Can breast implants ever look ‘real’?

Breast augmentation with implants is the UK’s most popular cosmetic surgery procedure and demand does not seem to be flagging. In February, the British Association of Aesthetic Plastic Surgeons (BAAPS), the UK’s leading plastic surgery association of which I’m a member, announced that breast augmentations were up 12 per cent on the previous year.

Demand is largely driven by two distinct groups of women; the first are younger, either in their late teens or early twenties, and they have usually always been dissatisfied with the size of their breasts. In rare cases, women can suffer from hypoplasia, where there is a significant underdevelopment or incomplete development of the glandular breast tissue.

How your breasts appear, once puberty has concluded, will not change until your body goes through a physical change such as pregnancy, breastfeeding or excessive weight gain and loss. The ageing process can also affect the breasts as skin loses its elasticity and begins to sag. This brings us to the second group of women; they have seen less than pleasing changes to breast shape and size and are keen to restore their previous contours.

One of the most frequently asked questions during my Leamington breast augmentation consultations, is concerned with the appearance of the breasts after surgery. The majority of woman that I see are keen for their breasts to look as natural and as ‘real’ as possible.

Before you arrive for your consultation, there are a number of questions you can ask yourself that will help you visualise your ideal breasts:

  1. How big would you like your breasts to be? Do not become fixated on a cup size, but visualise how large and full you would like them to be.
  2. What shape would you like?
  3. Where would you like your breasts to sit on the chest wall?
  4. How would you like your cleavage to appear? Although be aware, that this will largely be dictated by the underwear and clothes you wear.
  5. How pert would you like your breasts to be?
  6. Where would you like the nipples to be positioned?

Once we have discussed your hopes and expectations, I will perform a careful physical assessment, as there are certain physical factors that have to be taken into account, in terms of surgical planning, but that might also limit what is possible to achieve. This includes the amount of existing breast tissue, the size of your frame and chest wall and also the degree of ptosis or sagging of the skin and breast tissue.

Leamington breast implant surgeryOnce this has been taken into account, I can advise you which size, shape and projection of implant will best deliver the results you’re hoping for. Although there are many hundreds of variations of implant size and shape to choose from, you’ll find that only a very narrow choice will be appropriate.

The natural breast

Ideally, the breast will have a gentle slope, towards the nipple, with more volume in the lower half of the breast. The nipple will sit above the breast fold on the outer curve of the breast and the breast itself will be positioned approximately at the mid-level of the arm.

The ‘fake’ breast

This is generally a reflection of the use of an excessively large size of implant, which is not only out of harmony with the overall body frame and shape but is also too large in the upper part of the breast area, resulting in breasts which sit unnaturally high on the chest wall and appear very round with ‘bubbly’ cleavage. If too large an implant is used then it is more likely to be possible to detect the edges of the implant.

Luckily, this ‘Celebrity’ look is much less popular than it was. My aim is to produce a naturally beautiful enhancement of the breasts that should boost your confidence and self-esteem rather than just your cup size.

To arrange a breast augmentation consultation at my Warwickshire cosmetic surgery clinic, call 01926 436341 to speak to my secretary.

Fat or not? The difference between gynaecomastia and pseudogynaecomastia

Leamington gynaecomastiaSummer is finally here and for most of us it’s a chance to strip off the layers and enjoy the warmer weather. However, for many men the thought of revealing their chest in a tight T-shirt or baring their body round the pool or on the beach will leave them full of dread.

Gynaecomastia, also known as male breast enlargement, man boobs or moobs, is a very common condition and it is estimated that a third of men will be affected at some point in their lives. Whilst the male chest area begins to more closely resemble female breasts, the swollen appearance can be caused either by an excess of fat or tissue, or a combination of both.

‘True’ gynaecomastia results from an over-development of naturally occurring glandular breast tissue. ‘Psuedo’ gynaecomastia, on the other hand, is caused by excess fatty tissue or skin. Even if weight is lost, the skin easily become stretched and will not ‘snap’ back. So, how do you know which condition you have?

Understanding the causes of gynaecomastia

True gynaecomastia is usually caused by a hormonal imbalance; an increase in oestrogen levels or decrease in testosterone production can cause the tissue to overdevelop.

