Size Doesn’t Matter

In this video Jonathan discusses why size is not the only factor to consider when it comes to choosing breast implants.

When Should You Change Breast Implants?

There is a lot of information about when to change breast implants but it is important to separate the facts from opinions.

  • Have you heard that you need to change breast implants every 10 years?
  • Do you know what to look out for if you have had your implants in for several years?
  • Do you need to change breast implants if you have a capsular contracture?
  • How can you tell if your implants have ruptured?
  • Do you need to have a check up of your implants at a certain time?
  • Are there risks if you were to change breast implants?

Jonathan is one of the UK’s leading plastic surgeons with a practice dedicated to cosmetic breast surgery. If you are worried or just curious about whether your breast implants need to be changed, watch this video to find out the answers.

If you have any questions or would like to come to the Staiano Clinic to have your breast implants checked, please get in touch and one of the team will be happy to help.

ALCL – Rare Cancer associated with Breast Implants

You may have heard in the news about ALCL, a rare form of cancer associated with breast implants.

Read more

The 2nd Biggest Fear That Breast Enlargement Patients Have – Wide Cleavage

I am worried about a wide cleavage.

Probably the second biggest fear that patients having breast enlargement have is that they will be left with a wide cleavage (the first biggest fear is that they will look like Dolly Parton or Jordan).
This is not something that I see very much in my practice, but when patients search on the internet they find photographs of women with abnormally wide cleavages and they are worried that they might end up looking like this.

A wide cleavage is one of the biggest fears of breast enlargement patients.

Wonder Woman with a wide cleavage

This sort of result is an unnatural look and is usually caused by having implants placed in a submuscular plane without releasing the muscle sufficiently in the cleavage area.

Don’t worry so much about the size of the implant

I always make a point to my patients that choosing the size of the implant is an important part of the process to get the desired result. However, it is only one small part and I find that patients worry an awful lot about this and put a lot of importance on it. I see patients who have a lot of angst and sleepless nights trying to decide between two implants which may have 30cc or 50cc difference between them and so would not give dramatically different results. What is more important than the size of the implant is the shape of the implant, both in terms of its width and its projection and whether it is round or teardrop shape.

The position of the implant is crucial

The other thing that is crucially important is positioning of the implant as it does not matter what implant you choose, if it is not positioned correctly, then you will not have a good result. However, positioning the implant is entirely in the hands of your surgeon and is not something that patients tend to worry about but it is a reason to make sure that you choose you surgeon well and have confidence in his or her abilities. A widely spaced cleavage is an example of an implant that has not been positioned well.

What causes a widely spaced cleavage?

When making a space underneath the muscle there are quite large blood vessels supplying the muscle in the cleavage area. Surgeons like myself, who have experience of microsurgical breast reconstruction are very familiar with these blood vessels as we actually dissect them out and connect them to blood vessels from pieces of tissues transferred from the tummy in order to reconstruct the breast after mastectomy. It is very important to be aware of the presence of these blood vessels because this area needs to be adequately released in order to place the implant in the right position to enhance the cleavage. If the muscle is not adequately released, it can pull the implant sideways creating this very wide appearance which looks unsightly and unnatural.
Having said this, I always stress to my patients that the appearance of the cleavage area does differ between individuals. Some individuals have breasts that sit quite close together whilst others are slightly more widely spaced. The aim of breast augmentation surgery is to enhance the natural breast that you have. The examples below show good results with a pleasing enhancement of the cleavage area but you will note that the patient on the top has a slightly wider cleavage naturally than the patient on the bottom.

natural wide cleavage

naturally wide cleavage

naturally narrow cleavage

naturally narrow cleavage

Push up bras

The other important thing to note is that these photographs are taken with no clothes on and it is possible to manipulate the position of the breasts with clothing.  There are bras which can push the breasts together to enhance the cleavage or push the breasts up to make the upper part of the breast look fuller.

Natural Result

Surgery is all about enhancing the natural breast. There are some circumstances where the position of the breast may need to be manipulated or changed such as in cases of breast asymmetry or differences in the inframammary fold height or in tuberous breast deformity and so different skills may need to be utilised here. However, for many patients the breasts are in a natural position and breast implants can achieve an enhancement of this and an improvement in the size and shape of the breasts.

