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Breast enlargementPublished by Bupa's health information team, October 2007. This factsheet is for women considering having breast enlargement or breast augmentation surgery. This operation is done to enhance your breast size. Your care will be adapted to meet your individual needs and may differ from what is described here. So, it's important that you follow your surgeon's advice.
What is breast enlargement?Breast enlargement surgery involves putting implants behind the breasts. You may choose to enlarge your breasts because:
The operation may also be offered if you are having reconstructive surgery as part of treatment for breast cancer or other conditions that may affect the size and shape of your breasts. The implantsBreast implants are made of elastic silicone and are usually filled with silicone gel. Your surgeon will advise what size, shape and type of implants are suitable options for you. Can I breastfeed with implants?Breast implants should not interfere with breastfeeding, and there is no evidence that silicone is found in breast milk. But, it's important to tell your surgeon beforehand that you plan to breastfeed because this can affect the type of operation you have. Do implants affect breast screening?Breast implants may interfere with mammography, a low-dose X-ray of the breast tissue used to help detect cancer. Tell your radiographer that you have breast implants, so that special measures can be taken to minimise any interference. How long will implants last?Breast implants generally last for at least 10 years. Over time, some of the advantages of the procedure will be lost and you may need further surgery to replace the implants. Getting adviceIt's important not to rush into the decision to have cosmetic surgery. Discuss your options with your GP, who may be able to recommend a reputable surgeon or give advice about how to choose which hospital to be treated in. Before opting for breast enlargement, discuss with your surgeon what you are hoping to gain from the operation and the result you can realistically expect. Preparing for your operationYour surgeon will discuss how to prepare for your operation. For example, if you smoke you may be asked to quit as smoking will increase your risk of getting a chest or wound infection and slow your recovery. The operation is usually done as a day case, but sometimes an overnight stay is needed. The procedure is usually carried out under a general anaesthetic. This means you will be asleep during the operation. You will be asked not to eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand. Bring in a soft, supportive bra without underwiring to wear after surgery. Your surgeon will advise you about the most suitable type of bra beforehand. At the hospital, your nurse will explain how you will be cared for during your stay, and may do some tests such as checking your heart rate and blood pressure, and testing your urine. Your surgeon will usually visit you to discuss 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 and the position of your nipples. Your surgeon may mark the position of the surgical cuts on your breasts. Photographs may be taken, so that the results of surgery can be compared with your original appearance and you may have a mammogram. Your nurse will prepare you for theatre. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs (deep vein thrombosis, DVT). About the operationThe operation usually takes one to two hours. Your surgeon will make cuts in the crease under your breast, around your nipple or towards your armpit. The implants are inserted into position beneath the breast tissue or under the chest muscle. The cuts are closed with stitches (which may be dissolvable) and your breasts are wrapped in a special supportive dressing or support bra. Fine plastic tubes may be left in each breast for up to 48 hours afterwards. These allow blood and fluids to drain into a bag.
What to expect afterwardsYou will be given painkillers to help relieve any discomfort as the anaesthetic wears off. You will need to arrange for someone to drive you home. If you are going home on the same day as your operation, you should have a friend or relative stay with you for the next 24 hours. Before you go home, your nurse will give you advice about caring for your breasts, hygiene and bathing. You will usually be given a date for a follow-up appointment. Dissolvable stitches will disappear on their own in seven to 10 days. Non-dissolvable stitches are removed a week after surgery. Recovering from breast surgeryAt home, if you need them, you can usually take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice. General anaesthesia can temporarily affect your co-ordination and reasoning skills, so you should not drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. Follow your surgeon's advice about driving. You shouldn't drive until you are confident that you could perform an emergency stop without discomfort. You will need to wear your support bra for four to six weeks after the operation. This helps to stop the weight of the breasts pulling on the healing wounds. Don't lift heavy objects or do any strenuous activity for the first two to three weeks after the operation. If the implant is placed under your chest muscle, activity may be restricted for longer. If you have any concerns or get pain that can't be controlled with painkillers, a high temperature or your breasts feel unusually hot to touch, contact your GP or the hospital as you may have developed an infection. At your follow-up appointment, your surgeon will give advice about when you can resume your usual activities and return to work. It may take several months before your breasts settle into their new shape. What are the risks?Breast enlargement is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications. Side-effectsThese are the unwanted, but mostly temporary effects of a successful treatment, for example, feeling sick as a result of the general anaesthetic. For a few weeks after surgery, your breasts will feel sore, swollen and hard, and you will feel a burning sensation in your nipples. Using extra pillows when sleeping can help reduce the swelling around your breasts. You will have scars, they will be pink and noticeable at first, but they should fade gradually. ComplicationsThis is when problems occur during or after the operation. Most women are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT). Specific complications of breast enlargement are rare, but can include:
It's possible that you still won't be satisfied with your appearance after the operation. The exact risks are specific to you and will differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by cosmetic surgeon Mr Miles Dickson, MB BS, FRCS and by BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: October 2007. Expected review date: October 2009
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