Breast Augmentation & Enlargement

Volume enhancement due to aesthetic/medical reasons:
For personal preference (dissatisfied with the shape and size of breast)
Replace breast volume lost after having children and breastfeeding
Correct uneven breasts
Correct mild to moderate ptosis (breast droop)

For complications from previous breast enhancement surgery:
Capsular contracture
Rupture/ Bleeding implants
Bottoming out

To correct congenital conditions involving the breast:
Poland syndrome
Tuberous breast
Pectus excavatum
Scoliosis
For Breast reconstruction
Correct large volume deficit after previous lumpectomy for breast cancer
After mastectomy

Mild breast asymmetry is not an uncommon scenario. Most women live with this all their lives without even realising. Unfortunately, sometimes asymmetry can be quite marked and noticeable. This can be a source of distress for some women, especially if one breast is very small and other has marked ptosis (breast droop).

There are four types of asymmetry. Type I and type II are not very difficult to correct as the asymmetry is not very striking. These are either corrected by augmenting one side (in type I) or by reducing one side (type II). Type III and IV are complicated and need careful assessment and correction. They may take more than one surgery. In cosmetic breast surgery, correction of these later types is most challenging and needs an experienced and skilful surgeon. Although it's challenging and difficult surgery, it's very rewarding for the cosmetic breast surgeon when the desired results are achieved and the patient is happy and satisfied with the results.

Fees for breast augmentation start from £4,100. Different factors are taken into account e.g. type of implant, revision, site of operation etc.

Your consultation is always with Mr. Ahmad. This is a detailed meeting to assess your current situation, medical history, suitability for breast enlargement, and to perform the bio-dimensional assessment.

You will have a full breast examination, comprehensive measurements made of your frame, existing breast size, glandular analysis, tissue characteristics, and anatomical variations in typical dimensions.

The type of breast implants on the market, their safety, and the ones that have the best life span and lowest complication rate will be discussed.

Mr. Ahmad will also detail your options and alternatives, the potential complications, any limitations, short and long term breast changes, costs, the need for future surgery, mammography and follow-up.

If indicated you will have a full 3D image assessment using Crisalix. This can help customers to choose appropriate size breast implant.

Mr. Ahmad uses several methods to assess the optimum size of breast implant, particularly 3D imaging system, Crisalix.

Crisalix 3D imaging systems enables the client and surgeon decide on size based on your proportions. This is the safest way of balancing the desire of breast enhancement with reduced detrimental effects. Most women desire to be a C or D cup but some will request bigger sizes and although cup-size is not absolutely guaranteed, Mr. Ahmad will be able to show you how your breast shape can be augmented, and take into account your preference.

If you ask for a size that is much larger than your assessment suggests then you must be aware that there may be higher risks of complications and detrimental changes: e.g. breast tissue sag, palpability, less natural appearance, numbness, arms rubbing against side of breasts, ache, and future mal-position.

Mr. Ahmad assesses women for large breast implants and advises them regarding the feasibility of mega-enhancement / enlargement. Some of these mega-enhancements may require two-stage procedures.

Mr. Ahmad will always strive to meet your expectations but if there are limitations as to what can be achieved (often related to your starting point) then these will be discussed.

It is important to be realistic.

Mr. Ahmad uses a wide variety of breast implants, including Allergan or Mentor, Sebbin and more recently B-Lite breast implants, which are 30% lighter than other breast implants. These all have an excellent reputation for durability and a very low incidence of capsular contracture - a complication following breast surgery, when scar tissue tightens causing misshapen and hard implants.

The sub-pectoral (under the muscle) or sub-glandular (under the breast/in front of the muscle) position is used.

The chest area often feels tight and tender for a few days. Often one side feels slightly tighter, or more tender initially due to an implant settling earlier on one side than the other. You will be able to move about as normal, but you should avoid using your chest wall muscles forcibly, to minimise discomfort.

The vast majority of women feel relaxed and comfortable immediately after surgery. Breast tenderness and a tight feeling usually become apparent gradually.

At this stage your surgeon should be happy for the nursing staff to dispense painkillers which are given in combination for few days, but most of the patients are quite comfortable with taking paracetamol after a week or so.

It is quite common for one breast to be more tender, and to swell slightly more (this is often the right side). Similarly one breast will often recover more quickly and this is quite normal.

Although it would be very rare, the gradual appearance of a great discrepancy in size would not be normal and should be assessed. Similarly if you feel unwell, feverish and develop a temperature you would need to consult your surgeon. If the skin over the breast swells and becomes reddened and tender you would need to consult your doctor.

Changes like this would be very unusual indeed, but it is important to know that should they occur, a prompt review is required to assess the cause and treat it.

Most commonly breast enlargement surgery is done as a day case, however if you have surgery in the evening you will normally stay overnight. Mr. Ahmad will review you the morning after surgery and, if everything is satisfactory, will discharge you from the hospital normally by midday.