Choice of surgeon is more important than choice of implant

I hope this blog post has been useful. At the Staiano Clinic we try and empower patients and give the information that you need to make an informed decision. We do not wish to over complicate things or for you to get bogged down with small details, but it is important for you to know that the training and experience of your surgeon is critical because there is a lot more to getting a good result with breast implants than simply choosing the right size of implant.

For more details about breast implants – download our FREE guide with FAQs


Keep in touch

If you would like any further information please feel free to contact us though our website, Facebook or Twitter. If you would like to subscribe to our quarterly newsletter, please click here.

Cosmetic surgery can be truly life-changing

We need more positive news stories.

You may have seen our patient featured in The Sun, The Mirror, The Daily Star and The Mail last week.
She lost a significant amount of weight (8 stone) and had lost shape and volume in her breasts.  It is a great story as she is due to be married and has worked so hard to regain her body shape.  It is heartening to see stories like this in the media, as in this day and age, plastic surgery will often get negative press.  I specialise in breast and body contouring and the vast majority of patients that I see want a natural result that is in proportion with their frame.

Cosmetic surgery is about making people look and feel better

Plastic surgery is about restoring form and function and cosmetic surgery is about enhancing and improving on this.  It is not about overdoing it, whether it be breast implants or lip fillers.  The media is full of stories of strange looking people who have overdone plastic surgery, but this is a very small minority and something that I hardly ever see.

My waiting room is full of normal people like you

The waiting room in my clinics in Edgbaston and Harley Street are full of mums who have lost volume in their breasts following breast feeding or have redundant skin on their tummy which will not tighten, no matter how much exercise they do.  Or people like Chantelle, who have lost weight and they feel deflated and want their shape restored.

Thank you Chantelle, we need more positive role models

Cosmetic surgery can be truly life-changing, yet so many people carry guilt and feel that they are putting themselves through unnecessary surgery.  We need more positive role models like Chantelle to show the world that plastic surgery is for normal people who want to restore their self-esteem and their confidence and that there is absolutely nothing wrong with that!

Thank you, Chantelle, for sharing your story and good luck with the wedding!  I look forward to seeing you soon for your follow up appointment.


The Supernatural Breast Augmentation

The Supernatural Breast Augmentation

The public perception of breast augmentation is that it is for people who want to have huge breasts that are out of proportion with their bodies and that it is unnecessary surgery.  As a plastic surgeon with a practice dedicated to breast augmentation, I have to tell you that this is far from the truth.

Patient Satisfaction

Cosmetic surgery has a reputation for being for people who are vain and don’t really need the surgery, but in fact, cosmetic surgery patients have one of the highest patient satisfaction levels than any other group of patients.  One of the most important things that a doctor can do, is to improve a patient’s quality of life and breast augmentation is one of those operations that has a profound effect on self-esteem and quality of life.  Additionally, because we are usually treating young patients, this benefit is felt for many years to come, which makes breast augmentation one of the most worthwhile operations there are in terms of improvement in quality of life when adjusted for years of life that the patient has to be able to benefit from it.

Who Needs a Breast Augmentation?

The majority of my patients are either mothers who have lost shape and volume in their breasts, or patients who have always had breasts that are out of proportion with their frame in that they are either too big, too small or asymmetrical.  Most people are looking for a natural result that is in keeping with their figure and the majority do not want to look fake or top heavy.  This is in line with recent trends away from large round implants towards the more couture boob job where a modest, natural augmentation is achieved.

The ‘Natural Breast Augmentation’

During my consultations with patients, I go through my portfolio of cases and I show photographs of patients with all different sizes, shapes and projections of implants.  I have noticed that when patients look at the teardrop implants, or low profile round implants “ the implants that are often associated with a more natural look “ they comment that they don’t want to look too natural!

breast augmentation with low profile round implants

Low Profile Round Implants giving a Natural Breast Augmentation

Breast Augmentation with Teardrop Implants giving a Natural Breast Augmentation

Teardrop Breast Implants giving a Natural Breast Augmentation


The ‘Supernatural Breast Augmentation’

I am finding that patients are increasingly wanting some fullness in their breasts and while they don’t want to look fake, they do want some roundness in what I would call the ‘supernatural look’ “ like the natural look but with a bit more.  This is achieved by choosing an implant that will complement the frame in terms of the width of the implant and with a certain degree of roundness that can fill up the upper part of the breast, which is often empty, particularly following child birth or weight loss.  This ‘supernatural breast augmentation’ gives patients back what that had before, or feel that they have always had missing, plus a bit more.  It gives the breasts a fullness and perkiness that might be associated with a push up bra but without looking fake or out of proportion.

supernatural breast augmentation

Supernatural Breast Augmentation

If you are considering breast augmentation, then please read our guide to breast implants, available here.
If you would like to know more about the supernatural breast augmentation, or have any comments or questions, please get in touch by emailing the clinic at or give us a call on 0121-454 3680.

