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Breasts

Too big, too small, too droopy, uneven? Whatever the problem with your boobs, cosmetic surgery can help.

ENLARGEMENT
WHY? If you often wish your breasts were larger, fuller, or more shapely, and if you experience the following feelings or conditions, breast augmentation may be right choice for you:

  • You are bothered by a feeling that your breasts are too small.
  • Weight loss has changed the size of your breasts.
  • After having children, your breasts have become smaller and have lost their firmness.
  • One of your breasts is noticeably smaller than the other.
  • You feel self-conscious wearing a swimsuit or form-fitting top.

HOW? Breasts can be enlarged by inserting implants (mammaplasty) made of an outer layer of silicone and filled with either silicone gel (either a solid, jelly like gel or more fluid) or salt water (saline). Implants are usually inserted through an incision made just under the breast (called the inframammary fold), or an incision around the nipple (periareolar) or in the armpit (axillary).
The operation takes between one and two hours and is usually done under general anaesthetic. You’ll have to stay in hospital overnight.

Aftercare
Your breasts will be swollen and bruised so don’t use your arms or chest area excessively as this may cause irritation or bleeding. Also avoid:

1.    Getting the wounds wet for a week.
2.    Sleeping on your front for a month.
3.    Heavy lifting for three to four weeks.
4.    Driving for at least a week.

Your surgeon may recommend wearing a tight-fitting support bra for two to six weeks after your operation. You may experience general discomfort or painful twinges for a few weeks but this is normal.

Results
The results of your implants will depend on your existing breasts, the position of your nipples, your age and skin texture. Your breasts are likely to feel taut at first but over a few months, they’ll appear more natural as the breast tissue, muscle and skin all stretch to accommodate the implants. You will also have scarring wherever your incision is made. The scars normally settle after a year, but some scars may take longer.

Risks
The risk of complications is low, however it’s important to be aware of possible risks before you embark on any surgery.

  • Capsular contracture When scar tissue shrinks significantly that your breast feels hard and is painful. This is the most common problem of breast implant surgery and affects one in 10 women. The implant may have to be replaced.
  • Rupture This occurs when the breast implant develops a split or hole in its casing. Depending on what your implants are filled with, you may not need treatment. Your body will safely absorb the sterile salt and water solution of saline implants. If a silicone gel implant leaks, it can sometimes spread into the breast and cause small lumps to develop, known as siliconomas. These may feel tender to touch. If they cause pain, they will need removing.
  • Nipple sensation For three to six months after surgery, your nipples may be highly sensitive, possible even painful. Conversely, about one in seven women find their nipples become less sensitive, or have no sensation at all. You may be more at risk of losing nipple sensation if your incision is made around the nipple.
  • Rare complications Infection after surgery is rare and most infections can be treated with antibiotics. If your breast becomes severely infected, the implant has to be removed until the infection has cleared but could then be reinserted. On rare occasions, fluid can build up around your implant. This is known as seroma and sometimes surgery is needed to drain this fluid away.

Cost: the average cost around £4,000

‘Having my new boobs has totally changed my life – I love them’
Dawn Almond, 36, works as a probation officer and is mum to Ethan, 10, and Tianna, 7. She lives in Bushey, Hertfordshire
‘Before I had children I was a 34B but after two children, and breastfeeding, they went to nothing. I was a 34AA and I hated them.
‘I decided to use Jan Stanek because a friend’s mother had been to him for various procedures. He was very professional but reassuring at my consultation and the fact he had a long waiting list was encouraging! ‘I had wanted to go up to a size D but Jan said that would be too big for my frame. In the end I opted for a small C cup because I was scared of the massive difference.
‘Immediately after the operation I looked in the mirror – they were very swollen to about a double D. But after a week or so I really started to like them.
‘I was quite sore for four to five days and couldn’t lift my arms up because of the stitches, and they were slightly uncomfortable for about two weeks. I had to wear a sports bra at night and I had to massage them five times a day for six weeks but I’ve never had any problems with them.
‘The operation cost £4,500 but it was worth it. I have no regrets and love my new boobs. It sounds like a cliché but having them done has totally changed my life. I’m more confident and think they’re a major improvement in my body.’

REDUCTION
WHY? Particularly large breasts can cause psychological distress and physical discomfort in women. So a breast reduction can increase comfort and satisfaction.
HOW? A breast reduction operation involves excess tissue and skin being removed from the breasts. The breasts are reshaped to form smaller breasts and the nipples are repositioned. Breast reduction (or reduction mammoplasty) is usually done under general anaesthetic and the operation lasts from two to four hours.
It’s sometimes possible to leave the nipple and areola in place, but particularly if the breasts are very large the nipples are often moved to suit the new shape. The skin is reshaped and the incisions are closed. Your breasts will then be wrapped in a supportive dressing or support bra. As with enlargement, plastic drainage tubes may be left in each breast.
Aftercare
As a basic guide, follow the same four rules of what to avoid as after breast enlargement. Your breasts will feel painful, swollen and tender and be bruised for several days. You’ll need to wear a support bra for four to six weeks to help stop
the weight of your breasts pulling on the wounds. Use extra pillows when you’re sleeping as this can help reduce the swelling. Try to avoid lying in bed for extensive periods as it’s best to keep moving.
Results
It may take several months before your breasts settle into their new, smaller shape. Changes in sensation are common, particularly when the nipples are moved during surgery.
Risks
Although rare, there is a risk of infection, internal bleeding or scarring that can take years to improve. There are some additional, albeit rare, risks to consider as well. Alterations in the blood supply may result in the loss of part, or all, of the nipple, breasts may become uneven and nipples may not be level with each other. Sometimes, small folds of skin develop at the end of your scar. You may need an operation to remove these if this happens.
You may be unable to breastfeed after the operation (usually if the nipple is moved), but if this is an issue for you, discuss with your surgeon.
Cost: between £3,000 and £6,000

UPLIFT
WHY? As you age, the shape of your breasts change and they gradually droop. This effect is greater following pregnancy, breastfeeding and in particular after a large amount of weight loss.
HOW? A breast uplift (also known as a breast lift or mastopexy) changes the shape of your breasts, not the size. Sections of slack or redundant skin are removed and the breasts are reshaped using the remaining skin. The operation requires surgery which usually takes place under general anaesthetic. It usually involves an overnight stay in hospital.
Aftercare
Following surgery, to keep the breast supported, you will need to wear an appropriate bra day and night for six to 12 weeks. If stitches need to be removed, this will be done around seven days later. It is usual to take some time off work, and avoid heavy exercise for a few weeks.
Results
Your breasts will appear higher, as will your nipples. Breast lifts can be permanent but your breasts may droop again as you age, or if you become pregnant or put on weight.
Risks
In rare cases the procedure may leave you with different size breasts, asymmetrical nipples, permanent nipple loss, or a loss of feeling in your nipples or breasts.
Cost: between £3,000 to £6,000

Nicky Hambleton-Jones says…
‘There’s no end to what you can do to your boobs these days. Less is more if you want a youthful look and do bear in mind that implants don’t last forever and you may need another op to replace or lift further down the line.’

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