores her sense of self-confidence and self-esteem.

Recovery: 10 days to 3 weeks depending on type of reconstruction.

Result: Final result is usually seen between 9-12 months depending on the type of reconstruction.

Notes: Breast reconstruction is a highly personal choice and the decision process can seem overwhelming. It can sometimes mean undergoing multiple or accompanying procedures. It is important to think both short and long-term. Work with your doctors and plastic surgeon to thoroughly discuss and plan your treatment. A few of the things to consider while planning include: the stage of your breast cancer and any adjunct treatments, your general health and healing ability, your breast size and whether one or both breasts will be reconstructed, your preferences for balance and shape, elected procedures, your downtime and costs. It is important to take time to consider your options so you can feel confident about what you decide.

Indications: Gynecomastia or enlarged male breast. Enlarged breast can be made up of fatty tissue, breast gland tissue, or a combination of both fatty and glandular tissue.

Procedure: It involves reduction of breast size, flattening and enhancing the chest contours. Techniques used can be liposuction or a combination of liposuction with excision of glands through the areola. In severe cases, where excision of skin is also required, similar techniques as in female breast reduction may be applied.

Op-Time: Takes between 60-90 minutes and is performed under general anesthetic.

Benefits: A natural and more youthful breast shape.

Recovery: 7-10 days.

Result: Final result is usually seen between 6-9 months. Hormonal imbalance, significant weight fluctuations and ageing will alter the results.

Notes: If gynecomastia is caused by hormonal imbalance, it is important to treat that first before undergoing surgery to change the appearance and size of the breast.

To learn more read: Have You Heard Of Gynecomastia Surgery?

Thorough consultation, open communication and personalised treatment plan are key in achieving the best possible outcome.

To conclude, Mr Rezai shared this checklist of what he believes to be the most important considerations to be taken into account when contemplating breast surgery or any other surgery for that matter.

For more information about breast augmentation surgery or any other types of breast surgery, please call +44 2075808001

RealSelf Patient Reviews of Allen Rezai, MD

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.

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.

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.

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.

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.

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.

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.

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.

Breast augmentation is extremely unlikely to impair lactation or interfere with breastfeeding, especially when the implants are placed in the sub-muscular position.

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:

For more information about breast augmentation surgery or any other types of breast surgery, please call +44 2075808001

RealSelf Patient Reviews of Allen Rezai, MD

There are two main breast implant shapes – round and anatomical or teardrop shape. Round implants are round as the name implies with harmonious distribution of the volume, whereas anatomical implants are teardrop shaped, similar to the anatomy of the normal breast, with most of the volume in the lower pole. Round implants come in two cohesivities and both smooth and textured surface, but anatomical implants come only in textured surface and one cohesivity.

Each shape has its pros and cons and some surgeons prefer one over the other, whilst others are happy to use both shapes depending on the patient’s anatomy, indications and preference.

It is a common myth that round implants produce a more “fake” look. This is not true. Both shapes can produce “Natural Looking” results if selected correctly. Factors to consider are patient’s chest anatomy, amount and distribution of breast tissue, Implant placement (Behind the muscle or behind the glands) and of course the patient’s desired “look”.

I always encourage my patients to try both shapes of implants in a bra to see how the volume is distributed over their chest. And many times, they know straight away which shape they prefer. If I see that one shape suits an individual more than the other, I discuss this with them and explain why this shape is better for them, but ultimately it is the patient’s decision, my role is to make sure they understand the implications involved and the type of outcome they should expect.

Both round and anatomical implants come in different profiles, heights and width. All these factors impact the final look.

The most commonly misunderstood characteristic of breast implant is its Profile or Projection which refers to how much an implant projects forward from the chest wall when standing. Implants are available in several different profiles including low profile (rarely used), moderate profile, moderate plus profile, high profile, and ultra-high profile. Implants of same size volume cc (cubic centimeter) can have different base width and Profile. In round implants, the higher the profile gets, the smaller the width of the breast implant becomes and vice versa. Many times, the width and profile of implants vary depending on the implant manufacturer. Below profiles are based on Mentor Implants.

Low Profile – The low profile breast implants have the least projection and the widest base. These are suitable for patients with wider chest frame who prefer relatively “flat” and minimal projection. This profile is rarely used in cosmetic breast surgery procedures.

Moderate Profile – The moderate profile breast implants have slightly more projection than low profile but retain a similarly wide base-width. Not suitable for narrow or small chest frames. Not commonly used.

Moderate Plus Profile – The moderate plus implants offer more projection and narrower width than standard moderate implants.  This implant profile is favored by patients who prefer a subtle upper breast volume and a “wider” look. In my practice, this is the most commonly used implant profile after high profile.

High Profile – The high profile implants yield fuller upper breast volume compared to moderate plus, and have a narrower base-width. One main benefit of this profile is that patient can opt for a larger natural size, without increasing the risk of visible wrinkles and rippling on the side of their breast. compared to opting for same size in moderate plus. In my experience this profile provides a more “youthful” look and is preferred by many of my patients.

Ultra High Profile – This is the implant profile with the highest projection and narrowest base. This is usually preferred by patients who have a small chest frame and prefer larger size implants with maximum projection and upper fullness of breasts. This implant profile offers the least natural looking results and not commonly used in my practice.

To give you a better idea of the differences between profiles, here is a comparison between moderate, moderate plus and high profiles of 300cc Mentor Memory Gel Implant.

