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Breast augmentation (breast enlargement, also referred to as a “boob job”) is still the most popular plastic surgery procedure in the UK. Mr Pacifico is a renowned breast augmentation surgeon, and lectures at international conferences on the subject. His expertise and views are sought by industry as well as professional colleagues alike.

Mr Pacifico uses the very latest 3D imaging technology as part of his pre-operative consultations. This proves to be an excellent communication tool to give you a good idea of the results achievable in your situation.
“Breast enlargement is such a rewarding procedure to perform as the confidence boost it gives my patients is second to none. It is important that the breast implant fits the breast like a hand fits a glove, so careful pre-operative planning and choosing the right implant for the right patient and her breasts is crucial. I am a great believer in patient education and detailed discussion prior to any procedure, as this results in happy and satisfied patients with realistic goals and expectations.”

The procedure

Breast implants (made from silicone) are inserted under the breast – either directly beneath the breast tissue or alternatively partially under the muscle underneath the breast (known as dual plane). The scar is around 4 or 5cm long and is hidden in the breast crease. The choice of pocket (below or above the muscle) is determined as part of the clinical examination process, and will also depend on the type of implant chosen.

breast_augmentation_1
The photograph above shows a patient of Mr Pacifico who has had a subglandular (over the muscle) breast augmentation using low profile anatomical (shaped or teardrop) silicone breast implants. Note the natural shape achieved and the increased fullness to the breasts.

What does it involve?

The procedure is performed under a general anaesthetic (with you asleep) normally as a day case procedure (going home the same day). The procedure takes place in one of the leading private hospitals Mr Pacifico operates in. The surgery takes around 45-60 minutes and Mr Pacifico does not use drains. You will wake up wearing your surgical bra, with tapes on the wounds.

What are the benefits?

Breast enlargement will restore volume and improve shape to your breasts  – whether this is due to limited breast development or changes with pregnancy, weight loss or ageing. It remains such a popular operation as it brings about significant improvements in self-confidence and self-esteem. Breast augmentation is safe and will increase the size of your breasts. Breast-feeding is still possible (and safe). Breast cancer detection by mammography is also possible, but you must tell the radiographer that you have implants so they can adjust their machine. Some studies, however, suggest that a small part of the breast will not be visible on the mammography if you have breast implants.

As with any procedure, there are limitations in what breast augmentation can achieve. Importantly, you should understand that:

  • If your breasts are widely spaced apart to start with, they will remain widely-spaced, as an implant is put under the existing breast “footprint”
  • If your nipples point in slightly different directions beforehand, they can look more uneven after your breast enlargement
  • If you do not have much breast tissue to start with, the implant will be palpable (you will be able to feel it) and sometimes even visible (you may even be able to see the implant lying under your skin) – furthermore, with time, breast implants and ageing can contribute to the gradual loss of your breast tissue.

How long does the surgery take?

The operation itself may take between 45-60 minutes, depending on the technique required

What is the recovery period?

After surgery, you will wake up wearing your post-surgical bra, which you should continue wearing day and night for 6-weeks. After the surgery the wound will be dressed with medical tape. This is splash-proof and shower-proof but not bath-proof. You will be able to shower from the day after surgery, and dab the tape dry with a clean towel and then use a hair-dryer on a cold setting to dry the tapes. You will be able to return to sedentary activity (i.e. an office job or light duties) within a few days, depending upon how you feel.

How long before daily activities may be resumed?

You should avoid all heavy physical activity and contact sports for 6-weeks following the surgery to prevent damage to your new breasts. Mr Pacifico does, however, recommend that you do light shoulder exercises after the surgery to prevent you from getting stiff. In fact, the best way to start is to wash your own hair the day after the surgery. This also has the added benefit of making you feel much better!

What are the success rates?

Breast augmentation has a high success rate with a low complication rate. As mentioned above, it results in a very positive boost to self-esteem and self-confidence in most patients.

What are the possible complications?

Immediate complications after breast augmentation are uncommon. Bleeding into the breast implant pocket can occur and if it does, returning to the operating theatre will be required to wash out the blood.  Infection rates are low, but in the rare time an infection develops around the implant, it may require a further operation to remove the breast implant which may then be re-inserted after a 3-6 month break. Over time, some people can develop lumpy scarring which might require future treatment.

Longer term issues with breast implants can include traction rippling (this describes rippling of the implant seen in the cleavage when bending forwards) – this may be reduced when using smooth implants. Capsular contracture is an important possible complication to be aware of – this refers to tightening of the naturally forming scar tissue around the implant that may change the shape of the breast or cause discomfort. This would necessitate further surgery to replace the implant and release the tight scar tissue. Rupture of the implant, in which the integrity of the shell of the implant is damaged, is another issue that can arise. This might not be noticeable, as the ruptured implant is usually hidden inside the capsule of scar tissue around the breast.

Finally, a recently recognised, but fortunately very rare phenomenon, is BIA-ALCL (breast implant associated anaplastic large cell lymphoma). This is a rare lymphoma that has been found to be associated with particular types of implants with a very rough texturing on the surface. Patients typically present around 8-years after their breast augmentation with a spontaneous swelling and fluid collection in a breast. This needs to be carefully investigated if it occurs – the treatment is normally removal of the breast implant and surrounding scar tissue.

For more information about breast augmentation, please download the PDF using the button on the right of the page.