A loose button-down shirt is ideal. Avoid clothes that would need pulling on over your head.

The most common side effect is feeling sleepy for a few hours. Sometimes the anaesthetic or morphine make you feel sickly, but usually for a short time only.

You may feel slightly bloated for a few days. This is often due to slight constipation caused by medication. A gentle laxative (lactulose, movicol or senna) will help resolve this.

Complications from breast augmentation surgery are rare, but Mr Ahmad is unable to give you a categorical guarantee that they won't occur.

The kinds of problems that can occur are haematoma around the implant in the first 24-hours which will require evacuation, or implant infection needing implant removal in the first few weeks.

If these complications do occur you will be covered by the fixed price package for further surgery.

For example, if you need to have the implants removed because of an infection in the post-operative period, this is covered, as is the subsequent operation to replace new implants.

Your first appointment post-surgery takes place 10-14 days after the procedure with the surgical nurse practitioner, who makes sure your healing is progressing in a satisfactory manner. Dressings are checked and redressed if required. Mr Ahmad sees you again a few weeks later.

Skin healing occurs in the first seven days, but continues to mature over 6-12 months. The scars must be cared for and you should avoid touching or feeling along the scar line for the first eight weeks.

A good idea is to tape the scar for three months to keep the scar line like a fine pencil line. The scars gradually fade over the first 12 months to a pale colour.

This process can be speeded up by using silicone gel called Dermatix or Cica-care.

Wearing a well-fitting bra after your recovery is important (usually from four weeks). An underwired bra is safe and recommended. A shock-absorber type bra should be worn during sport and wearing a comfortable sports bra at night is also very useful.

Once you have recovered from surgery there is no reason why you shouldnu2019t go without a bra on occasions, as long as you feel comfortable it will not have a detrimental effect. In the long term however breast tissue will be more susceptible to droop if you do not wear a bra most of the time.

Yes. Please check with your surgeon in relation to what you do. Generally you will require at least one week off. Two weeks or more may be needed if your job involves lifting or heavy manual work.

If your work is very sedentary, you can occasionally return after three days, but remember that you will still be taking painkillers.

Anatomical implants (also called teardrops and shaped implants) need more time to settle and for tissue in-growth onto the textured implant surface to reduce future risk of a rotation.

Different implant manufacturers have different types of texturing, which has an influence on your choice of breast implants. Texturing allows tissue in-growth and stops excess movement of the implant, helping prevent capsular contracture.

Excess movement early on (first four weeks) will prevent in-growth and encourage a small seroma to form (like blister fluid), further preventing in-growth. Therefore, you will have more restrictions with your recovery programme to allow for this, and no excessive stretching/movement should be undertaken for four weeks.

With round breast implants the restriction is much less, especially if the implants have been placed in the sub-glandular position.

In general, the answer is yes. Breast tissue is composed of thick glandular tissue and soft fatty tissue.

Just as when you put on weight you find that it goes onto the bottom/hip area, you will also often find some of it goes onto the breast area. Big shifts in weight are therefore not desirable. However, most people have minor weight fluctuation of 2-4 lbs, which has negligible effect.

If your starting breast size was very small (A to AA cup size), then losing weight tends not to make the augmented breast smaller. Instead it reduces the thin normal fatty tissue layer under the skin, and in the breast tissue layer. This makes the implant edge more easily palpable (particularly in the outer edge near the armpit, and in the skin crease area under your breast).

Implants that are partly under the muscle have the additional coverage of soft tissue that this provides, which is particularly helpful in thin individuals, but remember - the pectoralis major muscle does not fully cover the implant, generally just the upper half.

Some sagging is inevitable but careful choices can modify your risk.

Your breasts will always change as you get older, and this is irrespective of whether you have breast implants or not. This is because of biological changes that occur with ageing.

These changes include: loss of elastin, stretching of collagen, atrophy of breast tissue, loss of skin elasticity, sun damage to skin, smoking related damage, effects of weight change on skin and breast tissue, effects of pregnancies and breastfeeding on skin and breast tissue, hormonal changes, weight of breast tissue and implant weight and size.

3D imaging with Crisalix assessment goes some way to reducing excessive implant sizes being chosen by women. The larger the implant the greater the long term detrimental effects. This is because of the additional weight, and the compressive force of the implant on the surrounding tissues, which become thinner, and more stretched.

Avoid very large augmentations and implant sizes that exceed your natural dimensions. Submuscular breast implant augmentation may provide additional support to the implant.

Avoid the use of sunbeds and do not smoke at all (both have a very detrimental effect on skin elasticity and quality, as well as micro-vessel blood flow). Keeping the skin over the breasts moisturised helps to maintain the elasticity (Bio Oil is possibly advantageous here).

Maintain your weight in the healthy range for your body mass index.

Mr Ahmad also uses special techniques in certain cases to minimise the process of sagging. He will advise you at the time of consultation on these techniques if indicated.