What is Breast Augmentation?

Breast Augmentation is a cosmetic surgery procedure designed to increase the size, shape and volume in breasts using Breast Implants. The breast is made up of fatty, glandular and fibrous tissues. Within it are blood vessels, milk ducts, fat, glands and sensory nerves. A layer of fat surrounds the breast to give it a soft consistency and contour. Beneath the breast is the Pectoralis Major, a large muscle close to the chest wall that assists in arm movement.

Women’s breasts vary greatly in both size and shape. The size and shape of breasts are determined by the amount of breast tissue and fat present in them. Size is also affected by factors such as age, past pregnancies, genetics and skin elasticity. Even breasts on the same body may vary, making one breast slightly different from the other. Such variations in size and shape are common for natural breasts and occur in most women. By inserting an implant behind each breast, cosmetic surgeons are able to increase a woman’s bust line by one or more bra cup sizes.

What types of Breast Implants are available?

The most popular form of Breast Augmentation is breast implants; which come in many shapes and sizes. Implants also have differing inner and outer materials (such as silicone implants and saline implants). Together, you and your doctor will select the options that are best suited for you and most likely to achieve the results you desire. In this section, we will discuss some of the most important differences between various types of breast implants. All breast implants have an outer pliable envelope enclosing a soft-solid (silicone gel) substance. The implant shapes are generally round, oval or contoured. The surface of the implants has traditionally been smooth to the touch, but now there is another option, a textured Surface. The Silicone-filled implants stay as one solid membrane, meaning that in the rare event of a rapture, the implants will stay in once piece rather than leaking through the body as the old styles used to. This makes replacing an implant quick and simple.

What shape Breast Implants are available?

Tear Drop ‘Anatomical’ shaped or Round shaped breast implants are the two main shapes of breast implants.

At Cosmos Clinic, we believe that the shape of your breasts after breast implants will be determined by the natural shape of your existing breasts and the size and placement of the implants, NOT by the shape of the implant. We do prefer the use of round implants for the following reasons:

• Round breast implants feel softer than tear drop implants.
• If a round breast implant were to rotate, the shape of your breast will not change. However, if a tear drop implant rotates or migrates over time, your breasts may become asymmetrical.
• Round implants tend to take on a natural shape when implanted, as they form a tear drop shape when a woman is standing.

That being said, you can discuss your options with Dr Choy, to choose which shape you would like.

How does the body react to Breast Implants?

The body’s natural response to any foreign object is to reject it. The degree of this rejection response is partly dependent on the biocompatability of the materials that make up the foreign object. The more biocompatible a material is, the less the body will reject it. Scientists are continuously researching new materials that are biocompatible to the body. At present, the most common biocompatible material utilized in breast augmentation implants is silicone. This material is used in many medical implants such as pacemakers and joint replacements, as well as consumer products like antacids and preservatives (see Potential Risks and Complications). The body will form scar tissue, made from collagen, around the surface of the implant – this is called the capsule. Capsule formation is a normal reaction to any implant. In some women, the collagen capsule can contract, causing a condition known as capsular contracture. This results in a firmer or hardened breast, which may cause discomfort or pain. However, the textured surface of the implant is designed to disrupt the body’s collagen interaction with the implant surface and the resulting capsule formation.

How are Breast Implants placed?

Usually breast augmentation implants are surgically inserted utilising one of three traditional incisions:

• the inframammary incision
• the periareolar incision
• transaxillary incision

All of these incisions allow the implant to be placed either submuscular (below the chest muscle) or subglandular (between the chest muscle and your breast tissue). No one incision and placement is right for every woman. Therefore, by knowing your options and discussing them with your doctor, together you can decide upon the best combination for you. The inframammary incision is made in the skin fold below the breast, and the breast implant is inserted through this incision. The breast tissue is minimally disturbed, and the remaining incision scar is concealed within the fold of skin under the breast. The periareolar incision is made along the edge of the colored area around the nipple, and the breast implant is inserted through this incision. The incision scar is well camouflaged in this area. The transaxillary incision is made in the armpit and the implant is inserted through this incision. An additional option that patients with ptotic or sagging breasts may elect to have during the breast implant surgery is a mastopexy (breast lift).

There are many important factors that may have an effect on your particular procedure, your recovery and your results. They should be well understood and carefully discussed with your doctor. Some of these factors are:

• Your overall health;
• Your chest structure and overall body shape relative to the breast augmentation you desire;
• Your healing capabilities (which can be affected by smoking, alcohol and various medications);
• Prior breast surgeries; and
• Bleeding tendencies.

How long do Breast Implants last for?

There is no definitive answer on how long breast implants last, basically they last until there is a problem, with most follow up surgeries carried out to correct movement of implants or replace implants due to changing breast shape (sagging with age). On average, tear drop implants tend to last approximately 15 years, with round implants lasting approximately ten years. Keep in mind you will need follow up surgeries eventually.

Is a Breast Augmentation procedure painful?

Most of our patients describe the post surgery feeling as pressure rather than pain, similar to having done a heavy chest workout at the gym. The duration of this discomfort will depend on the size of implant and may also vary among patients, younger women with tighter chest skin may feel discomfort for longer than older women with looser chest skin. Some discomfort is expected after surgery, and patients usually take painkillers for 3-4 days post surgery.

How long is the recovery process?

You will experience the most discomfort during the first 24 – 48 hours after your surgery and your breasts will remain swollen and tender for up to two weeks. Although every woman’s recovery time is different, you should be able to resume many of your regular activities after one week and will need to wait at least one month before resuming any strenuous physical activity. You will be given a compression bra to wear for six weeks and instructions on how to perform breast massage to reduce the risk of capsular contracture. Should any problems occur after surgery, contact your doctor immediately. This is especially important if your temperature is elevated, or one of your breasts is noticeably more swollen and tender to touch, painful, red or inflamed. Most of our breast augmentation patients are back at work after 3-7 days, this may vary from patient to patient, and will take longer if you are a smoker. You will have to wear a garment for 6 weeks, this can be easily hidden under clothing.

Will Medicare or private health insurance cover the costs of a Breast Augmentation?

You will not be able to claim any costs from Medicare. You may be able to claim some costs of the surgery from private health cover.

Can I breastfeed after a Breast Augmentation?

There is no medical evidence that breast implants will have any effect on breastfeeding. If you are planning on becoming pregnant or breastfeeding post surgery, please discuss this during your consultation.