Like a Virgin “ Conical Breast Implants

Conical Implants “ for patients who are borderline for a breast lift.

During my consultations, I have a selection of breast implants to show patients.  The conical implants always invite comment, usually along the lines of ooh, I don’t think I would like those or are those the Madonna implants?
However, the truth about these implants is very different.  Conical implants are particularly good in patients who are borderline for a breast lift but do not want a large round implant, which might otherwise be necessary to ‘take up the slack’.

Breast Lift or Implants?

The main reason for patients requiring a breast lift (also known as mastopexy) is either following weight loss or after having children.  Both of these things causes the breasts to get larger, whichstretches the skin and then smaller, however, the skin does not recoil back leaving extra redundant skin and causing the breast to droop.  The best way to treat this is to remove this redundant skin and tighten the skin envelope, which is what is involved in a breast lift.  However, many patients do not want the scarring and potential complications that come with a breast lift and would prefer to have implants.  Furthermore, a breast lift in itself will not make the breasts bigger, and so a breast lift with implants may be required and this operation is challenging with an increased rate of potential complications.

Can I Avoid a Breast Lift?

Nobody wants a breast lift if they can avoid it.  If you could have an operation with fewer complications and less scarring, then obviously that would be better.  However, like most things in life, it is not always that simple!  A breast lift is the most effective way to improve the shape of the breasts and some patients need a breast lift.  There are three groups of patients:

  • Patients who need a breast lift 

this group of patients need a breast lift and whether or not they have implants is a matter of choice, depending on whether they want the cup size to be bigger, but the lift is necessary.  If this group of patients have breast implants without a lift, there is a risk of an elongated appearance to the breast where the implant is sitting in the right place but the breast is sitting low and ‘falling off’ the implant.  This is sometimes referred to as a ‘Snoopy deformity’.

  • Patients who are borderline for a breast lift

this group of patients would benefit from a breast lift, which would give a better shape to their breasts, but it is not essential.  It is this group of patients who may benefit from conical implants.  Conical implants have allowed me to increase the number of patients who are in this group and I have seen a number of patients who have been seen by other surgeons and recommended to have a breast lift, but they did not want this.  Many surgeons do not use polyurethane implants and so they do not have the option of using conical implants.  Conical implants open up this option in patients who would otherwise need a lift.

  • Patients who do not need a breast lift 

this group of patients may feel like they have lost volume in their breasts and want more fullness, but they do not need a lift and the fullness can be achieved with implants.
It is only after clinical examination that you will know which group you are in, so if you would like to come along to the clinic for an examination and to look at some before and after photographs of what is achievable with conical implants, then click hereto book a free consultation, or call us on 0121-454 3680.
Conical Implants

Breasts after breastfeeding

Breast feeding “often accompanied with the strapline the most natural thing in the world” has been proven to be the best option for your child’s health and development. This much we all know. But what happens when the breast feeding stops? For better or worse “ many women agree that after the milk stops, their breasts change in both shape and size, and for some this can affect their self esteem and body confidence.

It’s the most natural thing in the world

Fluctuations in the shape and size of a woman’s breasts will be common throughout her lifetime. Puberty, weight loss or gain and the ageing process can alter both the volume and shape of a woman’s breasts. Pregnancy and breastfeeding are arguably the biggest game changers however “ bringing both positive and negative effects. No two women are the same and every woman’s journey and experience is different.

The most important thing to remember is that changes in your breasts are very normal and natural.
One of the most common experiences after breast feeding is ptosis- which is the medical term for the drooping or sagging of the breasts. Breasts fill with milk throughout pregnancy and breast feeding, and the skin stretches accordingly. When the breast feeding stops, the milk disappears but the skin does not recoil. In other words, breasts do not always go back to their original shape or size.

