Q: I am thinking of breast implants. What should I ask a potential surgeon to be safe and avoid a PIP disaster?
Mr Fazel Fatah, former President of the British Association of Aesthetic and Plastic Surgeons (BAAPS) on questions to ask before you have implants.
What brand? Safest include Allergan, Mentor, Nagor or Sillimed and any manufacturer should have at least 10 implant types – including circular and ‘anatomical’ – you can ask to see and feel. Check they’ve been around for at least 20 – ideally 30 – years,’ says Mr Fatah. ‘They should contain medical grade silicone. ‘Saline implants are rarely used in the UK as their rupture risk is high and they can become rippled-looking over time’ he says.
Is there a warranty? Some provide a lifetime warranty against rupture and/or ‘capsular contracture’. The latter is implant hardening in six-17 per cent of cases causing inflammation and pain (the first sign is a change in implant feel from supple to firmer in parts). Rupture is normal in 1 or 2 per cent of cases (up to seven per cent for PIP) and won’t cause symptoms where medical grade silicone is used (PIP implants contain industrial grade silicon) – but if you have any unusual symptoms such as swelling, pain or shape changes tell your surgeon immediately.
Are they going to be under or above the muscle? ‘Thin women with little fatty tissue and those that do lots of exercise are best with implants under the muscle. One is no riskier than the other,’ says Fatah.
What exactly are the risks? Infection, bleeding or clotting can occur in around 1-5 per cent of cases so you should get a mobile number to report problems. But as some surgeons travel from abroad you may be left to the NHS so make sure the surgeon lives in the vicinity and is around 24/7 to take care of any surgical complications at no cost.
What training have you had? Anyone can perform cosmetic surgery in the UK. Ask for their surgical training with any of the royal colleges in Britain and look for FRCS after their name. Log on to the General Medical Council on gmc-uk.org and check they’re on the specialist register as a plastic, ear, nose and throat, maxillofacial or ophthalmic surgeon. Check they’re also a member of BAAPS (baaps.org.uk) or the British Association of Plastic, Reconstructive and Aesthetic Surgery (bapras.org.uk).
What’s included in this price? Cost shouldn’t be too cheap or expensive – from £4-5500 – (any more will mean it’s inflated) and include fees for surgeon, clinic, anaesthetist and hospital depending whether you have an overnight stay from a general anaesthetic or go home the same day (breast surgery is often now done same-day under local anaesthetic with sedation). You should get three follow-up appointments, one a week, another about eight weeks from the surgery and a last a year afterwards included and your doctor needs to be around to call if anything goes wrong.
Can I breastfeed? ‘If you could breastfeed before, you’ll be able to breastfeed after your op and large scale studies show breast milk from implanted breasts won’t harm your baby,’ says Fatah.
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