Dr. Laurence Kirwan – Breast enlargement – what is it?

July 24th, 10:06
Technically known as Augmentation Mammaplasty, this is one of the most popular cosmetic procedures in the US and the United Kingdom. An implant is inserted through a small incision and positioned either behind the pectoralis major muscle or beneath the actual tissue of the breast. When the implant is beneath the muscle, it may have a more natural appearance, Kirwan says.Dr. Laurence Kirwan explains that an implant may look unnatural in front of the muscle if you have a small amount of breast tissue and not much subcutaneous fat. Wrinkling in the implant is also more visible when the implant is placed in front of the muscle.
The ProcedureProf. Laurence Kirwan considers a breast enlargement takes approximately one hour. In the United Kingdom, the surgery is carried out at a private hospital. You will usually stay in the hospital for one night. In the United States, surgery is usually performed at our Accredited Surgical Center in Norwalk, Connecticut. For patients who request or require a hospital setting, cosmetic surgery is performed at the Greenwich Hospital in Greenwich Connecticut or the New York Eye and Ear Infirmary in Manhattan, New York, Kirwan says.

The Recovery Period

Implants are either positioned in front of or behind the muscle. After surgery, you will wear a “bandeau” (for 14 days, day and night and for 2 more weeks during the day only) to position the breast implants. In most cases, no bra is recommended for 6 weeks. Under-wire bras are usually to be avoided except for social occasions. Some sutures may be removed 4 days after surgery. Most sutures do not need to be removed. The remaining sutures will absorb spontaneously and help to give you a narrow scar that is barely visible, Dr. Laurence Kirwan says.

Although you will be out of bed on the same day as your surgery, you will be advised when you can resume your daily routine. Light exercise, such as gentle walking, is permitted at one week, more vigorous exercise at two weeks. You may return to a regular exercise schedule at three weeks. To permit proper healing, you should avoid lifting weights for three weeks, Kirwan says. The decision regarding when you should return to work and fully resume normal activities depends on how fast you heal and how you feel. Most patients return to work within seven days. Air travel is permitted after 5 days. No heavy lifting (greater than 5 pounds) is recommended for 10 days. You may drive after 7-10 days. Automatic transmission is easier than a manual transmission or “stick shift.” Dr. Laurence Kirwan says.

How will I look?

You will discuss the eventual size of the breasts with Prof. Laurence Kirwan during the initial consultation. Your new breasts should look and feel natural. After the procedure, most women adapt quickly to their new shape and rarely give a second thought to their implants. They will not affect fertility, pregnancy or your ability to breastfeed, Kirwan says
Since the purpose of the procedure is to make, your breasts look attractive;
scars are kept as small as possible and usually made either under the nipple or under the crease of the breast.

Type of implant

Breast implants are made with either a smooth or a textured surface. There are some theoretical advantages to a textured implant in that it may be associated with a decreased rate of capsular contracture.
The disadvantage of a textured implant is that it remains immobile on the chest wall and has a harder feel and more unnatural look. For this reason,Prof. Kirwan prefers silicone gel implants with a smooth envelope. The following implants are available:
Anatomically Shaped Cohesive Silicone Gel
This unique shape-retaining cohesive silicone gel implant maintains its original shape. The disadvantages of the anatomical or tear-drop shape is that it keeps the same shape in the standing and the lying position whereas a normal breast is round in the lying position and tear-drop shaped in the standing position. Studies have shown that the round implant is teardrop shaped in the standing position. Anatomical implants generally have a greater forward projection than the same volume round implant, Laurence Kirwan says.

Silicone Gel Implants

Silicone implants have been successfully used since 1962. Silicone gel has an excellent texture as a filling material because it is soft and pliable and allows for natural movement. Silicone gel feels like natural breast tissue. The possibility of silicone interfering with the standard mammography can be overcome easily by informing your radiologist about the presence of the implant; he or she can alter the technique to obtain the optimum result (Eklund Technique). Radiologists, who perform this procedure as well as other diagnostic studies for breast tissue and implants, will be recommended by Dr. Laurence Kirwan in the USA and the UK. There has been no evidence that silicone gel is related to connective tissue disease. In fact, silicone appears to be one of the most inert materials known.

