Breast Augmentation

Length of operation: 90 minutes
Type of Anaesthesia: General
Length of stay in hospital: One night hospital stay
Recovery time: 10 to 14 days for the bruising and swelling to subside. Full recovery is between 6 weeks to 3  months
Time off work: 1 to 2 weeks after operation depending on nature of work

About breast augmentation: Breast augmentation or breast enlargement surgery is a procedure that cosmetically enhances the size of a woman’s breasts. The procedure is a frequently performed to correct underdeveloped or small breasts .  Breast augmentation can be performed for cosmetic or medical reasons.

Breast implants are used to enhance the breasts and these are usually made of silicone that has an outer shell filled with either medical grade silicone gel or a salt water solution known as saline.

Suitable candidate:  If any one or a combination of the following conditions trouble you – breasts that did not develop fully or developed unevenly, small sized breasts, changes in the shape of breasts after pregnancy or due to age – then you would be an ideal candidate for breast augmentation surgery.

Reasons not to go ahead: patients on blood thinning medicine, excessive smoking, overweight patients. A desire to become pregnant needs to be discussed with the surgeon, as pregnancy can alter breast size and shape in an unpredictable way which could alter the results of the procedure.

Pre op: The consultation with your surgeon will be your opportunity to discuss your expectations, learn about the surgery and ask queries or clarify any doubts you might have. The surgeon will perform an examination in order to be able to assess your individual needs and discuss the results in length with you.

On the day: If you decide to go ahead with the procedure, you will receive advice about what to do and what to avoid, prior to surgery. Following the operation a tape dressing is applied to the suture line in the crease underneath the breast.  The patient is allowed home the following day in a supportive soft brassiere. Most patients are discharged either the same day or the following morning from the hospital.

Post op: Most patients are able to shower at home but dressings need to be kept dry and clean for one to two weeks after surgery. An appointment will be made for removal of sutures one to two weeks following the operation, when the wounds will be inspected and cleaned. The patient will receive a complete list of postoperative care instructions before leaving the hospital including how to care for the surgical scar including application of moisturising cream and massage to help the swelling and the bruising to settle, medications to take for pain relief and  specific concerns to look out for at the surgical site.

A review appointment is usually offered six weeks and four months after the operation.

Convalescence: For the first few days, you will feel tired and sore. The breast can be bruised and swollen and appears larger in the first few days after surgery than the eventual size. In approximately six weeks the swelling and bruising settles to a large extent and the final shape of the breast becomes evident. There will be scars after the operation and they will be firm and pink for about a month and a half. They may even remain the same size for several months. These scars may take up to two years to fade – the time differs from patient to patient. It is also fairly common for the skin above the incision to feel a bit numb for some months, but this rarely extends to the nipple.

It is possible to do light activities for the first few days but it is not advisable to do any strenuous activity for the first two weeks. On average, recovery will take around one to two weeks. It is advisable to avoid sexual activity for approximately the first four weeks following surgery, after which care must be taken to be extremely gentle with your breasts for the next month or so.

Immediately after surgery your new breast size will be apparent, but please be aware that that the final shape of your breasts will take around six months to emerge.

Risks and complications: A small percentage of patients can have complications just like for any surgical procedure.
Infection: minor wound infection can be usually readily treated with an antibiotic. Rarely an infection around the implant may require removal of the implant
Haematoma (blood clot in the breast) or bleeding: a re-visit to the operating theatre may be necessary.
Delayed healing of the wound: particularly true in case of diabetic patients or those who smoke. This needs to be discussed with the surgeon during the consultation stage.

Change in nipple sensation is usually temporary.

Implant rippling or palpability (folds in the implant and the implant being felt under the breast).

Capsular contracture: a condition in which the scar tissue around the implant shrinks, squeezing it so it feels firm or even quite hard. This usually occurs several years after surgery. It can occur to varying degrees. If it is severe, it can cause discomfort or changes in the breast’s appearance and in such cases, further surgery may be needed.
Mild asymmetry: usually occurs only when the breasts are uneven to begin with.
Implant leak: will require surgical replacement with a new implant.

Implants affect mammography (an x-ray for breast screening for cancer offered to women after the age of fifty) but you can still have a mammogram.

Effects of the procedure:  The results of your breast augmentation surgery will be long-lasting; 10 to 15 years is considered a reasonable time-frame for implant survival. However, gravity and the effects of ageing could eventually alter the size and shape of the breasts. The implants usually will need replacing several years after the operation (10 to 20 years).