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Breast enlargement

Expert reviewer, Mr Ian Grant, Plastic Surgeon
Next review due December 2024

Breast enlargement (or breast augmentation) surgery involves putting an artificial implant just behind your breast to make it bigger.

About breast enlargement

Breast enlargement surgery makes your breast, or breasts, bigger. It uses an artificial implant that’s usually filled with silicone gel. The implant is placed either directly under your breast tissue or under the chest muscle behind your breast.

Breast enlargement surgery is a major operation. It can take you a number of weeks to feel completely better afterwards.

It’s also a commitment for life because most implants eventually need replacing. This means you might need more surgery in the future. Any future surgery is unlikely to be funded by the NHS and it may cost more than the original surgery.

People want to have a breast enlargement for lots of different reasons. You may:

  • feel like your breasts are too small for you
  • have noticed your breasts have got smaller or have changed shape after you’ve lost weight or following a pregnancy
  • be unhappy that one of your breasts is smaller than the other

Deciding on breast enlargement

It’s important not to rush into a decision to have breast enlargement surgery. You need to think carefully about what you’re hoping to get out of it, what is and isn’t possible, and the risks involved. If you decide to have the surgery, choose your surgeon carefully. It’s important to do your research to make sure you find someone with the right qualifications. Your GP may be able to refer you to a reputable surgeon who works near you or give you advice on how to find one.

Initial consultation

You’ll need to book an initial appointment with the surgeon you’re thinking about going to. Your surgeon will discuss what you’re hoping to get out of the surgery. They’ll also:

  • check your breasts
  • ask about your general health
  • ask about any illnesses you have, or have had in the past
  • ask about any medicines and herbal remedies you’re taking

You can take someone with you to the examination if you want to. Your surgeon may ask to take some photos of your breasts for your medical records.

Everyone’s different, and everyone’s breasts are different. Your surgeon will tell you which technique they would recommend and discuss which implants are right for you. This will include whether the implant is filled with silicone gel or saline, as well as its size and shape. They’ll talk to you about what will happen during the procedure, including the possible complications and the results you’re likely to get. It’s also important to remember that breast enlargement isn’t the right choice for everyone.

This is your chance to get all the information you need to make a decision, so be sure to ask questions if you have any. And think about why you want to have the surgery and what you expect to get out of it. Sometimes you might be encouraged to get support for your mental health.

Making your decision

Take your time to decide. You should be given a ‘cooling off’ period of at least a couple of weeks before having surgery. If you still have questions after this, it may help to have a second consultation with your surgeon. If you decide to go ahead, you’ll be asked to sign a consent form – so it’s important to make sure you feel properly informed. You can change your mind at any time before your procedure.

Preparing for your operation

Your surgeon will explain how to get ready for your operation. Keep your weight within a healthy range for your height. If you smoke, you’ll be advised to stop smoking at least six weeks before your operation. This will mean you’re less likely to get complications after your surgery.

You may be able to go home on the same day as your surgery. But lots of people stay in the hospital for one night. If you have to stay overnight, you’ll need to plan for this in advance. If you go home on the same day, you’ll need to have someone who can drive you home. You’ll also need to have a responsible adult who can stay with you overnight.

You’ll usually have breast enlargement under general anaesthesia, which means you’ll be asleep during the operation. Having a general anaesthetic means you’ll need to stop eating and drinking for some time before your operation. Your surgeon will give you clear instructions about this – it’s important to follow their advice.

At the hospital

On the day of your procedure, your surgeon will meet with you to check you’re well and still happy to go ahead. The staff at the hospital will do any final checks and get you ready for surgery. You may be asked to wear compression stockings or have an injection of an anticlotting medicine to help prevent blood clots (deep vein thrombosis).

Your surgeon will measure your breasts and check their shape, your skin and your nipples. They’ll probably draw on your breasts to mark the operation site.

What happens during breast enlargement?

Breast enlargement surgery usually takes around one-and-a-half hours.

Once the general anaesthetic has started working, your surgeon will make a cut in the skin on your breast, before putting in the implant. The cut is usually made in the crease under your breast, but it can sometimes be around your nipple or in your armpit.

Your surgeon will make a ‘pocket’ for the implant, either under your breast tissue or under your chest muscle. They’ll then put the implant in – sometimes they’ll put a trial one in first to check that they’re using the best size for you.

Your surgeon will then close your wounds with stitches and may also wrap your breasts in a supportive dressing

What to expect afterwards

You’ll be given painkillers to help ease any pain as the anaesthetic wears off. It’s normal for your chest to feel tight and your breasts and ribs to feel sore after your operation. You may have fine tubes running out from the wound to drain any extra fluid into a bag or bottle. These will be taken out before you go home.

Before you go home, you should be given a discharge letter with dates of any follow-up appointments. You’ll also be given advice about caring for surgical wounds.

Having a general anaesthetic can have a big impact on you. You may find you’re not as co-ordinated as usual or you’re not thinking clearly. This may last for around 24 hours. In the meantime, don’t drive, drink alcohol, operate machinery, sign any legal documents or make any important decisions. If your stitches aren’t dissolving stitches, they’ll need to be taken out after about a week.

Recovering from breast enlargement surgery

You’re likely to have some swelling, bruising and pain after your operation. It can take a few weeks for this to get better. You may have been given some painkillers at hospital to take home with you or you can take over-the-counter painkillers such as paracetamol. You’ll probably need a week or two off work, but this may be less depending on which type of surgery you’ve had.

