Mr Oliver, surgeon specialist in breast augmentation | David Oliver - Consultant Plastic, Reconstructive and Aesthetic Surgeon, Devon, South West of UK.

Breast augmentation is a surgical procedure to enhance or increase the size and shape of a woman’s breast, and can add volume and contour post pregnancy, weight loss or through the natural ageing process.

Restoring or adding to the existing breast volume can be achieved with a breast implant.

Mr Oliver will guide you through the choices in your implant selection, type and shape of the implant and the surgical placement to try and optimise your breast shape at your desired size.

Mr Oliver only uses the highest quality implants from Mentor, Allergan and Eurosurgical. Breast augmentation usually just involves one night in hospital and one to two weeks off work.

What is a breast enlargement procedure and why is it performed?

A breast enlargement procedure is one of the most commonly performed cosmetic procedures in the United Kingdom.

The procedure is appropriate for patients looking to increase the size and fullness of their breast and/or to correct minor sagging. Breast enlargement surgery is performed on women within a broad age range who wish to improve their breast size and shape for the following reasons:

A dissatisfaction with their original breast size
A desire to regain or improve breast shape and size following significant weight loss or having children and breast feeding
A wish to correct uneven breasts (asymmetry)
Correction of a congenital deformity of one or both breasts

Breast augmentation surgery can provide both physical and psychological benefits. Patients who have undergone a procedure of this type report that they feel more confident about their new shape. A breast augmentation procedure is performed by inserting a breast implant behind a woman’s natural breast tissue. The inserted breast implant pushes and projects the natural breast tissue, giving a fuller and larger breast appearance.

Implant shape

Implants can either be round or tear drop shaped. Round implants provide a bigger volume at the top of the breast, along with a deeper cleavage. Teardrop shaped implants can look more natural with less volume at the top. With either of these options, there are varying degrees of projection, depending on whether patients want their augmented breasts to look subtle or more noticeable. A helpful service that would be provided by Mr Oliver or one of his cosmetic nurses, is breast sizing. This involves placing a temporary implant inside a bra top and allows patients to visualize and assess which implants will help them achieve the personal augmentation that they require.

David Oliver Exeter Cosmetic Surgery for breast, body and face

How is this procedure performed?

Breast augmentation surgery is generally performed under a general anaesthetic. The procedure takes approximately an hour and a half to perform and patients typically stay in hospital for one night to recover.

Breast augmentation surgery is performed by making a small incision in the crease-line beneath the breast and making a pocket where the implant is then placed. The implant can be positioned in one of two places within the breast cavity in order to push the breast forward and to enlarge the original breast volume. The two potential sites are:

In front of the pectoral muscle. This route is typically chosen when a patient has sufficient skin and breast tissue to give good natural-looking coverage over the breast implant.
Behind the pectoral muscle. This route is typically chosen when a patient has insufficient skin and breast tissue to give a natural-looking coverage over the breast implant. This method is often favoured for very slim or particularly flat -chested women.

Watch a short video of Mr Oliver performing a Breast Augmentation. Key steps in dual plane breast augmentation and use of the Keller Funnel.

What are the results like?

This procedure can provide excellent results in women wishing to improve and increase their breast shape and size. This corrective procedure should be undertaken by a Consultant Plastic Surgeon who is fully qualified and well experienced in this type of specialist breast surgery.

Improved results will take place immediately following surgery, but the final result will be obscured by minor swelling, which is usual following this type of surgery.

It can take up to 14 days for the initial swelling and bruising to settle, but residual swelling will settle down gradually over several months. Typically the incisions and subsequent scars that are made by performing this procedure are well hidden near the natural breast crease. The scars will gradually change colour and should eventually become pale and barely noticeable. The wounds are sutured (stitched) with dissolvable sutures that do not need to be removed.

How will you feel after a breast augmentation procedure and what is the recovery period like?

Patients will be mobile from day one. Most women experience some discomfort following breast surgery and take pain killers for up to one week following the operation. It is important to allow for a natural period of healing to take place and for women who lead busy lives to abstain from strenuous activity or exercise for approximately four to six weeks following surgery. Initially, breasts will be firm and swollen and they will take at least six weeks to soften to a more natural appearance and feel. Breast swelling will settle down completely after several months.

