Q. I am considering having a boob job (breast augmentation) to make my breasts bigger. What do I need to know?

According to published figures, almost one-third of cosmetic surgery procedures are related to the breasts, and the most common “boob job” is breast augmentation; a procedure which aims to increase the size, shape or fullness of the breast. Ideal for those who wish to either enlarge naturally small breasts, restore shape post-partum or after weight loss, there are two main techniques, namely fat transfer and implants.

Fat transfer is the surgical process by which fat is transferred from one area of the body to another, in this case the breast area. Excess fat is usually taken from the hips, thighs or abdomen. Fat transfer augmentation procedures are really limited to patients who are a dress size of UK10 and only desire a modest increase in size, while implants can be used to increase breast size – in theory, to any extent – in all patients.

Implant surgery takes around two hours and is done under general anaesthesia and the implants most commonly used are silicone gel implants although rarely, and upon patient’s request, saline implants can be used. Saline implants are filled with a sterile saline solution, which is held within an elastomer silicone shell. These implants can be filled with varying amounts of solution, to alter the feel, firmness, and shape of the breast. Silicone implants come in various gel configurations and these implants can be round, or teardrop shaped. Shaped implants have a tapered upper edge and give more projection behind the nipple.

How to decide which implant to get?

I always advise my patients that the base width of your chest should define the parameter of implants. Your skin may impose a size limit too, particularly if there’s a tight envelope to your breast tissue. For women lacking projection due to weight loss or deflation since breastfeeding, a higher profile may be required to fill out the missing space.

Aside from the size of the implant and its shape, you will need to decide on the placement of your implant too. A sub-muscular placement goes under the pectoral muscle and this positioning is recommended if you are very lean because the muscle can conceal implant characteristics, edges and rippling may be less visible. Sub glandular placement goes behind the breast tissue, over the pectoral muscle. The advantages of this include a better cosmetic result with no interference with pectoralis muscle function and no requirement for stretching of muscle for the implant to settle into its final position.

It is important to remember that although breast implants don’t have an expiry date; it isn’t guaranteed that they will last a lifetime. In fact, saline or silicone implants should only be expected to last 10 to 15 years at the most so it is crucial that you bear in mind that this is not a procedure that you will do just once.