BREAST ENLARGEMENT SURGERY

What is ‘breast augmentation’ surgery?

Breast augmentation is the medical name for a ‘boob job’. It means increasing the size of the breasts with a medical implant. This implant is usually made of silicone and is inserted into the breast via an incision in the crease underneath the breasts. These implants are a silicone rubber shell filled with silicone gel or saline solution. The insertion and type of implant will depend on Patient's body type, personal preference and Patient's surgeon’s advice. Patient will be given a general anaesthetic and the implants will be inserted via the incisions made in the creases underneath the breasts. Other options include the armpits or near the areola (the circular area around the nipple). Patient's surgeon will then close the incisions with ordinary or dissolvable stitches. These are then taped for extra support and a light bandage will be applied. Patient will experience some bruising and soreness after the surgery. This is completely normal and Patient will be given medication to control any pain. Patient are looking at one to two weeks recovery time (approx.)

Who is the right candidate for breast enlargement surgery?

If Patient consider Patient's breasts to be too small and would like to increase their size then this procedure is suitable for Patient. Many women feel less than feminine as a result of having small breasts. If a woman is looking to have a baby and breastfeed this baby then bigger breasts are better although they will increase in size during pregnancy. But, what can happen is that the breasts lose size after pregnancy. If so then a ‘boob job’ can return them to their original size. Another reason is when one breast is larger than another: this surgery can ensure an even balance in breast size. And, breast augmentation can be used as a reconstructive technique if the patient has undergone another type of surgery. Some women want a more Patientthful appearance or to increase their confidence and bigger breasts may help to do that. Ideally, if Patient are aged 18 or over, in good health, not currently pregnant and are realistic about this surgery then Patient will be considered suitable for surgery.

Who is not suitable for breast enlargement surgery?

Many surgeons won’t operate on anyone aged fewer than 16 as their bodies are still developing. If Patient are under 16 then a surgeon will ask Patient to wait until Patient have stopped growing before seeking surgery. All girls develop at different rates throughout puberty and some will develop bigger breasts before others. If Patient are hoping to look like a well known celebrity or model, or achieve a ‘perfect body’ then Patient are likely to be disappointed. A surgeon will try to achieve the very best result for Patient but Patient must be realistic about what he/she can achieve. If Patient do not have realistic expectations then a surgeon may be reluctant to go ahead.

Are there any reasons why a lady shouldn’t have breast enlargement surgery?

Patient may find that a non-surgical approach is better for Patient. Some women would like to have bigger breasts but without undergoing surgery. If so then there are several options open to Patient. These include:

• Breast Feather Lift
• Brava Breast Enlargement Shaping System
• Breast Pumps
• Caci Bust Treatment
• Microlane

Breast Feather Lift: this treatment is best suited to those women who have sagging breasts. It involves using special ‘threads’ which are inserted under the skin of the breasts using a syringe. This means no big incision wounds and tiny exit wounds that heal quickly. These threads are activated and so pull the skin which causes any excess skin to tighten and lift. This procedure means no scarring and these threads are practically invisible under the skin.

Brava Breast Enlargement Shaping System: this is the name of a specialist tissue expansion system. It involves placing tension on the breasts which stimulates the growth of new breast tissue and so increases their size. It takes the form of two semi-rigid domes which are worn over the breasts. These domes then exert a downwards pressure on the breasts. This tension is controlled via a computerized ‘smartbox’ which contains a sensor responsible for the level of tension. It also contains a small pump which removes air from the domes which cause them to act as a vacuum. These domes fit tightly onto the breasts and pull down on them. This tension triggers the growth of new breast tissue.

Breast Pumps: these are a natural form of breast enlargement. They are small, hand held pumps which are often used by women who are breastfeeding. They work by creating a vacuum around the breast that pulls fluids into the breast tissue. This causes the breasts to increase in size. However, the pump needs to be used on a regular basis or the breasts will return to their normal size. These pumps come in manual and battery operated versions.

Caci Bust Treatment: this treatment helps to lift tone and firm the muscles around the breasts. It involves using an electronic hand held device which is placed against the skin. This device emits electrical currents which cause the muscles to tighten and tone.

Microlane: the Microlane TM breast enlargement system is based upon using a special gel which is injected into the breasts. This gel sits beneath the breast tissue and can be moulded into shape. This gel adds volume to the breasts and results in a natural looking appearance.

How much does breast enlargement cost?

