Breast Implants In Twatt

There are two main parts to an implant: the outer shell and the inner filler.

All breast implants are surrounded by a firm, silicone elastic (or elastomer) shell. The surface of the implant may be smooth or textured.

There are currently two types of implant filler available in the U.K.:

• a filler made from a silicone gel, which is semi-liquid and moves easily so that it can maintain a good shape. It is generally accepted that a silicone implant gives the most “natural feel” to a new breast;
• saline filled implants that are usually placed inside the breast before they are filled with salt water.
  

Implants come in many different shapes and sizes, and with a number of different implant manufacturers and distributors active in the U.K. there is usually no problem in finding the appropriate implant for you.
 
Please see our Products section at the top of the page for more information on implants available in the U.K..

It is important that during your first discussion with a surgeon, you should explain clearly what you expect from the treatment and how you would like to look afterwards.

Careful discussions regarding the reasons for wanting implants, and the suitability of implant surgery are very important at this stage. Make sure that you obtain as much information as you can to enable you to make a fully informed choice about the procedure. You need to think about the type and size of implant that may be suitable for you before your operation, as well as the point at which the implant will be inserted into your breast, how it will be placed inside your breast and the type of anaesthetic used.

A medical history should also be taken, to ensure that there are no reasons why you shouldn’t have this operation. At this point, you would normally be asked to sign a consent form stating that you have understood the potential benefits and risks associated with breast implantation.

Photographs may also be taken by the practitioner, as the basis for a “before and after” comparison at a later date.

The surgeon will wish to write to your G.P. giving details of the operation so that if there are any problems associated with surgery in the short- or long-term, the G.P. is aware of the procedure and can help you as you recover.

Your surgeon should also send information about your operation to the National Breast Implant Registry (N.B.I.R.) so that information about breast implants can be collected from all over the country and used in further research or in the gathering of statistics about cosmetic surgery. This has proved to be very important in recent years when some types of implants have had to be recalled by their manufacturers and their patients informed immediately.

However, you do not have to register your implant operation with the N.B.I.R.. This is a purely voluntary action to help future research. If you do choose to do this, you will be asked to sign a form that will contain all the information given to the Registry including your implant details.

Anaesthesia

Breast augmentation can be performed under a general anaesthetic, although some surgeons use a local anaesthesic, combined with a sedative to make you drowsy, so that you remain awake but feel very little discomfort during the operation.

Remember that a general anaesthetic will always carries a greater risk than a local anaesthetic, but you should discuss your thoughts about this with your surgeon before you undertake the treatment. He/she will offer you the best advice for your comfort.

The operation

Every patient’s needs are assessed individually and it depends entirely on your body as to which method of inserting the implant is used. A short incision can be made either in the crease under the breast, or around the areola (the dark skin around the nipple) in the armpit, or even via the navel (belly button). The latter is generally not recommended, however. It may reduce the level of scarring in a much less obvious area than the breast, but it is a more complicated procedure and can only be used for inflatable saline implants.

Implants may then be positioned either between the glandular tissue of the breast and the pectoral muscle (sub-glandular - as in the right hand picture below) or behind the muscle (sub-muscular - left hand picture below).

Saline filled implants are generally inserted empty and then filled with the salt water solution – this helps to reduce the size of the cut required and consequently leaves a smaller scar afterwards.

 

Drainage tubes are rarely needed following the operation. The surgery generally takes about ninety minutes to complete. Slow dissolving stitches are usually used to sew up the wounds.

You will feel sore and tired for a few days after the operation, just as you would after any surgery. 

You may also experience a burning sensation in your nipples for some days after the operation, which will ease as the bruising starts to go down. Both the bruising and the slight discomfort afterwards are normal parts of the healing process.

The swelling in your breasts can take 3 - 5 weeks to go completely. Scars will be pink for several weeks, but they will begin to fade after a few months, although they will never disappear completely. 

