Ask the Surgeon: Cosmetic and Plastic Surgery Questions and Answers - By: Felicity Lightbody

How long will my breast implants last? The implants that I use are guaranteed for life and never have to be changed, unless there is a problem. If you should develop a problem, such as capsular contracture, replacement implants will be provided free of charge, although you may have to pay any associated hospital costs.

What types of implants are available? All implants have a shell of silicone, but they can be filled with either silicone or saline. Silicone implants consist of cohesive gel, which means they have the consistency of a jelly baby and they will not leak if the shell should fail. Silicone implants can either be round or anatomically shaped - the relative merits of these different implants can be discussed with your surgeon.

Are silicone implants safe? In the early 1990s, silicone implants were taken off the market in the United States over concerns that they may contribute to ill health. However, several large studies have shown no link between silicone implants and systemic illnesses and they are now approved for use again in America. In the UK, silicone implants have always been used and they have a long and well proven track record for safety. They are widely regarded as giving a much more natural and long lasting result when compared with saline filled implants.

What cup size will I be following my breast enlargement? This is something that everybody wants to know, but is actually very difficult to predict. The size of the implant is not only related to the volume of gel (eg. 300cc) but also to the dimensions of the implant. A 300cc implant with a wide diameter will look smaller than a 300cc implant with a narrow diameter. Furthermore, cup sizes are measured based on the difference between your chest circumference and the circumference around your breast. This difference is proportionally greater in patients with a smaller chest, and so a C cup in someone with a narrow chest will look bigger than a C cup in someone with a broad chest. This illustrates that cup sizes are not a precise entity and can only be used as a guide.

Can you show me what I will look like with breast implants? There are many tricks to determining how you may look following breast augmentation, including filling bags with water or rice and putting them in your bra or putting implants in your bra, but these do not give an accurate assessment of how you will actually look postoperatively. It is important to discuss the size that you are hoping to achieve with your surgeon and it may be helpful to bring photographs to illustrate the 'look' you are after. At the end of the day, there will have to be an element of trust between you and your surgeon and you will need to appreciate that a precise cup size cannot be guaranteed.

How long will my recovery be? You will usually stay in hospital overnight and go home the following day. You should wear a supportive bra day and night for the first few weeks after surgery to help reduce swelling. The sutures are usually dissolvable and do not need to be removed. The dressings are usually removed after a week. You should avoid lifting or exercising your upper body for 4-6 weeks. It often takes 3 months for the swelling to start to settle and your final result becomes apparent.

About the Author

Mr Jonathan Staiano BSc MBBS MSc FRCS(Plast) was the expert answering the above questions.Mr Staiano is a consultant plastic surgeon with a special interest in cosmetic and reconstructive breast surgery and body contouring. He has a busy NHS practice largely dedicated to breast reconstruction and is one of the few surgeons in the region trained to perform microsurgical DIEP flaps, which are widely regarded as the gold standard in breast reconstruction in selected patients. He is a full member of BAPRAS and BAAPS. He is one of a select group of plastic surgeons invited to be in the safer cosmetic surgery group and is a founder member of VIP Cosmetic Surgery

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