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This factsheet is for women who are considering having an operation
to enlarge their breasts.
A breast enlargement (also known as breast augmentation) operation
usually involves placing an artificial implant either under your
breast tissue, or under your chest muscle behind your breast.
Why have a breast enlargement operation?
The reasons why you may choose to enlarge your breasts include:
- feeling that your breasts are too small
- loss of breast volume after pregnancy (although enlargement
will not lift them)1
- a difference in size between your two breasts
- reduced breast size after losing weight
Breast enlargement surgery may also be offered if you are having
surgery for breast cancer or other conditions that may affect
the size and shape of your breasts.
The implant
Your breast implant will be made of an outer layer of firm, elastic
silicone, but may be filled with silicone gel or salt water (saline).2,3
Your surgeon will discuss the various options with you.
Can the breast implant leak?
Breast implants leak in around 10 percent of
women and this usually starts six or more months after surgery.2
The breast implant often has to be removed.2
The contents of the implant can either leak slowly through the
coating, or suddenly if the implant breaks open. This can lead
to pain and an abnormally hard feel to the implant in the breast.
The body naturally forms a fibrous capsule around the implant,
which helps to contain the contents of the implant. The newer
designs of breast implants have features to reduce the likelihood
of the implant leaking or breaking.
There have been concerns that leaking breast implants may be
linked to serious health problems such as cancer but there is
no conclusive evidence to support this.2,3
Can I breastfeed with implants?
Having breast implants does not usually interfere
with breastfeeding, and there is no evidence that silicone is
found in breast milk.2,3 But, it is important to tell
your surgeon before your operation that you plan to breastfeed
because this can affect the decision about where to make the cuts
for your operation.1
Will the implant affect mammography?
Breast implants interfere with mammography,
a low-dose X-ray of the breast tissue used to detect cancer.3
You should let the radiographer or nurse know that you have implants
as special X-ray views can be taken to minimise this interference.2
How long will the implant last?
Breast implants generally last for at least
10 years.2 Eventually some of the advantages of the
enlargement surgery will be lost and you may need further surgery.
What happens before a breast enlargement operation?
It is important to discuss with your surgeon what you are hoping
to gain from the operation and the result you can realistically
expect.
Your surgeon will discuss how to prepare for your operation.
For example, you may be asked to stop smoking before surgery.
Smoking increases the risk of chest infection, deep vein thrombosis
(DVT) and slows the healing of wounds.4,5
What should I expect in hospital?
Before surgery you will talk to your surgeon about the operation
and you will be asked to sign a consent form. This confirms that
you understand the risks, benefits and possible alternatives to
the procedure and have given your permission for it to go ahead.
Your surgeon will measure your breasts and assess their shape,
your skin and the position of your nipples. He or she may also
draw on your breasts to mark the operation site.
Your surgeon may want you to have a mammogram taken. He or she
may also suggest that you have a photograph taken of your breasts
before the operation so that the results of surgery can be compared
with your original appearance.
If you are having a general anaesthetic, you will be asked to
follow fasting instructions. Typically, you must not eat or drink
for about six hours before a general anaesthetic. However, some
anaesthetists allow occasional sips of water until two hours beforehand.
The operation
Breast enlargement usually takes between one and two hours and
is done under general anaesthetic, which means that you will be
asleep throughout the procedure and will feel no pain.1,6
Usually it requires an overnight stay in hospital, but occasionally
may be done as a day-case, which means you can have the operation
and go home the same day.
Your surgeon will make some cuts, the exact position of which
can vary. They may be in the crease under your breast, around
your nipple or towards your armpit.
Your surgeon will then make a space, or pocket, for the implant.
The pocket will probably be beneath your breast or under your
chest muscle.
The cut will be closed with stitches. If these are not dissolvable,
they will be removed about a week after surgery.6 Bandages
or dressings will be applied over the operation area.
Illustration showing the position of breast implants
What to expect after the operation
You will be given painkillers to help relieve any discomfort
as the anaesthetic wears off.
Before you go home your nurse will give you advice about caring
for your breasts, hygiene and bathing. He or she will also give
you advice about wearing a special supportive bra in the days
after the operation.1,6
Recovering from a breast enlargement
Once home, you can take more painkillers if you need to, as advised
by your nurse or surgeon.
There are some important things to remember while recovering
from a breast enlargement:
- don't shower for four to seven days after the operation
- don't lift heavy objects
- don't do any strenuous activity for the first two to three
weeks after the operation as advised by your surgeon - if the
implant is placed under the muscle, activity may be restricted
for longer
Deciding on treatment
It's important not to rush into the decision to have any cosmetic
operation. And it's sensible to discuss the options with your
GP, who may be able to recommend reputable surgeons or give advice
about how to choose which hospitals to be treated in.
Breast enlargement is a commonly performed and generally safe
operation. For most women who want the operation, the benefits
in terms of improved appearance outweigh the risks. However, if
you are deciding whether or not to have this procedure you need
to be aware of the possible side-effects and the risk of complications.
Side-effects are the unwanted but usually temporary effects of
a successful procedure. An example is feeling sick after the general
anaesthetic.
Anyone having a breast enlargement can also expect:
- pain, swelling, tenderness and bruising for at least a few
days1
- a burning sensation in the nipples for a few weeks, but this
should go away as you heal1,6
Complications are unexpected problems that can occur during or
after the procedure. Most people are not affected. The main complications
of any operation are bleeding during or soon after the procedure,
infection and an abnormal reaction to the anaesthetic.
Specific complications of breast enlargement include those listed
below.
- There may be a difference in size between the two breasts,
possibly caused by natural differences that are highlighted
by the surgery.2
- You may get an infection in the breast. If this happens, the
implant may need to be temporarily removed to allow the infection
to be completely treated.1,2,6
- Abnormal scar tissue can form around the pocket in which the
implant sits. This may squeeze the implant and cause firm, painful
breasts. This is known as capsular contracture. If the breast
goes hard, further surgery may be required.1,3,6
- There is usually a temporary difference in skin and nipple
sensation following breast enlargement but this can be permanent.2,3,6
- Fluid can build up around the implant. This is called a seroma
and may require further surgery to remove.3
References
- MayoClinic.com, Breast augmentation: Breast implants reshape
self-image.
www.mayoclinic.com
accessed 03 March 2005
- British Association of Aesthetic Plastic Surgeons (BAAPS),
Breast Augmentation.
www.baaps.org.uk
accessed 03 March 2005
- Department of Health, Breast Implants.
www.dh.gov.uk
accessed 04 March 2005
- Smoking and wound healing. Am J Med, 1992 Jul 15;93(1A):22S-24S.
- British Heart Foundation, Deep Vein Thrombosis.
www.bhf.org.uk
accessed 21 February 2005
- American Society of Plastic Surgeons, Breast Augmentation.
www.plasticsurgery.org
accessed 03 March 2005
Published by BUPA's health information team, healthinfo@bupa.com,
June 2005
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