In some instances, it can be a combination of excess glandular tissue and fat, as being overweight can actually trigger true gynaecomastia as well as presenting as pseudo gynaecomastia; an enzyme that is found in adipose or fat tissue can convert androgens, the male sex hormone, into oestrogen, so an increase in adipose tissue as a result of obesity will stimulate production of this enzyme.

There are certain periods in life where hormonal changes can make you more susceptible to developing gynaecomastia. During adolescence, you will experience a number of testosterone surges and it’s estimated that over half of adolescents develop gynaecomastia, although the glandular tissue usually remains tender and will resolve after one or two years. The later years, as testosterone levels drop, is another vulnerable period and 70 per cent of men aged 50 to 60 have asymptomatic gynaecomastia.

Certain drugs can trigger gynaecomastia and account for a quarter of all cases, so if you’ve recently been prescribed medication, then see your GP and ask if it could possibly be a factor.

See a male breast reduction specialist

A plastic surgeon, experienced in body and breast surgery, is the appropriate specialist to see regarding your problem. At your consultation, they will perform an assessment of the chest area. In true gynaecomastia, there will be a mound of tissue that will feel firm when palpated. It is usually circular in shape and sits behind the nipple.

Pseudogynaecomastia will feel very different; there will be no discernable disc of tissue present and it usually doesn’t feel hard. When both excess glandular tissue and fat are present, which is often the case, careful planning is required to ensure that treatment deals with both factors.

If you are interested in discovering whether you’re suffering from true or pseudo gynaecomastia, please call 01926 436341 to book a consultation at Mr Richard Matthews’ Leamington cosmetic surgery clinic and he can offer expert and impartial advice on which surgical procedure will be most appropriate for you.

Rhinoplasty: it’s a balancing act

rhinoplasty to balance facial featuresThe Rhinoplasty operation, commonly known as a ‘nose job’, is one of the oldest performed cosmetic surgery procedures and it is popular amongst men and women who may have always been unhappy with the appearance of their nose.

The most important consideration when planning a rhinoplasty is balance. Sometimes, there may be an aspect of the nose – such as a marked hump, crookedness or a very bulbous tip, or any combination of these – that requires attention, but some patients that I see at my Leamington cosmetic surgery practice, may not be able to pinpoint exactly what is wrong, simply saying, “My nose is too big” or “I can’t stand my nose” without being able to quite put their finger on exactly what it is about their nose that bothers them.

Whilst they may be right about the size, quite often it is more that their nose is out of balance with the rest of their facial features. My job as a cosmetic surgeon is to create balance between the nose and the rest of their face and often only quite subtle adjustments are required to achieve proportion.

The rhinoplasty consultation

This is probably the most important stage of the rhinoplasty procedure. I discuss with the patient, at length, the source of their dissatisfaction and what they are hoping to achieve. Sometimes their expectations are unrealistic in which case I politely decline to do anything and sometimes their concerns are suggestive of a possible wider picture, in which case a psychological assessment is sought before taking matters any further.

However, if perceptions and expectations are realistic and coincide with my own assessment, the surgical approach to improvement is explained in detail, together with necessary precautions in the weeks after surgery, potential problems and complications, the fact that perfect symmetry is not always achievable and that sometimes surgical revision is necessary.

The perfect nose for me

If the nose is in perfect balance, then it should complement your other facial features rather than dominate them. Typically, your nose should be about a third of the length of your face and, in the Caucasian face, the width at the base should be about two-thirds of the width of your mouth. The angle of the nose should also be proportionate, with the tip revealing neither too much of your nostrils nor obscuring them completely.

The chin should also be taken into consideration. In profile, if a line was drawn from the edge of your lower lip, it should touch the edge of your chin. Often, though, the chin can either protrude or recede beyond that point and this can have a drastic impact on facial balance and the nose in particular. A receding or ‘weak’ chin can throw the nose into more prominence and reducing the size of the nose alone may fail to achieve optimal enhancement of your facial features. For some patients, surgery to the chin alone may be the best option or chin augmentation or reduction may be required, generally to match the nose once initial rhinoplasty swelling has resolved.

If you are unsatisfied with the appearance of your nose and would like to discuss in more detail your options, please call my secretary on 01926 436341 to arrange a cosmetic surgery consultation.