What is Breast Augmentation?
Breast augmentation is an aesthetic surgical procedure to increase the size of breasts. Augmentation mammaplasty will also correct slight sagging of the breast and can increase breast firmness. A similar procedure can be used to recreate a breast after mastectomy.
How is Augmentation Mammaplasty performed?
Breast enlargement is performed by making a space behind the breast, usually behind the pectoral muscle and placing a breast implant (prosthesis) into this space. The implant is inserted via the crease under the breast.
The surgery needs to be individualised in relation to the type and size of implant used. The choice will depend on the patient’s body shape, her breast shape and size, her chest shape and her expectations. The breast tissue itself is not operated on. The implant is simply placed behind the breast to give it more projection and fullness.
What results can I expect?
Results may differ from person to person. In general, a successful augmentation will give you fuller breasts that are in better proportion with your overall body size and physique. The procedure may also lead to reduced sagginess and increased firmness of the breasts.
Is Breast Augmentation suitable for me?
The decision to go ahead with an aesthetic procedure is a very personal one. The first step is a consultation with one of the qualified plastic surgeons at the Aesthetic Day Surgery. Whatever your reasons you should frankly discuss your personal goals and expectations with respect to the outcome of the procedure (both physical and emotional) with your surgeon. As with any aesthetic surgery you should always keep in mind that the desired result is improvement, not perfection.
You may wish to have an augmentation mammaplasty if you feel your breasts are smaller than normal or out of proportion to your body size. Augmentation mammaplasty is also useful if your breasts are unequal in size or if they have decreased in size following pregnancy.
How long will the procedure take?
Depending on the extent of the procedure, breast augmentation surgery may last anywhere from 1 1/2 to 2 hours. However, please keep in mind that this is only actual surgery time. To ensure the highest standard of personalised patient care, attention to detail and results, the Aesthetic Day Surgery requires you to spend appropriate time both immediately before and after the procedure within the Day Surgery. In general you will need to allocate up to a full day of your time to allow for pre-operative procedures, the surgery itself and appropriate post-operative care. (Note: this time would be in addition to your initial and follow up consultations with an ADS Surgeon).
How long will it take me to recover from a Breast Augmentation?
Patients normally will require complete rest for several days following the procedure. Normal activities can be resumed in 2-3 weeks although strenuous activities and exercise should be avoided for 6-8 weeks. Time taken to return to work varies and can be anywhere between 1-4 weeks.
Will the procedure leave any scars?
The advanced surgical techniques applied by the surgeons at the Aesthetic Day Surgery are designed to minimise visible scarring. While some scarring is involved with breast augmentation, the scars are usually just a few centimetres long and are located in such a way as to become barely noticeable as they fade with time. Usually patients are advised to tape the scar for the first 2-3 months with micropore tape to promote the best scar possible.
Are there any side effects of this procedure?
Although each patient varies, in general you will have some bruising and swelling of the breasts. After the operation there is a large well-padded dressing firmly applied to the breasts. This helps to reduce the pain and also the swelling after the surgery. Swelling, bruising and tightness of the breasts are common after the surgery and usually subside in a week or two. Most patients experience a degree of pain which can be quite annoying for the first 2-3 days but this can be fairly well controlled with medication.
Most patients are very happy with the results of breast enlargement but you should be aware of certain facts. Some of those are as follows:
- The breast will feel firmer than a natural breast. Scar tissue forms as a sheet to encircle the implant and this is called a ‘capsule’. Occasionally this scar tissue will contract to encircle the implant more tightly, causing the implanted breast to feel harder and the implant to assume a more rounded shape, causing some distortion in the shape of the breast. This problem could occur months or years after the surgery. It is lessened by placing the implant under the pectoral muscle
- At times an edge of the implant can be felt or a rippling at the edge may be felt
- Other infrequent complications of the surgery are infection, rejection, rupture and changes in the sensation of the skin and the nipple
Your surgeon at the Aesthetic Day Surgery will discuss side effects and any potential complications directly with you at your initial consultation.
Can all Breast Augmentation be carried out at the Aesthetic Day Surgery?
Most breast augmentations may be performed as Day Cases at the Aesthetic Day Surgery. However this will depend on the extent of the procedure, your general health and your surgeon’s advice. In appropriate instances, some breast augmentation operations are performed by an Aesthetic Day Surgery surgeon at St. George Private Hospital.
Are Breast Implants Safe?
Possible local complications from implant surgery can occur and will be discussed by your surgeon.
A rare form of cancer known as BIA-ALCL can occur in association with certain types of breast implants, and your surgeon will discuss this with you in detail at your consultation prior to surgery. Current expert opinion recommends patients with breast implants should undergo 12 monthly review by their surgeon or GP.
What is BIA-ALCL?
BIA-ALCL is a rare form of non-Hodgkin lymphoma (a cancer that affects the immune system) which develops in the fluid and scar tissue that forms around a breast implant.
Symptoms usually involve a swelling of the breast due to fluid accumulation, typically 3 to 14 years (an average of 8 years) after the operation to insert the breast implant. Less commonly, BIA-ALCL can take the form of a lump in the breast or armpit.
The vast majority of BIA-ALCL cases in NSW are detected in early stages and completely cured by removal of the implant and the surrounding capsule. However, in patients with no symptoms and/or signs of BIA-ALCL or other breast implant related complications, removal or replacement of breast implants or tissue expanders is not recommended.
Risk of BIA-ALCL varies depending on breast implant type
The estimated risk of BIA-ALCL is between 1-in-2,000 and 1-in-36,000 people with implants depending on the implant type.
All Australian cases of BIA-ALCL have involved textured implants, or implants that have polyurethane coating (described as Grade 2, 3 or 4). No cases have involved smooth surface (Grade 1) implants.
Risk of developing BIA-ALCL is considered highest for grade 3 and 4 textured implants, however all patients with a breast implant should undergo regular surveillance regardless of implant type (as with any medical device, other complications can emerge over time).
There have been over 100 reported cases of BIA-ALCL confirmed in Australia (2020).
Am I more likely to develop breast cancer as a result of Breast Augmentation?
No. Medical science has shown that the chances of developing breast cancer or any other disease are not changed by this procedure. Please note that BIA-ALCL is not breast cancer.
Will I still be able to breastfeed following a Breast Augmentation?
Yes. There is no evidence to suggest that breast augmentation interferes with breastfeeding.
What different types of breast implants are available?
The breast implant (prosthesis) consists of an outer silicone bag which is filled with either saline, silicone gel or cohesive gel. Your surgeon at the Aesthetic Day Surgery will talk to you about your various prothesis options and the pros and cons of each during your initial consultation.
How will breast implants affect a mammogram?
Implants may interfere with mammography and theoretically could interfere with detection of some breast cancers. Some women may need additional tests such as ultrasound, specialised mammography or MRI.
Australian Breast Device Registry (ABDR)
The Australian Breast Device Registry (ABDR) is a Commonwealth Government initiative established to monitor the safety and quality of procedures involving implantable breast devices.
Your surgeon is contributing to the ABDR so your data will go into the Registry. The Registry will collect information such as the reason for your surgery, the type of procedure, type of device and whether you’ve experienced any complications.
References / Other useful information can be found at:
TGA website: Breast Implant Hub
NSW Health website: Breast implants and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)
ABDR website: ABDR