The following FAQs have been reviewed by Rajiv Grover, Consultant Plastic Surgeon London and Secretary of the British Association of Aesthetic Plastic Surgeons (BAAPS) www.rajivgrover.co.uk. They reflect some of the questions frequently asked by women considering breast implants.
What is a breast implant?
What is silicone?
Are silicone breast implants safe?
How are breast implants placed?
Are breast implants available in different shapes?
What size breast implant should be used?
What are the possible complications?
How long will my breast implants last?
When is a second operation necessary?
How long does breast enhancement surgery take?
What if my breast implants rupture?
How much will it cost for me to have breast implants?
Is it safe for me to breastfeed?
Should I have regular mammograms?
Can breast implants cause cancer?
I have heard that breast implants cause autoimmune diseases, such as rheumatism. Is this true?
Medicines and Healthcare products Regulatory Agency (MHRA)
Download the MHRA Leaflet to assist in making an informed choice about breast implants.
What is a breast implant?
Typically a breast implant consists of a silicone shell that’s filled with either silicone gel or cohesive silicone gel with shape-retaining memory. Breast implants may also be filled with a saline (salt and water) solution. Not only are there choices in fillers, but the design of the shell that houses the gel can also vary. The surface may be textured or smooth. Your surgeon will discuss the benefits of the various breast implant options available and help you choose the best breast implants for you.
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What is silicone?
Silicone is a compound made from silicon, a natural chemical element, in fact, it is one of the most common elements.
Silicone is used in many everyday products, including food ingredients and packaging, medicines, and cosmetics such as lip gloss, creams, and lotions. Silicones are plastics or ‘polymers’ and, depending on their structure, may be a liquid, gel, or solid. Silicones have been part of the consumer industry for over 50 years. Because they’re biocompatible (i.e., accepted by the body without adverse reaction), they are used in many medical devices such as heart valves and artificial joints. Over the past 30 to 40 years, innumerable scientific assessments and studies have demonstrated that silicone can be regarded as safe.
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Are silicone breast implants safe?
Silicone has long been regarded as one of the most compatible materials available for implants into the body. It has been extensively tested in laboratory studies as well as clinical studies that study human health.
It’s used in medical devices like surgical instruments and hypodermic needles, and provides a very natural feel for breast implants. Scientific evidence has also been gathered on the experiences of the 1 to 2 million women who have received breast implants. There’s been no epidemiological evidence found associating silicone breast implants with permanent connective tissue disease or cancer. Specific assessment of the safety of silicone breast implants was performed by the UK Government which published a report confirming their safety based on the published data of international trials (Independent Review Group 1998). This has since been confirmed also by the European Union and the Food and Drug Administration in America (2006).
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How are breast implants placed?
A breast implant is usually inserted either under the breast tissue or deeper under the large breast (pectoral) muscle on top of the ribcage. The incision for insertion is most often made in the fold of skin under the breast. Although it’s less common, the incision may be made around the areola (the area around the nipple) or in the armpit.
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Are breast implants available in different shapes?
Yes. Breast implants are available in round and anatomical options. Anatomical breast implants are designed to reflect the shape of the breast. With its upper area gently sloping downward and outward, the shaped breast implant is more likely to match natural contours. Anatomical breast implants are also available in different heights and projection, so the implant can be selected to suit the breasts’ existing shape and each woman’s desires, whether they prefer discreet or more pronounced enlargement. The round breast implant will enhance breast size and may produce a more rounded appearance to the upper breast.
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What size breast implant should be used?
You will probably want to choose a breast size that flatters your figure and gives you the natural look and feel you want. Most women want the firmer and fuller breasts they used to have or always wanted. You may also want to minimise the space between your breasts and find out how you can bring your breasts into proportion with the overall shape of your body. Discussing what you have in mind with your surgeon is important, so that he or she can take your expectations into account when the implant size and shape are selected.
For a natural look, you will probably want your new breasts to be in balance with your body as a whole. Breast width, height, and projection are all-important considerations. The width of your breast is what will determine the size of the space between the breasts (cleavage). Breast width also determines the outer curve of the breasts, a contour that is essential to the balance between breasts and hips.
Shaped anatomical implants maximise your surgeon’s ability to respond to your desire for good breast width without excessive upper-breast fullness. Discussing your personal preferences in terms of breast width, height, and projection can help clarify for your surgeon what you see as the ideal shape and size for your new breasts.
