Breast Augmentation

Breast augmentation (augmentation mammoplasty) is one of the most common breast surgery procedures. Women have many different reasons for choosing to undergo breast augmentation surgery. Most women choosing to have breast augmentation operations want to improve their self-esteem and self-image, and a breast augmentation procedure can help to improve their appearance and increase their self-confidence.

Implant options

Breast augmentation implants are available in a variety of shapes, forms and sizes. A breast implant can be made of natural body tissue or synthetic (manmade) materials, such as saline breast implants or silicone breast implants. Natural tissue implants are usually only used on women having breast reconstruction surgery (after breast cancer treatment) and are rarely used for cosmetic purposes.

Breast implants generally do not tend to last a lifetime. If you decide to have a breast enlargement, you may well need at least one additional surgery on your breasts over your lifetime, for example if the breast implants break down or rupture; other complications (for example breast pain); or if the breasts are asymmetrical, of an unsatisfactory size, or if there is wrinkling/rippling of the breasts. The possible future financial cost of further breast implant surgery (breast revision) must also be taken into account.

The first major step towards getting breast implants is to schedule a breast augmentation consultation. During a consultation with a surgeon you should be prepared to ask your most important questions, preparation and research leads to a more satisfying experience.

Discussion of your personal goals: size, shape and implant options

A consultation for breast augmentation will include discussion about the type of breast implant that is most appropriate for you. There are many shapes, sizes and materials of breast implant from which to choose. Your surgeon will be able to recommend the best choice for you based on your body type, contour and amount of change that you desire.

How is a breast augmentation procedure performed?

The following demonstrates how breast augmentation operations are usually carried out, though individual surgical practice may vary.

Step 1 – Anaesthetic

Breast implant operations are usually carried out under general anaesthetic, though sometimes your surgeon will use intravenous sedation. Your surgeon will recommend the best choice for you. It is possible to have a breast augmentation operation as day surgery, though you will normally need to stay in hospital overnight. Breast augmentation usually takes about one to three hours to complete. The length of the procedure varies according to the technique used, the placement of the implants, the patient’s anatomy, and type of anaesthesia used.

Step 2 – Types of incision 

Your doctor will first make an incision, or cut, in an inconspicuous area to minimise visible scarring. You will be able to discuss these options with your doctor before your operation to decide on the one that is best for you. Incisions vary based on the type of breast implant, degree of enlargement desired, your anatomy, and where you would like the scars to be.

Incision options include:

  • Inframammary – a small cut is made in the fold beneath each breast.
  • Transaxillary – a cut is made in your armpit, and may cause more visible scarring than the other types of incision.
  • Periareolar – this incision, made around the nipple, causes only minimal scarring, though there is a possibility that nipple sensation may be affected.
  • Transumbilical – breast implants are implanted by first going through an incision of the belly button area. A thin instrument is inserted into the belly button area, which later inserts the saline implant.

After the incision has been made, the implant is inserted either beneath the breast tissue (sub-mammary/sub-glandular) or under the pectoral muscle (sub-muscular).  Again, your surgeon will advise you on the best option. The cuts are then closed using fine stitches which may be dissolvable, and your breasts are wrapped in a special supportive dressing or support bra. You may also need to have drainage tubes fitted for up to 48 hours, to help drain away excess fluids.

Step 3 – Results

The results of your breast augmentation procedure will be immediately obvious. While most women are pleased with how they look, they are not always as happy with how their breasts feel. You may have numbness in your nipple area which is a common complication, or your breasts may feel supersensitive and painful to the touch. Your breasts may remain swollen and sensitive to physical contact for a month or longer, though over time the swelling subsides and the incision lines will refine and fade.

When you wake up you will feel tired, sore and stiff, and you will be advised to take painkillers. Post-operative care may involve the use of a post-operative bra, compression bandage, or a jog bra for extra support and positioning while you heal.

Your breasts will be wrapped with gauze bandages as well as a tighter bandage for protection and support after your breast implant surgery. Someone will need to drive you home, and you may need assistance over the next couple of days. Before you leave the hospital, you and whoever is caring for you post-op will be given instructions on the symptoms you may experience, and the possible complications of which to be aware. It is very important to take the medication prescribed to you by your surgeon.