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Introduction to Breast augmentation
Breast augmentation is also known as mammoplasty wherein plastic surgery for the breasts is done so as to increase the existing breast size. As a primary reconstruction, augmentation procedure is applied to change the shape of breast (Alderman, 2017). A tissue expander is emplaced and used to prepare the recipient site to receive and accommodate the breast implant prosthesis. It involves breast implants or fat which is also referred to as fat transfer breast augmentation. This generally increases the size of breast or it also restores the breast volume that has been lost after pregnancy and any other situation. Typically breast augmentation can increase fullness of the breasts and it also improves the balance of your figure.
Most often women prefer to go for breast augmentation because that enhances their self-image and self-confidence. Breast augmentation does not correct severely dropping breasts; it merely help the women to lift up the size of breast with conjunction of breast augmentation process (Barnea and et.al., 2017). Specially, it add volume to existing breast tissue to create a fuller chest. It involves silicone or saline, rounded or shaped and textured or smooth which comes in a variety of sizes; thus as per the preference women opt for the same.
In the year 2013, around 13% of women opted for breast enhancement surgery (UK cosmetic surgery statistics 2013: which are the most popular. 2013). Meanwhile, it is also ascertained that demand for breast reconstruction has rocketed by 260% and breast reduction by 212%. Data collection from the research of Hall (2003), states that frequency of women have been increasing who are seeking surgery for breast enhancement. It costs around £3,000 to £5,000 in the private sector and the number is also growing in popularity as women believe that doing such thing could make their lives better.
Background and rationale
Breast Augmentation is UK’s most popular cosmetic surgery procedure for women that comprises enhancement in breast size. More than 11,000 cosmetic surgery procedure were performed in UK in last year as per the research conducted by British Association of Aesthetic Plastic Surgeons. 9652 cases were there in UK regarding breast augmentation among both male and female. However, on the other hand, there were 6246 cases related to breast reduction in UK. Breast augmentation was the most popular procedure in UK as more than 11,123 cases were happened during the year 2012. Significantly, it shows increment by 13% (Women seek NHS breast enlargement. 2003). Blepharoplasty (eyelid surgery) was the second most popular cosmetic procedure, followed by face or neck lifts in third place which also holds third position in the realm of cosmetic surgery (Brown, Brown and Murphy, 2017). About 75 per cent of women are genuinely helped by breast augmentation surgery; hence this is the reason, practitioners recommend to have the same surgery. However, on the other hand there were about 4% women who were unhappy with their shape and had been matched for breast size. The study also found that the women seeking surgery suffered more depression, anxiety and low self-esteem.
Organization of choice
In the study, health care organizations of UK that are involves in delivering services to women (having breast cancer) are being involved.
Department of health
NHS is entitled to offer health care services to the women who suffers issues related to breast cancer. All women who have received an implant from NHS will be contacted so that they can have a PIP implant and this also provide relevant information and advice about the patient and surgical areas. Consultation services with GP are also available along with the surgical team which works for the purpose of managing issues in women.
Weaknesses of the department of heath
The department affects the cost and investment aspects of NHS and this changes the economic facets. Further, as per the areas, only specific services are being available to the patients by GP’s. Further, the department do not easy accessibility to global health care services for women having breast cancer.
Reasons why women go for Cosmetic Breast Surgery
Most of the cosmetic surgeons have recognized that some women seek plastic surgery because they consider it as a source through which their sexual life could be improved. In this regard, Gray, Pockaj, Garvey and Blair (2017), said that women who receive breast implants typically experience higher levels of sexual arousal and satisfaction. Women usually witness significant increase in their sexual well-being which apparently is a good motivational source of livelihood. Sudden breast growth occurs more commonly in women; however sometimes it leads to growth spurt which is an underlying problem and needs medical attention (Women seek NHS breast enlargement. 2003). For many women, breast size plays an important role in body image. Most of the women prefers to have breast enhancement surgery as they consider it as a source which boosts their self-esteem. Women who are dissatisfied with their appearance often experience a huge increase in confidence after following breast augmentation surgery. Most of the women have shown a significant increase in their confidence level which improves their livelihood.
