Breast Augmentation – Breast Implants

Are breast implants an option for you?

After breast implants, many women have reported satisfaction with the appearance, size, and the softness of their breasts. They have also reported that breast implants have improved their self esteem, self image and maintained or increased their sense of well being.
But there are many factors you must seriously consider before having this procedure.
Considerations before beginning your Breast Implant journey

Breast augmentation or a boob job is an elective procedure that involves surgically enhancing the shape and size of your breasts. It can be done using breast implants or fat transfer.
In your own mind, it is important to have real reasons for wanting breast implants.

  • Improve the size and shape of your breasts
  • Improve the fullness of your breasts
  • Improve the projection of your breasts, making them perky
  • Make you look in proportion
  • Reconstruction following a mastectomy
  • Replacing implants for medical or cosmetic reasons
  • Correction of a congenital deformity
  • may improve your self esteem

Factors to consider when making your decision

Are breast implants the best option for me?
Do the benefits outweigh the potential risks of the procedure?
What complications can happen after the implants are inserted?
How long do the implants last?

Types of breast implants

Silicone Breast Implants
Silicone gel filled implants are designed to mimic breast tissue. They have an outer silicone shell encasing a firm, cohesive silicone gel that offers a more natural feel. The cohesive silicone gel has a consistency that retains its shape.

If the implant leaks the gel may remain within the implant shell or it may escape into the capsule around the implant.[/gdlr_tab]

Saline Breast Implants
Saline breast implants are a silicone envelope filled with a determined amount of sterile salt water. They provide a uniform shape, firmness and feel. They will feel firmer than the silicone implant. Saline implants are filled through a valve during the procedure when the implant is in position in the breast pocket. If the implant shell leaks, the implant will collapse and the saline will be absorbed in the body. Because the saline implant is inflated in the body the incision is generally smaller.

Shape of the Breast implants

Round Breast Implants

Round breast implants have a tendency to make breasts appear fuller than form-stable implants. They can come in multiple profiles from low to high projection to personally fit each patient. Higher profile options can achieve even more projection
Because the implant is the same shape all over, there is less concern about them rotating out of place.
Anatomical or tear drop shaped breast implants

With a fuller lower pole the tear drop breast implant or anatomical breast implant, more closely resembles the natural shape of a breast. Their design gives them greater projection in relation to the size of the base , making them suitable particularly for women with little breast tissue.
A precise degree of accuracy is required when positioning the anatomical breast implant because if they shift after surgery, the shape of the breast maybe notably distorted.
The shell of the breast implant

Smooth breast implants

Smooth breast implants are the softest feeling. These implants can move with the breast implant pocket, which may give more natural movement.
Textured breast implants

The texture of the implant may offer some advantage in reducing the risk of a capsular contracture.
Implant manufacturers occasionally introduce new styles and types of breast implants, so there may be additional options available.

Size of your breast implant

Size is perhaps the most important variable for patients who are considering undergoing breast augmentation. The one decision that will determine whether you are happy with your breast augmentation, is the size implants you have chosen.
A confusing point for a lot of prospective patients is that they get set on precise measurements and images on the internet. Obviously the same breast implant is going to look different on someone who 150cm tall as compared to someone who 170cm tall. The result will also depend on how much breast tissue there is in the first place.
Focus on size or on bra cup size that you think would suit your shape and you will find this easier to convey to your surgeon.

Your breast implant consultation.

We have types of consultations, one with a patient advisor who will give you information on only on the procedure, show you the different types of implants, and discuss complications and aftercare. It is a great way to begin your journey by talking to someone face to face, and not just rely on word of mouth, or google! And one with the Dcotor

The most important consultation is with your cosmetic surgeon.
The surgeon should take the time to answer all your questions and concerns. It is important that you are comfortable with his answers and the information he gives you.
He will also ask you about any past medical concerns, particularly relating to your breasts previous surgery, and if you have a family history of breast cancer.
He will discuss a number of options, whether breast implants will achieve the look you are the type and shape of the implants, the location of the incision, the position of the implant, complications of the procedure and having implants in your body, the aftercare, the protocol to additional surgery if complications arise.
The surgeon’s information at this consultation will help ensure your expectations and motivations are achievable.
Breast augmentation candidate

The most important consideration before you are deemed a suitable candidate for this procedure is that you are doing it for yourself.

In considering whether you are a suitable candidate you should be

  • physically healthy
  • have realistic expectations
  • your breasts are fully developed
  • You are concerned that your breasts are too small or have lost volume
  • your breasts are asymmetrical

Previous conditions in which implants may not be used and should be discussed with your Doctor

  • Previous unsuccessful breast implant surgery
  • a history of repeated breast cancer or other cancer that has spread
  • A recent infection
  • Cystic or lumpy breasts
  • Ptotic (drooping) where a breast lift with or without breast implants may be a better alternative

What breast implants will not do?

If your breasts have lost volume and severely droopy, then you may not be a suitable candidate for implants but a breast lift with or without implants.

What happens during breast implant surgery?

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include light sedation and general anesthesia. It will be a discussion with your Doctor as to which is the best option for you because your comfort is the most important

Step 2 – The incision

Inframammary fold incision (in the breast crease): This is the most common incision. It needs to be 4.5cm long and is placed on the underside of your breast in the skin crease at the junction of where your breast meets your chest wall. This incision has the advantage of giving immediate access to space behind your breast and allows direct visualization of the inframammary fold.
Axillary incision: Access the breast and place an implant using an incision, again 4.5cm long, on the anterior part of the armpit. This incision is placed high up, just on the front side of the hair-bearing skin. It has the advantage of not placing any scars on the breast, but has the disadvantage in being remote from the breast and therefore is often technically more demanding. It is almost impossible to conduct any revision surgery through this incision and hence the inframammary fold incision is used for secondary surgery.
Around the nipple.

