Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

Breast enlargement frequently asked questions

What to expect on the day of your breast enlargement procedure

  • Can I speak to the anaesthetist before the procedure?

Anaesthetist Consultant Dr Victoria Webster (MBBS, FRCA), will be on hand to talk to you in person or over the phone prior to the operation about any questions you may have.

  • What do I need to bring on the day of the operation?

This pre-op checklist will help you ensure you have everything you need to feel comfortable post-surgery:

  • A sports bra (or a selection) in your new breast size for immediate fitting after surgery
  • A loose front-fastening top, as it will be difficult to lift your arms above your head at first
  • Loose, elasticated trousers
  • Slippers and dressing gown
  • Books, magazine and tablet with charger
  • Wet wipes
  • Moisturiser and lip balm
  • Water bottle with a straw, so you can drink more easily when lying down
  • Snacks—you won’t be able to eat before your surgery so you’re likely to feel hungry after the procedure. You might also want to pack some crackers or ginger biscuits to help combat nausea.

If your surgeon recommends you need to stay in overnight, you will need to pack loose, comfortable PJs and overnight toiletries.

Download this breast augmentation surgery checklist here

  • Where will my personal belongings be kept?

Although you will have your own secure locker in your room, we recommend that you leave any valuables at home. We may ask you to remove any jewellery, including piercings, before your surgery. You will also need to remove any glasses or contact lenses.

  • Is the procedure painful?

You won’t experience any pain during the operation as we will put you under a general anaesthetic. After the surgery, the swelling and bruising might cause you some pain, but we will prescribe you painkillers for this.

You may find that:

  • your chest feels tight and uncomfortable for a week after surgery due to swelling, especially if you have had implants inserted under the chest muscle
  • you experience pain in other areas of the body, such as the back and shoulders

Back and shoulder pain is most likely because you will naturally want to hunch over to support and protect your chest if it’s feeling tender. You should find this pain lessens as your body heals and adapts to your new breasts.

If:

  • the pain is severe and medication has no effect
  • your breasts feel engorged or hot to the touch
  • you have a fever

call us immediately, as these are signs of infection.

  • How long does breast enlargement surgery take?

In most cases this type of surgery can be performed in less than two hours. Many clinics will recommend that you do stay overnight but in some cases you can be in and out within a day.

  • What is your cancellation policy?

You can cancel your surgery at any time. We just ask that if you are unsure, you postpone the booking in good time.

  • Will I need to stop taking any medication before the procedure?

You may need to stop taking some types of medication, so it’s important to talk to your surgeon beforehand about any medication you are on, whether it’s prescribed or over-the-counter.

  • Will I need to stop taking herbal supplements before the procedure?

Some herbal remedies increase the risk of bleeding. This can interfere with the healing process. DO NOT TAKE ANY HERBAL MEDICATION FOR FOUR WEEKS prior to surgery. For more information on the best steps to take before surgery, visit our section titled: Reducing the Risk of Surgery.

  • Will I need to have a blood test before the procedure?

This will be decided at the pre-operative assessment. Sometimes we take a complete blood count to assess your overall health.

Types of breast augmentation procedure

  • How do I know if a breast enlargement or lift is best for me?

Breast augmentation will not always correct a drooping breast. If the nipple is positioned at the bottom of the breast and pointing down, this suggests lift surgery would be best. If there is little or no droop, and you simply want larger breasts, augmentation will help with this.

However, sometimes both procedures are necessary. Make sure your surgeon goes through all the different options with you before you make a decision.

You can find out more about having a breast lift procedure by reading the top eight questions you need to ask before having surgery.

  • How are the implants inserted?

This will vary depending on your surgeon and which method they think is most suitable for you. Generally speaking, an incision is made either under the breast, around the edge of the areola or in the armpit. The implants are inserted into the incision and then the incision is closed.

  • What types of implant are available?

The most common breast implants in the UK are a silicone shell which is filled with silicone gel or saline, which is a saltwater solution. Both are available in a range of shapes and sizes and your surgeon will be able to give you advice on the best option for you.

You can read about the differences between saline and silicone implants with our guide to choosing the right breast implants for you.

  • How do I know which shape of implant is best for me?

Breast implants are available in round and teardrop shapes. Both have different benefits. You can read more about choosing the best size and shape breast implants for your body here.

Your surgeon will discuss the two options with you.

  • What do the different breast implant profiles mean?

There are three different types of breast implant profiles—low, moderate and high.

