Breast Augmentation
We carry out more breast implants than any other provider in Ireland, at our state of the art, internationally accredited private hospital
BIA-ALCL is a rare but potentially serious condition. It is not breast cancer. The increase of awareness over the last couple of years has led to early detection and positive prognosis. Some cases of death are known, some of which due to the illness itself, others due to late diagnosis, a refusal of treatment or aggressive/inappropriate therapy (e.g. stem cell therapy). Cases of spontaneous regression are documented in literature.
We still have a lot to learn about BIA-ALCL. It is currently classified as a Lymphoma; several scientists have suggested to classify it as a lymphoproliferative disorder. The cause of BIA-ALCL is as yet unknown. There is no proven theory, though several research efforts concentrate on different possibilities: surface roughness, biofilm, genetic factors, etc, or a combination of all these.
It is also hard to provide risk ratios for each implant type and brand: concerning the numerator, the number of cases is not always clear (the FDA raised the issue of double reporting, incomplete reporting, reporting with no information on the implants at the time of diagnosis or on the previous implants); concerning the denominator, it is unclear how many years of sales should be taken into account, as testing of the serum for ALCL is relatively recent, but seromas between the 1990s and the 2010s were never tested for BIA-ALCL (the sales from un-tested times should not be included). The institution of registries and international cooperation between them, will hopefully lead to more uniform reporting and to more transparency over sales numbers.
What we can tell you is that: Per the US FDA data (July 2019) over 80% of cases are associated with one manufacturer: Allergan. Auralia does not use Allergan implants.
What can Auralia do?
Auralia is a wholly owned, internationally accredited private Irish hospital. It’s the largest provider of breast implant procedures in Ireland with longer and greater experience than any other provider. Thousands of women in Ireland have had breast implants. Reports in the media about BIA-ALCL may cause some women to be concerned about their implants. Auralia, as the leader in this field, has set up a special BIA-ALCL clinic. We are available to any concerned patient who would like to come for a consultation with our Consultant Surgeon, Dr Ahmed Salman. The consultation is a completely free service which is available to every woman who has received breast implants from any provider, at any time, in any country. As we have said, BIA-ALCL is rare – there are no reported instances of it in Ireland. Notwithstanding, many women would undoubtedly feel reassured following a professional consultation. If you are concerned, or simply have questions, why not contact us today and make a free appointment with Dr Salman.
If you want to do further research please look at https://www.hpra.ie/homepage/medical-devices/special-topics/breast-implant-associated---anaplastic-large-cell-lymphoma-(bia-alcl)
Further information can be obtained on the website of the Irish regulatory authority, the Health Products Regulatory Authority (HPRA) on the link below:
https://www.hpra.ie/homepage/site-tools/search?query=alcl
About this treatment
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Who will benefit from breast augmentation surgery?
Of course, breast augmentation will help those who are looking to have bigger breasts, however this treatment will also be suitable for those hoping to bring balance to asymmetrical breasts or to restore their natural breast volume, which may have decreased as a result of pregnancy, weight loss, or simply through aging. There are a large number of choices of possible implants to suit all requirements. The style, shape and size of breast implant are important considerations and will be discussed with you at length during your consultation with Dr. Salman to find the best choice for you.
What would I expect at the consultation?
All breast surgery consultations are private one-on-one sessions with Dr. Salman that normally last 30-40 minutes. During that time a full medical history is taken to confirm suitability for surgery. A breast examination will allow assessment of breast tissue characteristics as well as the size and shape of the rib cage/thorax. A wide variety of implants are available during the consultation and you will have the opportunity to choose your preferred size, shape and projection. Once this is done, you can try on a special garment in order for you to see and feel the new breasts you have chosen. You can then then change the size or shape until you’re totally happy with your new outline. During the consultation, the patient is in the driving seat and any questions and concerns can be addressed to ensure the patient can be confident in making an informed choice.
What is involved in breast augmentation surgery?
All surgery is performed by Dr Salman himself – Ireland’s leading expert in breast augmentation and enhancement – at our state of the art facility in Park West, Dublin.
