Breast Augmentation

Breast Enlargement is one of the most common cosmetic surgery procedures performed. Achieving the look you expect is our goal. Expertise & extensive experience in breast aesthetic surgery, cosmesis, reconstruction and revision reassures that we can achieve your desired look.

Introduction

  • Breast augmentation uses breast implants to enhance the size and shape of the breasts. Implants commonly used are either round or “teardrop” and usually textured on the outside. Both saline and silicone implants can be used, though in modern practice silicone is preferred as it has more durable long term results.

    Whatever you call it – a boob job, breast lift, breast enlargement – and whatever your reason for deciding to have the surgery, the choice is personal and the enhancement you are looking for is what we will work with you to achieve.

    Initially, you will have a full consultation with one of our breast surgeons who will talk you through the procedure, guide you through the choice of implants and discuss the size and shape desired.

    At your initial consultation we will discuss your reasons and your expectations:

    • to enhance smaller breasts
    • to lift a sagging bustline
    • to create more symmetrical breast
    • to enhance the breast following pregnancy
    • reconstruction following breast removal or mastectomy

    Irrespective of the reasons for deciding to undergo breast augmentation surgery, creating the desired appearance, symmetry and balance that you are looking to achieve with natural looking results is what we aim to deliver.

    You will be admitted to the Mater Private Hospital on the morning of your procedure. First you will meet with your surgeon who will discuss the procedure, make some outline marks on your skin and answer any questions you may have.

    Following this, you will meet with the anaesthetist who will talk you through the anaesthetic. You will be given a general anaesthetic for the procedure and a local anaesthetic will also be administered to reduce any post-operative discomfort.

    When you are ready, you will be taken to the theatre where your procedure will take place. The procedure time in theatre is approximately 1 hour.

  • We offer only a consultant led service at the Mater Private. It involves a full and detailed consultation with the consultant breast surgeon, who will fully assess your needs, requirements and expectations to produce the best outcome aesthetically and clinically. A specialist pain nurse is also involved in your care to help manage pain while in hospital and following your discharge.

    The first step is to undergo a consultation with one of our consultants. This consultation is extremely important in establishing what your expectations are and understanding how we achieve this. We will also discuss at this appointment the range of breast implants that are available and the most appropriate choice for you.

    The procedure itself is performed as a Day Case surgery at the Mater Private Hospital Cork. Day case means you can expect to go home on the same day as your surgery.

    Following your surgery, the recovery period is a crucial time as your body is healing and your implants are settling in to their proper position and shape. We will provide you with clear follow up instructions and advice. It is essential that you follow these instructions as well as attending any follow up visits arranged. This is part of the process to ensure that the best outcome is achieved.

The Procedure

  • Where possible, it is important to avoid aspirin or non-steroidal anti-inflammatory drugs such as ibuprofen (Brufen/Nurofen) and diclofenac (Voltarol) for two weeks before surgery. These drugs reduce the ability of the blood to clot and can make bleeding more of a problem during and after surgery.

    Smoking can increase the likelihood of wound problems and abstaining from smoking for at least 2 weeks before and after surgery is a sensible precaution.

  • Typically the procedure is carried out as a daycase under general anaesthetic. You will be completely asleep for the entire procedure.

    During surgery a small incision (4-6cm) is made under the breast. The implant is placed either under the breast or under the muscle of the chest wall. Your surgeon will decide which the best option for you is; neither site is best but under the muscle seems to give better long term results.

    You will be asleep under general anaesthetic for the surgery and a local anaesthetic is used around the incision area to reduce any discomfort following surgery. The surgeon will carefully create the “pocket” precisely tailored to the new breast implant. The implants are placed in position and final adjustments to the shape are then made.

    A supportive dressing is placed over the breasts and our consultant anaesthetist will then gently wake you before you are returned to the recovery ward.

    Following your surgery you will be in recovery and observed. Pain relief medication will be arranged to ensure that you are in minimal pain. You will be monitored on the ward until you are ready to be discharged later that day.

    After the surgery it is important to rest, avoid strenuous activity and wear a support bra for 6 weeks.

  • Breast implants have been used for over 30 years and have a very good safety record. Serious concerns were raised about 10 years ago regarding the use of silicone breast implants. Fortunately, several very large studies involving many women with and without breast implants have led to the conclusion that these fears were unfounded. You can discuss this with us at your consultation.

