What are the long-term consequences of breast augmentation?
If you have a breast augmentation as a young woman you must accept that you are likely to have implants for many years. You may well have further surgery for any of the reasons outlined above. An operation that gives you more youthful looking breasts may seem quite appealing at the time, but will this be something that suits you when you are older?
Breast implants push your natural breasts forward and so do not make it any more difficult to examine your breasts for lumps. They do, however, interfere with mammography. A mammogram is an X-ray of the breast looking for signs of a breast cancer that you cannot feel. It is used as a screening test in the UK from the age of 50 years. The X-rays cannot pass through the implant so some of the breast tissue is obscured. If you are called for a screening mammogram you need to tell the mammography service you have breast implants. They may scan you at a different centre and take special views. Submammary implants are more of a problem than sub-muscular implants. The more of your total breast volume that consists of implant the greater the problem with mammography. If you have a breast augmentation you will have to accept that this will reduce the sensitivity of a future mammogram.
Several myths have arisen about implants such as it being unsafe to sunbathe, or unsafe to fly in an aeroplane. Neither of these two activities present a problem. There is no need to massage your breast implants. Indeed this is not recommended with modern textured surfaced implants.
Routine implant replacement after a specified time is not recommended. Replacement is only advised if you are unhappy with the appearance or have developed a problem
Are there any alternatives to breast augmentation?
The only alternative surgical technique to enlarge the breast is lipofilling. This is a relatively new technique where fat is removed by liposuction from another area of the body such as the hips or thighs and injected into the breast area. Only a relatively small amount of fat can be injected so patients will require multiple episodes to bring about a worthwhile effect. Some of the fat is absorbed in the initial weeks after the operation, but fat that lasts beyond this time will bring about a permanent enlargement. This is a much more gradual approach compared with implant based breast augmentation, but does avoid a breast implant. Since it is a relatively new technique we cannot be entirely sure how effective it will be in any given patient.
Your own fat is the only substance that can be safely injected into the breast. Other materials have been tried, and then withdrawn from use. Do not allow anyone to inject anything other than your own fat into your breasts.
Do I need a breast uplift operation?
Some patients are bothered by droopiness of the breasts. If you are bothered by droopiness and are happy with the size of augmentation, but may be offered a breast uplift operation called a mastopexy. This is a quite different operation that involves lifting the position of the nipple and breast tissue and tightening the skin of the breasts. There will be an incision around the areola and possibly incisions passing vertically downwards and underneath the breasts. So, the scarring is more obvious than simple breast augmentation, but no implant is used. All breast uplift operations will tend to droop again as a consequence of time and gravity.
Mild degrees of droopiness can be improved by a breast augmentation alone. Sometimes your situation falls between these two options and your surgeon feels that you may need a breast augmentation and mastopexy. In most instances it is best to do one or the other first and then see what result can be achieved with the proviso that the other operation can be done at a second stage if needed. However, in some patients it is clear from the outset that both operations will be needed and your surgeon will agree to do both at the same time. This requires careful preoperative planning and counselling. This is difficult surgery. The results are not always entirely predictable in terms of size and breast shape.
Introduction to breast augmentation
What complications can occur?