Breast Enlargement Surgery

One of the most common operations performed in the UK cosmetic surgery industry is breast enlargement surgery, or breast augmentation. This involves the insertion of an implant into the chest wall to enhance the size of the breasts. The implants are inserted into a pocket either below the breast tissue or below the pectoral muscle, or in some cases partially under each. Implants may be round or teardrop shaped; their surface may be smooth or textured; the contents may be silicone or saline, and there are advantages and disadvantages with each option. Some implants are more expensive than others (probably because they’re better!)
Different surgeons will use different implants for various situations, and most will be more than happy to justify what they're using and why. This can sometimes be an important part of the discussion during the consultation and at the end of the consultation both your surgeon and you should be happy with the choices made.

If you’re thinking of having this procedure done, then you might want to have: the best implants, the best surgeon and the best aftercare. I have my own views about the best implants, your surgeon should be highly experienced and should be able to perform all types of breast cosmetic surgery and should be doing this regularly, and your aftercare should be for at least a year because if you do need a minor tweak to get things right then it will happen within a year.
POCKET PLACEMENT
The implants need to be placed within a pocket. There are three types of pocket and the best place to put the implant depends on the characteristics of the breast being enhanced, the implant being used and the desired look.
Submuscular Pocket
The submuscular pocket is often referred to as "under the muscle", as the pocket is made under the pectoral muscle of the chest wall. This pocket is often used in women who have minimal breast tissue so that the top of the implant is hidden under as much of your own tissues as possible to prevent a sharp take off of the breast and to reduce the chances of the implant being felt or seen. However, it can lead to the muscle being pushed forward on top of breast tissue which slides down as time goes by. This can lead to a “double bubble” problem where there are two bulges on the chest wall which may need further surgery for correction.
Subglandular Pocket
This pocket is often referred to as one which is made "on top of the muscle". The "sub" part of subglandular means "under" and the "glandular" part refers to the breast itself. So, the subglandular pocket is made under the breast, on top of the muscle. This pocket is often used when there is already a reasonable amount of breast tissue in someone who has little projection but is generally flat. It can also work well in someone who already has a reasonable breast volume but simply wants to be larger and is also used when someone wants to have an enhanced look following their surgery.
Dual Plane Pocket
The dual plane pocket is one that is made partially on top of the muscle and partially under the muscle. It involves splitting and releasing the muscle at exactly the right point so that you can have the benefits of having some of the implant above the muscle and some of the implant below it. This is often used in women who have a low take off and little tissue in the upper pole of the breast. By using a dual plane approach, what we achieve is to get the upper part of the implant hidden by the muscle but we prevent the appearance of two bulges in the breast (the double bubble effect) because of the low take off of the breast tissue by placing the lower part of the implant above the muscle.
IMPLANT TYPES
Breast implants come in three different varieties: the shape, the surface material texture and the filler. All implants have a silicone outer coating and implants of each type come in various different sizes.
Implant Shapes
Implants may be round or teardrop (anatomical) shaped. Both types have their advantages and disadvantages and the shape of implant can be discussed at the time of the consultation.
Implant Textures
Implants can be smooth or textured. Textured implants have a rough surface and smooth implants have a smooth texture. Textured implants have a lower risk of developing capsular contracture, which is hardening of the breast as the years go by.
Implant Fillers
Implants are commonly called silicone implants or saline implants and this refers to the fluid used to fill the implant. All implants have a silicone outer coating, but the filler material can differ. The most common filler materials we use nowadays are silicone or saline. Saline implants are filled with salt water at the time of the operation and a valve within the implant reduces the risk of saline leaking out of the implant causing deflation. Silicone implants have been extensively tested for safety. Different types of silicone are also available - some implants have thicker silicone within them, and the silicone will not leak out of the implant even if the implant ruptures. Other implants use softer silicone gel. These implants are more affordable and feel softer but can potentially leak silicone into your breast.
SIZES
Choosing the right implant size is a matter of balancing what you already have with what you want and what we can use. You might be measured you during your consultation and these measurements will determine the size of the implant that should be used, the pocket placement (ie below the muscle or over the muscle) the shape of the implant and the incision placement. The amount of nipple droop (or breast ptosis) will also tell whether you need to think about any other procedures to reshape the breast at the time of implant placement or at some other time in the future.