By: Philip Turton
Created on 11th August 2010
Specialist breast surgeon Mr Philip Turton identifies the key considerations for those contemplating breast augmentation or redo breast augmentation
Getting exceptional results from breast enlargement or revisional breast augmentation requires a combination of elements to work perfectly together.
The starting point for most patients is getting the best surgeon for the anatomical area of cosmetic surgery to be undertaken. It is very important to see their photos and ask about their success rate.
After listening to patients describe their desires, I perform a full clinical, breast and biodimensional assessment. This is the pre-requisite to a first or redo breast enlargement that is in proportion to the patient’s frame and shape.
Getting this consistently perfect is a skill that has been refined from many years of performing a full array of aesthetic breast surgery (reduction, augmentation, mastopexy, liposuction) as well as full breast reconstruction (prosthetics, biomaterials, LD flap, autologous flap, lipotransfer, oncoplastic approaches).
Most of my patients come to me from personal recommendations that follow my work, and I perform over 300 breast operations per year.
The importance of implants
Choosing the right breast implant is a critically important step. There are many cheaper implants on the market that are available for use in the UK, but I would not be comfortable using them in my patients. A surgeon who is independent of any manufacturer, and who can choose from a range of suppliers is important.
Different implants can influence the final breast shape, size and feel of the breast, but perhaps more importantly capsulation and rupture rates are also different. This is particularly the case in revisional breast surgery where there are greater limitations, higher complications and complexities.
The French agency that regulates breast implants has recently suspended the use of silicone gel filled breast implants manufactured by Poly Implant Prothese (PIP), specifically between 2001 and 2009 with model numbers: IMGHC-TX, IMGHC-MX, IMGHC-LS. This was because most breast implants manufactured by this French company since 2001 have been filled with a silicone gel with a composition different from that approved.
I have never used the PIP implants but I am now involved in helping women who have been left with a problem, and I’m currently carrying out their revisions. The recommendation to concerned women with these implants is to seek advice from their GP, their original surgeon or to find a more specialist breast implant surgeon.
I have had many women from all regions of the UK who have come for revisional work because of my experience in this area. The problem is we do not yet know if there are any safety implications from the unapproved material in these implants.
Where can I get more information on implants?
You can find further information from my website (www. cosmeticbreastsurgeon.co.uk) and on the MHRA breast implant webpage (www.mhra.gov.uk/ mhra/breastimplants), where you will also be able to find a pdf version of the MHRA information booklet on breast implants.
The treatment process
My assessment when I see women who require revisional surgery is necessarily detailed and thorough.
The first step is to establish the current type of implants, any associated symptoms and signs that may suggest an immediate problem, and then to investigate further with appropriate breast and possible axillary imaging (looking at the lymph nodes in the arm pit area, which is the first place that the breast lymphatics drain to).
Where appropriate or requested I then revise the breast augmentation. This involves explantation (removing the existing implants), and if there is free silicone gel present, this should be removed from the breast pocket too. If there is silicone elsewhere that is evident, removal is considered based on concomitant symptoms, anatomy, and possible risks.
New breast implants can then be placed, using an approved manufacturer where the safety data is fully established. Additional work may be carried out to correct problems with the implant pocket, or ptosis in appropriate cases.
In conclusion
For the very best results and to
avoid unnecessary problems with
breast enlargement the message
is clear: choose the right
surgeon and the right implant to
get the right outcome.
Available from: Mr Turton
accepts referrals from all over
the UK, and with excellent
facilities for patients to
stay overnight this is a very
common approach for his
patients. For more information
visit Mr Turton’s website,
www.cosmeticbreastsurgeon.co.uk, or contact his secretary
Lisa Harris by email on lisa.
harris@nuffieldhealth.com or
call on 0113 3882193
