Breast Augmentation

Breast Augmentation is the most popular Aesthetic/Cosmetic procedure. It has many positive effects upon self esteem and body image.

I have performed well over 1000 successful breast augmentations and I think that the operation is hugely empowering to women.

I been asked for my opinions and advice on breast implants and breast augmentation by NICE (National Institute for Health and Care Excellence), implant manufacturers (Allergan/Natrelle) and also sportswear firms such the global research and development team (Aqualab) of Speedo International Limited, to help develop sports support garments especially for breast support.

There are several factors that need to be taken into account to achieve the desired result. The type of implant, size of implant, position of implant and shape of implant all affect the result.

From experience, I know that there are some slight differences between the shapes of the breasts in each lady. In addition, the chest wall/ ribcage is not always symmetrical.

There are also risks of any operation and it is important to be aware of these.

It is important to remember that Breast implants are a long term commitment.

Depending on the age of the patient, the implants will need replacing at some point in the future.

Below, are some pictures of my patients (all have given their consent to appear).

I have chosen these to illustrate different breast shapes and how surgery needs to be tailored in order to achieve the desired result.

 

Click on images to browse different angle views of each patient.

Patient 1

Ladies have breast augmentation for many reasons. For example, the breasts may not have developed in proportion to the rest of the body or pregnancy and perhaps breast feeding may have led to loss of volume and sagging. This lady had round silicone implants placed in a prepectoral position (infront of muscle).For her, this gives a nice result.The exact shape, position and type of implant can affect the cosmetic result.I offer whichever implant will give the desired result for each patient as an individual. I am not constrained to just one particular type of implant or manufacturer.

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Patient 2

For example, this lady had anatomically (teardrop) shaped silicone implants placed in a Subpectoral/Dual plane position (under muscle).This has given her a more natural result than she would acheived with round implants.There are still some differences betwen the breasts, which is normal.The 5cm long scars are hidden in the crease below each breast, so they are hidden. If you click on the pictures the side views will appear. This shows patient two from a different angle. She has gone to a D cup size. Size and shape need to be discussed in detail before surgery.Many of my patients prefer the more "natural" look. However, some like a very full cleavage area.It is important for my patients to tell me exactly what they are trying to achieve, so that I can advise accordingly.

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Patient 3

Here I have placed high profile round implants in a subpectoral (under muscle) position.Note the slight asymmetries between each side still persist a little after the procedure. There was very little breast tissue in the upper poles of the breasts (following pregnancy).In this case, I placed the implants under the muscle to give a more natural appearance to the upper poles.The round implants help to give a fuller cleavage in this case. Press on the pictures to see the side views.

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Patient 4

Again, this lady has had anatomically shaped implants placed. The implants used were in this case made by Allergan.I offer implants from the following manufacturers:Natrelle/Allergan/McGhanMentorNagorI also offer the Polyurethane foam coated implant (Pure) from Silimed (which is thought to have a lower capsular contracture rate)

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Patient 5

Breast feeding and age changes have essentially led to some deflation of this lady's breasts.The markings are made preoperatively and show the position of the pectoralis major muscle which varies between people.The implants have lifted the breasts and improved their shape. In additon the breasts are larger and the cleavage is improved when she puts her bra on.The markings that I have drawn on preoperatively show the base of each breast and the position of the Pectoralis Major muscles.

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Patient 6

It is important to discuss size with me, during the consultations prior to surgery.This lady wanted a moderate enlargement.The shape of the breasts has been improved and the breasts fit nicely with her frame.

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Patient 7

This lady did not want a huge bust. She just wanted to have a fuller, more youthful bust. Similar to the bust she had had prior to having her children. The implants are anatomical/tearshaped and I placed them under the muscle.This gives a more natural look from the side, as you can see here. Press the picture to view side view.

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Patient 8

Following pregnancy, the breasts lost a lot of volume. I have used implants here to bring the breasts into balance with the rest of the figure.

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Patient 10

A moderate augmentation. This gives more fullness to the breast especially restoring the upper pole volume (press picture to see this from the side).

