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Breast augmentation background

Breast augmentation surgery (or augmentation mammaplasty) is a surgical procedure performed to increase the size and volume of the breast.

By inserting implants beneath the breast tissue the surgery will modify the breast shape such as enlarging breasts that have always been small, or filling out breasts that used to be larger.

Breasts change a lot during a woman’s life. Some common reasons are pregnancy, breastfeeding, weight loss, aging and hormonal changes. These continuous changes will potentially impact the size and firmness of the breasts.

Please note that individual results will vary depending on the individual, their genetics and lifestyle factors, and all surgeries have associated risks. Before proceeding with any surgery, it is advisable to seek a second opinion from an appropriately qualified medical practitioner such as a Plastic Surgeon. Dr. Gary Avery (MED0001633092) a registered medical practitioner, with specialist registration in Surgery – Plastic Surgery. Dr Avery is also a member of the two leading professional associations for plastic surgeons in Australia, Australasian Society of Aesthetic Plastic Surgeons (ASAPS) and Australian Society of Plastic Surgeons (ASPS). Their websites provide additional information regarding plastic surgery in Australia that you might find useful, please visit ASAPS and ASPS.

Words cannot express how grateful I am. Your amazing team are so friendly and supportive.

During pregnancy, breasts tend to swell and enlarge. After birth, the breasts become temporarily engorged because the breast tissue overfills with milk, blood and other fluids that are necessary for milk production. Once the mother decides to stop breastfeeding, her breasts will naturally soften.

Fat tissue often makes up part of the tissue in the breasts, and this may change with ageing.

When women lose a significant amount of weight, the cells in the fat tissue shrink along with other fat cells in the individual’s body. Therefore, losing weight can have a noticeable impact on the size of the breasts. Moreover, each time a woman gains weight or loses weight, the skin around the breast tissue may lose more of its elasticity, reducing its ability to contract to the new breast shape.

Some women do not develop much breast tissue because of their genetics; this is referred to as breast hypoplasia. In most cases, this condition does not cause any physical or medical problem, but the size and shape of their breasts might not be proportionate to the woman’s body and/or does not reflect her preferences.

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Dr Avery will assess your health and medical history to ensure any surgical procedure you are considering is a safe and appropriate choice for you.

Breast augmentation is also known as augmentation mammaplasty. Its goal is to achieve larger breasts that project outward. The implant type and size will depend on factors such as the woman’s breast anatomy, skin thickness and elasticity, body type and personal preferences.

Depending on the patient’s expectations, a surgeon may recommend to combine a breast augmentation surgery with a breast lift, to remove excess skin and reshape the breast tissue to raise the breasts.

Patients considering any form of breast surgery will need to come in for a consultation with Dr Avery to discuss your expectations, along with the surgical options for how these can be achieved. During your consultation with the Avery team, we will ensure that the surgery you are considering is the appropriate choice for you.

At Avery, we welcome the opportunity to have an open conversation with you to understand the changes you are looking for with surgery. Our patients’ stories matter a great deal to us.

Wherever you are on your personal journey, we would like to assist you. Your reasons for having surgery and your expectations from surgery are important conversations to have before undergoing surgery. Dr Avery will also assess your health and medical history to ensure any surgical procedure you are considering is a safe and appropriate choice for you.

Your Breast Augmentation

Consultation

Your GP or another specialist that knows you well must make a referral to Dr Avery. The decision to have a consultation may be made after talking with family or friends or following your own research into plastic surgery and Dr Avery.

The purpose of your initial consultation with Dr Avery is to discuss your motivations for surgery and expectations from surgery. It is an opportunity to openly communicate what you want to change, alleviate or remove. We will discuss any concerns you may have about your potential surgery and its outcome. We will also collect information that is specific and tailored to you, to add to the knowledge you acquired through your research outside of the consultation process.

When you arrive at Avery, you will check in with our Care Team and complete a medical history form, if not already completed. We encourage you to bring a supportive family member or friend who can remain with you throughout the consultation if you like, and be a sounding board during your decision-making process following the consultation.

The consultation with Dr Avery will include an examination of the area of your body that you are concerned with and considering changing. Our aim will be to determine if plastic surgery can achieve what you hope it will, and if so, what specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.

Plastic surgery procedures can impact physical appearance and there may be a psychological response to the changes in your body after surgery. Besides the reasons for having plastic surgery, it is important to be fully aware of any potential limitations of the operation and how they apply to your unique situation. This includes the risks of having surgery and all of the possible complications that can occur after surgery, and what can be done if these occur.

We will discuss what the surgery involves, how it relates to you specifically given your uniqueness and current state of health, what the possible risks of the surgery are, and then decide if having the surgery is a safe and appropriate choice for you as an individual.

Your consultation will also include a discussion of the estimated financial implications of having this surgery or surgeries that were discussed with Dr Avery.

After your consultation, our Care Team will be there to talk through any further questions you have, including the cost of the surgery.

At Avery, our goal is to ensure you are equipped with the knowledge needed for you to feel empowered throughout the decision-making process, surgery and post-surgery.