You’ll be able to move around as usual straight after your operation. But don’t do any strenuous exercise or lift anything heavy for the first few weeks. It may take you up to six weeks to feel completely back to normal. You may find it more comfortable to wear a sports bra for a month or so while you heal. Ask your surgeon if they think this is a good idea.

It may take you a while to get used to the new shape of your breasts. They may look too high at first, but this usually settles down after a few weeks. You’ll have some scars after your surgery too. These may be quite red for the first six weeks, then usually turn purple before fading over 12 to 18 months.

Complications from breast enlargement surgery

Like all types of surgery, breast enlargement can cause some complications. These include:

  • an unexpected reaction to the anaesthetic
  • a lot of bleeding (a haemorrhage)
  • getting a blood clot in the veins of your leg (deep vein thrombosis (DVT)).

Breast enlargement can cause other complications too.

  • Capsular contracture. Scar tissue forms around the implant, so your breast feels firmer. It may start to feel sore and look different. You may need another operation to treat this.
  • Bleeding into the space around the implant. This is called a haematoma. It can make your breast very swollen and tight. It’s most likely to happen straight after your operation. You may need to have another procedure to take out the blood and stop the bleeding.
  • Infection. If your breast gets infected, it may be red, swollen and sore. You may also feel unwell. Sometimes an infection can be treated with antibiotics, but you may need to have your implant taken out. You can then have a new implant once the infection has cleared up.
  • Changes in sensations. Your breast skin and nipple may feel more sensitive after breast enlargement, or you may not feel very much when you touch them. This usually gets better over a few months. If your nipples feel completely numb, there’s a chance you won’t get any feeling back.
  • Leaking implant. Your implant may leak (rupture) because there’s a hole in it. You may not realise it’s happened, or your breast may look smaller, change shape or have a lump in it. If you do notice any changes, your doctor may suggest you have a scan. A ruptured implant isn’t anything to worry about, but you may need to have it taken out and replaced.

BIA-LCL

Some types of implants have recently been linked to a rare cancer of the immune system cells, called breast implant associated anaplastic large cell lymphoma (BIA-ALCL). This isn’t a type of breast cancer but is linked to scar tissue that forms around the implant. It’s usually treated by removing the implants and some of the tissue around them. Some people might need chemotherapy.

Scientists are doing more research to find out exactly which implants are affected. But it seems that smooth implants carry a lower risk of BIA-ALCL than textured implants. Speak to your doctor about how this risk applies to you and which implants you’re having.

Breast implant illness (BII)

A small number of people report having symptoms which they believe are caused by their breast implants. This is sometimes referred to as breast implant illness (BII). Reported BII symptoms include tiredness, ‘brain fog’, trouble sleeping and muscle aches. BII is not a medical diagnosis because there isn’t enough evidence that breast implants cause these symptoms.

But there are studies looking at possible links between breast implants and these symptoms. Some people report their symptoms improving after their implants are removed. Speak to your surgeon about the most up-to-date information about BII if you’re concerned.

Breast screening

You can still have mammograms to check for breast cancer if you’ve had breast enlargement surgery. But the implants can make the mammogram a bit harder to do. An experienced radiographer will need to take special views of your breasts. Mobile breast screening units don’t usually have the equipment they need to do this. This means you’ll probably have to go to a screening clinic in a hospital.

If you’re called for a mammogram, always tell the service that you have breast implants, and which type you have. This is because breast implants under your chest muscle are less likely to cause problems with breast screening than those directly under your breast tissue. The details of your surgery will usually be added to the Breast and Cosmetic Implant Registry (BCIR). This information is recorded in case there are any problems with the type of implants you have in the future.



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Related information

  • Discover other helpful health information websites.

    • Breast augmentation. British Association of Aesthetic Plastic Surgeons (BAAPS). baaps.org.uk, published August 2021
    • Breast augmentation. British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS). www.bapras.org.uk, accessed August 2021
    • Implant techniques. British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS). www.bapras.org.uk, accessed August 2021
    • Things to consider before choosing cosmetic surgery. British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS). www.bapras.org.uk, accessed August 2021
    • Good surgical practice. Consent. The Royal College of Surgeons. www.rcseng.ac.uk, published September 2014
    • You and your anaesthetic. Royal College of Anaesthetists. www.rcoa.ac.uk, published February 2020
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    • Turton P, El-Sharkawi D, Lyburn I, et al. UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma on behalf of the Medicines and Healthcare products Regulatory Agency Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group. Br J Haematol 2021; 192:444–58. https://doi.org/10.1111/bjh.17194
    • Other information. British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS). www.bapras.org.uk, accessed August 2021
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    • What complications can occur? British Association of Plastic, Reconstructive and Aesthetic Surgeons. www.bapras.org.uk, accessed 9 March 2022
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    • Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) – what we know and what we don’t know. British Association of Aesthetic Plastic Surgeons. www.baaps.org.uk, published June 2019
    • Breast Implant Illness – what we know, and what we don’t know. British Association of Aesthetic Plastic Surgeons. www.baaps.org.uk, published June 2019
    • Symptoms sometimes referred to as Breast Implant Illness. Medicines and Healthcare products Regulatory Agency. www.gov.uk, published 17 January 2020
    • Breast and Cosmetic Implant Registry. NHS. www.digital.nhs.uk, updated 20 January 2022
  • Reviewed by Victoria Goldman, Freelance Health Editor, and Abbey Stanford, Specialist Health Editor, Bupa Health Content Team, December 2021
    Expert reviewer, Mr Ian Grant, Plastic Surgeon
    Next review due December 2024

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