Isbell, Dunmore-Griffith and Abayomi, (2017), said that apparently women opt for breast enhancement surgery as they disproportionately have small breasts. This is also called as micromastia in which after puberty, breast size of women do not increase. The study also states that women who suffer from micromastia often experience intense embarrassment about their figures. Thus, breast implants can give such women a fuller figure and greater confidence (Ten Common Reasons Women Undergo Breast Augmentation. 2015). Contradicting the study, Lim (2017), contended that when one breast is larger than the other, women opt for breast surgery. Many women have asymmetrical breasts due to micromastia, growth spurts during puberty and uneven estrogen levels. Since, this condition is not common; thus it have an enormous impact on women’s appearance. Hence, many women choose to undergo breast augmentation surgery to even out their figures.
Apart from this, recent weight lost is one of the reasons that leads to cosmetic breast surgery. Following significant weight loss, women find that their breasts have lost their full and perky shape. Breast augmentation helps them to have a fuller chest; while at the same time they retain their smaller waistline and healthy weight. However, on the other hand Orton (2002), said most of the women undergo breast reduction surgery as well especially when the breast size increases improperly. Around 3% women in UK has opted for breast reduction surgeries. Most often breast size changes after pregnancy which disappoints a women. Losing weight seems to be a good thing for women, but some mothers find that after pregnancy and nursing, their breasts droop or get smaller; hence this becomes the chief reason for them for which they opt for breast implants. It usually restores women’s pre-baby body.
Some women have health problems and because of that they have to opt for numerous surgeries. Women who have a mastectomy (due to breast cancer and any other health problem) often experience long duration to regain their full and healthy figure. Breast reconstruction is a more involved procedure than to simple augmentation. The surgery does not include the placement of an implant; but it also includes skin grafting and the construction of a nipple and areola. Polgár and et.al. (2017), stated about the most common reason that is psychology of women for better breasts. Most of the clothes for women are designed for a size C cup from fashion industry which usually do not fit for every women; hence this is yet another reason that drives the women to opt for breast enhancement (Ten Common Reasons Women Undergo Breast Augmentation. 2015).
There is a perception among women that they will look younger if they will have big breasts. As when women age, they notice that their breasts begin to sag and get smaller. Breast augmentation, especially in conjunction with a breast life can restore a youthful and perky look to women’s figures. Rohrich, Shah and Patel (2017), said that choosing breast augmentation is a highly personal decision and it should never be taken lightly. Women should not opt for breast implants to make someone else happy and it should only be adopted when women think that they are derive positive impact after undergoing with breast augmentation surgery. Apparently, women’s bodies come in all shapes and sizes and their breasts do not stay the same. Hence, most often women compare the body size and shape with others and as a result, they get disanointed if they have smaller breasts (These are just ordinary women' – how breast surgery has soared in the UK. 2011). Therefore, just to make social life more happening and satisfied, most often women opt for breast augmentation.
Factors that lead to Cosmetic Breast Surgery
Cultural factors: In UK, women prefer to have big breasts and most of them opt for such surgeries. Since, they have economic capacity; thus they can afford for the same. Women are highly cautious about their physical look and this is the reason, they adopt several things to make their body attractive (Is cosmetic surgery the new acceptable face of womanhood. 2015). Youngsters as well as old aged women both prefer to have big breasts; therefore this is the reason they change their attitude towards breast surgery. It has been found out that the level of body dissatisfaction is negatively associated with acceptance for cosmetic surgery. Most of the women observe others who look more attractive and accordingly they adopt to change the size of the breast. A few celebrities are involved in breast enhancement advertisement; therefore this increases the frequency of breast surgery among women in UK. Women are highly emphasized towards self- esteem motive and they are also highly affected by public self- consciousness.
In recent years, television shows, movies and countless advertisements have reflected a drastic increase in cultural expectations for attractiveness. Thus, this is no more surprising fact if the rate of cosmetic surgery increases. Expectations related to attractive look increases among women; hence this has enhanced the degree of cosmetic surgeries in UK. Women are also likely to experience higher levels of objectified body consciousness which is also defined as the experience of one’s own body as an object. This usually occurs as a result of society’s tendency to objectify women’s body (Alderman, 2017). Most of the women are aware about the consequences of breast implants; however still they opt for the same merely to have attractive physical appearance. This is further also related to body shame, body surveillance and appearance control beliefs. It is also identified that all these three factors are positively related to acceptance of cosmetic surgery.
Social factors: Women always prefer to look good and attractive; hence in order to manage the attractiveness and physical appearance, they adopt various changes in their external appearance. In current scenario, it is quite apparent that women are highly conscious about their body; hence breast implantation aids them to have an attractive body (Barnea and et.al., 2017). For example – sometimes shape of the entire body is perfect; but due to small breasts, women are unable to keep high confidence level. At the same time, they get disappointed and they opt for numerous surgical options. Preferences of people keeps on changing; hence the same concept applies in this area as well. Moreover, social factors includes status concern which drives women to opt for the same.
