Breast Surgery FAQ2018-08-10T23:44:25+00:00

BREAST SURGERY FAQ

Breast Implants

What are some of the risks of breast implants?2018-06-29T21:29:22+00:00
  • False expectations: There is always a limit to what can be done and it is not a good idea to compare your breasts with someone else’s breasts.
  • Every patient is unique and your body can only accept reasonable size implants.
  • The goal of an implant is to augment the size of a breast, not to lift it.
  • If a breast is sagging, a breast uplift might also be required.
  • Scarring. The incision into which the implant is inserted will leave a scar.

 

Apart from the usual side effects including pain (three to seven days), swelling, numbness (three weeks), there are some potential risks which are uncommon:

  • Bleeding: If you are bleeding and it won’t stop on its own you will have to go back to surgery to have it stopped. This is why it is so important to stop smoking before the surgery.
  • Bruising.
  • Infection (this is why you have the antibiotics and why it is important to take a good shower the night before and the day of the operation.
  • Asymmetry (no breasts are totally symmetrical and it is generally more obvious after the surgery).
  • Capsular contracture is a rare condition when the breast gets hard (due to the building of inside scar tissue). The best prevention is daily breast massage after three weeks.
  • Life expectancy of implants: about 15 years.
  • Ripples.
  • Limits of size.
  • The absence of cleavage.
  • Rupture of the implant (highly unusual, unless you are involved in a car crash or something similarly traumatic). This will obviously require a change of implant(s).
  • Seroma (collection of lymphatic fluid).
  • Displacement of the implant (generally upward). This can happen directly after surgery. The best prevention is wearing a strap across the chest with the surgical bra).

Surgical-Bra-for-after-Breast-Implants

 

These risks of complications are rare but remember that surgery is not an exact science and there will always be risks involved that are even outside the control of the surgeon.

  • It is important to attend to all the postoperative consultations given by your surgeon.
  • During the consultation, your surgeon will explain these risks, and other risks that may pertain specifically to your circumstances.
  • If you have more questions, do not hesitate to ask your surgeon, who will be pleased to answer your questions by telephone, email or during a second consultation.
When are my follow-up appointments?2018-06-29T21:22:04+00:00

 

schedule

 

  • You are supposed to come back to the clinic after one week for the first wound check (but you can contact the office anytime in between), and then you will see your surgeon in the second week.
  • After this first post-operative check, you will see your surgeon after one month, three months and six months unless there is any need to see the doctor more frequently.
  • Your stitches will be trimmed after two weeks.
  • The initial swelling will disappear within 3 weeks, which is the time you need before starting to see what your final shape will look like.
What happens back home, after the surgery?2018-05-25T23:11:21+00:00
  • Back home you are supposed to take it easy; which means obviously no sport or heavy lifting for six weeks.
  • Ideally, you should sleep on your back in a slightly inclined position.
  • You cannot shower your breasts for one week.
  • You cannot drive for one week.
  • You might be in pain and will need to take some painkillers.
  • You will be told to take some antibiotics for one week.
  • Your dressing needs to stay clean and dry.
  • If necessary, it can be changed by a nurse every other day, before you see your surgeon again.
What happens directly after the surgery?2018-05-25T23:10:47+00:00
  • After the operation, you will spend half an hour in recovery, before being taken back to your room.
  • You may be discharged a few hours later and asked to come back to the clinic the next morning for a check-up, or sometimes you will stay overnight.
  • Your surgeon will explain your individual care plan closer to the date of the procedure.
What happens on the day of the surgery?2018-05-25T23:10:14+00:00
  • Before the operation, you are not supposed to take aspirin.
  • It is recommended to stop taking the contraceptive pill 1 month before surgery.
  • You will have to stop eating, drinking and smoking 6 hours before the operation.
  • You will see your surgeon before going to the theatre and have time to ask them anything you may have forgotten to ask.
  • Your surgeon will ask you to sign a consent form, where all the possible risks are mentioned. He will then do some markings on your skin and take some before photographs (they will stay in your file and are totally confidential)
  • You will meet your anaesthetist and you are free to ask them any questions you may have before being shown into the surgical theatre.
  • Your operation takes less than one hour.
What happens when I decide I want to go ahead with surgery?2018-06-29T21:22:56+00:00