  • Low profile—implants project minimally from the chest and are best for women with wider chests.
  • Moderate profile—implants provide medium level of projection and are best for women with narrow chests.
  • High profile—implants provide maximum projection which means the breasts look full and round and are best for women with narrow chests.

Discuss the profile options carefully with your surgeon to ensure you choose implants that will complement your frame and look natural.

Breast implant safety

  • What are the age limits for having breast implants?

There is no legal minimum age to have breast implant surgery. However, it’s recommended that you don’t have the procedure before the age of 18.

This is because the breasts are still developing at this age, and some women won’t have fully developed breasts until they are in their early 20s. This could mean that the surgery is unnecessary, or that it may result in a different size and shape than intended.

Some women choose to wait until they have had children before they have breast implants as the weight gain and loss associated with pregnancy can affect the size and shape of the breasts. You can read more about the impact pregnancy and breastfeeding have on breasts and breast implants here.

There is no upper age limit for having breast implants. Given that breasts do droop over time, a breast lift with implants is often the better option for older women. It’s important to bear in mind that breast cancer becomes more common as women age, so your surgeon may recommend you have a mammogram before implant surgery.

  • Can I have breast implants if I have a family history of breast cancer?

There are two points to be addressed here:

  • Do breast implants cause breast cancer?
  • Is it harder to monitor for breast cancer in a person with breast implants?

The first question is easy to answer—breast implants do not cause breast cancer.

In respect to monitoring, some studies suggest that implants can hide areas of the breast during mammograms. However, this can depend on whether they are placed above or below the muscle.

Despite this, there is no evidence that women with breast implants have a delayed diagnosis for breast cancer. It is important to speak with your physician about these issues before making a decision.

  • What happens if I have implants and then get breast cancer?

Breast implants do not stop breast radiation therapy from working, but they can increase the risk of encapsulation around the implant. This can affect how the breast looks, but is not a risk to health. Studies have also shown that breast implants don’t increase the need for a mastectomy in women with breast cancer.

  • Will I be able to breastfeed after having implants?

Studies suggest that breast augmentation therapy can affect a woman’s ability to produce milk. It was also found that the type of incision used during the surgery greatly affects this issue—an incision just below the nipple has a greater impact on milk production than one under the breast or in the armpit.

You can read our complete guide to breast augmentation, pregnancy and breastfeeding here.

Breast implant results

  • What can I do to ensure the best results?

There are a number of things you can do before and after breast surgery to increase your chances of being happy with the outcome.

Take your time when choosing the size of your implant. Make sure you discuss this with your surgeon first, and maybe try a few sizes out under a sports bra. You can read detailed information on how to choose the right cup size for your breast augmentation here.

When thinking of the type of implant, the incision, whether the implant will be under or over the muscle etc. weigh all the options carefully. Find out more about how to choose the right breast implant for you here.

Be sure to stick to the recovery advice your doctor gives you to avoid infections and other complications which could affect how your breasts look.

To find out more on how to ensure the best results, reads the following advice: Reducing the Risk of Surgery; Aftercare Advice; What To Expect In Recovery.

  • How can I reduce the risk of scarring?

There are many ways you can help to reduce scars after breast surgery, from wearing a support bra to gently massaging the breasts. You can find detailed advice with our guide How to Reduce Scars After Breast Surgery.

  • What if I don’t like how my breasts look after the surgery?

If you don’t like the look of your implants, they can be removed or replaced usually with little complication. But you should not take surgery lightly. Carefully consider what you want before agreeing to undergo surgery to minimise the risk of being unhappy with the results.

  • Do breast implants feel the same as natural breasts?

This depends on a number of issues:

  • the type of implant used
  • the size of implant
  • whether they are over or under the muscle
  • the size of your breasts before the procedure
  • whether the implants are inserted under or over the chest muscle

It’s generally accepted that gel implants feel very realistic, slightly more so than saline implants. A medium implant also results in a more realistic feel, as it doesn’t cause the skin to stretch as much.

Similarly, the more flesh covering the implant, the more realistic it will feel. Therefore, women with a fuller figure can use larger implants and still expect natural-feeling breasts. Women with a slighter build will benefit from having implants under the chest muscle (sub-muscular), as more tissue will cover the implants, resulting in a more natural feel.

  • How long will the implants last?

Manufacturers say that, on average, breast implants last for roughly 10 years. However, this can vary from person to person. Some implants can last up to 25 years, while others may need to be replaced after two years, depending on whether a problem (such as a rupture or fold) has occurred.

