§01 Breast · Cosmetic surgery
Breast enlargement · Breast implants · Bilateral breast augmentation (BBA)
Breast augmentation is an operation that enlarges or reshapes the breasts, most often by placing a silicone gel implant behind the breast tissue or the chest muscle.
The surgeon who would operate decides whether it is right for you and takes your consent personally. Vertex Medic helps you understand it first, then coordinates the consultation and the practical side.
Free to ask · No obligation · Never a clinical assessment
Vertex Medic is a booking, marketing, administration and coordination platform. It is not a clinic and does not employ surgeons. Your surgeon, an independent registered clinician working from registered premises, decides whether a procedure is suitable, takes your consent and carries it out. Vertex helps you understand your options, arranges the consultation and keeps the practical side in one place.
§02 What it is
Breast augmentation, also called breast enlargement, is an operation to make the breasts larger or fuller. In most cases a surgeon places an implant behind the breast tissue, either on top of the chest muscle or partly or fully behind it, through a cut usually made in the crease under the breast. Implants have a silicone shell and are usually filled with silicone gel; saline-filled implants exist but are used less often in the UK. A less common alternative is fat transfer, where fat is taken from another part of the body by liposuction and injected into the breast.
That approach usually needs more than one session and produces a more modest change. People consider the operation for different reasons: breasts that have always been small, breasts that have lost volume after pregnancy, breastfeeding or weight loss, or a noticeable difference in size between the two sides. A mild degree of droop can improve with an implant alone, but more significant droop usually needs a breast uplift (mastopexy), with or without an implant, and it is the surgeon who advises which applies in a particular case. It is almost always a private procedure.
The NHS funds it only in exceptional circumstances, such as a marked asymmetry or absent breast tissue, and criteria vary by region. The UK professional bodies describe breast implants as a long-term commitment rather than a one-off event: implants do not last a lifetime, further surgery is likely at some point, and anyone having the operation needs to be prepared for that personally and financially.
Vertex Medic does not assess suitability. This section exists so you can decide whether a consultation is worth your time; the surgeon decides the rest.
§03 Options
The surgeon recommends a technique after examining you. This is what the choice tends to affect, so the conversation makes sense when you have it.
A silicone shell filled with cohesive silicone gel. The UK professional bodies note that most people are offered these because they tend to feel the most natural, come in a range of shapes and are durable.
Often considered for: The majority of augmentations in the UK.
A silicone shell filled with sterile salt water. Saline implants tend to feel less natural, ripples and folds may be more visible, and they can deflate if the shell fails.
Often considered for: Chosen less often; sometimes preferred by people who want a saline fill for personal reasons.
The same width as height, giving more fullness at the top of the breast. If a round implant rotates the shape does not change.
Often considered for: People who want visible upper fullness, or where the surgeon prefers a smooth-surfaced implant.
Width and height chosen separately for more control over the final shape, with more volume in the lower part. These are usually textured to reduce rotation, because rotation of a teardrop implant changes the breast shape.
Often considered for: People seeking a more sloped, natural profile or with particular chest proportions.
The implant shell can be smooth, textured to varying degrees, or coated in polyurethane foam. Texturing is used to reduce capsular contracture and rotation, but nearly all reported cases of the rare lymphoma BIA-ALCL have involved textured implants. Smooth implants can take several months to settle into position.
Often considered for: A decision the surgeon discusses in light of shape, placement and current safety guidance.
The implant sits behind the breast tissue and in front of the chest muscle. Described by the professional bodies as the simplest option, usually with less discomfort, and it can help with slight drooping.
Often considered for: People with enough natural breast tissue to cover the implant.
The implant sits behind the chest muscle, giving more padding over the implant and reducing the chance of feeling or seeing its edges. The implant may move when the muscle contracts, which is called animation and is normal.
Often considered for: Slim people with little breast tissue.
The implant sits partly behind the muscle at the top and behind the breast tissue at the bottom, combining aspects of the two approaches.
Often considered for: A common compromise chosen by the surgeon for people with some drooping or thin upper coverage.
The implant is most often inserted through a cut in the crease under the breast. Alternatives are a cut around the lower edge of the areola or in the armpit. Each leaves a scar in a different place and has different trade-offs for access and control.
Often considered for: The inframammary fold is the usual route; the others are used selectively.