Notice the change in base-width and projection of each implant profile. Round implants are measured in diameter and projection. Moderate Plus and High Profile in round implants, are the most popular implant choices among patients.

When it comes to teardrop shaped or anatomical implants, these are measured in width and projection, but also in height. There are three different heights, low, medium and tall height. Here we’ll focus on various profiles of medium height implants as these are most commonly used. Similar to round implants, Mentor Memory Shape, Anatomical implants come in moderate, moderate plus and high profiles. Here you can see how they differ in projection.

NOT all implant profiles are suitable for every patient, hence guidance from your plastic surgeon is important in your decision making.

I strongly believe the goal with breast augmentation should be creating proportion between chest area and rest of the body. Many times, opting for too small implants can be as unnatural as having large implants. Creating proportion should be the main objective of the implant selection process.

The ideal implant shape and profile differs from patient to patient based on the following considerations:

• Patient’s ribcage, chest anatomy and measurements
• Patient’s desired upper breast tissue fullness and overall look
• Amount and distribution of breast tissue, i.e. more lower breast tissue or equally distributed
• Placement of breast implants, i.e., Submucular, Subglandular, Subfascial or Dual plane
• Elasticity of breast tissue and skin
• Implant size

Most patients have an idea about what they want in terms of fullness, size and even the type and shape of implant. But you’ll be surprised to know that many times, after their consultation, patients end up selecting a completely different implant shape or profile as what they initially thought they preferred.

In general, the higher the implant projection, the narrower the implant width becomes, and with less projection the base becomes wider. Patients with narrow breast base-width may benefit more from a high profile implant while individuals with wider breast-width may prefer the Moderate plus profile. It should be noted that normally there is more size limitation with moderate or moderate plus implants compared to High profile.

For example, if the maximum implant size a patient could have in high profile is 300cc, in Moderate plus profile it will be 250cc, this is due to wider base in lower profile implants. If the patient were to go for 300cc in moderate plus, the width of the implant would exceed the width of the breast, resulting in unnatural outcome and complications such as visible wrinkles and rippling on the outer sides or the breasts or Symmastia also known as “uniboob”, which is a complication where the skin lifts off of the sternum/breast bone and implants meet in the middle of the chest with no separation in between.

To better understand what implant types, profiles and sizes fit your frame and to know your limitations, a thorough consultation with an experienced plastic surgeon is vital. It is during this meeting that you can discuss your goals with wanting this surgery, and what your preferences are in terms of outcome

During consultation I examine my patients and take necessary breast measurements, and based on these I recommend a size range and profile that fits the patient’s anatomy and would provide natural results.  My patients also try the different profiles, shapes and sizes of implants in a sports bra just to get an idea of how the implants would look in terms of volume, distribution and projection. This is a vital part of the implant selection process and appreciated by all my patients.

If after your consultation, you are still unsure of the recommended implant size, profile and placement, your surgeon recommended, it is always good to see one or two more surgeons for their opinions. The aim is to achieve a natural outcome with minimal risk of complications. You do not want a surgeon who prefers to use only one type of implant shape or profile regardless of suitability or is someone who agrees with everything you say and want without considering your indications, instead your surgeon to discuss all available options with you and to explain why he or she recommends an option or implant type or profile for you.

The size of an implant is determined by factors such as its width, height (in anatomical implants) and profile or projection. CC (cubic centimeters) is the notation used for measuring the volume of the implant.

The most important consideration in breast implant sizing is matching the breast implant width with the natural base-width of the breast. In some cases, your surgeon would need to alter the breast base-width, but there is limitation as to how much this can be adjusted, thus the width of the implant should fit your breast base-width as much as possible. If the breast implant width significantly exceeds the natural breast width, surgery will result in unnatural shape and unnecessary complications, where some can be difficult to correct. The other factor to consider is the profile or projection of the implant, and this comes hand in hand with the breast implant width. The Higher projection an implant has, the narrower the implant width becomes and the wider the implant width, the lower projection the implant has. That’s why both implant width and profile should be considered when selecting a size.

It is important to keep in mind that Breast Implant size is a long-term life decision, you are not looking for short-term satisfaction, instead you should consider your lifestyle and think about how your breasts will look in the future, as much as how they will look in the first year after surgery and select a size that would provide you with a long-term satisfaction. This decision can be overwhelming for many patients, and ultimately it is your choice, but remember that your surgeon is there to guide you through this process and help you make the right decision.

Natural Results can be achieved when selection of Size, Shape, Profile and Placement of implants is based on Patient’s height, width of shoulders and hips, chest anatomy and chest measurements. There is also consideration of “look” preference, which varies between individuals. Some patients may prefer a wider base with less upper breast tissue fullness whereas others may prefer a perkier look with more upper breast tissue fullness.

I encourage all my patients to try various implant profiles within the size range I recommend based on their measurements, I guide them through and show them the type of outcome to expect with each profile. If I believe that a size or a profile will not suit their frame, I tell them and explain why. Ultimately, patients will have the final say in selecting an implant size and profile, unless what they opt for will increase the risk of complications for them in short- or long-term, that is when I intervene and sometimes reject a patient, as I know that she will damage her body by opting for a large size or a certain implant profile.

I have never come across a patient who has not appreciated my honesty and guidance when it comes to breast implants. Implant selection process is the most important part of a breast implant surgery, and the decision should not be taken lightly as it will impact your life more than you think, and I’m sure you want it to be in a positive Way!

RealSelf Patient Reviews of Allen Rezai, MD

RealSelf Patient Reviews of Allen Rezai, MD