How is a breast augmentation performed?
During the procedure, an incision is made and the silicone implant is placed in a pocket made in the breasts. The incision can be made underneath the breast, near the armpit or near the areola (the dark area around the nipple); some surgeons will always use the same technique and have a preferred incision location. However, I always approach each procedure on a patient by patient basis and the location where you wish the incision to be made can be discussed and agreed beforehand having explained all the relevant factors; for the majority of patients, an inframammary incision will produce the best results.
The implant can be inserted underneath the pectoral muscle or on top of the pectoral muscle (i.e. behind the breast tissue) and can be further supported with an acellular dermal matrix for extra reinforcement. There are pros and cons of both. This is decided during pre-operative consultations.
Implants inserted underneath the pectoral muscle tend to produce a more natural look to the enhanced breasts. As the implant is underneath the muscle, the resulting breasts often feel softer and look less rounded. Implants inserted on top of the pectoral muscle will typically give a rounder look to the breasts. The shape of the implant is also a factor; the choice is between a round or anatomical tear-shaped implant. The amount of existing breast tissue and patient’s own frame and preferred look are all taken into account when planning the procedure.
Clear expectations of what you want from the breast augmentation operation
As with all cosmetic procedures, it is important to go into the process with realistic expectations. A breast augmentation will be able to do many things to increase the size, shape, volume or evenness of your breasts, but what it cannot do is uplift breasts that have begun to droop. If you’re experiencing that problem then you may need to consider a breast uplift operation, known as a mastopexy. Breast uplifts may be performed in conjunction with a breast augmentation, as the two can yield positive benefits to the look and feel of the breasts when conducted together.
Patient safety is always my priority
Recently there have been reports in the media about a link between breast implants and a very rare type of cancer – not a form of breast cancer – known as anaplastic large cell lymphoma or ALCL.
In recent years, textured implants have become increasingly popular as they are thought to reduce the risk of capsular contracture and the link has been made between ALCL and macro-textured implants. Many surgeons are returning to the use of smooth implants now, but micro-textured implants which I use in my practice are believed to have a lower risk of ALCL. It is important to understand that this condition is extremely rare.
Patient safety is always my first concern and I keep regularly informed of the latest developments in my field. Coupled with my background as a reconstructive surgeon working in a cancer specialist hospital, it means I am ideally placed to guide patients to the ideal surgical choice and can discuss in depth all potential aspects of the procedure with the patient during their pre-operative consultations. I only use implants from leading manufacturers with an exemplary safety record.
One aspect of breast implant surgery that it is important that patients fully understand before going ahead, is that they are making a lifelong commitment to breast surgery and will probably require a repeat procedure at some point.
Cosmetic surgery is an elective procedure and is never deemed medically necessary. Therefore, it is essential that the patient is making the right decision for them – my role is to provide them with all the information they need to make an informed decision.
