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 well-recognised breast augmentation surgeon, and lectures at international conferences on the topic. His expertise and views are sought by industry as well as professional colleagues alike.
Mr Pacifico often uses the very latest 3D imaging technology as part of his pre-operative consultations to help you visualise your possible outcome. This has proven to be an excellent communication tool giving 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 medical grade 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 near to 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.
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 considered 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. You might be required to have an MRI if advised to further visualise the breast.
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 will wear for a further 6-weeks. After the surgery, the wound will be dressed with surgical tape that is splash-proof and shower proof, however, not bath-proof. After showering, we advise that you dab the tape with a towel and use a hairdryer on a cold setting to dry the tapes. You will be able to get back to light activity (i.e. a desk-based work ) within a week of surgery in most cases.
How long before daily activities may be resumed?
Exercise and heavy lifting should be avoided for 6-weeks after surgery. However you should mobilise you shoulders following the surgery to keep you from getting stiff. In reality, the perfect way to begin is to wash your hair daily after the surgery. Additionally, this offers the extra advantage of making you’re feeling far 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 unusual. Infection in breast augmentation is very unusual, however, should it happen, in the worst case scenario the implant might need to be removed. Bleeding after surgery is unusual but would require a return to theatre to washout the blood and control the bleeding. Scarring from breast augmentation is usually discrete, but some people form poor scars that can be red and lumpy, and may require further treatment.
Long term issues that can be associated with breast augmentation include capsular contracture (hardening of the scar tissue around the implant), implant rupture (usually confined within the capsule) and visible rippling (seeing the undulations of the implant through the breast). These would require further surgery to rectify the issue.
A recently recognised, but fortunately very rare occurrence in textured breast implants is an association with BIA-ALCL (Breast Implant Associated Anaplastic Large Cell Lymphoma). This is a rare cancer of the immune system, and is normally curable with surgery to remove the implant and the capsule. Patients typically present around 8-years after breast augmentation with swelling from spontaneous fluid development within the breast implant pocket. Should this occur it is crucial that you seek medical attention.
One final phenomenon recently being discussed is “breast implant illness”. This is not a medical diagnosis but is a term some women self-identify with, when they feel a number of symptoms they are experiencing might be due to their breast implants. There are ongoing studies and research in this field, but so far nothing has been found to link silicone breast implants to any systemic disease. For more information please click here.
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