Prices for cosmetic surgery vary as different hospitals/clinics and surgeons will set different prices. It is a good idea to obtain a series of quotes from different surgeons and compare these. Do not be guided by price though: reputation, experience and track record are much more important than getting the cheapest deal. As a rough guide Patient can expect to pay between $5,000 and $7,000 for breast augmentation surgery.

How one can get breast enlargement surgery abroad?

There is the option to travel abroad for surgery. It is often cheaper than here plus there is the chance to have a short holiday as well. Sounds great doesn’t it? We would recommend that Patient do Patient's homework very carefully if Patient are thinking about this. Do Patient's research, read up about the procedure and choose Patient's surgeon carefully. Make sure that the price includes all the things Patient would get here such as 24 hour access to the surgeon and his/her team, aftercare etc. A cheaper deal may seem attractive but if Patient then find out that Patient have to pay for these as ‘optional extras’ then it is likely to be anything but cheap!

One major issue is that of aftercare: this can involve follow up checkups as well as being able to see Patient's surgeon if something goes wrong. Now, if that happens here in India then Patient are a lot nearer to Patient's surgeon than if Patient’ve had surgery in South Africa. Are Patient prepared to pay for another flight to return to that clinic? Aftercare is very important: ideally, Patient's surgery abroad should include a suitable length of stay which will ensure that any complications can be dealt and that Patient get enough of a rest before flying home. Some providers offer a holiday package as well which means that Patient can have a short break after Patient's surgery. They should provide Patient with instructions on what to do following Patient's surgery and contact details. These will be a telephone number and an email address. An ideal situation is one in which the follow up visits take place as soon as possible. There should be several of these to ensure that things are progressing well. Patient could always find a clinic or surgeon who provides the consultation and follow up visits. Patient need to compare the standards of treatment and care with those in India. Make sure that these are as good as what Patient would get in India. Think about the language barrier as well. If Patient are going to a country where English is spoken freely then this is not a problem but could be if Patient are in a clinic where no-one speaks English.

If a lady interested in breast enlargement surgery what does she do next?

As this is such a major decision then it’s best to be as fully informed about it as Patient can. Do plenty of reading about the procedure, talk to other people who have had this surgery and research this as much as possible. If Patient are looking on the Internet then stick to information from hospitals, universities and respected health care providers. And, be honest with yourself about wanting breast augmentation surgery. Make sure Patient are doing it for yourself and not to please someone else. If Patient are going through any crises or upheavals in Patient's life then it may be better to wait until things have calmed down. It is also a good idea to talk to Patient's GP. Patient's GP will be non-judgmental about Patient's reasons for cosmetic surgery and will be able to advise Patient. He/she will be able to recommend a cosmetic surgeon and private clinics/hospitals. He/she will also provide a referral letter if needed. Even if Patient opt for surgery it is still a good idea to mention this to Patient's GP so that he/she is kept up to date with Patient's surgery. If complications do arise then he/she will be able to deal with them. The next step is finding a reputable surgeon. This means ‘shopping around’ to find the best deal for Patient. By this we mean a surgeon who understands Patient's reasons for this surgery and is prepared to talk this through with Patient. He/she will discuss the risks as well as the benefits of the surgery and what Patient can expect. He/she will also be able to provide Patient with an exact quote for Patient's procedure. It is a good idea to speak to several surgeons until Patient find the one Patient like, trust and at that right price. Price is important but is not the main factor here. Breast augmentation is a major surgical procedure and Patient want to be sure that Patient's surgeon is the best person for the job.

How does a lady find a reputable breast enlargement surgeon?

This is the most important part of the process. If things go wrong then it is usually down to inexperienced or under qualified surgeons. So, it is worth spending some time finding a few ‘possible’ before deciding upon the right surgeon for Patient. There are a variety of ways in which Patient can find a surgeon. Patient can ask people who have had this surgery to recommend a surgeon. He/she will be able to recommend a surgeon or refer Patient to a reputable surgeon.

Patient can find information about clinics and surgeons from the Internet. If Patient decide to seek treatment abroad then the same rules apply. Choose Patient's surgeon carefully as he/she is not readily available for follow up visits or if something goes wrong.

What questions should a lady ask her breast enlargement surgeon at the consultation?

