There’s definitely no denying, the B word has definitely been a talking point of late, not just in the media, but within my close circle of friends too. Would you? Wouldn’t you? Have you? Has she? I promise it’s not as ‘Real Housewives of Cheshire’ as it sounds... But whilst I'm only 28, the reality is that the constant stream of late nights, binge drinking (sorry Mum) and falling asleep with a full face of makeup on, are all starting to show their effects.

A breast reduction typically includes a lift.  However, a lift does not necessarily require a reduction.  Both operations have similar incision patterns and resultant scars, but they have different indications.  One of the first questions I ask a patient who desires an improved appearance of her breasts is if she would like to be the same size, smaller, or larger.  The patient who wants to be the same size and is happy with her breasts when wearing a bra but unhappy with the amount of sagging without a bra is a candidate for a breast lift alone.  The patient who desires to be smaller or has one breast noticeably larger than the other, is a candidate for a breast reduction-lift combination.  Sometimes patients feel their breasts look smaller after removal of the excess skin with the lift even though no breast tissue was removed; the reason for this is that some of what fills your bra cup is excess skin.  The patient with sagging who desires to have larger breasts is a candidate for a breast lift with implants.
Body type is a major factor you need to consider before going for breast augmentation. The wrong size of breasts for a particular body type can create many complications like neck and back pain. If your body is small in size and your bone structure is thin, don’t go for huge sized implants. Opt for the size that will make your body look proportional. Similarly if you have a heavy body, you might have to go for larger breast implants.
The current lifetime risk of BIA-ALCL in the U.S. is unknown, but estimates have ranged between estimated to be between 1 in 70,000 to 1 in 500,000 women with breast implants according to MD Anderson.[73] Certain geographic locations have demonstrated variable risks. For instance, a December 2016 update from the Therapeutic Goods Administration of Australia and New Zealand reported a risk of 1:1,000 to 1:10,000 for textured implants.".[71] To date (2017), there has not been a case of BIAL reported where the patient had only implantation of smooth shell breast implants or a textured tissue expander that was exchanged for a smooth implant. The paucity of cases reported in Asian populations has raised the possibility that there may be a range of genetic susceptibility to the phenomena, or alternatively merely reflect differences in how cases are identified and reported. 

Smooth breast implants are round in shape, come in many sizes and are available with different profiles, which is the amount of projection of the breast silhouette from the chest. The shells of smooth breast implants are slightly thinner than textured implants. Smooth implants are less likely to cause rippling of the implant shell and are less likely to rupture.

Tell your doctor about all your medical conditions, including: plans to have surgery; had surgery on your face; have trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® Cosmetic can harm your unborn baby); are breast-feeding or plan to (it is not known if BOTOX® Cosmetic passes into breast milk).
As with any medical/surgical treatment, individual results may vary. Only a surgeon/physician can determine whether reconstruction or augmentation>is an appropriate course of treatment. The following are general adverse events associated with breast implant surgery: Device Rupture, Capsular contracture, Infection, Hematoma/Seroma, Pain, Reoperation, Implant removal, changes in Nipple and Breast Sensation, unsatisfactory results, breast-feeding complications. Other reported conditions are listed in the Product Insert Data Sheet (PIDS). See full list in the PIDS for the product information. These potential adverse events, including contraindications, warnings, and precautions need to be discussed with your doctor prior to surgery.
The human body's immune response to a surgically installed foreign object—breast implant, cardiac pacemaker, orthopedic prosthesis—is to encapsulate it with scar tissue capsules of tightly woven collagen fibers, in order to maintain the integrity of the body by isolating the foreign object, and so tolerate its presence. Capsular contracture—which should be distinguished from normal capsular tissue—occurs when the collagen-fiber capsule thickens and compresses the breast implant; it is a painful complication that might distort either the breast implant, or the breast, or both.
When the patient is unsatisfied with the outcome of the augmentation mammoplasty; or when technical or medical complications occur; or because of the breast implants’ limited product life, it is likely she might require replacing the breast implants. Common revision surgery indications include major and minor medical complications, capsular contracture, shell rupture, and device deflation.[44] Revision incidence rates were greater for breast reconstruction patients, because of the post-mastectomy changes to the soft-tissues and to the skin envelope of the breast, and to the anatomical borders of the breast, especially in women who received adjuvant external radiation therapy.[44] Moreover, besides breast reconstruction, breast cancer patients usually undergo revision surgery of the nipple-areola complex (NAC), and symmetry procedures upon the opposite breast, to create a bust of natural appearance, size, form, and feel. Carefully matching the type and size of the breast implants to the patient's pectoral soft-tissue characteristics reduces the incidence of revision surgery. Appropriate tissue matching, implant selection, and proper implantation technique, the re-operation rate was 3 percent at the 7-year-mark, compared with the re-operation rate of 20 per cent at the 3-year-mark, as reported by the U.S. Food and Drug Administration.[64][65]
A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural looking breast mound for post–mastectomy breast reconstruction patients or to correct congenital defects and deformities of the chest wall. They are also used cosmetically to enhance or enlarge the appearance of the breast through breast augmentation surgery.
Your surgeon can take photos of your breasts and detail your physical symptoms caused by enlarged breasts in a letter. Get in touch with your health insurer early and make sure you understand exactly what they will pay for. For example, will insurance cover such things as lab costs or anesthesiologist fees? Asking in advance will help prevent surprise costs after the surgery.