Surgery may be carried out under general anaesthetic after discussion with the consultant anaesthetist. The surgery itself will last approximately 50 minutes and during this a 5 to 6 cm incision is made beneath the breast and this allows access to the tissues behind the breast. A space or pocket is created behind the breast tissue itself or at a deeper level behind the main muscle of the chest (pectoralis major). Within this space the implant can be placed and then the incision is closed with dissolvable sutures.
The patient is discharged the same day and will be able to shower and drive the next morning. If their job involves light office work they can go back to work within 3-4 days, otherwise back to work and carrying out house work after 7 days. The patient will be able to resume exercise or go back to the gym in 4-5 weeks.
Shape and style of breast implants:
Implants are available as round or teardrop in shape. Also different profiles (the amount of projection compared with the diameter of the implant) can be chosen. The best shape for you depends on the look you want to achieve and your existing shape. For example, a patient who has lost upper breast fullness after breast feeding would probably not do best with tear-drop implant. A patient with small, high breasts who does not want the round ‘Baywatch’ look, would be better suited to a medium profile or a tear drop shaped implant.
What is the recovery after breast augmentation surgery?
Dr. Salman uses the 24hr recovery technique invented by John Tebbett, a master of the art of breast surgery.
After the operation patients are discharged the same day and a friend should drive them home from the hospital. By in large most patients do not have any bruising after the surgery although occasionally some patients do but if this is the case, it will be beneath the breasts and thus be hidden underneath clothing. There will be a small degree of swelling within the breasts and very often the skin feels quite tight but these tend to relax in the first week after surgery and the breasts then assume a more natural appearance.
Painkilling tablets may be required for the first 5 days. Patients may be able to resume driving the day after surgery. When at home one should avoid lifting excessively heavy weights such as heavy shopping bags. Patients can shower the next morning. After your 7 day check up with Dr. Salman most patients can go back to work.
By week 6 and the final review appointment with Dr. Salman, the majority of swelling/tenderness within the breasts should have subsided by this stage.
What to expect at my consultation
Auralia’s chief surgeon is Dr. Salman MB, BCh, BAO, BMedSc. is one of the longest established & most trusted cosmetic surgeons in Ireland and has personally performed more than 2000 breast augmentation surgeries in Ireland. All consultations are private one-on-one sessions with Dr. Salman that normally last 15-20 minutes. At your consultation we talk you through all aspects of breast surgery, including sizing, so you can visualise exactly what’s right for you and your body. Dr. Salman will clearly discuss any potential risks of the procedure and answer any questions you might have
What are the risks of complication?
All surgeries, no matter how safe, carry some amount of risk, including infection, scarring and pain. You will have a chance to talk frankly with your surgeon about any worries you might have, and any possible risks will be clearly and honestly communicated with you before you make any decisions. You’ll also be given a copy of everything in writing, so you can take them home and go through them at your own pace. We’re also here for you if you have any questions.
Aftercare
Patient care has always been at the forefront of everything we do, this is why we are a leading cosmetic surgery provider in Ireland. We believe that ‘aftercare’ is just as important a part of the entire cosmetic treatment procedure as the treatment itself. With Auralia, you can be rest assured that all your aftercare needs will be completely fulfilled, providing you the support you need for a fast and stress-free recovery.
Aftercare is a very crucial part of recovering correctly after your breast augmentation surgery and the success of your surgery will depend on how well you look after yourself afterwards as advised by your surgeon. At Auralia our aftercare plan is individually tailored to each patient’s procedure and requirements in order that the quickest possible recovery is achieved.
We are proud to offer fully comprehensive and inclusive aftercare, so you can be reassured you will always be in the very best, experienced medical hands. At Auralia you are a patient for life. Once we meet you we will guide you throughout your surgical journey to a new you.
All your appointments with Auralia, from your initial consultation to treatment to your aftercare consultations, are carried out at our clinic in Park West, Dublin. We have state of the art operating facilities and a six-bedded recovery area, including two elevated needs beds, with a central nurse’s station, conducive to all your recuperation and recovery needs.
Our Irish based surgeon is contactable day and night – 24 hours a day – if you need him.
