Breast Augmentation – an update

Breast augmentation remains the most popular cosmetic surgical procedure in the UK and quite possibly in the world.

It has been around since the 1960’s and has remained safe and effective when undertaken by specialists and when offered to patients who have been assessed and counselled. Implants now have a variety of filler materials and a variety of a outer case (the outer shell). The majority of implants have silicone gel and either a smooth or textured (rough) outer shell. The shape of implants are also another nuance when your implants is selected. Both tear-drop (anatomical) and round implants can have their place, however, nowadays the round implants are selected for most patients. We will also after a clinical examination decide the pocket for placement if the implants. Either under the muscle (sub pectoral) or under the breast ( sub glandular) or both (dual plane) can be used to obtain a natural looking augmentation. This important decision is based on whether you have had any children or have breastfed as well as whether you wish to have any more children in the future. Another consideration is the quality of the breast skin. Tight skin will require careful dissection whilst loose skin might need tightening. Finally if you’ve lost a lot of weight and have lost volume in your breasts then this is a final consideration that we will make when deciding both the type the height and the placement of silicon gel filled implants.

The issue of texturing of the outer shell is also a consideration a majority of implants used to have macro texturing which is currently been shown to increase complications and so there has been a shift towards using a micro texture or nano textured implants. Either way we will select what we feel is the best implant for your frame to give the best result and lead to a safe and successful operation.

What is ALCL?

Anaplastic Large Cell Lymphoma ALCL this is a rare condition of a cancerous growth around the outer aspect of a breast implant. It is thought to arise from a response of the body to a foreign material. Currently it is thought to have an incidence of one in 24,000 cases. The risk of a female in the UK of breast cancer for comparison is one in eight. This condition is often called breast implant associated (BIA) ALCL. It presents as an insidious painless swelling of the affected implant and breast tissue which will then need a clinical assessment followed by ultrasound and finally by removal of the implant and the capsule. It is thought presently that this is enough to affect a cure of the BIA-ALCL. As the risk is so low we are dissuaded from removing implants with no features to suggest this condition and also the regulatory body the MHRA have advised us to continue using silicon gel filled implants.

What is breast implant illness (BII)?

This is a vague and ill understood condition whereby patients who have had breast implants in for some time developed both weakness and lethargy and exhaustion which after multiple blood test and analysis fails to show any other organic cause. Often these patients when they have the breast implants removed report a sudden positive recovery from those symptoms. It’s true incidents is unknown but must be borne in mind when considering this operation.