Your breast augmentation journey starts with the consultation. It’s during this time in which you can discuss how you would like your new breasts to look, the type of implant used, the shape, the procedure itself, risks and potential complications, your medical history and aftercare. We’ll also examine the breasts to get an idea of what we can achieve. 

Your surgeon will help you determine the best size for you by using a 3D simulation app to help you visualise how the size and shape of the implants may look.

At 111 Harley St., we also provide you with the opportunity to feel the implants and try the implants on to gage an idea of the weight, feel, and how they will look when wearing clothing.

A breast augmentation is performed under general anaesthesia and may require an overnight stay in hospital.

The surgeon will make an incision either below the breast, around the areola or under the armpit.

Working through the incision, the surgeon will lift the breast tissue and skin to create a pocket which is usually either directly behind the mammary tissue or underneath the chest wall muscle.

The surgeon places the implants centrally beneath the nipples and closes the incisions with stitches.

After around six weeks, the results of the breast augmentation surgery will begin to be visible. However, this varies from patient to patient, depending on the speed of healing. Over the next several months, the implants will begin to soften and settle into their final position.

If you’ve opted for under the muscle placement, the breasts may appear slightly higher due to the tension on the pectoralis muscle. The implants will ‘drop and fluff’ after around six weeks as the muscle starts to relax, and the implants shift from the upper portion of the breast to the lower pole.

Enhancing the appearance of your breasts doesn’t always require a breast augmentation. Depending on your aesthetic concerns, you may require a combination approach to breast enhancement or a single procedure. It’s important to remember that there is not a ‘one-size-fits-all’ approach to breast enhancement, and each pair of breasts is unique and come in various shapes and sizes. Many factors may influence your decision, including, scarring options, implant types and side effects, and overall look and feel.

If you don’t like the idea of breast implants, fat injections are suitable for small breasts. A breast fat transfer can increase the size of the breasts by 1-2 cup sizes and uses the patient’s fat. However, the operation does come with its risks and side effects such as lumpiness, mammogram implications, and fat reabsorption.

Recovery varies from patient to patient, but we encourage patients to be as healthy as possible before surgery to accelerate the speed of healing.

You may wish to consider taking a week or so off work and arrange help with driving, childcare etc. The general recovery time is six-eight weeks.

The duration of the procedure varies on the extent of the surgery itself. If you require a breast lift in addition to breast implants, this will take longer. Typically, it takes around 1 ½ hours to 3 hours perform the procedure.

During your breast implant removal (explant surgery or explantation) consultation, we will devise a breast reconstruction plan to suit your needs. Depending on the circumstances, we can mitigate the loss of the implants and improve the breast’s appearance through the reconstruction of the breasts, nipple and areolas, or with a fat transfer.

We will operate under a local or general anaesthetic, usually as a day case procedure. Your surgeon will use the initial breast implant incision to remove the implants. During the surgery, we will address the problems you’ve encountered due to your previous operation. That may include removing a capsule of scar tissue (capsulectomy) or other materials.

Depending on your preference, your surgeon will then reconstruct the breast and may insert new implants.

You may require surgical drains for a day or two to prevent excess blood and fluid build-up.

You may wish to have revision surgery or implant removal if you’re looking to change your breast shape or size, or have complications of breast implants including:

• Breast, shoulder or back pain
• Capsular contracture
• Bottoming out
• Double bubble
• Extrusion
• Rippling
• Rupture
• Deflation
• Leakage
• Infection

If you opt for a replacement of your breast implants, your breasts will start to settle after around six weeks. It may take several months before the tissues fully heal. It may also take some time for you to adjust to your new breast shape if you choose not to replace your previous implants.

You should be able to return to work and resume normal activities after around one week. Following your implant removal surgery, you may be a little swollen for a few weeks. You should avoid rigorous exercise for up to six weeks.

Implants removal takes around 1-3 hours to perform, depending on the surgical requirements.

