Breast enhancement: What really happens during a breast augmentation operation

A step-by-step guide to breast augmentation (or enlargement): the most popular cosmetic surgery carried out in the UK.

Thousands of women every year are delighted with the results of their surgery. However, the prospect of any surgical procedure can be daunting, especially if you don’t know what to expect.

We asked Mr Marc Pacifico, a Consultant Plastic Surgeon who works at Nuffield Health Tunbridge Wells Hospital, to explain everything you need to know about what a typical procedure involves, from the moment you arrive at the hospital until you go home again.

What happens when you are admitted?

On arrival at the hospital you will see three types of medical specialists. These are the nurses who will admit you and perform health checks, then your anaesthetist, who will put you to sleep during your operation and most importantly, your surgeon.

The role of the surgeon at this stage is to ensure you fully understand the procedure, and to get your formal consent. Like most surgeons, I then make some important drawings on my patients. Using a special pen, I mark where I will make any incisions, where the implant will sit and the midline between the breasts. I also write notes, such as the exact size of the implant that’s been agreed on. It's important to do this before surgery, as when a patient is anaesthetised and lying down, things look very different to when they are sitting or standing upright. I also take a photograph at this stage, to refer to in surgery.

After this is done, you will be brought down to the anaesthetic room. You may have a drip put in, and given some oxygen and gas via a mask, plus an injection in your hand or arm which together will ensure you drift off to sleep.

What happens in the operating theatre?

First, the whole chest area is sterilised with an antiseptic solution that’s painted on like a t-shirt. Then sterile drapes are placed over your body so only the area that's being operated on is visible.

To place the implant, normally I will cut at the breast crease to create a space for the implant to fit into. The placement of the incision may vary, and you should discuss it with your surgeon beforehand. Sometimes the pocket created will be in front of the chest muscle, and sometimes partially behind it.

The implant is then washed in a solution to sterilise it, and I also use an antibiotic solution which limits the risk of infection. The sterile implant is then pushed into the space made for it. When I am completely satisfied the implant looks right and the result is what the patient described, I will stitch the internal tissues together with dissolvable thread. These are the really important stitches that hold everything in place. The skin is then closed with further superficial, dissolvable stitches, which are then covered with surgical glue and a simple dressing. I normally just apply some surgical tape over the incision. I normally put my patients into their surgical bra at this point. Other surgeons prefer to bandage the area. Either is normal, so discuss what your surgeon thinks is right for you.

This process takes between 45 and 90 minutes, depending on the complexity of the operation.

What happens in recovery?

You will wake up in a recovery room. You may feel pretty groggy, and you might be uncomfortable; but you shouldn’t experience pain. You will probably be sore if you’ve had a large implant placed under the muscle. Some people experience nausea as a reaction to anaesthetic.

You will either be wearing your bra or bandaged, so you won’t see your final result, the incision or any stitches at this point.

You should be able to eat a meal around two hours after your surgery, and if your surgery was in the morning, my patients usually go home the same day. If your operation was later in the day, you may stay in hospital for one night. Again, your surgeon will advise you.

What happens after you leave hospital?

If you are experiencing any discomfort, you will normally only need to take over the counter painkillers in the first days after you leave hospital.

Dressings will stay on for two weeks, and during this time you should avoid strenuous activity. After a fortnight, you will have a follow up appointment, all your stitches will have dissolved, and you will be able to see your new breasts.

After your operation you may expect to experience a little discomfort and swelling, but if you suffer severe pain, bleeding, a high temperature or feel unwell, you should call your surgeon and go back to the hospital. If your surgery is at Nuffield Health, there are no time limits on your aftercare, in line with the Nuffield Health Promise (terms and conditions apply).

The best way to ensure your operation goes smoothly and safely, and that you love the result, is to do your research and find a fully qualified, experienced and insured plastic surgeon who works in a reputable hospital.

Last updated Wednesday 31 May 2017

First published on Monday 24 August 2015