The Cheltenham & Gloucestershire Specialist Breast Clinic


Breast augmentation is the most commonly performed breast cosmetic procedure. This is performed by the insertion of breast implants. The implants can be placed immediately behind the breast tissue and in front of the pectoral muscle (so-called sub-glandular placement) or behind the breast tissue and the pectoral muscle (so-called sub-muscular placement). Some people refer to sub-glandular as "in front of the muscle" and sub-pectoral as "behind the muscle".

Implants can contain either silicone or saline. In the UK and Europe, silicone implants are used in the majority of cases. The surface of the implant may be smooth or roughened (also known as textured). Most implants inserted in the UK are textured implants, as the textured surface helps to reduce capsular contracture around the implant. Capsular contracture is the formation of scar tissue around the implant; the scar tissue can shrink with time, thus causing the implant to "harden". Capsular contracture is the most common reason for later implant removal and replacement.

Normal implants have a fixed volume and may be either round or teardrop shaped. On some occasions, one may wish to use an adjustable implant or expander, particularly for ladies with developmental breast problems, such as tubular breasts. The choice of which type and size of implant as well as the placement (sub-glandular or sub-muscular) depends on the existing build of the lady and the size/shape of her bust, as well as her wishes.

We only use high quality breast implants, which we use for both our cosmetic and breast reconstruction work. We have never used PIP implants, although we have treated many women, who were unfortunate to have PIP implants inserted by cosmetic surgery companies, such as Harley Medical Group and Transform. We normally use implants from either Nagor (UK company based in Scotland) or Mentor Medical (US based - part of Johnson & Johnson); we keep a large bank of Nagor and Mentor implants in stock at the Cheltenham Nuffield Hospital. 

Sample photographs

Pre-operative teardrop sub-muscular implant

Post-operative teardrop sub-muscular implant - 3 months

Pre-operative teardrop sub-glandular implant

Post-operative teardrop sub-glandular implant - 15 months

Pre-operative round sub-glandular round implants

Post-operative round sub-glandular implants - 2 years post-op

Pre-operative teardrop shaped subglandular implants

Post-operative teardrop shaped subglandular implants - 1 yr post op

Please note: these patients have given written consent for the publication of these photos