Harley Breast Staff

  • You call the clinic on 020 3633 5055 and let you know what dates are available at the private hospital.
  • We then take a deposit to secure you a place in the hospital.
  • The deposit becomes non-refundable 2 weeks before your operation date.
  • It is sometimes recommended to see your surgeon for a second consultation.
Who should I contact following the procedure if I have any concerns?2018-06-29T21:23:31+00:00
  • If you have general questions or are needing follow-ups scheduled or other non-urgent assistance, you should contact the clinic directly (rather than your surgeon).
  • Your surgeon will provide you with their contact telephone number in case there is an urgent need to contact them.
  • You must contact your surgeon if you are seriously concerned about the healing, feel something is definitely wrong, or you are in excessive pain.
  • The clinic is contactable 24/7 in the case of an urgent matter on 020 3633 5055.
How long does it take for silicone breast implants to settle into place?2018-05-25T23:08:25+00:00
  • Breast implants are likely to sit a little higher at first and may take 1 – 3 months to settle into their final position.
  • You should know that your result may (or may not) change significantly in the first 1-3 months, and you should not be too concerned if the implants appear a little high at first.
  • Implant appearance continues to improve over the first 3 months, becoming more natural looking as they settle into place, and the breast area adjusts to the presence of the implants.
How much time do I need to take off work?2018-05-25T23:07:31+00:00

Time off work after breast augmentation

 

  • Obviously, the longer the better to give yourself time to heal at home in a relaxed environment.
  • We recognise that taking time off work is expensive, and takes away precious annual leave you would rather spend on holidays.
  • The minimum required time away from is 7 days in order to rest and recover from the operation.
  • Your surgeon will ask you about the nature of your work during your consultation.
  • If you have an active job (for example you are a personal trainer or dancer), rather than working in an office, then you may need to take additional time off.
  • You should certainly not stretch or lift heavy objects for at least 2 weeks following surgery, and take it easier than normal for the first month.
When can I go bra shopping?2018-06-29T21:29:52+00:00

Surgical Bra

 

  • You will need a new bra after surgery, particularly after breast augmentation by implants or reduction surgery, as your bra size will have changed.
  • You are likely to be wearing a surgical bra following the procedure (if your surgeon instructs you too). It is better to wait until the surgeon gives you the go-ahead to stop wearing a surgical bra before buying new bras. This will likely be around 1 month following surgery.
  • This also gives the breast time to heal and allows for swelling to subside and implants to settle into their final position.
When can I drive?2018-05-25T23:07:16+00:00
  • You will have reduced reaction time straight after surgery, and are unable to drive home on your own.
  • Also, you don’t want to risk any aggressive movements such as stretching that may be required in operating the motor vehicle during the first month after surgery.
  • If you are on any pain medication your driving ability and reaction time may be lowered.
  • You should seek the permission of your surgeon before you return to driving.
  • There may even be implications for your car insurance if you do not follow the advice of the surgeon and end up in a minor accident.
Will I have any change in the sensation of the nipples?2018-05-25T23:07:09+00:00

Numb of tingling nipples are normal and should stop by 2-4 weeks from the date of the surgery.

Will I need to sleep on my back?2018-06-29T21:30:51+00:00

Sleeping-on-back-elevated-following-breast-implants

 

  • Ideally, you will sleep on your back in a slightly elevated position after surgery, particularly in the first week.
  • As you may be recommended to sleep on your back for up to 6 weeks, you are advised to practice sleeping in this position in the days before your surgery, particularly if you are used to sleeping on your side or stomach.
  • Sleeping on your back will help to reduce swelling and discomfort, and also reduce the risk of the implant moving before you are fully healed.
When can I have a bath or shower?2018-05-25T23:06:54+00:00
  • If you are unsure of anything, please check with your surgeon or the clinical team.
  • Generally, it is better to keep the wound from being fully submerged in water (for example in a bath), for 6 weeks from the surgery date.
  • You will generally be able to shower from 1 week after the surgery, ensuring that you do not get the wound wet for too long, and you take care of it in the shower.
  • This means, for example, not having a long hot shower during the first 6 weeks, and not washing the area of the wound in a way that disturbs the healing skin.
  • Pat yourself dry after your shower, avoiding the wound and certainly do not rubbing the wound dry by passing the towel over it.
How soon will I be able to return home after breast surgery?2018-06-29T21:31:57+00:00
  • Breast augmentation and reshaping using either implants or fat transfer, and breast reduction, is usually as a day case, enabling you to return home on the same day.
  • You will usually stay in the hospital for at least 2-3 hours following surgery in order to monitor you and complete necessary post-op checks before you are discharged by your surgeon.