When you choose silicone gel-filled breast implants from Allergan’s Natrelle Collection, you have the additional peace of mind of our unique NatrellePlus lifetime warranty, to which you are automatically enrolled. This guarantees your implant against loss of shell integrity resulting in implant rupture that requires surgical intervention. This applies to all Natrelle products that have been implanted after 31 March 2004.

The NatrellePlus Warranty Features:

Lifetime Product Replacement
10 years of guaranteed financial assistance. Receive up to £700 of out-of-pocket expenses for surgical fees, operating room and anaesthesia expenses not covered by insurance
Automatic enrolment
Free size change and free style change
Free contralateral breast implant replacement on surgeon’s recommendation

We also offer BioDynamic breast sizing at consultation so you can visualise your new look with confidence.

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Dr Laurence Kirwan – Face lift

Coming soon: Laurence Kirwan ‘s algorithm for face-lifting, a step wise guide to procedures for facial rejuvenation

See article: Neck rejuvenation (Cosmeticbeautymagazine.com)
 by Dr. Laurence Kirwan

See also: Adjuncts to facial rejuvenation 
by Laurence Kirwan

See article: Six ways to tell if you need a facelift 
by Dr. Laurence Kirwan

See also: Short scar facelift 

by Laurence Kirwan


Definition: Rejuvenation of the lower face from the temples to the lower neck.

Age: From 30 years old and up.


Dr Kirwan’s surgical technique: The extra skin is removed. Fat is suctioned from the jowls and under the chin. The muscles in the face and neck are tightened. The cheek fat is elevated to a youthful level recreating the cheek highlights. The incisions are placed inside and behind the ear so that you can wear your hair back. The sideburn is left in its youthful position.

Dr Laurence Kirwan’s philosophy: Think of cosmetic surgery as maintenance surgery. Stay fresh and young looking with regular procedures.

Waiting until you are 65 and going in for the “works” expecting to come out looking natural is unrealistic. But if you already had a facelift at 45 or 50, then you will look good after a second facelift at 65. Those who ignore this advice may need a mini- facelift 18 months after surgery to tighten the skin again.

Surgical time and recovery fot Dr Laurence Kirwan’s face lift: Surgery takes about 2-3 hours. Stitches are out after 9 days. The patient can go back to work at 10-14 days.

Dr Laurence Kirwan’s related procedures: The most frequent related procedures are blepharoplasty and browlift. A chin implant corrects a receding chin. Alloderm lip implants restore a thin aging lip and a nasal tip-plasty will elevate the end of the nose to a youthful level and reduce a bulbous tip.

Adjuncts to facial rejuvenation: advices from Prof. Laurence Kirwan.

Facial aging involves loss of cheek and chin projection due to descent of the fat pads over the cheek and chin regions. In addition, in the chin area, the sagging of skin in the neck and often a pre-existing obtuse angle between the neck and jaw line, contribute to the loss of definition. Using implants in facial rejuvenation can help.

For the last 15 years Laurence Kirwan has used solid silicone implants. They are stable and imperceptible when placed immediately next to the bone. They can also be easily removed or replaced.

Cheek implants can augment the effects of a facelift and can be used either to elevate the cheek bones alone using a standard malar implant, or they can be used to augment the cheeks as well as filling in any hollowness in the dimple area. An extended implant is used in this case. Occasionally only the dimple area is treated using a “submalar implant”.

Dr. Kirwan thinks chin implants are especially helpful in the case of facelift patients with loss of neck definition or a flat contour to the front of the chin.

One of the signs of ageing is an enlargement of the nasal tip cartilages and a drop of the tip giving a hooked appearance. As the tip descends, the bridge of the nose appears more pronounced. Dr. Laurence Kirwan considers minor refinements of the nose can make a big difference. The tip cartilages can be reduced and the tip is elevated. The bridge of the nose is shaved without breaking the nasal bones. The effect is subtle but overall a definite boost to the facial improvement.

These procedures can be performed at the same time as face-lift.

1) Cheek Implants by Laurence Kirwan

Can be performed at the same time as a facelift or as a separate procedure. An incision is made inside the mouth just above the incisor tooth. A pocket is made along the bone and over the cheek area. An implant is placed in the pocket and sometimes secured with a stitch that comes through the skin or an internal stitch. The incision is closed with absorbable stitches.