Step 3 – Inserting and placing the breast implant

After the incision is made, a breast implant is inserted into a pocket either:
A. Under the pectoral muscle (a submuscular placement), or
B. Directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement)
The method for inserting and positioning breast implants depends on the type of implant and the amount of breast tissue.

Step 4 – Closing the incisions
Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin.
Breast implant recovery

After your breast implant procedure, you will be in a support bra to support your new implants and minimize swelling
You will be given analgesia for pain relief.
After a post-surgical breast augmentation recovery period of 24 to 48 hours and an additional reduced-activity period of a few days, you will likely experience soreness and swelling for a few weeks.

When can I return to normal activities?
Exercise and normal activity can resume after 6 weeks. It is important ot keep arm movement and exercise while healing takes place.
Breast augmentation risks and safety

The decision to have breast augmentation surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery.
You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

Frequently asked Questions

How long does the procedure take?
The majority of breast implant procedures are performed as a day procedure in a day surgery under a general anaesthetic. You will be there for approximately 4 – 6 hours. The procedure itself can take about one and a half to two hours.

How will I feel afterwards?
You will feel sore and may have some stiffness in moving your arms. It is recommended that you minimize the use of your arms while you are healing.

Breast implant risks
Possible breast augmentation surgery risks include:
Anesthesia risks
As with any type of sedation, there are inherent risks. This will be discussed in detail in relation to your health.
Bleeding can occur after any procedure. It is rare and usually occurs soon after your procedure. It to be surgically stooped.
Infection is possible with any surgery. It is more difficult to control when a foreign object, such as an implant in place in the body. It is very rare. Most infections can be treated successfully, and on occasions, the implants may be required to be removed while the infection is treated.
Changes in nipple or breast sensation
Poor scarring of the skin
Wrong or faulty position of the implant
This should be rare, as long as you have a detailed consultation with your Doctor and his staff. He should fully understand what you want to achieve, while you should fully understand what he is able to do in relation to your body shape. This may create limitations to the placement and size of the implant.
Fluid accumulation (seroma)
Wrinkling of the skin over the implant
Pain, which may persist
Possibility of revision surgery
These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your surgeon.

Risks associated with breast implants
Capsular contracture
Capsular formation and contraction is the most common change after breast implants
It can occur weeks or years after your procedure. The body’s response to any foreign object varies greatly from person to person. How much the capsule will contract, if at all, is hard to predict, as it is a personal healing response.
Other symptoms of contracture are:
• The feeling of the implant being hard
• Creasing or distortion of the implant
• Uneven thickening around the implant

• Implant rupture and leakage
If a cohesive silicone gel implant ruptures, the gel is usually contained within the capsule around the implant.
It must be stressed that an implant can rupture at any time after insertion, modern implants have a thicker envelope and are filled with a high viscosity silicone to reduce the possibility of rupture. Improvements in the manufacture of implants and surgical technique have lower the rate of rupture
Breast implants do not impair breast health. Careful reviews of scientific research by independent groups such as the Institute of Medicine have found no link between breast implants and autoimmune or other systemic diseases.
Other important considerations:
• Breast cancer – there is no medical evidence to date to show that women with breast implants have a higher chance of getting cancer including breast cancer.
• Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants
• Pregnancy, weight loss, and menopause may influence the appearance of augmented breasts over the course of your lifetime
• Breast augmentation requires regular examinations of your breasts’ health and to evaluate the condition of your breast implants.

How much do breast implants cost?

It is very difficult to give you an exact cost for a breast implant procedure. Every procedure is tailored to each patient’s expectations and body shape.
Our breast implant costs, which include all fees can range from $10,000 to $13,000.
Your price will be determined,
• By the type of implant you have
• Where the procedure is performed
• Type of anaesthetic you will require.
• Breast implant safety

Breast implants do not impair breast health. Careful reviews of scientific research by independent groups such as the Institute of Medicine have found no link between breast implants and autoimmune or other systemic diseases.
Other important considerations:
• Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants
• Pregnancy, weight loss, and menopause may influence the appearance of augmented breasts over the course of your lifetime
• Breast augmentation requires regular examinations of your breasts’ health and to evaluate the condition of your breast implants

Postoperative Care
Following surgery and recovery you will be returned to the ward where you will normally spend the next 24 hours in the hospital. This allows us to ensure that you have excellent medical care and supervision, that we can monitor the amount of drainage coming out of your drains and that we can ensure that you don’t have any postoperative pain.
After your stay in hospital overnight and following review by me the next morning you would be free to be discharged. The nursing staff would change your dressing to ensure that everything is progressing smoothly. You will be discharged home on antibiotics and will have an appointment to come and see us in our rooms, which are also located within the Royal Women’s Hospital complex at approximately one week following surgery. After this, you would normally return to see us again two weeks after surgery. During this period we will monitor your recovery and your progress and precisely advise you as to how much activity or exercise you should undertake and also advise you on things we may need to change in your postoperative management.

Further Surgery / Revision Surgery:

In most instances, the need to return to theatre is less than 1%.
Very infrequently revision surgery is required. It may be that in the early postoperative period the swelling on one side was greater than the other and may need to be drained. Or that your nipple on your left and right sides are different heights. Because of this, it is important that you discuss with your surgeon pre-operatively what arrangements he has in place should revision surgery be required. It is particularly important to ascertain exactly who is to pay for the revision surgery and if there are additional costs such as a return to theatre or to hospital.