You can find out everything you need to know about breast implants rupturing with our in-depth guide How to tell if your breast implant has ruptured.

Breast augmentation aftercare

  • How long will it take to recover from breast augmentation surgery?

4 weeks before surgery – stop taking all herbal medication

Breast enlargement surgery

1 day after surgery – seen by Stephen McCulley

2-3 days after surgery – lower dose of pain medication

4 days after surgery – resume day-to-day activities if feeling up to it

1 week after surgery – seen by Stephen McCulley’s team for follow-up

10 days after surgery – patient can begin driving again if feeling up to it

14 days after surgery – patient can return to work and begin gentle exercise (legs only) if feeling up to it

6 weeks after surgery – patient can begin gentle exercise using the arms and chest if feeling up to it

3 months after surgery – seen by Stephen McCulley for follow-up

You should be able to resume normal day-to-day activities four days after surgery, but avoid heavy lifting and exercise. You will want to take at least two weeks off work, though you could return earlier if you have a desk job.

Avoid exercise using the arms or chest for around six weeks. After this time, it’s normally safe to return to your pre-surgery routine, but it’s best to keep the scars out of direct sunlight for a year.

To find out more about recovery, go to our section titled: What To Expect From Recovery.

  • What aftercare do you recommend?

Your specific aftercare needs will vary depending on the type of surgery you have. For more information on aftercare, visit the sections of the website titled: Aftercare and also the What to Expect in Recovery section of our Resource Centre.

  • How will I manage the pain?

After two to three days, you will likely have recovered to the point where you only need a little pain medication. Up until this time, there are a number of methods you can use to control the pain.

You can inject local anaesthetic into the affected area, or administer it via a ‘pain pump’. You can also use muscle relaxers and anti-inflammatory drugs alongside narcotic pain medication.

After this point, you can simply use over-the-counter pain medication as and when required. For more tips on managing pain after surgery, visit the pages Aftercare and What to Expect in Recovery.

  • Will I need to take antibiotics after surgery?

Infection resulting from breast implant surgery is rare, but can lead to you having your implants removed so your body can heal properly.

To reduce this risk, we give you antibiotics at the time of surgery but rarely afterwards as there is no evidence they help following a procedure.

  • Will my wounds bleed after surgery?

You shouldn’t experience any bleeding from the scar after surgery. If you do notice some blood, this may be due to an infection, in which case you should consult your surgeon as soon as possible.

For more information about possible issues following surgery, go to our section titled: Potential Complications.

  • Is there any activity I should avoid?

No, breast implants are very hard to damage. Short of repeated blows to the chest, any sport or activity should be fine once you have recovered from the surgery.

  • Can breast implants cause stretch marks?

If the size of the implant you choose is incorrect for your body shape, it can cause stretch marks. The best way to avoid this is to speak with your surgeon beforehand—they will give you all the information you need to choose the most appropriate size.

  • What follow-ups will I have?

You will be seen by Stephen McCulley the following morning and then by his team after a week, or more regularly if needed. You will see Stephen McCulley again after three months.

  • What if I lose or gain weight after breast implant surgery?

It’s recommended that you reach a stable weight before the procedure. This is because any weight you lose afterwards can affect the way your breasts look—there is a chance that your breast will appear to drop or reduce in size after weight loss.

You can read more about breast augmentation and weight here.

  • Can I have breast implants if I’ve had cancer?

Yes, in fact, many women choose to have breast reconstruction as part of their breast cancer recovery process. If you’ve had a mastectomy, it’s likely you’ll be given the option to have breast reconstruction with implants. You can read more about breast reconstruction after cancer here (please link to this page https://www.stephenmcculley.co.uk/our-procedures/breast-cancer-and-reconstruction/breast-reconstruction-overview/). Stephen McCulley is one of the only plastic surgeons in the UK who can offer both the cancer surgery and the full spectrum of breast reconstruction options.

  • Should I have a mammogram before breast augmentation?

If you are over 50 and are considering having breast implants then it’s advisable to have a mammogram before the procedure. The NHS invites women over 50 to have mammograms (also known as breast screening) every three years. This is because the risk of developing breast cancer increases with age, so you are more at risk of getting breast cancer the older you are.
If you’re younger than 50 and are considering having breast implants and have a family history of breast cancer or ovarian cancer then speak to your GP or surgeon about this before opting to have breast implants.

Resources

A consultation with your surgeon will be able to answer any specific questions and provide you with additional breast enlargement information.

For more information on breast augmentation surgery, read our Comprehensive Guide to Breast Enlargement.

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