The best reaction came from my mum, who is always honest. She isn’t afraid to tell me I look tired, pale or spotty, but when I saw her after my treatment she couldn’t have been more complimentary. After confiding in her that I had botox she yelped and said, ‘Wow you did really need it, now you look so fresh, like you’ve had a month of great sleep’. Thanks mum.
You will want to spend some time researching a qualified surgeon and examine their before and after rhinoplasty photos so see the quality of their work. Scheduling a consultation with the surgeon would be a great next step to speak to them about their credentials and what their recommendations may be. During the consultation process you can also discover where the procedure would be performed. This will also play a role in total cost.
You and your surgeon will decide together which incision choice is best for you: underarm incision, incision in the crease of the breast (inframammary fold), or through removal of the areola. Your doctor will take into consideration your beginning breast size and shape, breast tissue, and a number of other factors before recommending which options are best for you and your body.
The weight difference between equal volumes of saline, silicone, and breast tissue is slim to none, so a natural C cup and an augmented C cup are very similar in weight, says Dr. Kolker. If you choose an implant size proportional to your frame, you will see little effect on your posture. However, if you choose large implants, you will feel the effects.
Many different types of breast lifts are now available in conjunction with a breast reduction, including lifts just around the areola (periareolar), vertical/lollipop mastopexies (incision around the areola and down to the breast fold, and full breast lifts with an anchor incision. For patients who have very loose skin in the armpit or back, axillary or bra lifts are also often combined with breast reductions.
A lot of patients are concerned over whether or not breast implants are safe. The answer to this is yes. To date there has never been a single study performed anywhere in the world that says that breast implants are dangerous or increase your risk of either breast cancer or any other systemic diseases. Furthermore, the new implants whether saline or silicone are manufactured much better than they used to be 10 or 15 years ago which not only makes them safer but has extended their lifetime use. Even the silicone envelope that encompasses the material inside, whether saline or silicone, is much more durable than in the past. If you do chose to go with silicone implants, even in the case of a rupture, the silicone does not leak to a distant site or go into your bloodstream.
In 2008, the longitudinal study Excess Mortality from Suicide and other External Causes of Death Among Women with Cosmetic Breast Implants (2007), reported that women who sought breast implants are almost 3 times as likely to commit suicide as are women who have not sought breast implants. Compared to the standard suicide-rate for women of the general populace, the suicide-rate for women with augmented breasts remained constant until 10-years post-implantation, yet, it increased to 4.5 times greater at the 11-year mark, and so remained until the 19-year mark, when it increased to 6 times greater at 20-years post-implantation. Moreover, additional to the suicide-risk, women with breast implants also faced a trebled death-risk from alcoholism and the abuse of prescription and recreational drugs.[12][13] Although seven studies have statistically connected a woman's breast augmentation to a greater suicide-rate, the research indicates that breast augmentation surgery does not increase the death rate; and that, in the first instance, it is the psychopathologically-inclined woman who is more likely to undergo a breast augmentation procedure.[14][15][16][17][18][19]
A great question that comes up often.  A breast reduction will both reduce the breast size and improve the shape of the breast while lifting it.  During this surgery, breast tissue is removed while preserving the tissue around the nipple.  The breast is then shaped and nipple placed in a higher, more ideal position.  This is essentially the breast lift component of this surgery.  With the reduction, we are accomplishing both. Hope this helps. 
They are essentially very similar procedures. The difference is in the amount of breast tissue removed. In a breast lift procedure, the nipple areolar complex is lift to a better position on the breast, and some breast tissue is removed and the breast envelope tightened. In a breast reduction, the nipple areolar complex is also lifted, but much more breast tissue is removed. 
The choice between silicone breast implants or saline breast implants is a somewhat subjective question. It really depends on your specific anatomy needs and finances. Both silicone and saline implants are excellent and for most people that have adequate coverage over the breast implant, meaning they have a little bit of breast tissue or a little bit of fat left that is going to cover the implant, saline breast implants work fine. In some instances, where the patient is very thin, it might be better to use the silicone gel breast implant because there are parts of the implant, about a third to one half that are not covered by the muscle and if you don’t have enough coverage over the implant, you will see some rippling and some wrinkling of the implant. This tends to happen especially when you lean over or lean forward. Therefore, in those cases, silicone gel implants are better. In terms of how they look, they are both great breast implants and they look very similar. The silicone implants are a little bit more expensive, so if the finances are a big issue than saline implants generally work very well and can give you the desired results, but again it is more of a personal preference.

