Breast implants are saline or silicone filled prostheses which are surgically inserted under the breast tissue or the breast muscle, usually to increase the size of the breasts. Known as augmentation mammoplasty and breast augmentation, enlargement of the breasts’ size is the most popular surgical cosmetic procedure in the UK. According to the British Association of Aesthetic Plastic Surgeons (BAAPS), the number of breast augmentation surgeries in 2015 reached 9,652 which is an increase of 12% since 2014.
Besides for “boob job”, breast implants can also be used to correct the shape or symmetry of the breasts and for breast reconstruction, for example to restore the breast shape after having a mastectomy (surgical removal of the breasts that is done to prevent or treat cancer).
Breast implants are most often used for breast augmentation which is a purely cosmetic procedure. The goal is not only to increase the size of the breasts but also to enhance the overall appearance of the breasts and subsequently, boost the patient’s self-confidence and self-esteem. Other uses include alternation of breast shape, making the breast appear more symmetrical and breast reconstruction. The latter is typically performed during or after mastectomy or breast removal for health reasons. Besides saline and silicone implants, breast reconstruction sometimes also uses the patient’s own tissue to create new breast mound(s).
Breast implants are available in different shapes (round and teardrop/anatomical), textures (smooth and textured) and sizes but they are also available with different fillings. Depending on the filling material, they can be divided into two types: saline and silicone breast implants.
Both saline and silicone breast implants feature an outer shell which is made of silicone. But unlike silicone implants, their saline counterparts are filled with sterile salt water. Silicone breast implants, on the other hand, are filled with silicone gel. Both types of breast implants have a long history of use and both have been shown to give excellent results. However, silicone implants are said to feel, look and move more like a real breast. Also, they are less likely to change position than their saline counterparts.
Compared to saline implants, the silicone ones they tend to be more expensive. Also, in the event of rupturing, they can cause considerable pain, while silicone gel may spread outside the implant which in turn can lead to formation of lumps and change in the shape or size of the breast. However, it is also possible for a silicone implant to rupture without causing any problems whatsoever. Not immediately, anyway. This is because silicone gel may be contained by the tissue or membrane that eventually forms around the implant. But even if it doesn’t cause any signs and symptoms, a ruptured silicone implant sooner or later needs to be surgically removed.
Saline breast implants can rupture as well. However, salt water leaking from a ruptured saline implant is simply absorbed by the body and doesn’t present a risk of any health complications. But as saline water gets absorbed, the breast’s size and shape will change. Also, the empty silicone shell usually needs to be surgically removed.
Compared to silicone implants, the saline ones are usually less expensive. And since they are inserted empty and filled with saline water later, their insertion requires a smaller incision. Another major advantage of saline implants over their silicone counterparts is that they can be adjusted after the surgery. If the patient is unsatisfied with the size, the latter can be increased or decreased without the need to go through surgery again. The surgeon can simply add or remove saline water with a syringe. According to most plastic surgeons and their patients, however, saline implants feel less natural and are more likely to wrinkle than their silicone counterparts. Also, they tend to have a shorter “lifespan” and need to be replaced sooner than the silicon-filled implants.
Both silicone and saline breast implants are inserted surgically, while the patient is typically given general anaesthesia. In rare cases, breast implants are also inserted during local anaesthesia which means that the patient is awake during the procedure
To insert the implants, the surgeon will make an incision just under the breasts (in the fold) and sometimes around the nipples or under the arm, depending on the type of surgery and type of implant. Unlike silicone implants which are inserted pre-filled, saline implants are inserted empty and filled with salt water when in place which can either be under the under the mammary gland or under the pectoral muscle. In the first case, the position of the implant is called the subglandular and in the former, the submuscular position. There is also the so-called subfascial position which involves placement of the implant in between the pectoral muscle and thin tissue known as fascia.
Each of the above mentioned breast implant placements has its advantages and disadvantages but in general, most cosmetic surgeons prefer the submuscular position. Compared to subglandular placement, it gives the breasts a more natural look, especially in women with small breasts. Subglandular position, however, may be an option for women with substantial breast tissue who are looking only for slight enlargement but only if silicone implants will be used. To create a more natural shape and feel, saline breast implants are almost always inserted under the muscle.
Good results can be achieved with both silicone and saline breast implants although the actual look and feel are not quite the same. As discussed in the section dealing with the two types of breast implants available, silicone implants tend to feel and look more like real breasts.
Neither silicone nor saline breast implants last a lifetime which means that the results are not permanent. The average lifespan of breast implants is 10 to up to 15 years. Afterwards, they need to be removed and replaced with new ones.
The actual size and shape of the breast may change after the surgery as a result of weight gain and/or weight loss as well as the effects of ageing. Women who are unhappy with the appearance of their breasts may need to have their implants removed and replaced. For optimal results, implant replacement is sometimes carried out in combination with other cosmetic procedures such as breast uplift.
Studies on safety and health risks of silicone and saline breast implants didn’t find any significant difference between the two types of implants. Neither silicone nor saline implants have been linked to increased risk of breast cancer or other serious health problems. Likewise, neither of the two types of breast implants interferes with the ability to breast-feed although some women report having difficulties breast-feeding after having breast augmentation or other cosmetic procedures involving insertion of breast implants.
