Purpose: To improve the contour and projection of the breast
Length of operation: 1 hour
Anaesthesia: General anaesthetic
Inpatient stay: 1 day or day case
Follow up: 1 week, 3 months, 6 months, 1 year
Time off work: 1 week
Recovery: 2-3 weeks
Risks: Infection, Rupture, Capsule Formation, Asymmetry, Implant Edge Visibility
This is a common plastic surgery operation for small breasts, commonly referred to as breast enlargement. The procedure involves inserting an implant below the breast tissue or the muscle under the breast, to increase the breast size. The results are generally excellent with high satisfaction rates. In this description I shall take you through the operation, hospital stay, recovery and the complications. Once you have met me for the initial consultation, I would be quite happy to see you again for a second consultation, so that you can clarify any of your doubts.
There are different implants which can be used including round implants or tear drop shaped implants. The implant can have a smooth or rough surface. Also the implants can have silicone of different consistency. The implants can be placed below the breast tissue or below the muscle which lies below the breast. Mr Azad will discuss with you the different implants and the site of implant placement. The implant type, shape and site of placement is chosen after careful discussion and evaluation, to get you the best result after your surgery.
It is advisable to stop smoking for 4 weeks and stop contraceptive pill and hormone replacement therapy for 4 weeks prior to the procedure. On the day of the operation, Mr Sanjay Azad will do skin markings over the breasts. The procedure is done under general anaesthetic and takes about 2 hours in total. The procedure is usually done by an incision at the lower border of the breast crease which heals extremely well over a period of time. While you are in hospital you will have blood tests, fluids through a drip and pain killers. The stitches are all dissolving in nature. At the end there is a fairly bulky dressing on the breasts and potentially a drain on each side. You will feel bruised and swollen after the operation and this settles in due course. This is more so after implants are placed below the muscle. We take precautions to prevent clots in your calves by putting on stockings and giving you a blood thinning injection. The hospital stay is conventionally 2 days and depends on recovery and drain removal.
At discharge the dressing stays on and you will need to attend the dressing clinic in a weeks time. The dressing will then be removed and you will need to go into a well fitting crop-top type of sports bra. This should be worn day and night for 3 months. The breast will feel swollen initially and it is quite important to move you arms and gently massage your breasts with moisturizing cream. This will help with an improved recovery.
You should avoid smoking for 4 weeks after the procedure. The recovery is individual, but most patients get back to work and driving in 2-3 weeks time. Aerobics and more vigorous exercise, especially with implants under the muscle should be done only around 3 months after the procedure.
Overall results are excellent but there are some well know limitations, risks and complications which you should be aware about. Scars, infection and blood clots are risks of any procedure. Implants can rupture, silicone can leak and one can occasionally feel the implant edge. Implants can form a firm scar shell around themselves. This can in some patients become hard and may necessitate further procedures. The life expectancy of implants is not known though bra manufacturers mention 10 years. It is quite common for patients to have these high quality implants for much longer.
Breast are never static and will change with age, weight changes and pregnancy. The aim of the procedure is to give you similar breast on both sides, but pre-existing asymmetry is likely to persist, albeit to a minor degree. Breast augmentation does not interfere with future detection of breast lumps or breast feeding. It does however need special techniques for performing mammography.
- Ensure that you wash your hair and shave your armpit the night before or morning of surgery.
- Ensure that you have bought a couple of sports bras of the anticipated size. You will need this after the first week at the first dressing change.
- Simple pain like a combination of codeine and paracetamol are best. Avoid using ibuprofen or diclofenac, because they thin the blood and can cause more bleeding and bruising after surgery.
- Any bleeding, discharge, undue pain or unusual breast hardness after surgery; please contact the team or contact numbers given straightaway.
- The dressing which acts like a brassiere is completely removed only a week after surgery and you can go into your elasticated sports bra. This must be worn day and night for 3 months. The bra provides external support and reduces discomfort. It helps as well in letting the swelling settle down earlier.
- During the first week after surgery keep your wound dry as water can seep below the dressing and cause maceration. It is a good idea to make a bra from cling film and then take a shower.
- It is common to have swelling and bruising after any form of breast surgery. This will settle in due course.
- It is quite important to use and move your shoulder after breast surgery. The anticipation of discomfort can make one stiffen at the shoulder and for this reason gentle shoulder movements should be started straight away.
- Do not drive during the first couple of weeks after surgery.
- It is advisable to avoid unnecessary activity, stretching or any strenuous exercise for at least the first few weeks. Aerobics and swimming can be done at 3 months post surgery.
- For sedentary occupations, you can return to work in 2-3 weeks. You will know when you are ready and do listen to your body which will tell you what to do.
- Massage with a good bland moisturizing cream (E45/Doublebase/Diprobase) helps the scars to settle down. This should be started about 2 weeks after surgery.
- Protect the scars from the sun by using sunblock for at least 2 years. This prevents them from getting pigmented.
- Ultimate breast size and shape is best assessed only 6 months after surgery. You can however go in for definitive lingerie at about 3 months when the breasts are reasonably settled.
- If the scars are getting lumpy they may need additional treatment. Please contact Mr Sanjay Azad.
Please contact Mr Azad’s secretary, Sue Byfield on 0121-6277895 to book an appointment for this procedure.
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