Patient need to go prepared for Patient's consultation. It is a good idea to have a list of questions written down beforehand. Ask as many questions as Patient need to. If there is a question Patient don’t understand then ask Patient's surgeon to explain it until Patient do. It is important that Patient fully understand what this procedure is, what it involves, the benefits and risks, aftercare and the results. If Patient's surgeon or clinic appears to be giving Patient ‘the hard sell’ or trying to persuade Patient to have additional surgery then go somewhere else. If they employ ‘pushy’ or aggressive tactics to get Patient to sign up for surgery then again, find someone else. It is important that Patient feel comfortable with Patient's surgeon and that Patient like him/her. Trust Patient's instincts. If something doesn’t feel right or Patient's surgeon is evasive then walk away. Patient may find that Patient are offered a free consultation. Make sure that there are no hidden costs with this. Patient should see the person who is going to perform Patient's surgery, not a nurse or counselor.

Here is a suggested list of questions to ask Patient's surgeon about breast augmentation surgery:

• How long does the surgery take?
• What does breast augmentation surgery involve?
• How long will I be off work?
• How long will the recovery take?
• Is breast augmentation surgery painful?
• What are the implants made of?
• What are the benefits of breast augmentation surgery?
• What are the risks of breast augmentation surgery?
• How long do breast implants last for?
• Is there a risk of the implants splitting or leaking?
• How long will it be before I can resume my everyday activities?
• What aftercare do I get following breast augmentation surgery?
• What can I expect from breast augmentation surgery?
• Can I breastfeed after breast augmentation surgery?
• How much pain and scarring will there be?
• Will this procedure have to be repeated again in the future?
• How much does breast augmentation cost?
• Will I have to wear a special bra after breast augmentation surgery?
• Will I lose any sensation in my nipples after breast augmentation surgery?
• If something goes wrong can I contact Patient?

Ask to see any ‘before’ and ‘after’ photographs so Patient get an idea of what the results of the surgery will be like. Also, make sure that Patient are happy for Patient's surgeon to show these types of photographs of Patient to other prospective patients. This also applies to Patient's records. For Patient's part Patient need to be realistic about what can be achieved. Breast augmentation can give great results but Patient need to keep these results in perspective.

When a lady decides to go ahead with breast enlargement surgery so what will be next?

If Patient are satisfied with everything discussed in this consultation then Patient can go ahead. However, most surgeons will recommend that Patient take a couple of weeks to think about it before making a final decision. At the end of the day it is Patient's decision, so take Patient's time over this. Remember, Patient can change Patient's mind at any time, even up to the day of the surgery itself. Main point is that Patient should obtain maximum information. If Patient are ready to go ahead then Patient will have a detailed discussion with Patient's surgeon about the breast augmentation procedure. He/she will run through everything about this surgery, and what Patient will need to do before and after the surgery. Patient's surgeon will then take a full medical history. Cosmetic surgery works best for those patients who are in good health so ensure that Patient are in the best shape Patient can be for Patient's surgery. If Patient are taking any medication or have any allergies then mention these. This is very important as failure to do so could result in complications. Patient may think that mentioning these could rule Patient out from surgery but that is not always the case. Patient must be honest about Patient's health and mention any past or current medical conditions. If Patient have had surgery before then also mention this. Patient's surgeon is concerned with Patient's wellbeing and it is important that he/she has all the information he/she needs about Patient. If Patient have given Patient's permission then Patient's surgeon will take a series of ‘before’ photographs. These will be compared with photographs taken after Patient's surgery. Patient will then be asked to sign consent forms which gives Patient permission for the surgery to take place. Patient's surgeon may write to Patient's GP informing him of Patient's surgery.

Patient will also be given advice on how to prepare for Patient's surgery.

How does a lady prepare for her breast enlargement surgery?

