Breast Augmentation Surgery is usually carried out under a general anaesthetic. Breasts are made larger by placing an implant either under the breast tissue or behind the muscle on which the breast lies. The implants are usually inserted through an incision placed in the fold underneath the breast, although other incisions are occasionally used. The gold standard for augmentation remains silicone implants, although the patient’s own fat can be considered for small augmentations.

Whilst much has been written about silicone implants, there is no scientific evidence that they cause any of the illnesses blamed on them. They offer the most natural looking and natural feeling results. Implants are available in a number of profiles, and consistencies, to allow tailoring of the final breast shape.

Surgery can be carried out as a day case. It is not usually a painful procedure and only simple analgesia is required. Tapes are applied to help support the breasts and a front fastening sports bra should be worn, night and day, for the first 5 weeks.

The tapes are removed 10-12 days later and patients can return to normal day to day activities within two weeks. Impact exercises are best left for 4 weeks.

Complications following breast augmentation are very unusual. Infection is rare, but may necessitate implant removal. Bleeding is uncommon and whilst alteration in nipple sensation can occur, this will usually settle. Scars will be left, but, whilst individual dependent, these usually settle well. The use of Solution for Scars can help improve scarring.

Scar tissue will also form around the breast implants – a scar capsule. In the healing phase these scars can shrink, (capsular contraction), which can make the implant become rounded and feel firmer. This is a limitation of healing in up to 5-6% of patients and may require further treatment. Breast augmentation does not usually affect breastfeeding.

Mammograms can still be carried out but the technique is altered. Although special views are required, the sensitivity of detecting breast cancer is not reduced.

Most women have some degree of asymmetry and this may not be corrected.

Whilst the manufacturers life expectancy of breast implants is ten or more years, implants have stayed in place, without problems, for much longer. If they do not cause problems, they may not need replacing.

A rare tumour has recently been described, associated with the scar capsule – Anaplastic Large Cell Lymphoma, ALCL. For most individuals, it is treated by removal of the implant and the scar capsule. It is a reactive tumour from irritation and is associated with implants that had coarse texturing of the covering shell. Although rare, these implants are no longer used. Most patients are treated with micro textured implants, which have a very low incidence of capsular contraction and have not been implicated in ALCL.

Very recently, squamous cell carcinoma in the scar tissue has been described in a few patients, (16 cases over 40 years).

Breast implant illness is still talked about. There is no evidence linking silicone implants the the range of illnesses blamed on them. The illnesses occur in the general population, without implants, in the same incidence as those with silicone implants.