Gravity also forces the breasts to drop or droop and this can leave some women feeling frustrated about how their breasts have changed.

Some fitness experts or Doctors will advise to do special exercises, which can help build up muscle again.

This can be a successful option for some. However, many women feel that plastic surgery is the best option for them. If you are thinking about plastic surgery to restore or enhance your breasts after breast feeding, there are a number of areas to think about carefully. First of all, we recommend that you only consider surgery at least a year after your baby is born and when you have finished breast feeding.

If you decide to have either a breast augmentation or a breast lift, both are significant operations and you will need time to recover. Lifting and carrying a baby might prove difficult in the initial stages of recovery, so we suggest waiting at least until your child starts walking. In addition, this gives time for your hormones to settle after giving birth, which can take up to a year. In an ideal situation, it’s best to have surgery when you have finished your family completely. This lessens the likelihood of repeat operations on your breasts as they are unlikely to change as much again.

Breast lift, breast implant or both?

There are different operations you can consider with your surgeon. The most common after breast feeding is a breast lift or a mastopexy.This is a procedure which involves removal of excess skin to lift the breast. During the procedure, the nipple is lifted to a higher position and the width of the breast is narrowed to create a better shaped breast.

It is important to be aware that scars will be inevitable and the extent of the scarring depends on the amount of tightening that is required. Scars are red and visible for the first 3 months but often fade within 6- 18 months.

A breast lift can change the shape of your breasts however it does not always address the issue of volume or size. The breasts sit higher after a mastopexy but you may still feel they lack the volume you desire. If this is the case, you may choose to have a breast enlargement as well as a breast lift. This operation is called an Augmentation Mastopexy and it involves implants being inserted into your breasts as well as the excess skin being taken away. It can be done in two operations or it can be performed in one operation, although it is technically more difficult.
The right decision for you

Many women report renewed confidence in their bodies after undergoing a breast reshaping operation. Whatever you decide, it is important to make sure you take time to discuss the right options for you with a Consultant Plastic Surgeon (not with a patient advisor or anyone else unqualified) and think carefully about what is right for you both physically and emotionally. At Staiano Plastic Surgery we offer emotional support and counselling to help you make the right decisions for you and your body and we always advise that family and friends support you on this journey.
If you would like to speak to Mr. Staiano or one of the team at Staiano Plastic Surgery don’t hesitate to call us on 0121 270 2867. We’d be happy to speak to you about any of the issues in today’s blog post.

Polyurethane implants: 5 key questions, answered

Polyurethane breast implants are used widely for breast augmentation surgery in South America, Europe and Australia. Although popular with high satisfaction rates, they have also sparked controversy in the past. Here are the key 5 questions and answers about Polyurethane implants.

1. What are they?
Polyurethane breast implants are silicone implants with a foamy texture on the outside of the implant. They are manufactured by a German company called Polytech.

2. What are the benefits?
The most significant benefit of Polyurethane implants is the reduced risk of capsular contracture. Capsular contracture is where scar tissue forms around the implant after breast augmentation surgery. This is a natural part of the healing process. In some cases however, over a period of time, the scar tissue can squeeze the implant. This will cause the breasts to harden and they can become painful. With a polyurethane implant, the textured foam layer prevents these harmful, later stages of capsular contraction. The scar tissue grows into the foamy texture and the implant becomes part of the breast tissue. With other types of implants, studies have shown that the chances of capsular contracture can be as high as 20% (1 in 5 women), 10 years after the operation has taken place. With polyurethane implants, the chances of capsular contracture were just 1%, up to 15 years post operation.

In addition, the polyurethane implants are also less likely to rotate in the breast, as the implant is more firmly attached to the breast tissue than with other types of implants.

3. What are the risks (including cancer)? 

As the implant becomes part of the breast tissue, it can be difficult to remove it. If a removal needs to take place due to infection for example, it can make the operation more difficult. The implants were also controversially linked to cancer studies carried out in the 1990s. In a series of trials, a high level of one of the chemicals used in the polyurethane implant was injected into rats and the rats developed the disease. However, this chemical has never been shown to cause cancer in humans and has been found in patients who do not have breast implants. After further studies, an FDA panel calculated the risk to be 1 in 1 million, the equivalent to smoking one cigarette in the lifetime of a patient!.  In other words “ negligible. It is important to note that cancer has never been linked to polyurethane implants in a human being.

