What is breast augmentation?

Surgery to increase the size of the breasts.

What does breast augmentation do?

• Upper body

  Increases breast size

Who can have breast augmentation?

• There is no legal age limit, but most surgeons will not operate on young people under 18

How long does breast augmentation last?

Some surgeons recommend replacing breast implants every 10-15 years. Complications may sometimes require removing and replacing the implant earlier than this.

How do I stay safe?

You should be aware that while the current evidence suggests that breast augmentation does not increase the risk of breast cancer, it can make breast screening more difficult 1, p.196, and you may have to attend a hospital imaging department instead of a mobile breast screening clinic 2, p.258.

To ensure you are receiving the safest possible treatment, you should follow this advice from the Care Quality Commission on how to choose cosmetic surgery.

What should I be aware of?

Common side effects of breast augmentation are capsular contraction (the body forming a tough shell around the implant which shrinks, often causing pain or change in shape of the breast), infections, and loss of sensitivity in the nipple area 3.

There is a significant risk of complications that require additional surgeries. The risk of additional operations being needed has been estimated by a UK surgeon as 1% a year, with about 10% of patients needing a new operation within ten years 2, p.259, though studies in other countries have reported 30% of patients requiring more surgery within six years 4. Some UK surgeons recommend that implants are replaced every 10-15 years for safety even if complications have not occurred 5. As implants can leak or rupture as time passes, you will need to be prepared for the financial cost of future operations, not just the initial breast augmentation 2, p.260.

For your safety, it is wise to read the advice on choosing who will do the procedure found on the NHS website.

Are there other options?

Alternatives for increasing breast size that do not need surgery include oestrogen therapy, bra inserts, and weight gain.

What kinds are there?

The most common method of breast augmentation is using implants, though some alternatives exist including fat transplantation from another part of the body 6.

There a number of ways of performing breast augmentation using implants, with different advantages and disadvantages, some of which may be appropriate for you. You should research the differences in:

• surgical approach: inframammary, periareolar, transaxillary, or umbilical incision
• implant position: submuscular or subglandular
• implant composition: saline or silicone gel
• implant shells: smooth or textured surface
• implant shape: round or anatomical (teardrop)

There is detailed information on the NHS website which can help you understand these choices.

How do I get ready for surgery?

Doing some preparation in advance can help make sure everything goes smoothly during your hospital stay and recovery. To help you avoid forgetting to do or buy something we have created a Getting ready for gender surgeries page.

How much will it cost?

It is possible to apply for funding for augmentation through exceptional funding processes within the NHS, but breast augmentation is not normally funded by the NHS, regardless of whether a diagnosis of gender dysphoria has been given.

In the event that you believe an exception to the funding rules should be made in your case, the following documents give information about to apply for this:

• England: Interim Commissioning Policy: Individual funding requests
• Scotland: Adult Exceptional Aesthetic Referral Protocol
• Wales: Patient guide to Individual Patient Funding Requests (IPFR)
• Northern Ireland: Individual Funding Requests

Where can I learn more?

You can read more about breast augmentation on the NHS website.

References

1. 1.
   Murjan, Sarah and T’Sjoen, Guy (2017) “Access to Clinical Services and the Role of Primary Care,” in Bouman, W. P. and Arcelus, J. (eds.), The Transgender Handbook: A Guide for Transgender People, Their Families and Professionals, Nova Science Publishers Inc, pp. 189–200. Link
2. 2.
   Yelland, Andrew (2017) “Chest Surgery and Breast Augmentation Surgery,” in Bouman, W. P. and Arcelus, J. (eds.), The Transgender Handbook: A Guide for Transgender People, Their Families and Professionals, Nova Science Publishers Inc, pp. 251–264. Link
3. 3.
   Palma, Adrian Fernando, Zuk, Grzegorz, Raptis, Dimitri Aristotle, Franck, Sophia, et al. (2016) “Quality of information for women seeking breast augmentation in the Internet.” Journal of plastic surgery and hand surgery, 50(5), pp. 262–271. Link
4. 4.
   Forster, Natasha A, Künzi, Walter and Giovanoli, Pietro (2013) “The reoperation cascade after breast augmentation with implants: what the patient needs to know.” Journal of Plastic, Reconstructive & Aesthetic Surgery, 66(3), pp. 313–322. Link
5. 5.
   Davies, Dai M and Stephenson, AJ (2007) “Breasts,” in Barrett, J. (ed.), Transsexual and other disorders of gender identity: A practical guide to management, Radcliffe Publishing, pp. 201–207. Link
6. 6.
   Largo, Rene D, Tchang, Laurent AH, Mele, Valentina, Scherberich, Arnaud, et al. (2014) “Efficacy, safety and complications of autologous fat grafting to healthy breast tissue: a systematic review.” Journal of Plastic, Reconstructive & Aesthetic Surgery, 67(4), pp. 437–448. Link

Acknowledgements

This page is illustrated using a photograph by Павел Сорокин available at Pexels.

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