Breast Augmentation (bilateral breast augmentation or BBA) is an operation to enlarge the breasts. It can be a life-enhancing procedure. However having a breast enlargement is a big decision. It is major surgery with potential risks, and the result you may hope for cannot be guaranteed. This booklet will help you understand the procedure better. It will also explain the risks of the operation both in the short and long term.
If you have any further questions after your consultations and reading the booklet, please ask your surgeon.
We have produced a printed version of the guide for people considering breast augmentation.
Copies are available by emailing the secretariat or download a PDF.
Please be aware we can only send out up to 50 copies at a time.
Who is this guide for?
This booklet is for those looking for more information about breast augmentation(breast enlargement). It aims to give an overview of options available, what is involved and the expected outcomes. It will also go through the possible problems associated with breast augmentation and breast implants. There are also links to other resources.
The guide is designed to be used alongside discussions with your surgeon, GP, family and friends to help you in making decisions.
What is breast augmentation?
Breast augmentation is usually done by inserting an implant beneath the breast to make it look larger. It will enlarge breasts that have always been small, but can also be used to fill out breasts that used to be larger. An example would be breasts that have emptied out, perhaps following pregnancy.
Breast augmentation will reshape breasts to some extent. The procedure can also be used to correct breasts that are of unequal size.
An alternative to enlargement using an implant, is to perform fat transfer, sometimes called lipomodelling, lipofilling or fat grafting. This involves injection of fat taken from elsewhere on the body, into the breast area. Fat transfer may be an appropriate method of augmentation in a few people but is not suitable for all. This technique often requires more than one episode of surgery. It can be also be used in combination with an augmentation.
Patients who have breast augmentation tend to be pleased with the results, however, it is important that you have realistic expectations.
You need to understand what can and cannot be achieved, the limitations of surgery and the long- term consequences of having breast implants.
What is my next step?
There are different ways to seek a consultation and your GP may be able to help with information about surgeons local to you. Some patients will choose to approach a private hospital or clinic directly and this is fine. If you do this, you should ensure that your initial consultation will be with the surgeon who will be doing the operation. Your surgeon will normally seek permission to write to your GP following your consultation. You should expect to pay a fee for your consultation. At your consultation you will be asked what is bothering you about your breasts and about your expectations from the surgery. It is important that you share all of your previous medical information with your surgeon. You will be examined and measurements taken of your breasts. Some discussion will follow about implant shapes and possible sizes and the position of the pockets that are to be made for the implants to sit in behind your existing breast tissue. To help give you an idea of the potential result some surgeons will use implant sizers in a bra. Others may use 3D photography. Although this can be helpful for you to have an idea of what you may look like after surgery, it is only a guide. It is important to realise that the same implant can look very different indifferent people. You should be told about the operation, the expected outcome and possible risks and complications. You should be given a ‘cooling-off’ period of at least 2 weeks before having surgery, and you should be offered a second consultation, before the operation. You should not feel rushed into surgery.
Why is there a ‘cooling-off’ period?
Breast augmentation is a lifetime commitment and must not be considered a one stop permanent solution.
It is essential that you are making the appropriate choice and understand all the implications of the surgery you are considering. You will need revision surgery as the years go by and you need to be prepared personally and financially for this. Nobody needs an urgent breast augmentation. If you are not offered a cooling-off period, or you are put under pressure to proceed, you should walkaway.
How can I check my surgeon’s qualifications?
All surgeons should be listed with the General Medical Council (GMC). You can check that the surgeon is on the register at www.gmc-uk.org; click the link ‘Check a doctor’s registration status’, type in the surgeon’s name and/or GMC number and their details will appear. Under ‘Status’ they should be listed as “Registered with a license to practise; this doctor is on the specialist register”. Surgeons may also be registered with the Association of Breast Surgery (ABS),the British Association of Aesthetic Surgeons (BAAPS) and/or the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS). Surgeons who are members of these organisations will have a standard set of recognised qualifications. It’s perfectly reasonable to ask the surgeon about their experience and qualifications also. Many patients use internet search engines to look up doctors and services. You should bear in mind that information accessed in this fashion maybe promotional in nature. Those listed may have paid for such a listing. A prominent listing is not a measure of service quality but rather a measure of marketing ability.
How much will it cost?
Before your consultation it should be possible to obtain an approximate cost for the surgery from your local private hospital or the surgeon’s secretary. It is also normal to charge for your initial consultation(s).After your consultation(s) and if you are planning to go forward with surgery, you should be given a written quote regarding the cost of the planned care. You should avoid any deal in which you are asked to pay any form of non-refundable deposit. In addition, you should not be offered a financial inducement to proceed, and you should avoid any such offer or time-limited deal. Even an agreement to refund a consultation fee if you proceed with surgery is considered an inducement and against GMC guidance. It is, however, appropriate to be offered a package price that covers the entire process and the cost of treating any complications arising in the initial weeks after the operation. Many hospitals will also offer a package to deal with any complications for a specified time. You should be told exactly what your quoted package includes. The cheapest deal may not be the best. Cosmetic surgery involves a significant financial commitment and you should ensure you are getting what you need. You should only proceed when you have the financial means to do so. It is important to remember you will need to pay for further surgery in the future.
Is this surgery available on the NHS?
Cosmetic breast augmentation surgery is not available on the NHS so you will have to consult a surgeon as a private patient and pay for the operation yourself. There are some exceptional circumstances where you might be able to get breast enlargement on the NHS –for example, if you have very uneven breasts (a significant difference in size) or no breasts, or as part of a breast reconstruction care plan. Your GP should be able to tell you more a bout the rules in your area .If you decide to go abroad for breast augmentation surgery it’s important to realise that on return to the UK, only emergency complications will be dealt with by the NHS.
Editors: Lee Martin, Emma de Sousa
Julie Doughty, Paul Harris, Mark Henley,
Nigel Mercer, Charles Nduka, Mary
O’Brien, Caroline Payne, Ruth Waters