Breast Surgery

Breast Enlargement

Why have a Breast Augmentation?

Many women choose to create the breast shape they want through breast augmentation.

Today, breast surgery offers many sizes and shapes of implants. If you have small breasts they may not sag or droop, but they also may not appear in proportion with your size, or allow you fashion options that enhance your figure. Creating the ideal size, shape, and soft feel with breast implants can create a more confident and feminine you.

What is involved?

Before the operation, we will discuss the type and size of the implant that will best achieve the final shape and appearance that you are seeking. During the surgery, I will make an incision and create a pocket for the breast implant.

Considered the safest and most widely used method is to make the incision along the crease beneath the breast where it meets the chest wall. The implant can be placed above the muscle or in the majority of the cases behind the chest muscle. We will discuss together best option for you before surgery.

Breast Augmentation surgery is performed using a general anaesthetic and usually lasts one to two hours, you will stay in hospital overnight, going home the next day.

I will attempt to increase your bust size by at least two sizes, for example from A to C cup size however, you can only be made as large as medically possible.

Normally 7 -10 days is required off work if your job involves any lifting or carrying, then you may be advised to take more time off. In this case I can supply you with a medical certificate for your employer.

Many breast augmentation patients say they experience more discomfort than actual pain, though you can expect to feel sore and tender afterwards, and you will experience a certain amount of post-operative bruising and swelling over the area.

Breast Augmentation Aftercare

After surgery

Immediately afterwards, expect to feel some discomfort. When the medical team feel you are ready you will be transferred to your room where you can relax in comfortable surroundings.

The next morning the pain will inevitably have eased considerably. Any remaining discomfort can be controlled by medication. Breast Augmentation requires an over-night stay at the hospital so your immediate recovery can be closely monitored.

Your recovery

Recovery depends greatly on the extent of the procedure. Expect to feel sore and swollen for several weeks.

Strenuous activity should be avoided for 4-6 weeks. Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain longer.

This procedure will leave scars that can be hidden by underwear, and can be expected to fade in most cases.

Post-op appointments

Post-operative follow-up is of paramount importance. Each patient undergoing Breast Augmentation surgery will be given post operative appointments for wound management and suture removal. Post-operative instructions are vital and we consider it very important that you adhere to them. Failing to follow these guidelines and attend your appointments can adversely affect the outcome of surgery and put patient safety at risk. Following Breast Augmentation the patient is asked to return on specified appointments and occasionally it may be necessary to return more regularly than those stated.

Breast Augmentation Risks & Conditions


Smoking increases the risk of complications, particularly infection which may result in implant removal, and slows down the healing process. It has been shown that a smoking patient has ten times more complications than a non - smoking patient.

Smoking reduces the blood supply to the wound and can impede the healing process.

Each cigarette further constricts acutely the blood vessels. It is highly recommended to stop smoking completely 4 weeks prior to surgery and 2 weeks after; no nicotine patches or chewing gum are allowed. The risk of infection and complications in general slowly decreases if the patient stops smoking, but still remains higher compared to a non-smoker.


The scar may not be exactly in the mammary crease, but slightly above or below, and may not be perfectly symmetric with the scar on the other side. The quality of the scar depends on the skin of the patient. For a few months it will be quite visible, but the tendency is to fade.

Occasionally patients produce excessive scar tissue, it may be prominent (hypertrophic scar, keloid). This scarring is rare in Caucasian (white) patients, but slightly more common in non-caucasian patients. The scars can be tender and painful, especially during the recovery period, and may even become permanent. Occasionally the scars on either sides may not heal at the same rate. A minority of patients may require scar revision under local anaesthetic several months following surgery.

Capsular contraction

Implants are foreign bodies and can be either accepted or rejected by the body. This problem is known as capsular contraction or encapsulation. Capsular contraction occurs in between 2-5% of the patients and can happen any time after the procedure. It consists of a thickening of the scar (capsule) around the implant with the breast becoming hard, painful and changing shape. Removal or release of the scar tissue and replacement of the implant usually treats capsular contraction. After a first encapsulation it is easier for the body to recognise the implant and therefore the risk of a secondary contraction is increased to 5-30%.

The capsular contraction does not depend on the Surgeon or the implant, but it is a reaction of the patients body. It may be that after repeated encapsulation it is best to remove the implants permanently; the patient may need breast reshaping surgery at this time.

Rupture of the implant

This involves a split or hole in the shell of an implant, this is not necessarily an emergency.

Further surgery will incur costs.