Fat is removed by liposuction from an area such as the hips, thighs or abdomen and injected into the breast. Only a modest amount can be added per session, some of the fat is reabsorbed, and several sessions are often needed. The professional guide notes that only a person's own fat should ever be injected into the breast.
Often considered for: People wanting a small increase without an implant, or to refine the result around an implant.
An implant combined with an uplift, either in one operation or in two stages. The professional guide describes this as difficult surgery whose results are less predictable in size and shape.
Often considered for: People with both loss of volume and significant drooping.
Revision surgery to replace, resize or remove implants, sometimes with removal of the capsule. This is a separate operation with its own risks and costs.
Often considered for: People with rupture, capsular contracture, a change of mind about size, or who no longer want implants.
§04 Consultation and decision
From the first consultation, every clinical decision is your surgeon's. Vertex Medic arranges the meeting and keeps the paperwork; it is not in the room.
The consultation should be with the surgeon who will actually perform the operation. UK guidance from the Royal College of Surgeons and the GMC is clear that only that surgeon should advise on the procedure and seek consent.
The surgeon takes a full medical history, including current medication, herbal remedies, smoking, previous breast problems, family history of breast cancer and any plans for pregnancy or significant weight change. A chaperone can be requested for the examination.
The surgeon examines and measures the breasts and chest wall, assesses how much skin and breast tissue is available, and usually takes clinical photographs for the record with separate written consent.
You are asked what bothers you about your breasts and what you hope surgery will achieve; the surgeon explains what can and cannot be achieved for your particular frame.
Options are discussed: implant fill, shape, surface, size range, placement and incision site, and whether an uplift or fat transfer would be more appropriate. Sizers in a bra or 3D imaging may be used, but only as a rough guide.
The surgeon explains the risks and complications, both early and long-term, including capsular contracture, rupture, changes in sensation, BIA-ALCL and the likelihood of further surgery in the future.
You should receive written information about the procedure and a written quote setting out what the package includes and excludes, including the cost of treating complications and any policy on revision.
The GMC requires patients to be given time and information to reach a voluntary decision. The RCS standards ask for a two-stage consent process with a cooling-off period of at least two weeks, and the BAAPS and BAPRAS guidance advises walking away from anyone who applies pressure or does not offer that time.
The surgeon should consider psychological needs and may suggest deferring surgery or referral to a psychologist where expectations seem unrealistic or where there is a history of repeated cosmetic procedures.
You should be told about the Breast and Cosmetic Implant Registry and, in Northern Ireland, asked for consent to be included; in England and Scotland inclusion is expected as standard.
The surgeon will normally ask permission to write to your GP. A second consultation is usually offered before the operation and a second opinion from another surgeon is reasonable.
§05 What generally happens
Every timing here is typical, not promised. Your surgeon and anaesthetist give you the plan that applies to you.
You are admitted on the day of surgery, usually having fasted, and the surgeon confirms the plan, marks the breasts and completes the second stage of consent.
An anaesthetist gives a general anaesthetic in almost all cases.
The surgeon makes the planned incision, most often in the crease under the breast, and creates a pocket behind the breast tissue or the chest muscle.
The implant is inserted and positioned; sizers may be tried first. Both sides are checked for symmetry before closing.
The incision is closed with stitches, often dissolvable, and dressings and a supportive bra or binder are applied. A drain is occasionally left in for a day or two.
The operation itself usually takes around 60 to 90 minutes; the professional guide says about one and a half hours.
You wake in a recovery area and are monitored before either going home the same day with a responsible adult or staying one night.
§06 Recovery
The scale is stretched in the early weeks so the first days can be read. Every timing is typical, not promised; your surgeon gives you the plan that applies to you.
Day 1 to 12 months on a logarithmic scale: the first fortnight takes up half the line because that is where the questions are.
First 48 hoursDays 0 to 2
Most people wake with dressings and a supportive bra in place. The chest usually feels tight, sore and heavy, and the ribs beneath the breasts may be tender; pain is generally controlled with regular painkillers prescribed by the surgical team. Some people go home the same day and others stay one night. If a drain has been used it is usually removed after a day or two. Someone needs to drive you home and it helps to have support at home for the first few days.
