Medico-legal Expert​​

     email:rick@ricklinforth.com 

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Breast Implants for underdeveloped breasts /tubular deformity/ asymmetry

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(Please note by choice Mr Linforth only provides Reconstructive Surgery and not pure cosmetic breast augmentation or reduction surgery)

Mr Linforth is expertly trained in breast enlargement and has been performing this operation for over 10 years at the Yorkshire Breast clinic and also in his NHS practice at Bradford Teaching Hospitals.

Mr Linforth spent 6 years training as a breast specialist surgeon and completed his reconstructive and aesthetic breast surgery training In 2005 with a year as the ABS/BAPRAS National Onco-Plastic Fellow at South Manchester University Hospital.
He also attended the well know Clinic Akademikliniken, in Stockholm, Sweden, with Per Heden, which is Europe’s largest private hospital for cosmetic surgery and who's ideology is to achieve ‘Beauty Through Science’ .  His other well know mentors have included:
Mr Krishner Clough ( Paris) Mr Moustaphe Hamdi (Belgium) and Stefan Paepke ( Berlin) to name but a few.

Since becoming a consultant Mr Linforth Pioneered the technique of accellular dermal matrices and breast implant reconstruction.

He performed the first operation of this kind in Europe in 2008, and has presented and published his work around Europe demonstrating the technique to over 1000 surgeons world wide.  

Risks associated with surgery:

Wound infection 1-3%, treated with antibiotics. However if the implant gets infected it usually has to be removed.

Scaring: All surgery leaves scars. These are usually under the breast and measure 5-8cm.

The majority of women have a very nice and long lasting result from breast augmentation. A thin layer of healthy tissue soon forms around your new breast implant to make it part of you. This is called the capsule.

This occurs around any implanted material whether it is a pacemaker or an artificial hip. In some people this tissue may thicken with time and the term for this is "capsulation "or "capsular contraction."

Capsular contracture is the most common complication that occurs with breast augmentation and can happen at any time. It seems to be more common in the first few months after surgery, but the incidence then rises again several years after surgery.There are probably several causes that affect some patients and not others. There are some factors that may increase the risk of capsular contracture.

Smoking 
The rate of capsular contraction is twice as high in smokers. Mr Linforth advises all of his patients not to smoke.
Infection 
Capsular contracture is more likely following an infection. It may occur following sub-clinical infection.

Haematoma 
This is a collection of blood around the implant. It can cause an inflammatory reaction, which can lead to capsular contracture. It is advisable to drain a haematoma if one develops.

Smooth Surface Implants 
The smooth surface implants seem to be associated with a significantly higher capsulation rate than the rough surfaced type. These rough surfaced implants were a new design change introduced over 10 years ago. The process is called "texturing". There are different ways to texture the implant. The textured implants inhibit the capsulation process and do dramatically reduce it's occurrence. The textured implants also unite better to the back of the breast tissue reducing risks of a rotation of a shaped implant. Occasionally you make get some texture-rippling form, if minor capsulation occurs with a textured implant in place.

Previous capsulation 
If you have had previous capsulation it is much more likely to occur again. There may be a genetic reason for this related to wound healing. This is unknown though.

Best advice is to stop smoking if you are a smoker. If there are no symptoms and the cosmetic result remains excellent you do not need to have anything done. It doesn't always progress.

Other complications include

Rippling and folding of the implants, making them palpable,

Rupture which can cause silicone to cause reactive scar tissue or "granulomas"

Implant Advice booklet 

Faculty of Breast Surgeons at the Acellity breast meeting Rome 2015

Left to Right

Stefan Paepke (Berlin)

Steven Kronovitz( Texas)

Stefan Pompei (Rome)

Michael Scflan (Israel)

Rick Linforth (UK) right hand side