This will take the form of a set of guidelines. For example, if Patient are a smoker then Patient will be advised to give this up before Patient's surgery. Smoking can affect the healing process as well as causing the formation of unsightly scars. What it does is to delay the healing process which, in effect, means that Patient's scars will take longer to heal. Ideally, Patient's surgeon would prefer Patient to give up completely but if not Patient must stop smoking at least two weeks before Patient's surgery. And do not start smoking again until at least two weeks after Patient's surgery. If Patient are carrying extra weight then it may be a good idea to try and lose some of that weight before surgery. Excess weight can increase the risks of complications during surgery. If Patient are taking any medications then check with Patient's GP about whether Patient should continue these before surgery. Patient may have to stop taking them a certain number of weeks before Patient's surgery. Other drugs include sleeping pills and aspirin. Again, check with Patient's GP or surgeon. If Patient are taking nutritional supplements such as vitamin/mineral supplements then Patient will be asked to stop taking these. There is the risk of these reacting with the drugs Patient will be given during or after the surgery. They may also react with general anaesthesia. Breast augmentation surgery means Patient will have to take a couple of days off work, maybe more so this is the time to arrange that with Patient's employer. It is also a good idea to arrange for someone to drive Patient home after Patient's surgery. Patient will have to rest for a few days following surgery so ask someone to help Patient with everyday tasks such as shopping and housework. Patient will have been given instructions about what to eat and drink before Patient's surgery. Patient should have Patient's last meal 6 hours before surgery. So, if Patient's surgery is scheduled for the morning, make sure Patient do not eat or drink anything after midnight. The day before surgery, pack a small case or bag with nightclothes and Patient's toiletries. Also include the clothes Patient will be wearing on the day of Patient's discharge. Remember to include any medications Patient might need. Throw in a couple of books and/or an iPod as well. Leave jewellery and any other valuables at home at the hospital/clinic cannot be held responsible for their safety.

What will happen on the day of breast enlargement surgery?

Have a shower before Patient leave but do not apply any skin creams or lotions. Patient will arrive at the clinic or hospital where Patient will have to complete some forms as part of the admissions process. This is routine procedure. Patient will then be shown to Patient's room. A nurse will visit Patient and will perform a series of pre-operative checks. These include taking blood and urine samples and checking Patient's blood pressure. Patient will also be given a pair of compression stockings to wear. These help to prevent the buildup of blood clots which can cause DVT (Deep Vein Thrombosis). Patient may also be given an injection of a blood thinning drug. This drug, called Heparin, will thin the blood to prevent the formation of blood clots. Patient will be visited by Patient's surgeon and the anaesthetist. This is to check that everything is okay and to answer any last minute questions Patient may have. Patient will, understandably, be nervous at this time and they will do everything they can to reassure Patient.

Note: Patient can still change Patient's mind – even at this point. Patient will be asked to remove any make up and to change into a theatre gown.

This procedure usually requires an overnight stay although it can be performed as day surgery in a few cases.

What is the breast enlargement procedure?

The procedure itself takes around 1.5 to 2 hours to complete and is usually performed under a general anaesthetic. There are two techniques used in respect of the positioning of the breast implants. These are:

• Subglandular
• Submuscular

Subglandular: the implants are placed above the major muscle of the chest. The advantages of this are less post-surgery pain, quicker healing and a better anatomical position for enlarging the breasts. The disadvantages are increased risk of capsular contracture, increased visibility and palpitation and problematic for mammography.

Submuscular: in this procedure the implants are inserted above the major muscle of the chest. The advantages of this are fewer risks of capsular contracture, easier for mammography, deeper placement and less visibility. The disadvantages are longer recovery time, more post-operative pain and worse results for athletic women. Patient's surgeon will make an incision either underneath the natural ‘crease’ beneath the breast or via the armpit or around the edge of the areola. Patient's surgeon has a choice of four incisions:

• Axillary
• Inframammary
• Periareolar
• Umbilical

Axillary: this incision is made in the site of the armpit.

Inframammary: this is the most popular incision. It is made in the crease beneath the breast.

Periareolar: the second most popular incision. It is made in the areola (the circular area surrounding the nipple). This incision is most likely to cause reduced nipple sensation.

Umbilical: this incision is made in the belly button. However, it is very difficult to place the implants below the chest muscle. The breast implants are silicone rubber shells which are filled with medical grade silicone gel or saline solution. Patient's surgeon will then insert the implants through one of these incisions. If Patient have chosen to have the incision through the armpit then he/she will use an endoscope to do this. He/she will also ensure the implant is positioned either subglandular or submuscular – again, this is a matter of individual choice. Patient's choice of technique and incision is based upon personal preference, current breast size, body type and Patient's surgeon’s advice. Once inserted, the incisions are closed with a series of stitches. These are either the removable or dissolvable type. Patient's surgeon will then place a light, supportive dressing over the chest area. This bandage must be kept dry for up to two weeks following surgery. After that time it will be removed so that the incision can be inspected and cleaned.

What will happen after breast enlargement surgery?

