Breast Augmentation

If you would like any further information or to make an appointment for a full consultation, please contact Eve McRae on 01793 816044 or e-mail me at ridgewaybreastcare@bmihealthcare.co.uk . I look forward to hearing from you.

Breast screening

Continue breast self-examination and you will soon get to know how your breasts feel. If you should notice any changes inform your GP. It is important to tell the radiographer when having a mammogram that your breasts have been augmented.

Follow-up appointments

I will review you in clinic 2 weeks and 6 weeks after surgery. There is no follow up charge to see me and I like to review you on an annual basis, just so you know I am available to you. I will take photographs at these consultations.

What should I look out for?

Once you are at home after surgery, it is important to check your wounds. I would advise that you carry out normal breast checks and become ‘breast aware’ – by getting to know what your breasts look and feel like so you know what is normal for you. If your breasts become red, swollen and painful or there is a discharge, you need to contact me or Charlayne Harding.

Sexual activities

Initially your breasts will feel tender and you may not feel up to physical contact. However, you may resume your sex life as soon as you feel comfortable.

Sport

Many sports can be resumed within a couple of weeks, but if the sport involves strenuous upper body movements, for example aerobics, golf, swimming and any racquet sports, you should recommence these activities gradually about a month after surgery.

Returning to work

Depending on the type of work that you do, you may be able to return to work within two to three weeks. You may feel quite tired at first. This is quite normal, and I suggest you talk to your employer about making a gradual return to work.

What should I do when I get home?

You should be able to return to most of your normal activities within two to four weeks after your surgery, although this will vary from person to person.

I recommend that you build up gradually to more strenuous tasks such as housework or gardening. You may need to ask someone to help you for the first couple of days as it is important that you get plenty of rest and that you set aside some time during the day for this.

Bra

You will need to wear a good, supporting, non-wired, sports-type bra continuously for a short period of time following surgery, as this will help with reducing the swelling and help the breasts settle into their new shape.

After surgery, you can expect to find some swelling and your breasts will seem high and firm which may seem unnatural to you. However, after a while the swelling will reduce and become more comfortable, and the breasts will take on a more natural shape. You must not lift heavy objects or play any strenuous sports for the first two to three weeks.

After the operation

The procedure usually takes about one to one and a half hours. When you wake up after the surgery, you will be in the recovery area. The nursing staff are very experienced and they will ensure that your recovery is as pain-free as possible. Painkillers will be given to you on a regular basis for as long as you need them. The operation does not usually cause much pain afterwards, although some tightness and bruising may cause discomfort. Please tell the nurses if your pain persists.

The surgery

Techniques for breast augmentation vary, depending on the surgeon and your body shape. The most common procedure involves making an incision in the crease under the breast then making an envelope to put the implant in.

The implant can be placed either behind the muscle or in front depending on what you have decided with your surgeon. The stitches are hidden under the skin and do not need to be removed afterwards.

Considerations

Breast implants are a long-term commitment. They are likely to need replacing and further operations will be required to maintain the benefits of the implants. The length of time that the implants last is unknown and varies depending on an individual’s personal factors.

Capsular contracture

This is a thin layer of scar tissue (fibrous capsule) that forms around any implanted foreign material (e.g. breast implants). As the scar tissue shrinks it is noticeable as an apparent hardening of the breast. This is one of the most common complications, although modern implants have a textured silicone shell with a lower incidence of capsular contracture. If a capsular contracture does occur you will need further surgery. The implant may have to be removed, along with the capsule, and replaced, if appropriate, with another implant.

Symmetry

Although every effort will be made to make your breasts equal in size and shape, you may find that there is a small difference between the two breasts. This is quite normal, but if you have any concerns or questions please talk to me.

Breast feeding

The implants should not interfere with the ability to breast-feed. However there has been evidence that suggests the amount of milk produced may be reduced in some women.

Nipples

As a result of the surgery, there may be a decrease in or loss of nipple sensation. Occasionally, the nipple sensation will be increased for a period of three to six months following surgery, and may be painful.

Scars

Any operation will leave a permanent scar. Even without any problems, the scar, at first, will look red, slightly lumpy and raised. Regular massage of the scar with a light non-perfumed moisturising cream around 2 weeks after surgery helps. If you have a tendency to produce scars that are raised and itchy, please discuss this with me.

Deep vein thrombosis

A blood clot in the legs. This is a potential complication following surgery and bed rest. Occasionally clots can break off and pass into the lungs, known as a pulmonary embolus. All patients are given compression stockings/socks, to try to prevent this problem.

Haematoma

A collection of blood around the prosthesis, which may occur after surgery. In some cases, you may require a drain, which is a thin plastic tube attached to a bottle. This would be removed before you are discharged. Even with this care, blood sometimes collects and the breast becomes swollen and painful. A second operation a day or two after the first may be necessary to remove the haematoma.

Pain

You may feel some pain for the first few days, especially as you move around. There may be further discomfort for a week or more. Regular medication will be prescribed to help with the pain.

What are the risks?

It is important that you are completely satisfied that you have been given all the information you need and that you fully understand the risks and benefits of you surgery, before you sign your consent form. You can change your mind at anytime before surgery.

Contraceptive pill or HRT

If you are taking the oral contraceptive pill or hormone replacement therapy, you do not need to stop taking this medication.

Smoking

As smoking has adverse effects on blood flow to surgical sites, as well as your heart, lungs and skin, I would not recommend having this operation unless you have completely stopped for at least 6 weeks prior to surgery.

The same applies for the use of nicotine replacement therapy, as although this will reduce the craving for a cigarette, the nicotine will also reduce the ability of the blood to carry enough oxygen to the tissues.

Pre-assessment clinic

You will receive an appointment before your surgery to assess your general health and fitness before surgery by tests and investigations including blood tests, ECG (electrocardiogram – heart tracing) and discussing your current medication and any allergies you may have, and information about your planned treatment and about the hospital services.

What arrangements do I need to make?
  • The hospital stay is normally overnight.
  • You should arrange help with shopping, housework and care of small children and pets, as you will not be able to manage these on your own for at least a week after surgery.
  • You will not be able to drive immediately after your operation, or do heavy lifting for a few weeks.
Our meeting

Our consultation will involve an informal chat about yourself, your circumstances and reasons behind having the surgery. I would like to know what you expect from the surgery and want to help you achieve what will be the best outcome for you. Charlayne Harding, our Breast Care Nurse will also be with us during the consultation.

I will examine you, take measurements and together, we can discuss what areas concern you the most and how we can improve them. I will take photographs, which do not show your face for your health records. Please bring a comfortable bra and wear a simple white fitted t-shirt or something not too patterned. You may try on “shells” inside a bra, in front of a mirror to see what size suits you the best. You are welcomed to bring a partner, friend or a family member along to the consultation.

Together, we can decide the most suitable implants for your body type.

What types of implants are available?

There are two types of implants that are commonly used in the UK – silicone and saline. I use textured silicone implants to reduce the risk of hardening and deformation (capsular contracture). The firm jelly-like silicone implants implants are less likely to leak. Implants come in two shapes, either round or anatomical (breast shaped).

Due to the controversy over silicone, the Department of Health undertook studies and found no scientific evidence that silicone implants increase the risk of immune system problems.

For further information you can visit the Department of Health website: www.dh.gov.uk or download an information booklet from:

http://www.mhra.gov.uk/Publications/Postersandleaflets/CON2022635

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