• Irregularities in the breast shape, particularly without replacement of new implants
• Asymmetry
• Infection
• Loss of volume and elasticity in the breasts
• Reduction in breast size – the doctor may need to remove a lot of scar tissue or breast tissue
• Loss of sensation in breasts or nipples
• Poor wound healing
• Bleeding
• Seroma
• Pain
• Scarring

The possible complications from a previous breast implant surgery usually present themselves within the first year but can also develop within the first several years. We recommend that prospective patients wait at least six months before considering a revision surgery to minimise future risks.

You may also choose to remove your implants because they are causing you pain and discomfort, or you’re dissatisfied with their appearance.

Removing implants altogether can help to reduce the stress associated with breast implants.

This minimally-invasive procedure requires a local anaesthesia with the possibility of IV sedation to minimise downtime.

The surgeon will make a periareolar incision which encircles outline of the areola to conceal scarring.

They will then remove the excess area of the areola and re-stitch to the surrounding skin. The scarring becomes virtually undetectable as it’s hidden within the perimeter of the areola.

Both men and women may benefit from areola reduction if they do not like the size or the appearance of their areolas.

It’s a suitable procedure for those with:

• Asymmetry
• Large areolas – due to genetics, breastfeeding, or weight loss

Depending on the severity, areola reduction could also address the puffiness of the areola. It can be an option for tuberous breasts where the areola is often disproportionately large in comparison to the breast. Correcting tuberous breasts would require a combination of corrective techniques.

INVERTED NIPPLE

You should see immediate results, but optimal results will show after around two weeks.

NIPPLE REDUCTION

After ten days, the nipples should be healing well, but optimal results will show between 3-6 months.

NIPPLE REMOVAL

After around two weeks. You may have a small scar which will fade over time.

NIPPLE LIFT

Results will be immediate, but you may have swelling that lasts for a few weeks.

Recovery is approximately one week. You may wish to take a couple of days off work, after which point, you can return. We may require you to wear a surgical bra for 2-6 weeks while the areolas heal. During this time you might also see some bruising around the site which will resolve within the coming weeks.

The procedure takes about two hours.

A breast reduction requires general anaesthesia. During the procedure, the surgeon will make an anchor-shaped incision that encircles the areola, extends downwards and follows the natural curve of the crease below the breast. The surgeon will remove excess glandular tissue, fat and skin before moving the nipples and areolas to their new position.

Skin from both sides of the breast is brought up and around the new areola to shape the contour of your breast. The operation may involve liposuction to remove any excess fat. In most cases, the nipples remain attached to their original blood vessels and nerves. The stitches encircle the areola, extending down in a vertical line along the crease of the breast.

You might consider a breast reduction for practical reasons such as if your breasts are large enough to be causing back and neck pain. You might also experience poor posture and painful rashes or sweating underneath the breasts.

Others may desire a breast reduction for aesthetic reasons and find their appearance undesirable. You may also wish to combine a breast reduction with other types of breast surgery.

Since your breasts can fluctuate in size and shape with pregnancy or if you’re considering losing a vast amount of weight, you may wish to wait until you have done so before you proceed with your operation.

The results from a breast reduction surgery will be visible immediately.

After your breast reduction surgery, you may feel a little sore and tender for the first few days.

Typical side effects might include swelling, bruising, pain and discomfort, which usually resides within two weeks.

You will be given a surgical support garment to wear during the first few days, which can eventually be replaced with a sports bra during your recovery. We may advise surgical drainage to remove any excess blood or fluid.

Book a week or so off from work and arrange for friends or family to help you with manual tasks as you should avoid anything strenuous such as lifting or exercise for up to six weeks.

Recovery rates vary from patient to patient, and scarring may be slightly raised and pink to begin with but should fade over time. You will have several follow-up consultations to check on the progress of your operation.

A breast reduction can take up to three hours, depending on the extent of the surgery.

