Are You Abreast With the Situation?There were more than 6,000 operations done in Britain in 2006 and around 330,000 in America. The average cost is £4000.

It seems the desire for this particular procedure is far greater than for nose adjustments or liposuction. The technical terms applied are breast augmentation, breast enlargement, mammoplasty enlargement or augmentation mammoplasty. But to most of us it is the plain old boob job.

Implants following breast cancer treatment where the breast can be reconstructed make up 20% of procedures. The remaining 80% of treatments are for personal or cosmetic reasons.

In 2007 the First International Conference on breast enlargement was held in London, attended by over 200 plastic surgeons. Topics included the ideal shape and opinion was that Caprice Bourret had the perfect pair but Victoria Beckham’s were too round!

But, this is not a modern day phenomena; in 1895 Vincenz Czerny, an Austrian-German surgeon, attempted the world’s first recorded breast implant using a benign growth on a woman’s back.

Then there was Gersuny, who in 1889 tried paraffin injections! Surgeons were trying anything: ivory, glass balls, ox cartilage, terylene wool and a host of other bazaar ingredients.

But from 1945 things improved when Berson, an American physician, and later in 1950, Maliniac, carried out an operation that involved rotating a woman’s chest wall into her breast to give it more volume.

The 1950’s and 60’s saw the first use of silicone injections and 50,000 women were treated. But for some the breast tissue became so hard that they ended up having mastectomies.

The major breakthrough came in 1962 when plastic surgeons in America, Dr’s Gerow and Cronin encased the silicone in a bag.

The first woman to have a silicone implant was a Texan housewife called Timmie Jean Lindsey. Pleased with the initial result, the implant began to harden 10 years later. But Timmie decided against further surgery.

The original design of the implants was silicone filler and a thick outer shell but as they evolved the shell was made of a thin elastic called elastomer, filled with a saline solution.

There are also different surface textures; smooth with a thinner shell wall that lasts longer but may move; or a textured surface that will stay put and is thought to reduce the risk of capsular contracture.

Silicone gel filled implantsThen there’s the shape of the implant: round ones are cheaper than anatomical or tear drop, the latter having more of a natural shape.

So having decided on the shape, texture and content, you then have to think about the position of the implant. It can be put between the breast and the chest muscle, this is called sub glandular placement. The recovery time is shorter and less painful and any future operations are easier, but the downside is there is a higher risk of the implant hardening and deforming.

Alternatively, it can go behind the chest muscle and that is submuscular placement. The recovery period is longer but it has a better appearance.

Finally there is the surgery itself. There are three types of incision: periareolar – this is an incision around the nipple area and leaves less of a scar; inframammory – where they make a small cut under each breast; and thirdlyaxillary – a cut is made in the armpit area. There is also a fairly new technique called endoscopically-assisted augmentation where a small camera guides the surgeon to position the implant and it leaves very little scaring.

The operation itself takes up to 2 hours to perform and you can usually leave hospital within a couple of days and it is generally three or four weeks later that the soreness subsides.

Once it’s all over and you can admire your new appendages, what dangers lie ahead?

The implant will not last forever, silicone filled implants have an average life span of 18 years and saline implants up to 14 years. So replacement is inevitable. There is also a possibility of capsular contracture – where the naturally formed scar tissue around the implant shrinks. This will cause the implant to harden and possibly deform. It is estimated that around 1 in 10 women need further surgery due to this problem.

Rupture – where the implant splits or tears. The danger here is that the contents of the implant will enter into the breast creating small lumps called siliconomas. Or worse still, the silicone could enter other parts of the body.

Infection – if blood or watery fluids build up around the site and there is too much for the body to absorb, then this would have to be surgically drained.

The industry is regulated by the Medical Devices Directive and safety is closely scrutinised by an Independent Review Group. A Government agency, the Medicines and Healthcare products Regulatory Agency (MHRA) offer various guides on the subject.

I tried to find out some statistics for plastic surgery and surgeons specifically relating to implants, but it proved to be virtually impossible. From the General Medical Council, through to the Department of Health information centre, with every other medical concern imbetween, I was unable to find out just how many plastic surgeons are practicing breast implants in the UK. The NHS has just over 800 plastic surgeons registered, but it seems we not only have the problem of NHS surgeons doing private jobs, but there are surgeons doing the work who are not registered with the NHS or any other recognised medical organisation and they may or may not be fully qualified to do the work.

There are some organisations that offer various levels of service, for instance First Cosmetics offer a chauffeur service so you can be collected from your home and delivered back safely after the operation. They also offer flexible finance plans.

But if the thought of going under the surgeon’s knife is too frightening, there are quite a few less invasive treatments. Organically grown herbal remedies or in-vivo tissue engineering are two alternatives.

It seems the procedure is increasing in popularity and with so many celebrities having the work done, it is not surprising that many are seduced by the apparent results; and why shouldn’t you? If you have the resources and you dislike your appearance to the point of wanting to hide it, what could be better for your low self esteem and to boost your confidence than improving your shape? The question is, are you prepared to deal with the consequences?

Are You Abreast With The Situation?

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