Patients will always be advised to take a specific amount of recovery time away from work, dependent on the type of work they perform, but it is usual to take 7–14 days away from work to rest and recover at home following this type of procedure.

Are there any risks involved having a breast augmentation procedure?

All surgery involves an element of risk from developing complications, and should not be undertaken lightly and without being completely informed and confident you know all the risks. However, cosmetic surgery is usually undertaken voluntarily and only when a patient is in good health. Therefore, the probability of experiencing complications from this kind of surgery are substantially lower than for those who undergo surgery due to ill health. General risks such as bleeding, infection, asymmetry and scarring will be discussed openly at consultation, as well as the scrupulous efforts to manage and minimise these risks to their lowest possible potential. However, there are also specific risks to this procedure that need to be considered. These are:

Capsular contracture (hardening)

Modern day implants have ensured that the risk of capsular contracture has never been so low; however, capsular contracture is still the most common complication experienced by women following breast augmentation. Capsular contracture occurs when the human body puts a wall of scar tissue (fibrous capsule) around an implant. This scar tissue can then thicken and shrink and is noticed by the patient as an apparent hardening of the breast implant. Where a capsular contracture becomes noticeable or unsightly to the patient, corrective surgery can be performed.

Rupture rates and life expectancy of breast implants

Recent advances in implant technology and manufacture mean that breast implant ruptures are highly unlikely. A true evaluation of the life expectancy of modern-day implants is difficult to predict accurately, as new implants may have the potential to last a lifetime, but they have not been in use for long enough to produce proof to substantiate such a claim. Consequently women are advised that they may need to consider renewing their implants after a ten-year period. Please be reassured that the implants used by Mr Oliver are of the highest specification and are from established and reputable suppliers.

Scarring

Scars resulting from breast augmentation surgery are typically fine and well hidden once the healing process is complete. However, very occasionally a scar may heal abnormally and become thick, raised and painful (hypertrophic). This condition can sometimes be treated with a special dressing or with anti-inflammatory injections or with corrective surgery, although results cannot be guaranteed.

Infection and rejection

Such events are extremely rare; however, it is important that all patients quickly recognise any signs of infection, such as severe pain, fever or wound discharge. Antibiotics given during your operation will help reduce this risk to a minimum, as will meticulous attention to your personal hygiene. On very rare occasions a patient’s body may be unable to cope with the introduction of a foreign body (such as a breast implant) and a resulting infection may lead to a total rejection of the new breast implant.

Changes in breast sensation

It is typical for most patients to notice an alteration in breast sensation following surgery. These changes usually subside when the breast has fully recovered from surgery. Occasionally, patients report that their nipples or breast skin remain either more or less sensitive in the long term following surgery. There is often a little numbness directly above the scar.

Palpability

Women with very little natural breast tissue should be advised that the rim of the breast implant may be visible or detectable to touch (palpable). Your surgeon may recommend placing an implant behind the pectoral muscle in order to minimise this effect if they believe that the implant ridge would appear unsightly.

General Issues

Pregnancy and breast feeding

Implants do not interfere with a woman’s ability to breast feed.

Breast cancer

There is no known association between breast cancer and breast implants.

Mammography

Women with breast implants should inform any future radiographer that they have breast implants, so that the most appropriate method of breast screening and mammography can be performed.

Travelling at high altitudes.

Implants are not subject to strain, pressure or rupture when travelling in an aircraft or at high altitudes.

Smoking

Heavy smokers may increase their risk of complications. Patients will always be encouraged to cease smoking before surgery

What to do next?

It is important for all prospective patients to have realistic expectations of the improvements that can be achieved through breast enlargement surgery. Mr Oliver will conduct a full and thorough consultation with you in which issues such as your general health, age, the existing shape and position of your breast tissue and nipples as well as the desired outcome you wish to achieve will all be discussed. You will have the opportunity to ask questions and ensure you are fully confident and informed of the procedure before deciding whether to consider surgery further.