After surgery the swelling increase for 2-3 days and then recedes. Most swelling is gone after 7-10 days but the appearance will continue to change for up to 12 months as the tissue reshapes around the implant.

2) Chin Implants by Dr. Laurence Kirwan

Usually performed at the same time as a facelift or as a separate procedure. A small incision is made under the chin. A pocket is made along the bone. An implant is placed in the pocket and secured with an internal stitch. The incision is closed with stitches which are removed 5 days later.

After surgery the swelling increase for 2-3 days and then recedes. Most swelling is gone after 7-10 days but the appearance will continue to change for up to 12 months as the tissue reshapes around the implant.

Nasal rejuvenation surgery by Prof. Kirwan

Usually performed at the same time as a facelift or as a separate procedure. Incisions are made inside the nose and the tip cartilages are visualised and reduced so as to give a more defined tip.

Sometimes an “open” approach is used which means that an additional incision is made in the skin between the nostrils on the under-surface of the nose. This allows more control of the final shape of the nasal tip. The nostrils can be narrowed by excising a wedge of the nostril rim in the crease at the side of the nose leaving a scar which is usually barely visible. The cartilage and bone of the bridge of the nose is shaved either through the internal incisions alone or through the open approach. The incision is closed with stitches which are removed 5 days later. A simple tape dressing is applied and left in place for 2-5 days.

After surgery the swelling increase for 2-3 days and then recedes. Most swelling is gone after 14 days but the appearance will continue to change for at least 12 months. Nasal tips in particular will remain swollen for several months and may take 6-12 months to see the optimal result.

More information for Professor Laurence Kirwan’s facial Plastic surgery procedures.

Laurence Kirwan, MD, FRCS, a Board Certified Plastic Surgeon, specializes in Aesthetic-Reconstructive Plastic Surgery of the face, breast and body.

Professor Kirwan was born in Liverpool and graduated from the Victoria University of Manchester. He is a Fellow of the Royal College of Surgeons of England. He also trained in General Surgery at Columbia Presbyterian Medical Center in New York. Dr. Laurence Kirwan training in Plastic Surgery was undertaken in Kansas City Missouri and in Hand Surgery at the University of Colorado.  He has a Plastic Surgery practice in Park Avenue, New York and Norwalk, Connecticut in the United States (USA) and in Harley Street London, England, UK (United Kingdom). He is certified by the American Board of Plastic Surgery (ASPS). Prof. Laurence Kirwan has been in private practice in the United States in Connecticut and New York since 1987. He has practiced in the United Kingdom since 1998. He is a Clinical Instructor for the Aesthetic Surgery Fellowship at New York Eye & Ear Infirmary where he is a Member of the Section of Plastic Surgery. In 1996 Laurence Kirwan was appointed a Professor of Aesthetic Plastic Surgery (University of Belgrade) at the International School of Aesthetic Plastic Surgery.

Dr Kirwan has been named one of the Best Plastic Surgeons in the Tatler Guide to Cosmetic Surgery in 2004, 2007,2008, 2009, 2010 and 2011. His patient, Ulrika Jonsson, a UK media celebrity and author, was featured on the cover of Hello Magazine after her breast reduction surgery by Prof. Kirwan, in 2009. The London Evening Standard has nominated him as one the 1000 Most Influential Londoners in 2008, 2009 and 2010. He is listed inDebrett’s ‘People of Today’ and was also named as one of the Top 20 Plastic Surgeons, Worldwide in the January 2006 issue of Russian Vogue.

Prof. Laurence Kirwan has published extensively in journals and books related to Plastic Surgery and Hand Surgery and taught Instructional Courses and participated in Expert Panels at National and International Scientific Meetings such as the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons.

Laurence Kirwan has written several books, including Cutting Edge,:(Artnik, 2004) ISBN 1-903906-22-9 and been featured in several others such as Plastic Surgery: The Worlds’ Top Surgeons and Clinics (Beyond Black Publications, 2007)  and The Goddess Guide by Gisele Scanlon (Harper Collins, 2007).

Professor Laurence Kirwan’s philosophy is never to do so much that the patient looks unnatural and never to do too little so that improvement is only in the eye of the beholder. His constant goal is to improve the aesthetics and quite simply create ageless beauty, whether it be a harmony of form or a recreation of youthful features.