It is quite common for women to experience a change in sensation in their breasts after surgery with silicone or saline implants. Mostly, women say that their breasts are less sensitive than they were before the operation. This is usually only a temporary stage and soon your breasts will return to being as sensitive as they were previously. It is estimated that 1 in 7 women may experience loss of or a lessening in nipple sensation after breast enhancement, and in a minority of cases, this can be a permanent state.

Other side effects include developing an infection which may rarely result in the implants having to be removed.

A condition known as “Capsular Contracture” is one of the most common risks or complications after having breast implants.

If a “foreign body”, such as a silicone implant, is introduced into the chest, your body will automatically grow a wall of "scar tissue" around it as a protective process. Fibrous scar tissue does shrink, but by just how much varies from person to person and even from breast to breast. 

Recent evidence in the U.K. suggests that in approximately 1 in 10 women who have had breast implants, the scar tissue can contract, pushing into the implant and causing it to deform. Often, the implant becomes hard and, in some cases, painful. The implant may have to be removed along with the capsule and replaced, if appropriate, with another implant.

Recent changes in implant design and technology with the more common use of textured implants (implants that have a roughened surface) claim that they help to reduce the likelihood of capsular contracture, with the rates of occurence having reduced from about a 10-15% chance to 5-6% according to some surgeons.

Can implants split and how long will they last? 

Implants can split, or rupture by developing a hole in the silicone shell wall of the breast implant. Rupture was common with early, thin-walled implants, but happens much less often now.

There is little information about how often ruptures have occurred in U.K. patients who have had implants. However, as science develops stronger materials, the rupture rates appear to be going down. As to the life expectancy of an implant, since the treatment is still relatively new, we have little idea as to how long they can last.

Rupture does not necessarily create a medical problem: different fillers will react differently. If a split occurs in the majority of cases of silicone gel filled implants, the silicone gel will remain within the capsule that the body forms and can be removed if the ruptured implant is removed.

Occasionally, the silicone can spread outside the capsule into the breast and create a series of lumps known as siliconomas. These may give rise to symptoms such as tenderness in the breasts. In a small number of cases where gel has been found in the breast tissue, the muscles under the breast, the armpit or, rarely, around the nerves to the arm, some of the breast tissue may be lost when the implants are removed. These cases are very rare.

The Independent Review Group (I.R.G.) set up by The Department of Health to review the safety of silicone gel filled breast implants published its report in 1998 (information is archived on the MHRA website).

No relationship was shown between silicone gel implants and long-term “systemic illness” (or illness affecting the whole body). 

The fact that implants are encased in an outer shell means that the chances of creasing or rippling in the “new” breast are unlikely. “Wrinkled breasts” are seen most frequently in women who had very little breast tissue before the implants.

There is no evidence that breast implants affect fertility, pregnancy, or the ability to breast feed a baby. If you have been breast feeding in the year before your surgery, you may produce milk for a few days after surgery. This can be treated with prescription medication to stop the milk flow.

There is no evidence that implants cause breast cancer, but you should let your doctor know that you have had implants before a mammogram (breast x-ray). You should then go to a radiology centre where staff are experienced in the special techniques needed to get reliable x-rays of implanted breasts. Ultrasound examinations may help to detect breast lumps in some women with implants.

There are few absolute medical reasons why you should not undergo a breast augmentation procedure as long as you are in good general health and have realistic expectations of the results.

If you have experienced healing problems with any past surgical treatments or if you are prone to keloid (red, angry, raised) scars, your surgeon may not recommend breast augmentation or may caution you that scars could be very visible.

Prices for a private breast implants procedure can range from £3,000 - £5,000.

Please note that results of cosmetic surgery vary enormously, depending upon both the patient and the skill of the individual surgeon, so outcomes for procedures will always be more variable than those for less invasive non-surgical treatments. 

(All before and after photographs featured are real patients treated by highly experienced surgeons, your results may differ).

 

B cup sized natural breasts before and 3 months after breast implant surgery with a D cup sized augmentation

Photographs courtesy of Consultant Plastic Surgeon, Mr Christopher Inglefield, BSc, MBBS, FRCS (Plast) at London Bridge Plastic Surgery.