Along with this, it can be said that income and lifestyle are two major dimensions that drives more women towards surgical changes in their body (Brown, Brown and Murphy, 2017). Women know that breast implants are highly expensive; still they opt for the same because they know that they can afford it. Thus, it can be said that income is one such source that aids the women to opt new changes in their physical appearance. Apart from this, this can also allow them to have other surgeries as well.
Psychological factors: Among psychological factors, women tend to opt for breast implants because consider it as a source that could change their livelihood. Along with this, it can be said that psychological factors are highly effective for a person and that needs to be considered on the same account. It is crucial for women to focus upon the way they manage everything in life; hence decisions related to surgeries should be taken appropriately. Most of the women who are involves in modelling are more concerned about their looks. Thus, such type of surgeries are adopted by them on higher basis (Gray, Pockaj, Garvey and Blair, 2017). Since, they have to keep their standards; so they adopt numerous changes in their body. On the other hand, there are several women who opt for breast reduction as they know that big breast is a matter of fun for others. Sometimes, women feel humiliation especially when they have oversized breasts.
Along with this, it is also identified that women who undergo with breast reduction procedure have to keep more concern about the breast so as to avoid the chances of infection and cancer. Silicone and saline implants have indifferent impacts on breasts; hence prior adopting the surgery, women should consult the surgeons and practitioners. This is also crucial for reducing all sorts of risks that could occur due to breast surgery (Isbell, Dunmore-Griffith and Abayomi, 2017). Cosmetic breast surgery helps the women to reconstruct the breast which also aids them to feel better and good. For example- most of the women feel insecure when they do not have big breasts as that reduces their confidence level. Hence, in order to enhance the level of self-confidence, women prefer to opt for breast enhancement surgery.
Types of breast implants
There are two basic types of breast implants such as saline and silicone gel and both are implanted after analysing the body type. Saline filled implants are silicone shells that are filled with sterile salt water and most often they are pre-filled. However, a few are filled during the implant operation (Lim, 2017). Silicone gel filled implants are silicone shells filled with a plastic gel. It aids the women to feel just like they are having real breasts than saline. However, they are highly risky if they leak. Both saline and silicon come in different sizes and have either smooth or textured shells. Each of the type of breast implant have different pros and cons; thus it is a matter of preference. It has been analysed that saline implants are more preferable as it requires a smaller incision which further minimizes scarring. It can also be filled after being placed; hence it makes implant sizing much easier.
It is also regarded as the most popular breast implant options for decades and many women continue to experience exceptional results with these implants today. It is beneficial as it is less expensive than silicone implants. Women prefer it as it gives natural look and feel; hence it does not impact the external appearance (Orton, 2002). Therefore, these are the reasons that have increased the popularity of breast surgery in recent years. Most of the studies have shown that both saline and silicone implants are safe. Women feel comfortable in knowing that saline implants are filled with a natural solution that can be absorbed by the body. Since, it is absorbed by the body; thus it clearly gives notice regarding rupturing. Henceforth, proper action can be taken to address the issue quickly and easily.
There is a drawback of saline implants that is related to the physical appearance. They tend to look and feel less natural than to silicone implants (Polgár and et.al., 2017). Saline implants tend to make the breasts look rounder in shape and women can also feel firmer than to silicone implants. However, on the other hand silicone breast implant is less likely to ripple and its effect is seen with saline kind of looks. This means that saline breast implants may ripple or wrinkle a little when the woman moves around. Silicone implants have several disadvantages as well such as they are more expensive as compared to saline implants. The silicone gel is actually more expensive and they can also be more difficult to work with. Along with this, the biggest disadvantage is that if it ruptures, it may not immediately noticeable (Rohrich, Shah and Patel, 2017). There is no evidence that the silicone gel causes any long term harm such as breast cancer or any other illness; however it may eventually causes breast pain and it can also change the size and shape of the breast. Thus, it can be said that scar tissue distorts the shape of the breast implant and it can also lead to change the sensation in nipple temporarily.
Risk of breast implants
- Ruptures are a risk that occurs at the time of breast implants and it might also cause surgical error to women. This can also increase the pressure exert on the breast during a mammogram.
- It also generates the need for additional surgeries with or without the removal of the device. Further, it is observed that breast implants leads to capsular contracture which scars the tissue that form around the implant and squeezes the implant (Risks of Breast Implants. 2013).