There is a rare type of cancer that has been linked with breast implants, but this has been associated with all breast implants, particularly textured silicone implants.  I have written a blog post about it here.
4. Will I need to get them replaced in the future? 

There is a lower chance of needing replacement as the chances of capsular contracture are significantly decreased.  However, you should always consider that there may be a need to have your implants changed in the future.

5. How do I decide whether to have polyurethane implants? 

There are many factors to consider when choosing breast implants, and my previous blog on choosing the right breast implants may help you understand other types of implants and what to consider. There are many factors involved and it’s important that you discuss the right implants for you. I highly recommend talking to as many women as possible who have had surgery and doing your own independent research.
Speaking to a consultant like myself can also help! If you have any questions, do not hesitate to contact me on

What is the Best Post-Surgical Bra?

What Type Of Bra Do I Need Following My Surgery?

Postoperative Bra

There are several things to consider when choosing a post-surgical bra.  You will need a supportive bra that is comfortable and fits snugly.  It should not be too tight because, although the bra is necessary to control swelling, it will be counterproductive if it digs in and causes discomfort.  It is important that your bra is not wired and so a sports bra or dedicated post-surgery bra would be best. 

Post-surgical bras often come in sizes small, medium, large and extra large, rather than the traditional 32, 34, A, B, C, etc. because they have a degree of flexibility or ‘give’ in the material.  They also often have some degree of adjustment, which is usually in the form of two or three rows of eyes for the hooks to hook in to.    You should make sure that the bra opens either at the back or the front because a lot of sports bras need to be put on over your head and this may be uncomfortable in the days following surgery.  Front fastening is best but can be more difficult to find.

What Size Bra Should I Buy?

Your back size should not change following surgery, although the cup size will be affected.  It is important to be aware that your bra size might vary in the weeks and months following surgery and so you should be prepared to alter or adjust your bra during this time. For patients having a breast enlargement “ it is always difficult to predict the cup size you are likely to be. 

I recommend that you buy a selection of bras around the size that you hope to achieve and keep the receipts and the labels on them so that you can return them later if they are obviously unsuitable. For patients having a breast reduction “ many patients seeking breast reduction are wearing the wrong size bra and so I recommend that you get a professionally fitted bra before considering surgery. 

It may be that a well-fitting bra will alleviate many of the symptoms that you are suffering from.  When choosing a post-surgical bra, it may be worthwhile choosing a bra with the next size up on the band size that you currently are “ this will allow for swelling.  The cup size is very difficult to predict and so a range of sizes may be needed.  I can give you guidance on this. For patients having a breast lift “ the breast should be around the same size that it was before surgery.  Clearly the shape will be different, with the volume sitting higher on your chest and a small amount of volume will be removed with the skin that is taken away, but you will be in a broadly similar cup size to what you were before.

Do I Need To Buy A Bra Before My Surgery?

For patients having a breast enlargement “ I will provide you with a postsurgical bra immediately following your surgery and you should wear this day and night for the first 4-6 weeks following surgery.  I will give you an idea of the size of bra you will need should you wish to purchase one.
For patients having a breast reduction or breast lift “ you will have dressings on your breasts immediately following surgery which will act like a bra and so you will not need to worry about a post-surgical bra to start off with.   The dressings will be removed after a week and you will need to bring your post-surgical bra with you to the dressing clinic appointment.

What Bra Do You Recommend?

Postoperative Bra - Black

Front opening post surgical bra

If you can find a bra that you are comfortable in and feels supportive, then you are half way there.  Try to avoid a bra with a wire and ideally get one with a wide band that is less likely to dig in.  I mainly use bras manufactured by Plie as they offer good support, have useful adjustability and are front fastening.    The grid below shows the sizes available and for patients larger than XL, I use Macom bras which go up to size 40HH.

Sizing Chart for Plie Bras






























X Large


X Large

X Large

X Large

X Large

X Large


Macom Bra Sizing

XL  38- HH
XXL  40 “ HH
You can purchase post-surgical bras here or by calling the clinic on 0121-454 3680.
The cost of the bras are £35 each (delivery is free).

Buy Our Recommended Post Surgical Bra Here


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