Breast Augmentation

Breast augmentation increases breast size using an implant placed either behind the breast tissue or behind the chest muscle. The most important thing to understand before deciding is that implants are not lifetime devices — most people will need further surgery at some point, and that should be part of the decision rather than a surprise later.

Key facts

Implants are not a one-off decision

This is the point most often understated. An implant is a medical device, and devices do not last indefinitely. Over a lifetime, most people with implants will need at least one further operation — for rupture, for capsular contracture, for a change in how the breast sits as it ages around the implant, or simply because preferences change.

Deciding to have implants is therefore deciding to accept an ongoing relationship with surgery, and to budget for that. Anyone presenting it as a single procedure with no future consequences is not giving you the full picture.

Augmentation does not lift

An implant adds volume. It does not raise the position of the breast or the nipple. If the breast has descended — after pregnancy, breastfeeding or weight change — putting an implant behind it makes a larger breast in the same low position, which is rarely the desired outcome.

Where lifting is needed, the operation is a mastopexy, either alone or combined with an implant. A combined procedure achieves more but involves more scars and carries a higher revision rate. We will assess nipple position relative to the breast fold and tell you which applies.

Placement and choice

Implants can sit in front of the chest muscle or partly behind it. Behind the muscle generally gives a more gradual upper contour and interferes less with mammography, at the cost of a more uncomfortable early recovery and some movement of the implant with muscle contraction. In front is a shorter recovery but shows the implant edge more readily in thin patients.

Size is limited by your own tissue. An implant much wider than the breast base or heavier than the skin can support will produce visible edges, thinning of the overlying tissue and earlier drooping. Choosing within what your anatomy supports is what produces a result that still looks good in ten years. [CONFIRM: implant types and sizing method offered at this clinic.]

Risks

Capsular contracture — scar tissue tightening around the implant, causing firmness, distortion and sometimes pain — is among the commonest reasons for further surgery. Implant rupture, rippling, visible edges, asymmetry, and changes in nipple or breast sensation, which may be permanent, all occur. Infection is uncommon but may require implant removal. Bleeding, poor scarring and blood clots are possible with any surgery. Implants can complicate mammographic screening, so tell any radiologist you have them. There is a recognised, rare association between certain textured implants and a form of lymphoma arising in the capsule; this should be discussed specifically at consultation. Breastfeeding is usually still possible but cannot be guaranteed.