Rest of the first weekDays 3 to 7
Swelling and bruising are usually at their most noticeable during the first week and the breasts often sit high and look tight. Gentle walking is encouraged from day one, but lifting, reaching overhead and driving are avoided; the NHS advises not driving for at least a week. Non-dissolvable stitches, if used, are removed at around a week. Showering is usually possible once the surgeon confirms the dressings allow it.
Return to light activityWeeks 2 to 3
Most people return to desk-based work after one to two weeks, later for physical jobs. A wound check with the surgical team usually falls in this period. Numbness, tingling or oversensitivity of the nipples and lower breast is common at this stage. The supportive bra is generally still worn day and night.
Gradual return to exerciseWeeks 4 to 6
The NHS advises avoiding heavy lifting and strenuous exercise for at least a month, and many surgeons allow a gradual return to full exercise by around six weeks. Scars are usually red and firm during this period. The high, tight appearance generally begins to soften as swelling settles and the implants start to drop into position.
SettlingAround 3 months
The shape usually looks more natural as the implants settle, and the professional guide notes that the longer-term result emerges at three to four months. Some surgeons advise wearing a sports bra continuously for up to three months. Scars often change from red towards purple in this phase before starting to fade.
Maturing6 to 12 months
Residual swelling has usually gone and the breasts feel softer. Scars continue to mature and fade towards a paler line but do not disappear. Sensation that is going to recover usually does so within this window, though some altered sensation can be lasting. This is generally the point at which the surgical result is regarded as settled.
Living with implantsYears afterwards
Implants are not lifetime devices. There is no fixed replacement schedule and routine exchange at a set time is not recommended, but rupture, capsular contracture, shape change or a wish for a different size can lead to further surgery. Breasts with implants still change with pregnancy, weight and age. Anyone with implants should tell the mammography service about them when invited for screening and seek advice about any new swelling, lump, firmness or change in shape.
§07 Scarring
Scars depend on the incision chosen. The most common approach is a cut of a few centimetres in the crease beneath the breast, which sits in the fold and is usually covered by the breast itself.
Alternatives are a cut around the lower edge of the areola or in the armpit. Scars are typically red and raised in the first six weeks, change towards purple over the following months, and fade to a paler line over a year or more.
Most people form good-quality scars, but scar healing is unpredictable and some people develop thick, stretched or raised scars. Scars fade but they do not disappear.
dashed: where an incision typically runs
§08 Risks and trade-offs
The list below separates the risks of any surgery from the ones specific to this procedure. No likelihoods are given here: your surgeon should explain how likely each one is for you, and how it would be treated if it happened.
§09 Questions to ask
Tick them as you go. The list stays on this device and goes nowhere else.
§10 Choosing a surgeon
Vertex Medic lists the checks. The registers are the source of truth, and they are free to search.
check the surgeon holds a licence to practise and is on the specialist register, normally in plastic surgery, at gmc-uk.org. The BAAPS and BAPRAS leaflets say to use only a surgeon on the GMC specialist register.
Open the GMC registerthe Royal College of Surgeons certifies surgeons in defined areas including cosmetic breast surgery; the register of certified surgeons is searchable on rcseng.ac.uk.
Open the RCS cosmetic surgery pagesBAAPS or BAPRAS membership indicates a standard set of recognised qualifications, though membership is not itself a licence.
Open the BAAPS directoryCQC registration of the hospital or clinic in England (Healthcare Improvement Scotland, Healthcare Inspectorate Wales or RQIA in Northern Ireland), and whether the hospital is signed up to the ISCAS complaints scheme.
Find a service on the CQC registerthe RCS standards require adequate indemnity covering the procedures undertaken and advise patients to confirm the surgeon is insured to operate in the UK and what the hospital's cover includes.
Open the RCS cosmetic surgery pageswhat is covered, for how long, and at what cost, including consultations, scans and further surgery.
a named doctor for complications rather than a helpline, out-of-hours access, and a discharge letter with follow-up appointments.
the GMC requires enough time and information for a voluntary decision, and the RCS standards specify a two-stage consent process with at least two weeks between stages, with consent taken by the operating surgeon.
Open the GMC registerthe GMC and RCS say surgeons should not use time-limited deals, discounts, two-for-one offers or non-refundable deposits to encourage a decision.