Our registered, professional and highly trained medical team are accessible at all times to advise you on your individual surgical needs, to explain exactly what the procedure entails and to assist you with any concerns you may have following your treatment. All patients receive three post operative consultations, however, if a patient feels they need more support and time to address any concerns, we can facilitate this without cost or question.
Preparing for breast surgery
Note – It is advisable to stop smoking prior to surgery
2 weeks pre-operatively
Stop taking any aspirin or aspirin containing products as these may increase the risk of bleeding. Also any non steroidal anti inflammatory drugs (NSAIDs) such as Brufen or Volterol such should be stopped, as should any Vitamin E tablets or multi vitamins containing vitamin E.
1 week pre-operatively
It is advisable to take 1 gm vitamin C twice a day to improve wound healing.
If your surgery is planned for the morning it is wise to have a shower the night before using a medicated shower gel/body scrub (e.g. hibiscrub or hydrex) and wash ones hair. Nail polish should be removed prior to surgery for the anaesthetic equipment requirement.
The day of surgery
Dress in loose clothing with a shirt and zip-up top and/or cardigan (as opposed to a pullover) as lifting ones arms may be sore initially after surgery. Also pack the sports bra to wear after surgery along with usual toiletries for overnight stay.
FAQs
Your surgeon: Auralia’s chief surgeon is Dr. Salman MB, BCh, BAO, BMedSc. – the longest established & most trusted breast surgeon in Ireland. Dr. Salman is Ireland’s leading expert in breast augmentation and enhancement. Quality is imperative to Dr. Salman, and everything from consultation, materials, procedure, and aftercare in Auralia is of the very highest standard. Dr. Salman provides a direct mobile line for patients to use 24/7 post surgery.
Implants used: At Auralia we know that the quality of the implant used is crucial to the long term health and happiness of patients. We refuse to use implants that are anything but the best. It is one of the questions many patients fail to ask when considering breast enhancement surgery, and it is one of the most important.
Benefits of Pure implants: One of the most common complications with breast implant surgery is capsular contracture. This is where the membrane which grows around all implants and which normally you can’t see or feel, behaves like “shrink-wrap”. This compresses the implant causing it to feel firm or hard, often distorting its shape. Unfortunately this complication is by far the biggest cause of dissatisfaction and the need for further surgery. However Pure – Polyurethane implants are cohesive silicone gel implants with a polyurethane foam surface which can reduce the risk of capsular contracture to around 1% in 10 years.
Will I be able to breastfeed? Breast implants are placed below the mammary gland and therefore will not interfere with breast feeding.
How long do the implants last?Silicone breast implants on average last approximately 15 years but like anything ‘man made’ it may be less or more than this figure. After 15 years if one feels discomfort or notice any asymmetries or firmness of the breasts then this may be an indication in that a breast implant is degrading and further consultation should be sought at that stage. If there were a degree of capsule around the implant then removal of the capsule with or without replacement of the implant would be an option at that stage.
Is it alright for me to fly after breast augmentation surgery?It is a common misconception that breast implants can rupture in an airplane. Breast implants are perfectly safe in this situation, however long haul flights, i.e. greater than 5 hours, would not be a good idea in the first week after surgery, purely to minimise the risk of deep venous thrombosis in the legs.
What are the potential complications after breast implant surgery? The complications after breast uplift surgery are well recognised and many things are done to minimise the risk of complications, but like all medical procedures one cannot eliminate the risk altogether. The potential complications will be discussed during consultation and you will be given a copy in writing.
PIP implant issues Dr. Ahmed Salman has always strongly opposed the use of low cost implants. Auralia is the most experienced clinic in Ireland in the use of polyurethane implants.
Post operative care for breast augmentation. Usually we contact patients daily for the first week after their operation. Our Irish based surgeon is contactable 24 hours a day if you need him. Standard follow up visits are at one week, six weeks and 12 months. Dr Salman will provide you with information regarding breast health and breast self examination and answer any questions you might have. Typically patients take one week off work and six weeks off vigorous upper body exercise.
Before and after pictures
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