Considering Breast Augmentation, Enlargement, Implants & Boob Job

The breasts define a woman. Breast size and shape have a profound effect on a woman’s self-esteem. Many women rightly need breast augmentation as a way of enhancing their femininity.

If you have ever thought one or more of the following you may be a good candidate for breast augmentation:

• It bothers me that my breasts are small. I am uncomfortable when undressing in the bedroom with my partner.
• I feel inadequate when I wear a swimsuit or a fitted top.
• Clothes that fit me well around the hips quite often gape around the breasts.
• My breasts are smaller and not as firm after having children.
• I have lost weight and the size and shape of my breasts have changed.
• One of my breasts is noticeably smaller than the other.

It is not recommended for:

• The very lean.
• Extreme obesity.
• The "I want to be the biggest in the block"- using breasts as statements.
• Planning to have babies soon.
• Significant medical problems. E.g. serious diabetes, malignancies etc.
• Unstable personality. Patients who cannot accept their body image whatever the outcome.
• Frequent recreational drug abuse ?especially acid (LSD)
• Already had 2 or more breast operations.

The ideal candidate is:

• In good health.
• Has no hang ups.
• Has realistic expectations.
• Has some breast tissue with good symmetry and anatomy. The base of the breast is large enough to accommodate an implant of choice.
• Has done all the necessary research.
• Has no serious misgivings or guilt.
• Able to make correct and appropriate decisions on choice.
• Has seen a previous patient and has been informed of what to expect.
• Has a supportive and empathetic partner or friend who accompanies her to the consultation and will be the vital, essential support person for after surgery care.

Research Subjects

• Saline vs Silicone implants
• Smooth vs Textured surface
• Subpectoral vs Subglandular placements
• Tear drop vs Round base
• Low vs High profile
• Inframammary vs Axillary or Areolar incisions
• General anaesthetic vs Twilight sedation with local anaesthesia
• Hospital vs Day surgery procedures

By being prepared with this information we can better customise specifications to your needs.

Saline vs Silicone Implants

Silicone Cohesive Gel-Filled Implants:

All silicone gels in use today are "cohesive". The silicone molecules are long and crossed linked which makes the gel sticky and stops it "running". This silicone gel is described as having a Turkish Delight-like consistency.

These implants have a silicone textured or smooth covering. The design and construction of silicone implants has improved immensely in the last decade:

• This implant is made up of a cohesive gel and the whole mass of the implant remains in tact. If it is pulled or compressed it can return to its original shape.
• Leakage is a few in 1000 over the years. Some cohesive gels are softer than others.

With the Cohesive Gel Implants there is also reduced risk of:

• Wrinkling / folding.
• Movement.
• Rupture.

Saline Filled Implants:

These implants are filled with a saline (salt water) solution.

The implant envelope is implanted first as part of the breast augmentation procedure. The saline solution is then inserted into the implant envelope through a small cannula via a valve.

Points to note when considering this type of implant:

• The saline implants are more likely to wrinkle and this may be noticeable on the surface of the skin when you are lean.
• There is the possibility of a waterbed effect.
• The valve in the implant envelope will be sealed, but because a device exists, the saline implants are prone to deflation and leakage. This averages out at 2% over 5 years.
• If the saline-filled implant leaks, the body will absorb the saline.
• There is the insecurity of impending rupture and cost of further surgery. All manufacturers want the faulty implants returned and will replace the implant under warranty.

Smooth vs Textured:

Most old breast implants have a smooth surface. These were associated with about 70% of capsule contracture (implants feel hard). The current smooth implants have a low capsular contraction rate similar to the textured. Current clinical impressions for both smooth and textured are about 5-7% capsular contracture rate.

Teardrop vs Round Base

Round Implants:

Give your breasts a fuller, natural shape. Most women are more likely to consider these implants. Generally, round base implants are preferred should the configuration fit the shape of the base of the breast. This style is suitable if you:

• Have some breast tissue.
• Want fullness in the upper part of your breasts.
• Want to create the illusion of cleavage.

Symmetrical implants are generally trouble free, give a more rounded configuration i.e. upper and lower pole fullness is the same. These are suitable when a patient has a breast shape.

Teardrop, Contoured, Anatomical shaped Implants:

Follow the body’s contour. Women most likely to consider these implants have:

• Very little or no breast tissue.
• Lost breast tissue due to weight loss or breast feeding.
• No breast shape at all.
• Who want a more natural shape.
• To reduce or avoid double bubble.

Contoured implants can rarely rotate.