 

  • In some cases, your surgeon will require you to stay overnight at the private hospital.  If this is the case you will be told beforehand with plenty of time in advance.
  • Patients that are staying overnight at the hospital have all meals provided for them.
  • All recovery rooms have a comfortable bed, television and internet access.
  • You will be allowed a visitor in some cases but not overnight.
  • Patients that stay at the hospital overnight are usually discharged between 8 am and 10 am the next morning.
Will I need to wear a surgical bra?2018-06-29T21:37:58+00:00

Surgical-Bra-for-after-Breast-Implants

 

  • Your surgeon may require you to wear a surgical bra following breast implant surgery, fat transfer or breast reshaping. You should wear the bra until your surgeon advises otherwise with the usual time required ranging from 2-6 weeks following the surgery.
  • The amount of time will vary from patient to patient and depends on a number of factors, including your healing progress, the nature and scope of the procedure performed, and your physical characteristics.
  • You will need to alternate between your surgery bra, and another surgical bra or support bra in order to wash the bra regularly.
  • One surgical bra from Macom Medical is included in the price of most Harley Breast procedures.
  • Additional garments may be purchased from Macom directly.
How do we decide upon the size of my breast implants?2018-06-29T21:36:25+00:00
  • The surgeon will take into consideration your current size and body shape, your measurements and the quality of your skin, and importantly what you want to achieve.
  • You can try different implants sizes in the consultation room, but this will only give you a rough idea.
  • For an added cost of £90, the clinic can produce a 3D scan of your body using the Crisalix system. You can then select from a range of popular implant sizes and the system will produce different projections of your new breasts.

Before-and-After Crisalix

Crisalix 3D

  • There is a limit to what can be done if you want your breasts to look natural. Having implants that are too large will look unnatural, and the added weight may increase the likelihood that they will start to droop over time.
  • In the case of very large implants, your surgeon may suggest lighter weight ‘B-Lite’ implants.

B Lite Breast Implants

 

  • The size you have decided before the operation can, on rare occasions, be changed during the operation, if the surgeon considers that the original size is not appropriate.

Breast Fat Transfer

Why are Breast Implants more popular than Fat Transfer?2018-05-22T20:00:05+00:00

There are a number of reasons that silicone breast implants remain more popular than fat transfer, including:

  • You can get a much larger result with silicone gel implants, compared to fat transfer.
  • Fat transfer can require multiple procedures spaced over more than 1 year.
  • Silicone gel implants are cheaper, costing around £5-7,000 versus fat transfer which can cost over £10,000 with multiple sessions.
  • Some patients do not have enough fat to transfer.
  • Lumps of fat can form is the fat transfer is not undertaken with sufficient skill, or in some cases may even form on their own, due to the bodies own healing process.
What are the main side effects and complications?2018-05-22T20:04:55+00:00

Fat Transfer Breast Augmentation is appealing to many patients due to its lower risk compared to breast augmentation with silicone implants.

The risk of infection is generally lower than with a breast implant and avoids the risk of capsular contraction, not uncommon with implants.

Your Surgeon will discuss the specific risks relevant to your circumstances on the day of your consultation.

Some of the risks associated with this procedure are:

  • Infection (a risk in all surgery).
  • Cysts, microcalcification (the forming of small hard lumps).
  • The death of some of the fat cells.
  • The possibility that some of the transferred fat cells will leave the breast area.
  • Complications are unlikely and can usually be addressed by the surgeon, should they occur.
How long will the breast fat transfer results last?2018-05-22T18:55:45+00:00

As long as you keep your weight reasonably stable, the amount of additional fat that exists after 3 months should remain permanently.

How much of the fat will survive?2018-05-22T20:01:49+00:00

The breasts naturally contain fat and are one of the better areas of the body for fat transfer.

In order for the fat taken from the donor site to survive in the recipient site (the breasts), the fat must re-vascularise (establish a blood supply).

Most of the transferred fat will establish a supply of blood in the first week after the procedure.

Therefore it is essential to rest for a week after the procedure in order for the breasts to heal and integrate the new fat.

As an option, P.R.P. can be added to the fat when transferred to the breasts if the patient wishes.

Am I a suitable candidate for Breast Fat Transfer?2018-05-22T20:06:20+00:00

A few preliminary questions must be answered.

