Everything You Need to Know About Getting a "Boob Job"

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Breast augmentation, better known as a "boob job," is not something that should be entered into lightly. Whether you want to increase your cup size, reduce your breasts or lift them post-pregnancy or weight loss, you want to enter into the process with your eyes wide open and fully informed. I spoke to Patrick Mallucci, founder of Mallucci London, to find out all there is to know about breast augmentation from the consultation to the recovery. Mallucci is a world-renowned breast surgeon who not only performs the procedures at his state-of-the-art clinic but also lectures on the subject of "perfect" breasts.

If you're thinking about undergoing breast surgery, keep scrolling for your straight forward guide to breast augmentation.

What does the consultation involve?

It involves a few things: Trying to get to know the individual and understanding the motivation that led them here. I learn about their medical background, in case there is anything relevant that may have significance when it comes to the surgery. Finally, I examine the patient physically, as this plays an important role whether going bigger, smaller or adjusting. Combining all those factors I get to a picture of what the patient wants, their expectations and what is realistically achievable.

The key is managing expectations. As you can imagine, people come in with a view of what can or can’t be done and I always use the phrase, "It’s not what you want, but what you can have." This is largely determined by your own anatomy and is true whether you're considering implants or a reduction. It's all about tailoring everything for that particular individual.

What questions should you be asking and what should the specialist be telling you?

People need to be well-informed about the procedure. Ask about the competence of the practitioner. Is this something they do often? How many cases do they do? What are their complication rates? Ask them to show you examples of their work and check that they are a member of a recognised organisation such as BAAPS or BAPRAS (you can look up who is registered on the websites). You could also ask your GP for recommendations.

How do you decide the size and shape?

One of the things I talk about is an aesthetic goal. I spent a lot of time trying to define what a naturally attractive breast should look like. Essentially, there are four key features of the breast that render it attractive. The end goal is trying to achieve this same attractive look whether lifting, going bigger or smaller:

The magic ratio between the upper pole and lower pole (meaning the amount of tissue above and below the nipple). It should be a 45:55 ratio—45% above the nipple and 55% below it. You want the breasts to be slightly fuller below than above.

With that ratio, you get a slight upward angulation of the nipple.

A natural upper pole slope from chest to the nipple.

A tight convex curve of the lower pole, from nipple to breast fold.

I use this as an aesthetic template. The size and volume then depend on the anatomy of the individual. Some will have more capacity than others. Some people are slim, and others are broader. This is called tissue-based planning.

Women can often fluctuate in weight, so what size should someone be going into surgery?

I think the key is stabilisation of weight if you tend to yo-yo. The extremes of weights are no-no's—obese or anorexic people are not good candidates. You should be at your ideal or stabilised weight. Some people say, "I’m a few pounds overweight, but this is me, and realistically, being lighter isn't going to happen," and that's okay.

Are there different types of implants?

There are many different brands of implants. I compare it to trainers (there’s Adidas, Nike, Reebok, New Balance and so on). In general, terms there are two different shapes: round or teardrop. They do different things and offer slightly different looks. People who want a more natural look will go for teardrop, while those after a less natural look will go for round. Anatomy may favour one over the other. In some instances, I may say you need a teardrop for your particular breast shape, or, on the other hand, round.

There was a lot of news about PIP implants a while back. How can you ensure the implants are safe?

Implants are never far from controversy. Ask the surgeon what implants they use, why they use them and for what reason they have been selected.

If someone doesn't live in London, how can they go about finding a reputable surgeon?

Going to the BAAPS or BAPRAS website is a good place to start. Ask your GP or maybe you know someone who has been treated. Get as much information as possible beforehand.