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Patient 11

Once the nipples have dropped below the inframammary fold (fold under the breast), then it may be difficult to achieve a good result without a nipple lift or breast uplift procedure, in addition. In this case, I have used the weight of the implant to drop into the lower pole. This improves the shape, without the need for an uplift procedure.

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Patient 12

The breasts here are very much anterior (on the front of the chest wall). So the challenge is to use an implant wide enough to make the figure more hour glass in shape, without being so tall that the cleavage ends up unnatural and too high. This has been achieved with low height, full projection, anatomically shaped cohesive gel implants. This time from the Allergan Natrelle range. Placed in a Dual plane/Subpectoral position.

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Patient 13

Breasts are attached to the chest wall at different levels in different ladies. In this lady, the breasts are attached in a low position on the chest wall (low busted). So, when augmented, the breasts sit in a low position on the chest. It would be impossible to get the breasts to sit very high on the chest, for this reason. However, in a bra the cleavage is a full as she wants it to be. The overall appearance is very natural.

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Patient 14

When there is very little breast tissue, then the danger is that the breasts can look very round and stuck on. They also sit higher on the chest wall. In this case, using a shaped anatomical implant, in a Sub pectoral/ Dual plane position can look very reasonable, especially in the upper pole towards the armpit, where there is no abnormal dent.

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Patient 15

Here I have used the implants to lift the breasts. A very natural result has been achieved in a naturally lower busted lady.

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Patient 16

After breast feeding her children, this lady found that her breasts had lost the upper pole volume and had dropped/sagged. After breast augmentation, the volume is restored and this has made a huge difference to the way she feels. She writes " At 35, I had my second and final baby. I always knew that after my first I would want a breast augmentation and spent years researching. I attended consultations with friends who have also had the op and saved hard. Pre children I had an impressive D cup breast which balanced out my frame and made me feel womanly. Since my first child and even the second my figure bounced back with training but my breasts were two sad small floppy objects that training could never fix. This hugely affected my confidence and my sex life hugely suffered.

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So why Spire, firstly after visiting several of the "cosmetic companies" I liked the idea that the spire are a private health care provider who specialise in many sectors of health care, not just cosmetic. Secondly, you are dealing with the Surgeon rather than a patient coordinator. This suited me as I ask a lot of questions!! Graham Offer listened to my numerous and probably tedious questions and took the time to answer them in full. He was extremely honest and open about the procedure and it's possible complications. On the day I was made to feel totally at ease. I had a level of guilt being there as I felt shallow amongst some of the other patients who were seriously ill but the nurses and theatre team treated me with absolute respect and care, they were lovely! and nonjudgemental. The anaesthetist even referred to my procedure as "rebuilding my breast"- Brilliant. The food was wonderful, homemade and a great choice. The aftercare I cannot fault, any concerns I have spoken to Graham on the day and seen him as and when needed. It's nearly five months on and they have changed me totally. I love them!! "

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Patient 17

I have used the implants here to try to give more shape to the breasts. Preoperatively, they are quite "pointy" towards the nipple. The implants gradually shape the breasts over time. Occasionally this can cause stretch marks on the lower poles of the breasts.

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Patient 18

I have used the implants here to give a full cleavage. With a larger augmentation it is worth wearing supportive bras afterwards to help reduce the long term risk of sagging of the breasts.

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Combined Procedures

A full abdominoplasty, Bodyjet liposuction and Breast Augmentation. There are a number of patients who would like both breast and tummy surgery at the same operation. This is possible but we would need to discuss this, as not all patients are suitable due to other factors such as medical conditions,etc. Please press/click the photos to see the side views.

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Replacement of PIP Implants

I never put any PIP implants in. I have had to remove many. The French Company PIP fraudulently used non medical grade silicone in it's implants. Many were put into patients who then developed problems. The whole debacle ended with the manager of PIP being jailed in France and many women left with faulty breast implants. I have removed many implants and replaced them, as shown here. (press on pictures for side views, then press again when the pictures appear). Obviously, PIP implants are now banned/ unavailable.

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Graham's Qualifications/

BSc (hons)/ MBChB/ FRCS/ FRCS(PLAST)