Open the GMC registerthe surgeon should record the implants on the Breast and Cosmetic Implant Registry and give you written details of the implant type, manufacturer and serial numbers.
Sources: GMC: Guidance for doctors who offer cosmetic interventions (2016) · Royal College of Surgeons: cosmetic surgery · CQC: choosing cosmetic surgery · CAP Code, section 12: medicines, medical devices, health-related products and beauty products. Vertex Medic follows the same rules on this site.
§11 What moves the price
Your chosen provider gives you a written, itemised quote after your consultation. This is what usually changes the number, and what the quote should say.
£3,500 to £8,000
Around £3,500 to £8,000 for breast implant surgery, which does not usually include the cost of consultations or follow-up care
Source: NHS, Breast enlargement (implants). Page last reviewed 21 September 2023; next review due 21 September 2026. Checked 5 September 2026.
Prices vary by surgeon, hospital, complexity and location, and the NHS figure excludes consultations, follow-up and any future revision or implant replacement. Vertex Medic does not set or quote treatment prices; any figure is provided by the independent surgeon or registered provider in a written quote.
§12 Common questions
Implants are not lifetime devices. The BAAPS leaflet says implants usually last about ten years, sometimes less and sometimes more, and the joint professional guide notes that implants can stay in without problems for much longer. There is no agreed replacement schedule and routine exchange at a set time is not recommended; replacement is advised only if there is a problem or you are unhappy with the appearance.
No. Implants are measured by volume, not cup size, and no surgeon can guarantee a cup size because the same implant looks different on different frames. The surgeon assesses your chest wall, existing breast tissue and skin and offers a realistic range; you can say whether you prefer the larger or smaller end of it.
Implants do not cause breast cancer, and they do not make it harder to feel for lumps. They do obscure some breast tissue on a mammogram, so you need to tell the screening service you have implants; extra views may be taken and the scan is less sensitive than in someone without implants. Mammograms are safe with implants and do not cause them to rupture.
Implants do not usually prevent breastfeeding, and there is no evidence of harm to babies of people with silicone gel implants. There is some evidence that milk supply may be reduced in some people. Incisions around the areola may carry a higher chance of affecting the milk ducts, which is worth raising with the surgeon if future breastfeeding matters to you.
Breast implant associated anaplastic large cell lymphoma is a rare cancer of the immune system that develops in the scar capsule around an implant, almost always a textured one, on average about eight years after insertion. It usually shows up as swelling of one breast from fluid around the implant, and is usually treatable by removing the implant and capsule. The MHRA does not advise removing textured implants in people without symptoms; anyone with new swelling or a lump should contact their implanting surgeon and GP.
Breast implant illness is a term some people use for symptoms such as tiredness, brain fog, joint aches and low mood that they associate with their implants. It is not a recognised medical diagnosis and no causal link has been established, but the symptoms are real to those who experience them. Some people report feeling better after implant removal and others do not; a surgeon can discuss the options and what removal would involve.
Almost never. The NHS treats it as cosmetic surgery, and funding is limited to exceptional circumstances such as a very marked difference in breast size or absent breast tissue, with criteria set locally. If you have private surgery, the NHS will usually only treat emergency complications, so long-term follow-up and any revision remain private costs.
UK guidance treats this as a warning sign. The GMC requires surgeons to give enough time and information for a voluntary decision and not to use promotional tactics that encourage an ill-considered choice. The RCS standards ask for a two-stage consent process with at least two weeks between stages, and the BAAPS and BAPRAS leaflets say that if you are not offered a cooling-off period or are put under pressure you should walk away and look elsewhere.
§13 Also considered
Ordinary editorial navigation: nothing here is inferred from anything you have told us.
Written by the Vertex Medic editorial team from published UK guidance, checked 5 September 2026. This page is general information, not medical advice. Your surgeon will assess you personally, and no surgeon can guarantee a particular result.
§14 When you are ready
Tell the Vertex Medic booking concierge what you are considering. A real person calls you back within one working day, explains what happens next, and arranges a consultation with an independent surgeon if you want one. No deposit, no deadline.
Free to ask · No obligation · Never a clinical assessment
Vertex Medic coordinates your care and remains your point of contact. Your treatment is carried out by the surgeon and registered healthcare provider named above, who are responsible for your clinical care. These details are confirmed to you in writing before you book.