Cosmetic surgery guide: Breasts

According to one leading plastic surgeon, within a few years breast implants will be injectable, making a lunchtime boob job a reality, not to mention more affordable and reversible. Apparently, the technology simply needs refining. Back to the present, however, and breast surgery, despite the apparent ease and frequency with which celebrities seem to have it, remains a major operation.

Breast augmentation, increasing the size and fullness of the breasts, is the top cosmetic surgery procedure for women, according to an annual audit by BAAPS, the British Association of Aesthetic Plastic Surgeons, with 6,497 operations being carried out in 2007. Implants all have an outer layer of silicone, with different fillers, such as soya bean oil, silicone gel or saline (salt water). They're inserted through incisions either in the crease of the breast, around the areola (the area around the nipple) or under the armpit and sit under the chest muscle or breast tissue. There are a variety of shapes, sizes and designs to choose from.[quote]

What are the risks?

As the procedure is performed under a general anaesthetic, the risks, such as blood clots and infection, start there. There are also potential complications, such as internal scarring, called a capsule, which would require another operation, implant rupture or leakage and loss of sensation in the nipple or breast tissue, which can be permanent. Having said that, the majority of women undergoing breast augmentation don't experience permanent problems. Equally, although there are scare stories linking leaky breast implants to cancer and auto-immune diseases, there's currently no real evidence to back these up.

What about breastfeeding and mammograms?

It's possible to breastfeed after a breast enlargement, but this should be discussed with the surgeon beforehand. Likewise, you can still have mammograms after the procedure, though special views are used. It's most likely that you would be given a mammogram before the surgery too.

How long do they last?

How long implants last is hard to predict as it varies between individuals, but recent research suggests around 16 years. You will have to have them replaced or removed at some stage though, depending on the age when you have augmentation. If you've had them in for a while and remove them, be prepared for droopier breasts depending on the quality of your natural breast tissue.

What about a breast lift or reduction?

It may be that you don't want bigger breasts, but simply want them to look perkier, or smaller. With a lift, or mastoplexy to give it its proper name, the intention is to reshape the breast to make it look more youthful. It involves removing surplus skin from under the breast and remodelling the breast to be tighter – an implant can also be inserted to create more volume. There are different techniques leaving different scars but, as with any breast surgery, it's fair to say you might feel self-conscious about sunbathing topless after having a procedure – scars fade, but not entirely.

Breast reduction is the most complex of the breast operations, involving the removal of fat, breast tissue and skin. The nipple may also be moved and as such would be separated from the milk ducts, so very few women would be able to breastfeed after a reduction. Exactly how the operation would be carried out depends on the size and shape of the breasts before surgery and the desired final size. All techniques leave a scar around the areola, plus usually a T-shaped scar down the centre of the breast from the areola and underneath each breast.

How much will it cost and what is the recovery time?

All of the procedures involve anything from at least an hour in the operating theatre, a couple of weeks off work and a budget of £4,000 plus.

Do your research

If you are considering breast or any other type of cosmetic surgery, be sure to do plenty of research first. BAAPS has designed a handy acronym, S.U.R.E, a good starting point, which we've abbreviated here (see www.baaps.org.uk for the full version):

Surgeon: Check your surgeon's credentials and qualifications Understand: Make sure you understand what's involved and that you are informed about the potential risks of each procedure
Recovery: You should be clear about the process of recuperation Expectations: Be prepared to review your expectations

Good contacts

The British Association of Plastic Reconstructive and Aesthetic Surgeons (www.bapras.org.uk)

Department of Health (www.dh.gov.uk)