Infection and implant removal

All surgery carries the risk of infection. In order to reduce it, patients are given antibiotics intravenously during the operation. In a few patients, the infection may be resistant to the treatment and it may be necessary to remove the implants. Following removal, the area is rested for several months and the implants are replaced once the patient is free of infection.

Personal hygiene is very important during the healing stage (1st week).

Haematoma (bleeding)

A haematoma is a collection of blood in the pocket of the breast. The risk is higher during the first 24 hours following any surgical procedure, but it can still occur at a later stage. In case of a major collection of blood it may be necessary for patients to return to theatre for a second operation to remove this collection, although extremely rare, excessive bleeding may lead to a blood transfusion and can be potentially a life threatening complication. In order to reduce this risk most patients will return from theatre with a small drain in place, which is removed prior to discharge. The risk of bleeding slowly fades in 3-4 weeks as the healing continues.

I recommend that you refrain from any heavy lifting and strenuous activity during this period.


Most patients will experience pain following surgery, especially if the implant is positioned behind the chest muscles. This certainly depends on the pain threshold of the patient.

Painkillers are given after the surgery to control the discomfort, a further supply is dispensed at the time of your discharge. It has been reported that pain may appear during this period and can become permanent, although this is a rare occurrence.

Patients may experience shooting pains, and burning sensation and itching, these are all symptoms of nerve bruising and will subside over the first month. Pain due to nerve damage (neuroma), is rarely permanent, but can be.


Patients with chronic depression may not be suitable candidates for cosmetic surgery. A letter from G.P or psychiatrist outlining a medical summary together with current medication may be required. I would also ask for their opinion as to your suitability for surgery.

Nipple Erectability

The ability of the nipple to become erect may be compromised after the surgery. This means that the nipple may not become erect in response to tactile and other stimulation. This condition can be permanent in rare circumstances.

Prominent veins

Prominent veins are often a sign of poor blood flow. After breast augmentation veins may appear or become more prominent permanently. This risk must be understood and accepted by the patient.

Position of the implants

The breast implants can be placed under the mammary gland or under the pectoralis major muscle: it depends on the anatomical feature of the patient and on the size of the implants. I will discuss with you the best option in order to offer the most natural result.

Size of implants and rippling

The implant is a foreign body and I will “hide” it in the chest area in order to increase the size of the breast of the patient. Within reason, it is normal to feel and see part of the implant (rippling), simply because there is an implant!

This condition can be more or less obvious according to the size of the implant and the anatomical feature of the patient (slim patients have a higher risk of the rippling than overweight patients, larger implants are more palpable than small implants).

Rippling may also result from weight loss or interruption in the use of the birth control pill.

The implant has to be totally covered by the breast, for this reason the post-operative size of the breast cannot be guaranteed. I will select the implant that you can disguise well under the breast tissue. The post-operative breast size also depends on the elasticity of the skin, pre-operative breast size and submuscular/ subglandular position.

Skin and nipple sensitivity

Skin and nipple sensitivity may change after the surgery, ranging from total numbness to hypersensitivity and pain. This may last up to 6 months, one year or even longer. Nipple sensation may never return at the same intensity or quality and, in some cases, it is possible to experience total or temporary numbness of the skin or nipple after surgery as well as permanent hypersensitivity. The patient may feel numbness in the arms and fingers initially post-op this is temporary.

Pregnancy/breast feeding

Implants will not normally prevent breast feeding and there is no evidence of any illness in children of women with silicone gel breast implants.

Stretch marks/veins

Stretch marks may develop, especially with bigger implants, also veins may become more noticeable on the breast surface.

Asymmetric result

The position of the nipples may be altered by the implants.

Breast cancer screening

While there is no evidence that silicone breast implants cause breast cancer, they may change the way mammography is done to detect cancer. Inform your radiographer that you have breast implants as additional views will be required. Preexisting lumps are often more visible and can be palpitated following surgery, as the implant pushes the lumps forward. Ultrasound examinations may be of benefit in some women with implants to detect lumps or to evaluate the condition of the implant.

Swelling and bruising

Some swelling and bruising will be present after surgery. Usually this subsides in a few weeks, but can last some months post-operatively.


In a very small number of women, fluid builds up around the implant.

Additional surgery may be needed to remove this fluid, usually this re-absorbs naturally.

Final result and sagging breasts (ptosis)

It will take a few weeks and sometimes even several months for the new breasts to settle and to reach their final shape and size. The patient must be aware that larger, heavier breasts will tend to sag more than smaller breasts and that at some stage, this patient may need a mastopexy (uplift) procedure.