When a breast mass is discovered, a biopsy is usually necessary. If you have had breast enlargement with a breast lift, care must be taken to avoid damaging the underlying implant. Sharp instruments must not come in contact with the implant due to the risk of implant rupture. Tell your physician you have had breast implant surgery so they can take appropriate precautions.
For detailed indications, contraindications, warnings, and precautions associated with the use of all MENTOR® Implantable Devices, which include MENTOR® Saline-filled Implants, MemoryGel® Implants, MemoryShape® Implants, ARTOURA™ Expanders, and CONTOUR PROFILE® Expanders, please refer to the Instructions for Use (IFU) provided with each product or visit www.mentorwwllc.com.
It has been shown that the rates of capsular contraction are much lower when the breast implant is placed below the muscle. Also, with the implant below the muscle, there is that extra layer of tissue between the visible part of the breast and the implant, therefore making it more difficult to be detected by touch and maintain the natural feeling of the breast. The breast will look more natural with this method as you will not be able to visibly see the edges of the implant.
Adam R. Kolker, MD, explains: Although silicone breasts feel similar to real breasts, they are still man-made and don’t feel like natural breast tissue. You’ll be more likely to notice there’s an implant in a woman who began with little breast tissue than a woman who had more breast tissue to begin with. Smaller implants and those that are placed below the muscle are harder to detect.
Fill	Filled with a highly cohesive gel for durable shape retention designed to give a youthful feel.	Filled with a proprietary cohesive gel that hold together uniformly while retaining the natural give that resembles breast tissue.	Filled with a saltwater solution similar to the fluid that makes up most of the human body; slightly firmer feel than gel.

Since the early 1990s, a number of independent systemic comprehensive reviews have examined studies concerning links between silicone gel breast implants and claims of systemic diseases. The consensus of these reviews (outlined below under Safety of Breast Implants heading) is that there has been no evidence of a causal link between the implantation of saline or silicone breast implants and systemic disease After investigating this issue, the U.S. FDA has concurred and since reaffirmed that “the weight of the epidemiological evidence published in the literature does not support an association between fibromyalgia and breast implants.”. A comprehensive systemic review by Lipworth (2011) [66] concludes that "any claims that remain regarding an association between cosmetic breast implants and CTDs are not supported by the scientific literature".
Breast implants are available in a variety of sizes. You should decide the cup size you want if you are considering breast augmentation. It is also important to make sure that you are not opting for a size that will be too large for your breasts. Breast implants are inserted by making an incision under the breast. So make sure you don’t opt for a size that is too big for your body and chest.
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