Both silicone and saline breast implants can rupture. But while saline water gets absorbed by the body without causing any health problems, leaking silicone has to be removed surgically. Rupture of a silicone implant can cause pain and changes in the size and shape of the breast but no evidence has been found for it to cause any serious health problems. This, however, doesn’t mean silicone or saline breast implants are without risks.
Health risks and complications associated with breast implants are very similar regardless of the filling material and include:
After the procedure, it is normal to experience some swelling, soreness and bruising. Scar from the incision will eventually fade but it won’t go away completely. However, since the incision is typically made in the fold under the breast, it is usually virtually unnoticeable.
If you are unhappy with your breasts’ size or shape, or if you recently had a mastectomy, breast implants may be worth to consider. They are most often used to increase the size of the breasts but they can be also used to correct the shape, make the breast appear more symmetrical and reconstruct the breast mound. It is important to keep in mind, however, that silicone and saline implants can’t correct or prevent breast sagging and that your breast will continue to “age” after the surgery. Also, they may also change in shape due to weight gain or/and weight loss. Last but not the least important, keep in mind that they don’t lasts a lifetime. On the contrary, they are usually removed and replaced within 10 years.
The NHS may cover the cost of implants for breast reconstruction but it won’t pay for breast augmentation and other corrective surgical procedures involving breast implants. If you want to have breast enlargement or improve the appearance of your breasts with the aid of silicone or saline implants, you will have to pay for the procedure including the implants yourself.
If you decide to have the procedure in the UK, expect to pay at least £2,600 or more, depending on where you want to have it done and the extend of the surgery. Please note that this price may not include the costs of aftercare and consultation after the surgery nor corrective procedures that may be required if the results don’t meet your expectations.
Table 1: Cost of Breast Enlargement in the UK
|Region||Lowest Price||Highest Price|
|London (Harley Street)||£2,600||£7,000|
|South East England||£2,600||£7,000|
|South West England||£4,070||£5,385|
|East of England||£4,139||£6,425|
|North East England||£4,665||£5,855|
|North West England||£4,049||£5,495|
|Yorkshire and the Humber||£4,139||£5,665|
Source: Private Healthcare UK
A large number of women also decide to have breast augmentation abroad. Just like in the UK, the prices tend to vary greatly not only between different countries but within particular countries as well. On average, however, the cost is considerably lower than in the UK. But when the cost of travel, accommodation and insurance is added, there is no longer such a dramatic difference.
Table 2: Cost of Breast Enlargement Abroad
|Country||Procedure Cost||Total Cost|
Source: Treatment Abroad
The best place to start looking for a surgeon to perform cosmetic breast surgery or breast reconstruction is your GP. They will tell you whether the desired procedure is suitable for you based on your medical record and provide advice on how to prepare, things to consider before making the final decision and other useful information including where and how to look for a good surgeon.
Take some time to inform yourself about different options including surgeons and hospitals/clinics offering the desired procedure. The Internet is a good place to do your research but be sure to use trustworthy and reliable websites. Examples include the BAAPS, British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS), Royal College of Surgeons (RCS), General Medical Council (GMC) and Care Quality Commission (CQC) some of which have excellent databases of plastic surgeons including those that specialise in aesthetic and reconstructive breast surgery. However, don’t limit your research to the Internet alone. Be sure to arrange an appointment with at least a few surgeons to get first-hand information as well as to get a better impression of what they are like and above all, whether they can meet your expectations.
While visiting clinics and hospitals that offer the desired breast surgery and speaking to their surgeons, be sure to ask as much as possible. In addition to helping you understand the procedure and both its risks and benefits, asking lots of questions will also help you determine whether or not you will receive care to the highest standards of quality.
Feel free to ask anything about the procedure including pre- and after-care but in particular, be sure to ask the following 10 questions:
Remember that the clinic/hospital must enable you to speak with the surgeon who is actually going to perform the surgery. They should assess your breasts and your preferences, and based on their expertise and experience provide opinion on what can and cannot be done, and why. A good surgeon will always be happy to answer any questions you may have to ensure that you fully understand what awaits you if you decide to have the procedure, including all the things that can go wrong. Likewise, a good surgeon will encourage you to take some time before making your final decision, even if you feel confident you want to go through with the procedure.
The risk of complications and unsatisfactory results is very low but unfortunately, there is always a chance of something going wrong. In the event you develop any problems or feel disappointed with the results of the surgery, you should first contact the surgeon who performed it or the clinic/hospital where the surgery was carried out. They seek to keep patient satisfaction levels as high as possible and usually do their best to resolve patients’ complaints in a satisfactory manner.
You can also make a complaint to the General Medical Council (GMC) or/and report poor care to the Care Quality Commission (CQC) or other health care regulator if the procedure wasn’t carried out in England. But resort to this option only if you feel that your complaint to the surgeon or clinic/hospital where the surgery was performed hasn’t been properly addressed.