Following surgery Patient will be taken to the recovery area where nurses will monitor Patient's progress. This means checking Patient's blood pressure, heart rate and other vital signs. Once they are happy with Patient's progress then Patient will be taken back to Patient's room. Once there a nurse will check Patient's progress again and will look at the operation wound. Patient will be bruised and sore but don’t worry, this is entirely normal and Patient will be given painkillers to control this. Patient will have special compression pads placed on Patient's legs which are designed to prevent the build of blood clots. Periods of inactivity, such as surgery can increase the risk of DVT and this will help to prevent that. Patient may also be given another injection of Heparin. Patient will be encouraged to get up and move around as soon as Patient can. Surgical drains may still be in place: these are a temporary measure only and will help to drain off any excess fluids. Once Patient's surgeon and his/her team are satisfied with Patient's progress Patient will then be discharged. Patient will be given a set of post-surgery instructions and an appointment for Patient's first follow up visit. Patient will also be given a supply of painkillers to take home with Patient. Patient's breasts will be very firm, high and swollen but this will ease over time. As the swelling eases they will become lower and softer. It can take up to a year before the implants settle properly into place. Patient may find it helps applying ice packs to the swollen areas which will reduce the swelling. Having an anaesthetic can make Patient feel nauseous and drowsy. This will pass but do not drive, perform any task which requires concentration or take any sleeping tablets for 48 hours following surgery.

What does recovery from with breast enlargement surgery involve?

When Patient arrive home Patient will still be a bit ‘woozy’: make sure Patient rest and take things easy. Watch television, read or listen to music. Make sure Patient have an ample supply of painkillers to hand. Do not attempt to do any of Patient's normal everyday jobs such as shopping, cleaning, washing etc. Patient will not be able to do anything strenuous during this time so ensure that Patient have someone who can.

Here is a list of things to have ready for when Patient arrive home:

• It is a good idea to have prepared a ‘To Do’ list beforehand.
• Have plenty of pillows and blankets to hand.
• Avoid sleeping on Patient's stomach for a couple of weeks.
• Make sure Patient have all Patient's medications and painkillers to hand. And, that Patient have enough of them.
• Loose, comfortable clothes such as baggy tops, jogging bottoms etc.
• Prepared or microwave meals. If Patient have someone who can cook for Patient that’s fine, if not ensure that Patient have ready prepared meals to hand. However, ensure that Patient do get plenty of fresh fruit and vegetables as the vitamins from these will help speed up Patient's recovery.
• Wear a comfortable, sports bra that fastens up at the front.
• Make sure any important jobs such as paying bills, feeding pets, picking children up etc are given to someone else to do. If Patient have a partner then they can take care of this for Patient.
• Avoid any unnecessary bending or lifting. Make sure that any items Patient will need are placed at eye level. Patient do not want to have to bend or stretch to reach anything.
• Keep a small table or chair by Patient's bed with Patient's medications, bottled water, books, phone and the TV remote control to hand.
• Avoid touching the incisions. Make sure that any deodorants do not come into contact with the incisions.
• Keep the incisions clean but do not fully submerge them via a bath or a swimming pool until they have completely healed.

The main thing here is to ensure that Patient get plenty of rest and let Patient's body heal. If Patient have a desk job Patient will be able to return to work after a couple of days. Everyone is different in this aspect: some people may need longer whereas others need less time off. If Patient do a job which involves physical activity then gives yourself a couple of weeks before returning to Patient's normal workload. In regard to recovery, Patient are looking at one to two weeks. And up to six weeks for a complete recovery. Patient's surgical scars will take up to seven months to fully heal. It is normal to feel a bit down after surgery. This can be a reaction to the anticipation and nervousness common before surgery. Post-surgery depression can result from various factors such as adjusting to Patient's changed appearance, after effects of anaesthesia and the procedure, worries or feeling guilty about the cost, dealing with Patient's friends and family’s reactions and being confined to the house during the recovery period. The recovery time is Patient's ‘me time’: this is where Patient will need time to rest and adjust to Patient's changed state. Moral support from Patient's partner and family/friends is vital. Another good source of help is a patient’s support group. If Patient are feeling depressed following Patient's surgery then contacts Patient's surgeon.

What are the benefits of breast enlargement surgery?

The main benefits of breast augmentation surgery are feeling happier with Patient's appearance, improved self-confidence and well being. If Patient have this surgery done for reconstructive reasons then Patient will be satisfied with the result. It is often performed at the same time as breast uplift surgery. The decision to have this surgery is a highly personal one and all that matters are how Patient feel about the results. If the results match Patient's expectations then it has been a success. It can give Patient a Patientnger looking appearance but it is not a ‘fountain of Patientth’! As with any form of cosmetic surgery Patient need to have realistic expectations about what it can do.

