Breast Augmentation


About the procedure

Breast augmentation is what is commonly known as a “boob job”. This procedure has been around for many years but many things about it have changed over time. Not only have the implants themselves seen extensive improvements and changes, but the technique of the surgery itself has been refined and improved on significantly. 

There is a common misconception that breast augmentation is a quick and easy operation and this is obviously why people go overseas or interstate for cheap surgery. Operations are only straight forward with careful planning, attention to detail and experience and this relates not only to the surgeon, but to the anaesthetic team and nursing staff involved as well.

Silicon implants are the ones most commonly used and they come in a variety of shapes, sizes, textures and softnesses. Saline implants are still used on a regular basis and there are pros and cons attached to each type of device. 

Matching the required implant to the patients body dimensions and desired outcome is really where the challenge lies in breast augmentation. 

Suitability

There are many factors to consider when contemplating breast augmentation and not everyone is suitable for the procedure. Body shape, existing breast tissue, family planning and exercise goals are just a few of the considerations that come into play. It is important that you take some time to consider your situation and goals regarding breast augmentation and then sit down and discuss this with a qualified plastic surgeon.

Pre-op planning

Whilst size is often the first aspect discussed, there are many aspects of you as a patient that need to be looked at in order to plan the right operation for you. Skin type and quality, existing breast tissue, how tall you are, whether you have broad shoulders and hips or narrow, where your nipple is positioned and are you symmetrical are just a few essential considerations. In this regard, careful pre-operative analysis, measurements and photos are used to plan a prescribe the right operation for you. This is done over 2 visits prior to surgery and on a least one occasion, sizing will be done as well.

The reasons for a woman to seek breast augmentation are many and varied. Everyone has their own reasons and it may be as simple as “My breasts never really developed and I want some shape in clothes and bathers” or “I’ve had kids, breast fed and now my breasts have deflated. I really want to restore them to what they were before kids”. It is the pre-operative planning that establishes the reasons and ultimately the goals you are looking for from surgery and ensures that I am able to achieve what you want.

Compare multiple implant scenarios with different size, style and shape options.

Compare multiple implant scenarios with different size, style and shape options.

Vectra XT 3D imaging

During your breast augmentation consultation, you will have the opportunity to see a 3D simulation of what the implants we have selected might look like following surgery. We can try different implants and ensure that you really are as informed as possible before committing to a surgical plan. Whilst this service is a separate cost to your consultation, it will be deducted from the cost of surgery should you decide to proceed.

Surgical technique

The operation is performed in an accredited operating theatre under general anaesthesia. This means you go to sleep and when you wake up, it is all done. Regarding the operation itself, there are a number of different techniques and approaches. My preferred technique is to use an infra-mammary approach. This means a cut in the fold below the breast to ensure that the scar is hidden. Aside from a really discrete scar, it provides good, safe access for placement of the implant. Intra-operative sizers or test implants, are used in all cases to ensure accuracy. In this way, the patient can be sat up during surgery to check the size, shape and position prior to committing to the definitive implant.

Recovery

Patients generally stay in hospital overnight to ensure complete recovery from anaesthesia and adequate pain relief. Local anaesthetic given at the time of surgery helps during the first 12 - 24 hours. In most cases, pain is then easily controlled with simple analgesia such as panadol.

Once at home, you really need to take it easy for a couple of weeks. This means no gym, no running and no heavy lifting. I get patients to wear a comfortable post-operative bra with no underwire to help support the breasts and control swelling. Avoid driving for 2 weeks. Generally, showering and getting the wounds wet is permitted from day one through use of a waterproof dressing. Follow-up is planned for 1 week and 6 weeks following your surgery at my rooms. Visits between these scheduled times are encouraged should you have any questions or concerns.

Complications

There are many potential complications from surgery and thankfully, the majority of these are extremely rare.

Capsule contracture, or, hardening of the implant is the most talked about problem with silicon implants. A great deal of work on the surgical technique has been dedicated to reducing the risk of capsule contracture.  The body naturally creates a layer of tissue around an implant to separate it from the surrounding structures. This tissue is known as a capsule. Unfortunately, the capsule can become thick and can contract causing distortion of the implant and resulting in poor cosmetic outcomes as well as pain and discomfort for patients. This is capsule contracture. Minimal handling of implants using introducing devices such as the Keller funnel, use of antibiotic solutions, improved choice of implant and plane of insertion below or above the pectorals muscle have led to more reliable and reproducible results and less capsule contracture.

Other potential complications include asymmetries, infections, scar and alterations in nipple sensation.

Overseas and interstate surgery

There is a lot of hype and media attention relating to overseas and interstate surgery. In the age of online forums, advertising and misinformation, it can be difficult to separate fact from fiction. The simplest response to this is that you get what you pay for. Cheap surgery is offered by taking shortcuts which equates to increased risk for patients. Some people are willing to take this risk and may get away with it. Unfortunately, when things go wrong, the complications can be devastating and potentially life threatening. There are too many unknown factors involved in these cosmetic clinics both here and overseas for anyone to safely recommend visiting them.

Further information

I encourage all patients to do further reading prior to committing to surgery. The more you understand about the procedure, the more likely you are to find the right surgeon for you and to get the result you want. The College of Plastic Surgeons has certified information to help patient be informed.  (see links to ASPS and Foundation for Plastic Surgery)