No Problem

By: Katharine Griffiths
Created on 18th June 2010

Thousands of women dream of increasing their bust size, and in recent years, advances in cosmetic surgery have made that dream a possibility for all of us. But what do you do if your new breasts aren't all they're cracked up to be?

Breast augmentation is far and away the most popular cosmetic surgical procedure for women in the UK, with a recent survey showing over half of us wish to alter the size or shape of our breasts. And you no longer need to be a millionaire to take that wish further - most of the major hospital groups offer financing options, which
means cosmetic surgery is now accessible to everyone.

However, whilst this all sounds great, there are some important decisions to be made before you book yourself in for the op. Of course, all surgery carries a risk, but with breast augmentation the most common complications are usually associated with certain
implant types, and are easily avoided by making sure you are
well informed about the different sorts of implant on offer.

What could go wrong?

Because a breast augmentation involves implanting a foreign
object in the body, it is hardly surprising that there is sometimes an adverse reaction. This can involve migration, rotation or rippling of
the implants, leaving you with misshapen breasts, or - more seriously - a condition called ‘capsular contracture'.

Capsular contracture is the most common complication arising from breast augmentation, with a recent study by the American Food and Drug Administration showing an incidence of 16 per cent at seven years post-op. But what exactly is it, and why is it so serious?

When implants, or any foreign object, are placed in the body, a lining or ‘capsule' is formed around it by your own tissue. This is the body's natural response and is quite normal, however in some people this lining will tighten and squeeze the implant, causing it to feel hard.

There are four grades of capsular contracture, and in the most extreme cases the breast becomes very hard to the touch and distorted in appearance. There is also a risk of pain or discomfort.

How can I avoid this happening to me?

Breast implants placed behind the muscle tend to have a slightly lower rate of capsular contracture than those sited in front of the muscle, and smoking has also been indicated as an increased risk factor. However, the safest way to protect yourself from the condition is to think about the type of implant used.

The quality of breast implants has improved considerably since their conception in the early 1960s, with the vast majority of breast surgeons now using silicone-filled implants as a matter of course.

However, the choice we are usually presented with is between silicone and saline filled implants, and even with the newer textured silicone gel implant, capsular contraction rates still remain high. With this in mind, it is necessary to look at the coating, rather than the filling, of the implant you choose.

There is an implant called Pure, which is manufactured by Silimed - one of the world's largest producers of silicone medical devices - and distributed in the UK by Eurosurgical Ltd.

The Pure implant is filled with silicone gel and coated with a special polyurethane foam. This foam helps to break up the membrane of the capsule and acts as a scaffold to stabilise the implant.

The advantages of this polyurethane implant are manyfold: firstly and most significantly, it reduces the rate of capsular contracture - incidence rates have been shown at just one to two per cent over 15 years.

There is also no risk of displacement or rotation of the implants, as the polyurethane foam becomes part of the capsule, holding the implant firmly in place.

Thirdly, the Pure implant is lighter than traditional implant styles, meaning there is less drag on tissues and a lower chance of distortion or rippling.

Great, where can I get them?

There are a number of surgeons in the UK offering Pure implants,
and the best way to find out if your surgeon uses them is to ask
at the consultation.

One surgeon who is already using Pure implants is Professor James D. Frame FRCS, a full member of BAAPS, who has been a consultant plastic surgeon since 1990.

"Polyurethane implants have transformed my practice since I first started using them," says Professor Frame. "By choosing the right implant for the patient's wishes and making implant adjustments
during surgery, the best results can be achieved on the operating table.

"With one in 12 women in the Western world developing breast cancer, in addition to those who opt for breast augmentation, it is important to understand the options available.

"The polyurethane implant has changed my views on a number of aspects of breast augmentation and breast reconstruction very favourably. While it is crucial to bear in mind that all surgery carries some risk, selecting a safer option such as the polyurethane implant helps to minimise that risk."

So if you are planning a boob job any time soon, make sure you do your homework, so you don't run the risk of getting anything less than your dream cleavage.