Cosmetic Surgery - A Female Perspective - An interview with Miss Austin

March 2009

Could you tell us why women choose to have breast augmentation?  Some women want to enhance their figure by increasing their bust size or cleavage while others are looking to regain their pre-pregnancy shape by improving the droop and lack of fullness that come with breastfeeding.

Others have breast augmentation as part of a reconstructive procedure.  Augmentation is often chosen by women who have had a mastectomy or who suffer with congenital problems that have resulted in abnormal development of the breasts.

Why do women consider the shape of their breasts to be so important?  Breasts define our sense of femininity and can shape our identity.  Feeling unhappy with our breasts can result in dissatisfaction with our image which can lead to loss of self esteem and confidence and may cause depression.  While cosmetic surgery can't overcome shortcomings in daily life, it can improve self image.

Could you explain the procedure?  Breast enlargement involves surgically inserting an implant behind the natural breast tissue to increase and enhance the size of the breast.  Most implants are made of silicone or saline and are placed behind the natural breast or the underlying muscle.  The position is a matter of patient preference coupled with factors such as thinness of skin; amount of underlying fat; breast droop and lifestyle.  Implants vary in shape but are mostly round or tear-drop shaped. Breast augmentation is carried out under general anaesthetic, either as a day case or with an overnight stay and recovery takes one to two weeks.  Swelling and bruising are likely to last a few weeks, with a further two to three months for the tissues to soften and settle.

How should readers choose a consultant to carry out their surgery?  GPs invariably recommend that the consultant be both fully trained and accredited.  Registration with BAAPS (The British Association of Aesthetic Plastic Surgeons) and BAPRAS (British Association of Plastic, Reconstructive and Aesthetic Surgeons) is preferable.

What happens at a consultation?  I'll take a full medical history, then discuss desired outcome: size, shape and overall appearance are the principle criteria.  Implants come in milligram and not cup sizes.  It's important to look at the overall size and proportion, including how the breast size fits in relation to shoulders, waist and hips.  Women with broad shoulders and wider hips commonly benefit from larger breasts as these will enhance their natural hour-glass figure.  At a consultation a patient would usually try on a bra in their desired size and a variety of implants would be inserted.  This will help the patient choose the correct implant size and, while it won't be an exact representation of the end result, it's a good indicator of size.  I will also take into account the condition of the non-augmented breasts; position of the nipples, age, skin texture, healing properties and general health.

What are the potential complications and associated considerations?  Once the implant has been chosen, I talk to the patient about the procedure and the potential complications.  It is so important that patients are fully aware of potential consequences and there are a number of excellent websites which also provide information.  Potential risks include scarring, infection, asymmetry, creases and folds, reduced nipple sensation and the possible need for future operations.

Other issues include the effects on pregnancy and breastfeeding, and future breast cancer surveillance, though it's important to point out that there is no recorded increased risk of breast cancer in women who have breast implants.

Can you tell us about breast reconstruction?  Implants are also used for women who have had a mastectomy or lumpectomy and in teenagers and young women whose breast development is abnormal.  Abnormal development tends to result in either oddly shaped or distorted breasts.  In such cases, augmentation may be carried out in association with an uplift or mastopexy.

What are the holistic benefits of having an augmentation?  The procedure can bring psychological benefits for women who feel that their breasts are inadequate.  It can help restore self-esteem and improve quality of lift, but it's important to have realistic expectations and to be aware of potential problems.