Breast enlargement

Expert reviewer, Mr Robert Hardy, Consultant Surgeon
Next review due April 2022

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

If you’re considering having breast enlargement surgery, it’s important to find out what’s involved in the procedure and what the potential risks are. If you decide to have the surgery, choose your surgeon carefully.

About breast enlargement

In breast enlargement surgery, an artificial implant – usually filled with silicone gel – is placed either directly under your breast tissue or under the chest muscle behind your breast. It’s a major operation, which can take a number of weeks to fully recover from. It’s also a lifelong commitment – most implants eventually need replacing, so you should be prepared for the possibility of further surgery in the future.

Image showing where breast implants are placed

There are several reasons a woman may choose to have a breast enlargement. You may want to have your breasts enlarged because you’ve always felt they’re too small. Some women decide to have the surgery if their breasts have become smaller or lost their shape after losing weight or after a pregnancy. You may also want to have a breast enlargement to correct a difference in size between your breasts.

Deciding on breast enlargement

It’s important not to rush into a decision to have breast enlargement surgery. You need to have a good think about what you’re hoping to gain, the limitations of the procedure, and the risks involved. It’s also important to do your research into finding a suitable surgeon. Your GP may be able to refer you to a reputable surgeon or give you advice on how to find one. For more information, read our FAQ: How do I choose the right surgeon?

Initial consultation

You’ll need to book a consultation with the surgeon you’re considering going to. Your surgeon will discuss what you’re hoping to gain from the procedure. They will also want to examine your breasts. You can have someone accompanying you during the examination if you would like to. Your surgeon may ask to take some photos of your breasts for your medical records.

Your surgeon will tell you which technique they would recommend and discuss what implants are most suitable 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 can realistically expect.

This is your chance to get all the information you need to make a decision, so be sure to ask any questions you have. The organisations listed in the section ‘Other helpful websites’ give examples of good questions to ask.

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, a second consultation with your surgeon may help. 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 prepare for your operation. For example, if you smoke, you’ll be advised to stop at least six weeks before your operation. This will reduce your risk of complications.

There’s a possibility you might have to stay overnight after your operation, so you’ll need to make any necessary preparations for this. 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 are well and still happy to go ahead. The staff at the hospital will do any final checks and get you ready for surgery. This may include asking you to wear compression stockings or having an injection of an anticlotting medicine to help prevent deep vein thrombosis (DVT).

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

What happens during breast enlargement?

Breast enlargement usually takes around one-and-a-half hours. You’ll usually have a general anaesthetic, which means you’ll be asleep during the operation.

Once the general anaesthetic has taken effect, your surgeon will make a cut in the skin on your breast, to insert the implant. The cut is usually 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. The implant is then inserted – sometimes a trial one is inserted first to check that the most appropriate size has been chosen.

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 relieve any pain as the anaesthetic wears off. It’s normal for your chest to feel tight and your breasts and ribs to feel tender after your operation. You may have fine tubes running out from the wound to drain excess fluid into a bag or bottle. These will be removed before you go home.

If you’re able to go home on the same day, you’ll need to have a responsible adult who can drive you home – don’t try and drive yourself. If possible, try to have a friend or relative stay with you for the first day or so. Sometimes, you may need to stay in hospital overnight. Before you go home, you should be given a discharge letter with dates of any follow-up appointments, along with advice about caring for healing wounds. You can also read our advice on caring for surgical wounds.

Having a general anaesthetic can really take it out of you. You might find that you’re not as co-ordinated or that it’s difficult to think clearly. This should pass within 24 hours. In the meantime, don’t drive, drink alcohol, cook, operate machinery or make any important decisions.

If your stitches are not 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 and it can take a few weeks for this to settle. 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, although this may be less depending on what 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 might take up to six weeks to get completely back to normal. Some women find it more comfortable to wear a sports bra for a month or so while they heal. Ask your surgeon if they would recommend this.

It may take 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 to white over 12 to 18 months.

Complications from breast enlargement surgery

Complications are unexpected problems that can happen during or after the operation. As with any procedure, there are some risks associated with breast enlargement. Your surgeon should explain these before you have the surgery. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot (deep vein thrombosis).

Specific complications of breast enlargement include those listed below.