- Additionally, breast implant increases the intensity of breast pain and as a result, it leads to mood swings in women.
- It also brings several changes in the nipples and also leads to transform breast sensation. Thus, it can be said that breast implantation can change the size and appearance of the breast; but it may further lead to other complications as well.
- Ruptures are highly painful and that may change the frequency of growth as well. It could lead to deflation of saline- filled implants. Most often, it can be noticed; but commonly it cannot be addressed (Soror and et.al., 2017). There are several ruptures that shows or do not shows the symptoms of silicone gel filled implants; hence this creates more issues for women.
- The longer women have breast implants; the more likely it increases the level of complication which needs to be suitably removed. Surgical implants do not guarantee any satisfactory cosmetic outcome from reoperation. It merely give short term outcomes.
- Since, the procedure involves cyst removal by inserting a needle through the skin; thus it could cut the skin to remove the lumps. Therefore, looking towards this, it can be said that cosmetic surgeries are much more risk associated (Thorarinsson and et.al., 2017).
- Other risks include, excessive bleeding during surgery and infection. At the same time, blood clots in large veins traveling up to the heart and lungs. Although this is not common, but it may leads to a threatening risk if it occurs while any such surgery.
Effects of Cosmetic Breast Surgery
The benefits that come with breast implants are highly dependent on the individual acquiring them and their reasons for undergoing the surgery. Thus, the outcomes are contradict because the surgeries have several risks as well. It has been observed that breast enhancement surgeries helps the women to feel more feminine because it leads to have a womanly figure (These are just ordinary women' – how breast surgery has soared in the UK. 2011). Along with this, it also increases the self confidence level that changes the way of perceiving things. Women can also enjoy wearing different kinds of clothes which aids them to improve their physical appearance. Similarly, breasts can also have a symmetrical appearance which aids women to feel better. Changes that occur after pregnancy and breast feeding can be corrected through breast implants.
NHS figures for the year 2008 shows that around 15,479 women in England who had mastectomies are now following breast cancer among which 3,216 women opted for immediate reconstruction. Certainly in the history of breast augmentation, it has been noticed that it is becoming a troubled and controversial procedure (Is cosmetic surgery the new acceptable face of womanhood. 2015). This can be said afterwards collecting the data which reveals that silicone implants were withdrawn in many countries.
More than 170,000 women claimed against the manufacturers wherein they also complain about the leakages of the ruptures, severe pain. However, from governmental point of view, they are considered as safe; still after such cases, they were not re-approved from the ruling bodies. Along with this, it has several negative impacts as well such as loss of feeling in the nipples or breasts. This is a temporary impact that lasts for a few months; but in several cases, it lasts for much longer. Women also become unable to do breastfeeding after surgery. Some can do as it depends on the type of reduction that happens with the women.
Policies on Cosmetic Surgery
Doctors carrying out their profession in UK are being issued with new guidance by the General Medical Council which also ensure that they provide the best possible care for patients. The guidance ensures that ethical obligation are being followed upon and due actions are also taken in respect of cosmetic surgeries (Tough new standards for doctors carrying out cosmetic procedures. 2016). GMC guidance covers both surgical and non-surgical procedures wherein doctors and medical practitioners need to advertise and market services responsibly so that they can provide factual information to the public. Doctors must give time for reflection and they also need to make sure that they have the time and information about risks which only helps them to decide what needs to be done further (Thorarinsson and et.al., 2017).
Doctors must also provide continuity of care wherein doctors should ensure that patients know who they are contacting with and how their services will be managed. Doctors are also responsible to support patient safety by making full and accurate records of consultations. For such process, they need to use systems to identify and act on patient’s safety concerns. Such programmes also leads to monitor quality facets that includes registers for devices such as breast implants (NSW Government reviews cosmetic surgery regulation. 2017). Along with this, it is also said by the governmental bodies that cosmetic interventions should not be entered into lightly or without serious considerations. Hence, suitable analysis needs to be conducted for overall patient safety and security. Above all, patients considering whether to have such a procedure need honest and straightforward advice which allows them to understand the risks as well as the possible benefits. Thus, this can also have a positive impact on patient’s health and safety facets.