  • There are a number of different surgical approaches possible for the procedure which will determine the exact details of any scars. For many there is a small scar just below the crease under the breast.

    Depending on what works best for you, we will discuss the possibility of scars at your consultation.
    Fortunately, in the vast majority of patients these scars fade well over the months following surgery.

  • Some discomfort is inevitable. Pain is a little more pronounced in patients who have implants placed below the muscle. Discomfort is usually well controlled with the painkillers provided by our experienced consultant anaesthetist. On discharge home, patients are generally comfortable using painkillers. We will advise you on what types of painkillers to use.

Following The Procedure

  • Your surgeon will arrange a follow up appointment post-procedure to check that all is well and to reduce the dressings. Dissolving sutures are used so you should not need to have any stitches removed.

    A second appointment a week later is required to remove the remaining dressings and to check your progress.

    A final follow up appointment is planned around 3 months after surgery.

    In the unlikely event that you require emergency care following your procedure, our surgeons can be contacted through the Mater Private Hospital at any time at (021 601 3200)

  • Most patients find they are able to resume normal activities over a 1-2 week period. However, remember that sports bras must be worn day and night for a period of 6 weeks.

  • If all goes to plan, normal activities can be resumed by about 2 weeks after surgery and most patients are back at work about a week later. Vigorous sporting activities and gym work are probably best left until 4-6 weeks after surgery.

Frequently Asked Questions

  • Breast implants do not seem to significantly reduce the likelihood of successful breastfeeding.

  • Yes. It is true to say that breast implants can make taking mammograms more difficult and it is important to tell the radiographer that you have implants so that special positions and views can be used to maximise the efficiency of the mammogram.

  • The manufacturers suggest that implants will last more than ten years on average and it is probably true that high quality modern implants may have an even longer lifespan. The implants will, however, almost certainly need to be replaced or removed at some point in the future. This can be discussed at your consultation.

  • Your breast augmentation procedure will be performed by an experienced surgeon who works to achieve good results with a rapid recovery. However, as with any surgical procedure there is a small risk of complications including the following:

     

    • Unfavourable scars – In some patients, especially those of Afro-Caribbean origin, scars can be thicker than expected or become raised. In the vast majority of cases, these settle spontaneously but occasionally other measures to improve the scar may be necessary. Most patients find that the scars settle well though all individuals are different and in some cases, scars can take many months to settle. Scars, of course, never disappear completely and some form of scar will always be present.

     

    • Infection – fortunately, infection is rare in this type of surgery and the risk is minimised by careful surgical technique and the use of a dose of antibiotic before surgery commences. You will receive a course of antibiotics to take home to further reduce the risk. Where infection affects the implant (perhaps 1% of cases) it may be necessary to remove the implant to allow the infection to clear.

     

    • Nipple sensation – many people find that there is some change in nipple and breast sensation after breast augmentation. A minority of patients find sensation is reduced though this tends to improve with time.

     

    • Asymmetry – Most women have a degree of asymmetry between the breasts prior to surgery. Breast augmentation may tend to emphasise differences between the breasts and some minor differences are always likely to be present.

     

    • Capsular Contracture – The body naturally makes a scar around any implanted material and silicone implants are no different. For the vast majority of women this scar is soft and cannot be felt. In a small proportion a thicker scar develops and some of these women may require further treatment or even removal of the implant.

     

    • Leakage of silicone – Older implants contained very runny, liquid silicone which could leak out of the implant shell if it developed a small hole or crack, though it would usually be retained within the scar mentioned above. Modern implants often contain firm (“cohesive”) silicone gel, similar to a set jelly, which has a lower likelihood of leaking from its original position.

     

    • Haematoma – Rarely, small blood vessels in the wound may bleed after the surgery, leading to a collection of blood under the wound (a haematoma). This will need to be released and washed out before resuturing (stitching) the wound. If this problem arises, it is typically on the day of surgery and does not affect the final result. 

     

    • Any surgery carried out under general anaesthetic carries a small risk of postoperative chest infection (particularly in smokers) and of thrombosis of the veins of the legs (DVT or deep venous thrombosis) and the concomitant risk of clot moving to the lung (embolism). Patients wear protective stockings during and after surgery to help minimise the risk of DVT and embolism. Early mobilisation after surgery is an excellent way of reducing the risk. We also use a compressive massaging device on the calf muscles in theatre to further reduce the small risk of this complication.