  • Capsular contracture. This is when abnormal scar tissue forms around the implant, making your breast feel firmer. It may eventually start to feel tender too and look abnormal. You might need another operation to treat this.
  • Bleeding into the space around the implant. This is called a haematoma and it can make your breast very swollen and tight. It’s most likely straight after the operation. You may need to have another procedure to remove the blood and stop the bleeding.
  • Infection. If your breast becomes infected, it may be red, swollen and tender. You may also feel unwell. Sometimes it can be treated with antibiotics, but often you’ll need to have your implant removed and replaced with a new one at a later date.
  • Changes in sensation. Your breast skin and nipple may feel more or less sensitive after breast enlargement. This usually improves over a few months. If you lose nipple sensation, there is a chance this may be permanent.
  • Implant failure. Your implant may rupture (leak). This isn’t serious, but you may need to have your implant replaced. For more information, see our FAQ: How will I know if my implant ruptures?

Certain types of implant have recently been linked to a rare cancer of the immune cells, called breast implant associated anaplastic large cell lymphoma (BIA-ALCL). Scientists are doing more research to find out exactly what implants are affected. In the meantime, your doctor can talk to you about how this risk applies to you and the implants you’re having.

Frequently asked questions

  • You’ll almost always need to pay privately to have a breast enlargement. The costs of breast enlargement vary from surgeon to surgeon and clinic to clinic. It’s only available on the NHS in a very few exceptional medical cases – and this varies between regions.

    You should be able to get an approximate cost from a private hospital or clinic before having a consultation. After your consultation, your surgeon should send you a written quotation. This may be a package price for all the care you’ll need, including treating any complications after the operation. Make sure you’re clear on what is and what isn’t included in the package. If in doubt, ask.

    Never base your decision on costs alone when deciding where to be treated. The cheapest option is rarely the best. It’s more important to make sure you’re happy with the surgeon and the hospital or clinic. You should also avoid any deal where you’re asked to pay a non-refundable deposit or deals that require you to book within a certain timeframe.

    When thinking about whether you can afford a breast enlargement, you should also bear in mind that implants often need to be replaced after around 10 years. You’ll need to think about whether you’ll be able to afford further surgery in the future.

  • You can still have mammograms to check for breast cancer if you’ve had breast enlargement, but the implants can make it a bit more difficult. An experienced radiographer will need to use a special technique to take different images of your breasts. Mobile breast screening units usually don’t have the facilities needed, so you’ll probably have to go to a screening clinic in a hospital.

    Breast implants placed under your chest muscle cause less of a problem with mammography than those placed directly under the breast tissue. If you’re called for a mammogram, always tell the service that you have breast implants and what type they are.

  • Breast implants are very tough, but they can sometimes rupture. This means they get a hole or split in the shell, letting the contents leak out. This isn’t usually serious – in fact, you often won’t even notice there has been a problem.

    The leak usually stays within the ‘capsule’ of scar tissue around the implant. Sometimes though, you may notice your breast looks smaller or its shape has changed. Or a lump might appear.

    This isn’t thought to be harmful but if you notice any of these signs, seek advice from your doctor. They’ll usually suggest having a scan; if this shows the implant has ruptured, they may advise having it removed and replaced with a new one.

  • If you decide to have breast enlargement it’s important that you choose a surgeon with the right skills and experience.

    It’s best to discuss any sort of surgery with your GP first. They may know of surgeons in your area and will be able to pass any important health information from your medical records to your surgeon. You can also look for a surgeon yourself but be careful to get as much information about their qualifications and experience as you can. Don’t be guided by price and do be very wary of advertising claims.

    Your surgeon must be registered with the General Medical Council (GMC). You can check this on the GMC website. Although not a legal requirement, the Royal College of Surgeons also recommends that any surgeon carrying out breast enlargement is additionally on the GMC’s specialist register. This should either be for plastic surgery or general surgery, with a declared interest in breast surgery.

    Your surgeon will also be able to tell you if they belong to a relevant professional association. These may include:

    • the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)
    • the British Association of Aesthetic Plastic Surgeons (BAAPS)
    • the Association of Breast Surgery (ABS)

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Related information

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    • Breast augmentation. British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)., accessed 7 March 2019
    • Other information. British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)., accessed 7 March 2019
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    • Implant techniques. British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)., accessed 7 March 2019
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    • Deep vein thrombosis (DVT) prevention. The MSD Manuals., last full review/revision, March 2018
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    • What complications can occur? British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)., accessed 7 March 2019
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    • Choosing a surgeon and hospital. Royal College of Surgeons., accessed 7 March 2019
  • Reviewed by Pippa Coulter, Freelance Health Editor, April 2019
    Expert reviewer, Mr Robert Hardy, Consultant Surgeon
    Next review due April 2022