In this respect, several new amendments are also introduced as an set up that ensure standards for cosmetic surgery and this also works along with the general medical council on a code of ethical conduct (Soror and et.al., 2017). Further, Health England is also leading a review of training for providers of some non- surgical procedures such as botulinum toxin and dermal filler injections. The council has also introduced a new policy which creates a breast implant registry. This is useful in reassuring women that if problem arises, patients need to contact with the psychiatrists. They can also take suitable treatment when it is necessary.
As per the review collected from the regulation of cosmetic interventions by the Department of Health in the year 2013, the value of UK cosmetic procedures was worth £2.3 billion in the year 2010 and it is also estimated to increase to £3.6 billion by the year 2017. The report also stated that non-surgical procedures account for nine out of ten procedures and 75% of the market value (Cosmetic treatment industry given strict rules to protect vulnerable. 2016). Since, the surgery involves risks and uncertainties; therefore medical practitioners should ensure that they are following all the standards so that they provide suitable services to the women as required.
On the basis of entire research study, it has been identified that cosmetic breast surgery is useful in several manner; however it poses risks as well to the women when the procedure is not carried out in optimum manner. This is essential to consider because it increases risk facets. The health department of UK have introduced many new strategies for the purpose of preventing the women from these risks and uncertainties. Cosmetic surgery has become a growth industry as people are getting highly concerned about their physical appearance. From the study, it is also identified that many patients do not seek a referral from their general practitioner because they fear an unsympathetic response.
They are also unaware about the regulations involved in the same procedure; hence they feel that cosmetic surgery is not fundamentally medical. This is the most appropriate reason for which they do not discuss with the practitioners. Several risks are included in the same procedure; henceforth medical practitioners are required to pay attention towards these aspects on higher extent. In the UK, women accounted for 90.5% of all cosmetic procedures in 2013 with a total of 45,365 procedures; hence cosmetic industry must ensure to adhere all these regulations.
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Recommendation for patient
At the time when women go for breast surgery, they must discuss the same with the health professionals and surgeons so that they can protect themselves from all medical risks and hazards. Silicon as well as saline both the implants are risk associated; however still while suggesting the same to the patient, the type of skin and effects needs to be considered. In market place, there are several medicines available which are used for breast enhancement (Women seek NHS breast enlargement. 2003). Such medicines should not be used as that are highly risk associated and that can impact the health aspects as well. It is recommended to the patients not to take such medicines without consulting the doctors.
Cosmetic surgeries look good for sometimes; however it affects the body internally and especially when people for enhancement surgeries.
The topic has been selected because issues in cosmetic surgeries are increasing on higher extent. Women are experiencing several health facets; therefore researcher aims to highlight all such issues through the present study. Hence, this is the major reason for which the study is being conducted. Apparently, in order to look good, women are opting different surgical options which impacts their body highly. Hence, the study will be beneficial for those who are unaware about the impacts of surgical procedures.
- Alderman, A. K., 2017. Discussion: A Qualitative Study of Breast Reconstruction Decision-Making among Asian Immigrant Women Living in the United States.Plastic and Reconstructive Surgery. 139(2). pp.369e-370e.
- Barnea, Y. and et.al., 2017. An Oncoplastic Breast Augmentation Technique for Immediate Partial Breast Reconstruction following Breast Conservation.Plastic and Reconstructive Surgery.139(2). pp.348e-357e.
- Brown, T., Brown, S. and Murphy, T., 2017. Breast Durometer (Mammometer): A Novel Device for Measuring Soft-Tissue Firmness and Its Application in Cosmetic Breast Surgery.Aesthetic Plastic Surgery, pp.1-10.
- Cosmetic treatment industry given strict rules to protect vulnerable. 2016. [Online]. Available through: <https://www.theguardian.com/society/2016/apr/12/cosmetic-treatment-industry-rules-vulnerable-patient-consent-procedure/>. [Accessed on 8th February 2017].
- Gray, R.J., Pockaj, B.A., Garvey, E. and Blair, S., 2017. Intraoperative Margin Management in Breast-Conserving Surgery: A Systematic Review of the Literature.Annals of Surgical Oncology, pp.1-10.
- Is cosmetic surgery the new acceptable face of womanhood. 2015. [Online]. Available through: <https://www.theguardian.com/lifeandstyle/2015/jun/28/cosmetic-surgery-normal-acceptable-face-womanhood>. [Accessed on 8th February 2017].
- Isbell, A., Dunmore-Griffith, J. and Abayomi, O., 2017. Strut-adjusted volume implant (SAVI) brachytherapy-based accelerated partial breast irradiation (APBI) in African American women.Breast Cancer Research and Treatment. pp.1-8.