1. Do you have enough fat to take from the donor site?

This treatment is not suitable for patients with very little body fat. You need an area or two where there is sufficient fat to liposuction from, generally the buttocks, stomach, or sides.

If you do have sufficient fat, the Surgeon will determine the quality of the fat and likelihood of successful fat survival in the recipient site.

 

2. Are you looking for a subtle or modest increase in breast size?

If you are looking to go from a B cup to D cup, this procedure is not suitable for you, and you may be better to consider breast implants.

Breast Lift

Scarring2018-05-26T10:51:44+00:00

One of the main downsides to a Breast Lift / Mastopexy is that scarring is inevitable.  A breast lift cannot be undertaken without causing the patient scarring.

Scarring will often by red and swollen for 2-3 months.

Scars will slowly fade in time becoming flatter, a closer colour to the surrounding skin, and generally less visible.

In some cases, however, scars can remain widened, whiter, or conversely, darker than the surrounding skin.

Scars may sometimes become hypertrophic or bumpy (cheloid) compromising the final aesthetic result. Pathological scars may require extended treatments over a number of months or years in order to improve their appearance.

What are some of the complications?2018-05-26T10:50:55+00:00

The risk of complications is present in every surgery.

In addition to the risks you have discussed with your surgeon during the consultation:

– Infection (treated with antibiotics and drainage).

– Blood clots or haematomas. These are uncommon and can be removed.

– Localised skin or gland necrosis. Rare with modern techniques. Can also delay healing.

– Numbness of the nipples. Usually temporary with most patients recovering normal nipple sensation after 6 to 18 months.

In every procedure, there is some degree of risk that is not able to be foreseen or controlled by the surgeon.

Will Breast Implants lift my breasts?2018-05-26T10:50:20+00:00

Depending on the degree of sagging you have, implants could add more weight to the breasts and make the situation worse.

The breast tissue needs to be reshaped in order to lift the breasts.

In some cases, a breast lift is combined with breast implant augmentation to restore lost volume, particularly in the upper poles (cleavage) of the breasts.

Advanced implants such as B-Lite are up to 30% lighter than traditional silicone gel implants and may be preferable in some cases.

Will I lose sensitivity in my nipples?2018-05-26T10:48:15+00:00

This will vary from patient to patient.

The majority of patients are able to retain either all or almost all of their sensation.

In the weeks straight after surgery, there is likely to be a loss or decrease in sensation or a change in the sensitivity of your nipples and breasts.

It is also possible to sensation will be temporarily heightened in the weeks following a mastopexy.

Pregnancy and Breastfeeding2018-05-26T10:44:58+00:00

Will I be able to breastfeed after breast uplift surgery?

A plastic surgeon cannot guarantee for certain that breastfeeding will still be possible after a breast lift surgery. Please consider this before proceeding with surgery.

If you are planning to have a baby you should wait until after your pregnancy to have a breast lift.

A pregnancy causes the breasts to enlarge and the skin to stretch. This will likely undo most of the results of the breast lift surgery.

It is better to wait until after your final pregnancy to have a breast uplift or you may have to repeat the surgery again.

Crescent2018-06-29T21:50:53+00:00

Crescent Breast Lift Scar

 

A Crescent lift covers only the top half of the areola and is frequently used when the patient has only mild drooping of the breasts. It is also commonly chosen when the breasts are being augmented with implants at the same time.

Circle2018-06-29T21:48:44+00:00

Doughnut Circle Breast Lift Scar

 

A Circle or Benelli lift is most commonly used when the patient has mild sagging and is also frequently used if breast implants are to be inserted. The scar is hidden to varying degrees as it traces the outline of the areola (the darker colour circular band of skin outside of the nipples).

Lollipop Incision2018-06-29T21:49:09+00:00

Lollipop Breast Lift Scar

 

A Lollipop incision is used in the case of moderate sagging. The incision is around the areola with a line vertically down under the breast to the crease. The incision is frequently chosen when the patient is not having implants at the same time as the lift.

Anchor Incision2018-06-29T21:49:56+00:00

Anchor Breast Lift Scar

 

An Anchor incision is used if there is a higher degree of sagging and it will also be the incision method used in a breast reduction or mammaplasty. The incision goes around the areola, with a vertical line down, like the lollipop incision, but with another incision along underneath the breast in the crease.