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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 will need to 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 that you have breast implants. They may scan you at a different centre and take special views. 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. Some patients opt to have a different type of scan called an MRI scan for screening after breast augmentation to avoid the issues mentioned above, but they usually have to pay for this privately. 

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 technique where fat is removed by liposuction from another area of the body such as the hips or thighs or tummy and then injected into the breast area. 

Only a relatively small amount of fat can be injected so patients will require multiple operations 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 having a breast implant. However, your surgeon cannot be entirely sure how effective it will be in any given patient and results are variable. 

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, particularly after weight loss, having children and older women may be bothered by droopiness of the breasts. If you are bothered by droopiness and are happy with the size of your breasts then you do not need a breast 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.

After mastopexy surgery the breasts often will seem smaller despite little or no removal of breast tissue. 
Mild degrees of droopiness can be improved by a breast augmentation alone. Often, patients complain of loss of breast volume and droopiness in this case breast augmentation alone will not solve the issue of droopiness your surgeon should discuss the potential need for breast augmentation and mastopexy either as a single operation or in two stages. 

In most instances it is best to do one or the other first and then see what result can be achieved with the knowlegde 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 and the results are not always entirely predictable in terms of size and breast shape.

Breast Implant Registry 

In the UK, there is a national Breast and Cosmetic Implant Registry established to record all implants being placed or removed and administered by NHS Digital.

It records the implants that have been used with patients details, and the organisations and surgeons that have carried out the procedures. The main aim of the registry is to be able to trace and inform affected patients in the event of any future recall of a failed implant. The registry will also allow the identification
of possible trends and complications relating to specific implants.

Your entry onto the register requires your consent and your surgeon will give you information about it.
You are strongly recommended to agree to the register if you undergo implant based surgery, for your own protection and the protection of others in the future. 

Read More

Introduction to breast augmentation
Implant techniques
What complications can occur?
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