Visualise the change in your appearance. Try out our Before & After Modeller.
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What are the possible complications?
Possible complications specific to breast implants are rare, but may include the following: implant rupture, capsular contracture, reoperation, implant removal, pain, changes in nipple and breast sensation, infection, scarring, asymmetry, wrinkling, implant displacement/migration, implant palpability/visibility, breast feeding complications, hematoma/seroma, implant extrusion, necrosis, delayed wound healing, breast tissue atrophy/chest wall deformity, calcium deposits, and lymphadenopathy.
You may also be dissatisfied with the way the implant feels, the appearance of surgical scars or, in the case of saline-filled breast implants, a noticeable ‘sloshing’. The full extent of any complications should be clearly explained to you by your surgeon before the operation. The full extent of any complications should be clearly explained to you by your surgeon before the operation and of course careful assessment before hand along with implant selection and placement will minimize the risk of these problems which are all infrequent when breast surgery is performed accurately. Review possible complications in more detail.
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How long will my breast implants last?
Breast implants are artificial devices which will gradually age and wear out and may eventually need to be removed or replaced. This should be considered after 10 to 20 years which is when the risk of problems may increase. In general, an implant may wear out over time or develop a microscopic fracture in the outer shell. How long the breast implant remains without complications depends on the type of implant inserted and the type of surgery you have had. The anatomical implants with high cohesive silicone filling are documented to have a lower risk of rupture than the traditional silicone gel implants.
It is important to remember that a breast implant, whatever it is filled with, is not necessarily in place for life and to remember that removal or replacement may be necessary.
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When is a second operation necessary?
If a patient is unhappy with her result or if she experienced a complication, a second operation may be necessary. Talk to your doctor about his rate of revision and to find out more information about the need for a second surgery.
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How long does breast enhancement surgery take?
Breast enhancement surgery usually lasts 1 to 2 hours, but it really depends on your surgeon’s technique, the location of the incision, and the placement of the breast implant. While your surgeon may discharge you after surgery, you should plan on an overnight stay after the procedure.
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What if my breast implants rupture?
If you have saline-filled breast implants and there is a rupture, then the saline solution will simply be absorbed by your body and your breast will become flat. You will then need another operation to insert a new implant.
If you have a rupture in a silicone gel-filled breast implant, the silicone gel from your implant will not flow freely into your body. It will most likely remain within the capsule around your implant. However, it may travel to nearby breast and other tissues, sometimes resulting in a palpable lump. A cohesive gel breast implant with its semi-solid gel greatly decreases the risk of leakage if the implant develops a small fissure.
The only way you’d know your breast implant had ruptured would be if you had an ultrasound or mammography. If your implant does rupture, you’ll need to have an operation to have it replaced. If you have Natrelle™ implants, this is covered by the warranty. See Warranty section for further information.
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How much will it cost for me to have breast implants?
The cost of breast implant surgery will depend on your surgeon, where the operation is performed, and the type of implant you choose to have. Your surgeon will be happy to advise you on this.
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Is it safe for me to breastfeed?
There is no indication that breast implants negatively affect a woman’s ability to breastfeed a child. Current information indicates that women with breast implants are able to breastfeed. And there is no medical evidence to show that breast implants interfere with breastfeeding. Breast augmentation surgery, however, may affect the shape, function, and sensation of the nipple and surrounding breast tissue. This may make it difficult for you to breastfeed. It is suggested that you discuss any possible problems with your doctor or midwife.
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Should I have regular mammograms?
For healthy women over 50 years of age, it’s recommended that you have a mammogram every 2 years for the early detection of breast cancer. Be sure to tell your healthcare provider if you have breast implants before undergoing a mammogram; this way, he or she can use a specialised mammography technique specifically for women with breast implants.
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Can breast implants cause cancer?
There is no medical evidence to date showing that women with breast implants are at increased risk of breast cancer. Following breast enhancement, you should continue to consult a physician to carry out normal checks to detect breast cancer.
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I have heard that breast implants cause autoimmune diseases, such as rheumatism. Is this true?
A review of recent scientific literature has established that there is no convincing evidence that silicone gel-filled breast implants cause autoimmune diseases, including rheumatism of the muscles and joints.
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