Breast enlargement also known as "Augmentation Mammaplasty", involves the surgical placement of an implant behind the breast to increase its volume and enhance its shape. Every year thousands of women undergo breast augmentation , and feel more confident about their appearance. You may be a candidate for this procedure if: - you feel that your breasts are too small - one of your breasts Is smaller than the other by one bra size or more. - weight loss or breast-feeding after pregnancy has decreased the volume of your breasts - clothes you buy fit well on the hips and are too large for the bustline. The operation can be performed at any age once the breasts are fully developed. It is important that the patient is emotionally mature and sure about the expected outcome from the procedure. Your consultation will involve discussions about your expectations and what is surgically possible. A full medical history will be taken with particular emphasis on a family history of breast cancer and the result of any biopsies or mammograms. There is no scientific evidence that breast augmentation increases the risk of cancer or autoimmune disease. However, it is technically more difficult to read a mammogram. Some Implants are available on the market which allow mammograms to be interpreted more easily. Your plastic surgeon can discuss these with you. It may only be a special consideration for those women who are high risk for breast cancer anyway. You must inform your surgeon if you are planning a significant weight loss or planning to get pregnant in the future. Both these changes will alter your breast size in an unpredictable way and could affect the long term results of your breast augmentation.

You should still be able to breast feed, with no risk to your child. The operation varies from patient to patient in three major ways, firstly the placement of the incision, secondly the type of implant used and thirdly the anatomical plane of implant placement. The incisions can be placed either underneath the breast (just above the breast crease,) or around the lower edge of the areola or within the armpit. The type of Implants use today largely contain an outer hard silicone shell with either salt water or soft silicone inside.Because of Food an Drug Administration legislation Saline filled implants are currently being used In the United States, while in Britain and continental Europe, silicone implants are favoured due to their superior result. Ongoing trials in the United States have failed to show that silicone filled breast prosthesis are in any way risky. There are now a number of "biodimensional on anatomic (teardrop shaped) implants on the market, you may discuss these with your surgeon. If saline filled implants are used, it may be necessary in thin individuals to place them under the muscle of the chest wall, so that the ripples sometimes created by the prostheis ( which occurs much less In silicone filled) are better hidden. Silicone filled prosthesis are placed under the existing breast tissue.

The subject of risks and potential complications are best discussed on a personal basis with your surgeon. Some of the things which will be discussed with you include reactions to anaesthesia, blood accumulation (which may need to be drained surgically), and infection. Although rare it may be necessary to remove the prosthesis In the event of infection. Nipple sensation may be altered temporarily by the operation, and in rare cases complete loss of sensation is possible. When an implant is Inserted Into the body a healing response causes a fibrous capsule to develop around the implant. This capsule occurs in all cases, but to varying degrees. In most patients It causes no problem whatsoever, but if it tightens it compresses the implant and the patient can feel it as hardening of the Implant. Surgery may be required in extreme cases to remove the capsule. Breast Implants generally have a manufacturers recommendation to be changed every ten years. However, I have seen that they can last considerably longer and with no ill effects. If rupture does occur the breast may appear flat, and the Implant must be changed or removed, A commonly asked question Is whether it is safe to fly at 35,000 feet with Implants - and the answer is YESI If you are a smoker it is always wise to stop smoking two weeks prior to surgery.

You should also not be taking any aspirin containing drugs, or even Non steroidal anti inflammatory drugs. The surgery is carried out under general anaesthesia, and involves a hospital stay of one day. In some centres it is done on an outpatient basis under local anaesthesia and sedation, and the patient is sent home in a few hours, I prefer to leave a small drain in the breasts post operatively, as this carries away extra blood and fluid which would otherwise accumulate inside. I believe formation of small haematomas (blood clots) within the breast which is at times inevitable if no drain is left increases the chance of capsular contracture. Sutures are removed about a week after surgery. You may have some bruising initially, but this will resolve in a couple of weeks. It will be possible to return to your job within a few days, but vigorous exercises especially those involving the arms should not be done for two to three weeks.

The results of this operation are very pleasing and except in the event of implant failure (requiring surgical replacement with a new implant) will be long lasting. Over the years gravity and the effects of aging will inevitably act on the breast and alter the shape. If you become dissatisfied with the appearance you may opt to undergo a breast lifting procedure to restore the more youthful contour. You must remember that following this operation a liaison with your plastic surgeon should continue with regular interval follow up care. You will be encouraged to undergo routine mammographic evaluations at the frequency recommended for your age group.