• Asymmetry
• Loss or changes in breast or nipple sensations
• Swelling
• Bruising
• Tightness
• Scarring
• Bleeding
• Infection

The extent of scarring will be partly dependent on the incision technique. Usually, there are three incisions involved: one around the areola, one that runs vertically from the areola to underneath the breast, and thirdly, one under the natural crease line of the breast.

Other techniques can reduce the appearance of the vertical part of the scar.

The surgery does impact the milk ducts. Usually, the nipples will remain attached during the operation so you should still be able to breastfeed. If we remove or reattach the nipple, then this may inhibit your chances of being able to breastfeed. Therefore, some surgeons may suggest that you wait until after your last childbirth before considering surgery.

The approach to surgery will vary depending on the concerns, level of ptosis (sagging) and your breast size and shape. For a grade 1 ptosis (minimal drooping of the areola and breast complex which is usually up to 2cm), then it can usually be treated with a donut incision, otherwise known as a periareolar which encircles the areola.

If breast sagging is more extensive, we can perform the incision with a lollipop technique which involves a periareolar incision and a vertical incision that extends from the edge of the areola down to the inframammary fold.

For the most significant ptosis, we use an anchor-shaped incision following the natural contour of the breast.

Your breast lift will require general anaesthesia, but you will not usually have to stay overnight.

During the operation, one of our highly-experienced and board-certified cosmetic surgeons will elevate your breasts to a higher position.

If you have an additional breast implant procedure, we will insert the implants through the same incision location. The incision will then be closed with sutures.

You may consider a breast uplift after pregnancy. A combination of weight gain and an increase in breast tissue and ligaments can cause the skin to stretch and shrink in a relatively rapid amount of time, contributing to sagging. Breastfeeding also causes the skin to stretch and shrink daily. Although the skin has elasticity and collagen to support this process, these supportive proteins are often broken down with ageing, drinking, smoking, environmental influences, and other external factors, making the skin less able to bounce back as freely.

This procedure can also be suitable for anyone who has any varying degree of breast ptosis or asymmetry.

The results of a breast uplift will be visible immediately after surgery, but it may take from 6-12 months for breasts to settle.

Recovery rates vary from patient to patient, but generally, the recovery process for a breast uplift takes around six weeks.

We advise patients to take a week off from work and avoid lifting for three to four weeks.

The sutures may be removed around two weeks after the procedure.
You should avoid strenuous physical activity for around one month.

We may recommend wearing a supportive garment for a few weeks following your surgery.

A breast uplift can take between 1-3.5 hours.

Possible risks of a breast uplift might include (but are not limited to):

• Anaesthesia complications
• Hematoma 
• Necrosis or wound dehiscence 
• Bruising 
• Infection 
• Changes of sensation in the breast or nipple
• Asymmetry or undesirable results
• Seroma
• Loss of nipple
• DVT, or other pulmonary complications

A breast reconstruction surgery, whether that be a breast uplift, breast augmentation, areola reduction or nipple reconstruction, is often unique to each patient. We often combine a breast lift with other procedures such as a tummy tuck as part of a makeover or with breast implants. Your surgeon will alter the approach depending on your goals and limitations.

If you’re concerned about your ability to breastfeed after this operation, you should discuss this with your surgeon so that they can preserve the lactation capabilities as much as possible.

Usually, the lactation system remains intact, even though we may need to reposition the nipple. If this is the case, we don’t often separate it from the glandular tissue.

Before having your surgery, the technique and the type of incision will be discussed with your surgeon. Any procedure that involves an incision will leave residual scarring. The scars usually fade over one to two years.

There are three conventional approaches to a breast lift:

• Vertical Scar (Vertical line down from the bottom of the nipple)
• Inverted T (One vertical line pointing down from the nipple and a horizontal line)
• Benelli Scar (Around the areola)

The inverted T requires removing the most amount of skin with the most visible scar, whereas the Benelli scar (around the areola) will be the least noticeable. Due to the contrast in colour between the breast flesh and the areola, scarring will fade into the nipple line and be virtually undetectable.