Breast enlargement
- Mr Ian Grant, Plastic Surgeon
Breast enlargement (implants) is surgery to make your breasts bigger. It’s also sometimes called ‘breast augmentation’ or a ‘boob job’. The surgery involves putting an artificial implant behind your breast.
How breast enlargement surgery is carried out
Procedure | Aftercare | Recovery | Watch in 2 minutes
This video shows what happens during and after breast enlargement surgery.
About breast enlargement
Breast enlargement surgery makes your breast (or breasts) bigger. It usually uses an artificial implant filled with silicone gel. The implant may be placed either directly under your breast tissue4 or under the chest muscle that lies behind your breast.
Breast enlargement surgery is a major operation. It can take you a number of weeks to feel completely better afterwards. However, it is common for people to be able to feel their implants and in some cases they can cause discomfort.
It’s also a commitment for life because most implants eventually need replacing. This means you might need more surgery in the future. Future surgery is unlikely to be funded by the NHS and will most likely be an additional cost above that of your original surgery. It could also be a bigger and more expensive operation.
People want to have a breast enlargement for lots of different reasons. You may:
- feel like your breasts are too small for you
- have breasts that are smaller or have changed shape after pregnancy or weight loss
- be unhappy that one of your breasts is smaller than the other
If you want to have breast enlargement, surgery is the only option. There is another type of surgery, called lipo-filling or fat transfer. You have your own fat taken from somewhere else and injected into the breasts. This is done gradually, with multiple procedures and isn’t suitable for everyone. Ask your surgeon if you’d like to know more.
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. Or you could look on the register of plastic surgeons that is run by the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS).
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
Your surgeon will also talk to you about why you want the operation. They may ask you about your psychological well-being and how you feel about your appearance. Some people asking for this type of surgery may have a distorted view of how they look. They may be better helped by examining this more closely with counselling or a similar type of support.
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.
The right implants for you
Everyone’s different and everyone’s breasts are different. Your surgeon will recommend the technique and type of implants that are right for you. This includes the size and shape of the implant and whether it’s filled with silicone gel or saline. They’ll talk through what will happen during the procedure and the likely results. They’ll also go over all the possible complications so that you’re fully informed.
It’s important to remember that breast enlargement isn’t the right choice for everyone. Seeing your surgeon is your chance to get all the information you need to make a decision. Be sure to ask any questions that you have. 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.
It’s also worth thinking about how you’d manage after surgery, particularly if there were any complications. If you have any reservations about having the surgery, then you shouldn’t go ahead with it.
Making your decision
Take your time to decide. With cosmetic procedures, your surgeon must give you a ‘cooling off’ period of at least a couple of weeks. 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. Even after you've agreed and signed, 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. You have a lower risk of complications if your weight is within a healthy range for your height . If you smoke, your doctor will advise you to stop smoking at least six weeks before your operation. This will also 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.
You can’t drive after having a general anaesthetic. So if you go home on the same day, you’ll need someone to take you home. You’ll also need to have a responsible adult to stay with you overnight.
You usually have breast enlargement under general anaesthesia. So you’ll be asleep during the operation. With a general anaesthetic, you have to stop eating and drinking for a time before your operation. Your doctors 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 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 have compression stockings to wear. Or you may have an injection of an anticlotting medicine. Both of these are 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 your anaesthetic is working, your surgeon will make a cut in the skin on your breast to put 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. This may be 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 cover with a dressing.
What to expect afterwards
You will have 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.
When you go home, your nurse should give you a discharge letter. This will have dates of any follow-up appointments. You’ll also have 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. During this time, don’t:
- drive
- drink alcohol
- operate machinery
- sign any legal documents
- make any important decisions
If you don’t have soluble stitches, you’ll need to come back to have the stitches taken out about a week after your operation.
Recovering from breast enlargement surgery
You’re likely to have some swelling, bruising and pain after your operation. It can take several weeks for this to get better. You may have some painkillers from the hospital to take at home. If not, you can take over-the-counter painkillers such as paracetamol. You’ll probably be off work for one to two weeks. Exactly how long depends on which type of surgery you’ve had and how you are recovering.
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. Surgeons views on this differ, so 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 will fade over the following months.
Complications of breast enlargement surgery
Like all types of surgery, breast enlargement can cause some complications. These include:
- a 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.
- Scar tissue can form around the implant (capsular contracture). Your breast feels firmer and may feel sore and look different. You may need another operation to treat this.
- Bleeding around the implant (a haematoma) can make your breast swollen and tight. If this happens, it’s most likely straight after your operation. You may need another procedure to drain the blood and stop the bleeding.
- Infection may make your breast red, swollen and sore. You may also feel unwell. You’ll need antibiotics, but you may also need to have your implant taken out. You can have a new implant around three to six months after the infection has cleared up.
- 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 are completely numb, you may not get any feeling back.
- Your implant may leak (rupture). You may have no sign of this. Or your breast may look smaller, change shape or have a lump in it. If you notice any changes, your doctor may suggest you have a scan. This isn’t anything to worry about, but you may need to have the implant replaced.
There is a national Breast and Cosmetic Implant Registry (BCIR) in the UK. The details of your surgery will be added to this. This information is recorded in case there are any future problems with the type of implants you’ve had.
Breast implant associated anaplastic large cell lymphoma (BIA-ALCL)
Some types of implant have recently been linked to a rare cancer called breast implant associated anaplastic large cell lymphoma (BIA-ALCL). It isn’t a type of breast cancer – it develops from 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 believe that symptoms they have 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. 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 improved after their implants were 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 if you’ve had breast enlargement surgery. But the implants can make the mammogram a bit more difficult to do. An experienced radiographer will need to take extra views of your breasts.
If you’re called for a mammogram, always tell the service that you have breast implants, and which type you have.
Sepsis (adults)
Sepsis is a very rare but life-threatening complication that can develop after any surgery. Although it’s rare, you’re more at risk than usual for a few weeks after you’ve had surgery.
Sepsis is a medical emergency. Call 999 or go to A&E immediately if you have any of the following symptoms:
- slurred speech, confusion, difficulty making sense
- extreme shivering or muscle pain
- passing no pee (urine) during a day
- severe difficulty breathing, feeling breathless or breathing very fast
- a feeling of doom or sudden acute fear of dying
- blue, pale or blotchy skin
Breast augmentation and breast enlargement mean the same thing. The surgery can make your breasts bigger and change their shape.
For more information, see our section about breast enlargement.
Breast implants will usually last for 10 or more years. But sometimes they can leak and need to be replaced with new ones.
For more information, see our section on complications of breast enlargement.
Surgery is the only real option if you’d like breast enlargement. Besides implants, there is another type of surgery called lipo-filling or fat transfer. It doesn’t involve a major operation. But you do have to have it done multiple times.
For more information, see our section about breast enlargement.
General anaesthesia
General anaesthesia is when medication is given to make you temporarily unconscious during an operation, so don't feel pain or other sensations.
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- Liz Woolf, Freelance Health Editor
