All surgery carries risk and although a good part of your consultation for cosmetic breast surgery will focus on the benefits and the final result, it is vital that you fully understand all the possible risks before signing on the dotted line.
In practice, this means that before you make the decision to go ahead, you should be able to clearly describe what the procedure involves, what outcome you can expect, all the potential risks and complications and the chance that you may require a repeat operation at some point in the future. Your surgeon should also discuss with you alternative treatments or the option of doing nothing at all.
What is a ‘cooling off period’?
In light of the PIP breast implant scandal which emerged in 2010, the Government formed a committee led by Sir Bruce Keogh to evaluate the provision of aesthetic treatments in the UK. One of the many recommendations of the report that was published in 2013 was the cooling off period.
You should be given a cooling off period of at least two weeks to consider the implications of your proposed procedure before making the decision to go ahead and be wary of any cosmetic surgery provider that puts pressure on you to commit by offering financial inducements to do so.
Ideally, your cosmetic surgeon should provide you with written information on your procedure to take away with you and be happy to provide a follow-up consultation, often free of charge, if you have further questions.
Your cosmetic surgeon will describe all the potential risks of your procedure, explain how likely they are to occur and they should also touch on how they personally deal with any complications that arise:
Reaction to the anaesthetic; although some cosmetic surgeons offer breast augmentation under ‘twilight anaesthetic’, which is a combination of local anaesthetic and sedation, the majority of cosmetic breast surgery procedures are performed under a general anaesthetic which has a number of risks to the patient.
Infection; your cosmetic surgeon may use intravenous, topical or oral antibiotics, before, during and after the procedure, to lessen the chance of an infection developing.
Scarring; these should flatten and fade over time, but a small percentage of patients will suffer from keloid or hypertrophic scarring, where the scar becomes very thick, raised and red. Further scar reduction treatments may be required after surgery, although it is not possible to fully reverse this type of scar.
Haematoma; this is a collection of blood and is a more common occurrence. It will happen in the immediate period after surgery and you may notice pain, tenderness, swelling, bruising or discolouration in one breast. Haematomas can clear up on their own but it may be necessary to return to surgery for blood to be drained.
Seroma; a build-up of fluid around the implant or in the incision area. Surgery may be required but it is usually possible to remove the seroma with a needle.
Asymmetry; all women have slightly asymmetrical breasts with up to 40% having breasts that are different by one cup size or more. If the asymmetry is not taken into account prior to a breast augmentation procedure it can become more noticeable afterwards. A breast uplift or reduction which changes shape, size and position of the breasts can also produce asymmetry.This may need to be corrected in a follow-up operation.
Capsular contracture; this is a problem that relates to breast implant surgery alone.The body reacts to the implant by creating a shell of scar tissue around the surface of the implant and, over time, it can contract, causing the breast to feel hard or change shape and even pain.This is the most common long-term complication after a breast augmentation.
Change in sensation; some women report that there is an increase in sensitivity in the breasts after surgery, although more likely will be the chance that there is decreased sensitivity. Normal sensation should return as the body heals, but for a number of patients there will be permanent loss of sensation.
Deflation or rupture; all implants have a risk of rupture, usually as the result of wear and tear over time. It is immediately obvious when a saline implant has ruptured as the saline filling will instantly – and safely – drain away, leaving you noticeably flatter on one side. The new cohesive gel used in silicone implants means that the filling rarely ‘leaks’ but instead stays inside the shell or the scar tissue that has formed around the implant.
Why do I need a follow-up consultation with my surgeon?
“Every surgeon approaches this differently. I don’t think it is possible to understand all the risks and complications and make all the necessary decisions about the procedure in just one consultation.
With breast augmentation, in particular, there are so many options in terms of implants, sizing and placement, that I strongly believe two consultations are required and the patient should have a period of time in-between to consider all the implications.
I also give all my patients a comprehensive procedure guide to read between their consultations.”
Mr Marc Pacifico, Consultant Plastic Surgeon
Click here to see more of The Ultimate Guide to: Cosmetic Breast Surgery.