Breast enlargement (implants)

Having a breast enlargement is a big decision. It's major surgery, the results are not guaranteed and there are some risks to think about.

During the operation, implants are inserted into your breasts to increase their size, change their shape, or make them more even.

Breast enlargement is often known as a "boob job" or breast augmentation.

You cannot usually get breast enlargement on the NHS

You'll usually have to pay to have breast implants.

There are some circumstances where you might be able to get breast enlargement on the NHS – for example, if you have very uneven breasts or no breasts.

It often depends on the area you live in. Your GP should be able to tell you more about the rules in your area.

How much breast enlargement costs

In the UK, breast implant surgery costs around £3,500 to £8,000. This does not usually include the cost of consultations or follow-up care.

You'll also have to pay for any follow-up surgery you may need in the future.

What to think about before you have a breast enlargement

Before you go ahead, be sure about why you want breast implants. Take time to think about your decision.

Read more about whether cosmetic surgery is right for you. You could also speak to your GP about it.

Choosing a surgeon

If you're having breast enlargement in England, check the Care Quality Commission (CQC) to see if the hospital or clinic is registered with them. 

All independent clinics and hospitals that provide cosmetic surgery in England must be registered with the CQC.

Be careful when using the internet to look for doctors and clinics who provide breast enlargement. Some clinics may pay to advertise their services on search listings.

Check the surgeon is registered with the General Medical Council (GMC). They should be listed on the specialist register and have a licence to practise.

Surgeons who perform cosmetic procedures are also usually members of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) or the British Association of Aesthetic Plastic Surgeons (BAAPS), or other professional associations. Most associations have online registers that you can check to see if your surgeon is listed.

Always book an appointment to meet the surgeon before the procedure.

You may want to ask your surgeon:

• about their qualifications and experience
• if they're a member of any professional associations
• how many breast enlargement operations they've performed
• how many operations they've performed where there have been complications
• about the type and manufacturer of the implant they use and why
• about the surgical technique used and the placement of the implants
• what results you can expect
• what sort of follow-up you should expect if things go wrong
• what their patient satisfaction rates are
• about any alternative options

Read more about choosing who will do your cosmetic procedure.

Choosing your implants

There are 2 types of implants, made of silicone or saline.

Silicone implants are the most common type used in the UK. They're less likely to wrinkle and feel more natural. However, they can spread into your breast and cause lumps.

Saline implants are more likely to fold, rupture or go down over time. If they do go down or rupture, the saline will safely be absorbed into your body.

You should discuss the pros and cons of each type of breast implant with your surgeon, along with the size and shape of your implants and where they'll be placed (behind the breast or behind the breast muscle).

How long breast implants last

Breast implants do not last a lifetime. It's likely they'll need to be replaced at some point.

Some women may need further surgery after about 10 years, either because of problems with the implants or because their breasts have changed around the implants.

What a breast enlargement involves

Breast implant surgery is usually carried out under general anaesthetic.

The operation involves:

• making a cut (incision) in the skin next to or below the breast
• positioning the implant – either between your breast tissue and chest muscle, or behind your chest muscle (as discussed during your consultation)
• stitching the incision and covering it with a dressing

The operation takes between 60 and 90 minutes.

You may be able to go home the same day, or you may need to stay in hospital overnight.

You'll be given pain relief if you experience any discomfort afterwards.

Recovery

You should be able to move around soon after having breast enlargement surgery.

It can take a few weeks to fully recover from surgery, so you should take a week or 2 off work. You should not drive for at least 1 week.

Some surgeons recommend wearing a sports bra 24 hours a day for up to 3 months after breast surgery (check with your surgeon).

Avoid heavy lifting or strenuous exercise for at least a month.

• After 1 or 2 weeks: your stiches will be removed (unless you had dissolvable stitches).
• After 6 weeks: you should be able to return to most of your normal activities. Your scars should also start to fade.
• After a few months: your breasts should start to look and feel more natural. You may be able to stop wearing your sports bra.

It's safe to sunbathe and fly if you have breast implants.

What could go wrong

Breast implants can sometimes cause problems, including:

• thick, obvious scarring
• the breast feeling hard because scar tissue has shrunk around the implant (capsular contracture)
• a ruptured implant – this may cause small tender lumps (siliconomas), which are only noticeable on breast scans; the implant will need to be removed
• creases or folds in the implant
• the implant rotating within the breast, resulting in an abnormal shape
• rippling of the implant – this happens when the implant is only covered by a thin layer of tissue which sticks to the surface of the implant, and is very difficult to treat
• nerve problems in the nipples – they may become more sensitive, less sensitive, or completely numb; this can be temporary or permanent
• when breastfeeding, producing slightly less breast milk than you would without implants 

Also, any type of operation carries a small risk of:

• bleeding and clots – blood clots can be life threatening
• infection – this is rare and would need to be treated with antibiotics
• an allergic reaction – to medicine or products used during surgery, such as antibiotics or latex

Your surgeon should be able to tell you more about these problems, including how likely they are and how they'll be corrected if you have them.

Other problems

You should be aware of an association between breast implants and an uncommon type of immune system cell cancer. It's called breast implant associated anaplastic large cell lymphoma (BIA-ALCL).

A very small number of people who've had breast implants have developed BIA-ALCL in the scar tissue around their breast implants.

GOV.UK has more information about breast implant associated anaplastic large cell lymphoma (BIA-ALCL)

Some women have also reported having other symptoms after breast implant surgery, such as tiredness, anxiety and joint pain. This is sometimes known as breast implant illness.

GOV.UK has more information about symptoms sometimes referred to as breast implant illness

A type of breast implant, called PIP (Poly Implant Prostheses) implants, were banned in the UK in 2010 after it was found they contained unapproved silicone gel and were more likely to split (rupture) than other types of implant.

Read more about PIP breast implants.

Breast and Cosmetic Implant Registry

The Breast and Cosmetic Implant Registry (BCIR) was set up in 2016 to record the details of anyone who has breast implants for any reason.

This is so they can be traced if there's a safety concern about a specific type of implant.

Find out more about the Breast and Cosmetic Implant Registry (BCIR).

Breast screening (mammogram) after implants

It's important to remember you can still get breast cancer after having breast implants. This means you need to be aware of how your breasts look and feel and report any changes quickly to your GP.

Read more about how to check your breasts.

You should also still have regular breast cancer screening (mammogram) after having breast implants. Mammograms are safe and do not cause the implant to rupture.

Tell the person doing your mammogram if you have breast implants. X-rays cannot pass through implants, so they may need to do the mammogram a different way to allow as much breast tissue as possible to be seen.

Read more about breast screening.

What to do if you have problems

Cosmetic surgery can sometimes go wrong, or the results may not be what you were expecting.

Contact the clinic where you had the operation as soon as possible if you have unexpected pain or symptoms such as a burning sensation, unusual swelling in or around your breast or changes in the colour of your skin.

You can report problems with your breast implants through the government's Yellow Card Scheme. By reporting any issues, you're helping provide more information about the safety of the implants.

If you're not happy with the results or think the procedure was not carried out properly, speak to your surgeon at the hospital or clinic where you were treated.

You can also contact the Care Quality Commission (CQC) if you have concerns about your care. If necessary, you can raise a concern about a doctor to the General Medical Council (GMC).

The Royal College of Surgeons also has more information and advice about what to do if things go wrong with cosmetic surgery

More information

• British Association of Aesthetic Plastic Surgeons (BAAPS): breast augmentation
• British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS): breast augmentation
• Royal College of Surgeons: cosmetic surgery