What are the risks of breast enlargement surgery?

This is a relatively straightforward procedure. Patient's surgeon might have performed this surgery countless times. However, all surgery is risky and it is as well to be aware of these risks. Every cosmetic procedure will have complications which are specific to that procedure although they are rare.

The main risks of breast augmentation surgery are:

• Capsular Contracture
• Bleeding
• The implant clearly ripples or undulates
• Infection
• Haematoma
• Diminished or loss of nipple sensation
• Reaction to anaesthesia
• Implants break or leak
• Asymmetry
• Links to immune system disorders – still unproven
• May need to repeat this procedure

Some of these apply to all surgical procedures but the others relate to breast augmentation in particular.

Risks specific to breast augmentation:

Capsular Contracture: this is the name given to the most common complication that may arise. It is where the skin or capsule around the implant begins to harden or ‘contract’ hence the name. If this happens then the breast will feel hard to the touch. It can be painful or cause the breast to take on a misshapen appearance. If this happens then Patient's surgeon will prescribe anti-inflammatory medication to soften this hardening. If this fails then further surgery will be needed to free up the scar tissue. One way of preventing this is to massage the breasts on a regular basis. Another is using compression straps. The risks of this happening can increase over time so it is as well to be aware of this.

Bleeding: Any blood not drained away from the surgical site can collect in the pocket specially created for the implant. If it’s not attended to then it can cause the breast to swell and become painful. If this happens then Patient will require further surgery to stop this bleeding and remove the haematoma.

Diminished or loss of nipple sensation: Patient may notice a loss in nipple sensitivity. What can happen is that the nipples become either oversensitive or under sensitive. In a few rare cases the sensation is lost altogether. This may ease over time but can be permanent in a small minority of cases.

Infection: the implant can become infected. Symptoms of this include soreness and redness around the surgical wound. If this happens then the implant will need to be removed. This removal is only a temporary (6 weeks). Patient may be given antibiotics before and after surgery to prevent this from happening.

Asymmetry: this is where the breasts take on an uneven appearance. They may have been like that before the surgery. If this is hardly noticeable then Patient can live with it but if they are obviously uneven Patient may need further surgery to correct this.

Links to immune system disorders: there have been cases of women experiencing breast pain, join swelling, fever and fatigue following this surgery. This may be related to problems with the immune system but there is no evidence to show that it is linked to breast augmentation.

Implants break or leak: there have been cases where the implants have ruptured or leaked as a result of an injury or normal compression. If Patient have had a saline implant then the salt water solution will be flushed as normal out of the body. However, if Patient have the gel implant then gel may enter the surrounding tissue or scar. It might even travel to another part of the body. If this happens then the breast will change in shape and firmness. If either of these occurs then Patient will require further surgery to remove the damaged implant. Other problems include firming of the breast: this is where the breast hardens as a result of calcium deposits in the scar tissue. Another factor is capsular contracture.

Is there an ‘aftercare’ service for breast enlargement surgery?

Aftercare is an important part of the whole process. Do not feel that Patient's provider’s responsibility to Patient ends after Patient's surgery. Patient will require several follow up visits to check on Patient's progress. These will include regular mammograms to check that there are no problems with Patient's breasts. Complications are rare but they do happen and if they do then Patient will be able to contact Patient's surgeon immediately.

How long does breast enlargement surgery last?

Breast implants are safe and tend to last for around 15 to 20 years. However, they are subject to normal ‘wear and tear’, for example, from exercising which means that this figure can vary from one individual to the next. The most likely damage is tiny cracks in the outer shell of the implant. However the body protects the capsule by means of a natural ‘biological’ bag which forms a protective layer around the implant. This acts as a seal which can prevent any leakage from the implant travelling to other parts of the body. It is a good idea to have Patient's breast implants checked after 11 years to see if there are any signs of excessive wear and tear. A major worry for many women is the safety of silicone. Silicone gel is often preferred over saline as it gives a more natural shape. Plus it does not leak even if there has been a rupture of the implant. There have been worries about a link between cancer and breast implants but there is no concrete evidence to support this. Capsular contracture is a condition which can happen even years after Patient's surgery and may require further surgery. This would involve replacing the implants but this is unlikely to happen before five or ten years have passed.