Procedure

Implants are supplied by volume in millilitres or weight in grams. An assessment of the woman’s chest wall, existing volume of breast tissue and skin is needed to determine how large the implant can be. Dr Avery will recommend breast implant sizes that are appropriate and proportionate to the patient’s body. The implant will be less obvious if it is not oversized and if the patient has a reasonable amount of tissue to cover it.

Implants can either be round or teardrop-shaped (also known as anatomical). Round implants provide a bigger volume at the top of the breast, and by design are the same width as they are tall. The teardrop-shaped implants are designed to mimic the appearance of a natural breast and the surgeon has the ability of choosing the width and height separately, thus enabling more control of the eventual shape.

With either of these options, there are varying degrees of projection, depending on whether the desired effect is to look subtle or more noticeably pert.

Another element that will impact the overall result is the implant material. There are two main types of materials:

  1. Saline
  2. Silicone Gel

Saline breast implants are filled with sterile saltwater solution similar to the fluid that makes up most of the human body. In the event of a leakage, the saline solution will be harmlessly absorbed by the body. These implants come as empty silicone shells that are filled with saline solution after they have been implanted in the body, requiring a smaller incision, resulting in less scarring.

Silicone breast implants have an outer silicone shell filled with a silicone gel. This implant material is softer than the saline implant and feel more like natural breast tissue.

For most patients, implants are expected to last at least 10 years before they should be removed and/or replaced. The longer a breast implant is inside the body after 10 years, the more likely it is to deteriorate and rupture.

A breast implant rupture will usually present as a slow leak and can cause the breast to become misshapen, lumpy or sore. If you notice consistent symptoms such as these, it is recommended that you arrange a consultation with Dr Avery as soon as possible.

As with any foreign material placed within the body, breast implants do carry a risk of complications and the implant may need to be removed. At the time of the implant removal, surgical options include removal only, replacement using the same or different size implants, and both of these options can be combined with a breast lift.

Risks

As with all surgical procedures, Breast augmentation surgery does have risks, despite the highest standards of practice. It is not usual for any surgeon to outline every possible side effect or rare complication of a surgical procedure. However, it is important that you have enough information about the most common risks to fully weigh up the benefits, risks, and limitations of surgery.

The following possible complications are listed to inform and not to alarm you. There may be other complications that are not listed. Smoking, obesity, and other significant medical problems will cause greater risk of complications.

Some general risks and possible complications of surgery include, but are not limited to the following:

  • Heavy bleeding from an operated site. This may require a blood transfusion.
  • Infection that may require treatment with antibiotics or further surgery in some cases.
  • Allergic reaction to sutures, dressings or antiseptic solutions.
  • The formation of a large blood clot (haematoma) beneath an incision site may require further surgery.
  • Complications such as heart attack, pulmonary embolism or stroke may be caused by a blood clot, which can be life threatening.
  • Pain, bruising and swelling around the operated site(s).
  • Slow healing, often related to smoking or diabetes.
  • Short-term nausea following general anaesthesia and other risks related to anaesthesia.
  • Tissue cannot heal without scarring and that how one scars is dependent on individual genetic characteristics. Dr Avery will do his best to minimise scarring but cannot control its ultimate appearance.
  • Smoking or using nicotine products during the 3–4-week pre-operative and post-operative periods is prohibited as these could dramatically increase the chances of complications.
  • All medications I am currently taking, including prescriptions, over the counter remedies, herbal therapies and supplements, aspirin, and any other recreational drug or alcohol use can affect the safety of my surgery.
  • There can be no guarantees about the results of any surgery.

Some specific risks for breast augmentation surgery include, but are not limited to the following:

  • Delayed wound healing
  • Chronic pain
  • Ability to feel the implant
  • Infection that may require removal of the implants
  • Asymmetry
  • Pneumothorax (air in the chest)
  • Bleeding or hematoma (clot) requiring surgery
  • Uncertain life span of the implant
  • Capsular contracture (firmness)
  • Degradation of breast implant
  • Scars
  • Need for more surgery for surgical corrections (revision surgery)
  • Further recovery time if further surgery is required
  • Change in nipple and skin sensation, including numbness
  • Possibility of late calcification (capsular contracture)
  • Rupture/leakage requiring replacement
  • Malposition of an implant
  • DVT (deep vein thrombosis) – clot in legs or PE (pulmonary embolus) – clot in lungs
  • Disappointment / dissatisfaction with result
  • Possible impact on ability to breast feed
  • ALCL (lymphoma) – textured surface implants
  • Allergic reactions to tape, suture material, topical preparations, medications

The Australasian Society of Aesthetic Plastic Surgeons (ASAPS) has further information about breast augmentation surgery including the possible risks for this surgery.

Recovery

Breast augmentation is usually performed as a day procedure and depending on the complexity of the surgery, up to two weeks off work may also be recommended.

If you have undergone another surgery in addition to the breast augmentation, a longer stay in hospital might also be necessary for recovery. As with any operation, you will need to organise somebody to drive you home. We encourage our patients to have another adult stay with them during the first night after surgery.

The full recovery period for breast augmentation is usually around six weeks, which can be broken down as follows:

The first 2 weeks after the procedure:

It is recommended that you don’t put any unnecessary strain on your body. This includes exercise, picking up children or even driving, as any pain or discomfort experienced while driving could be dangerous.

Between 2 and 4 weeks after the procedure:

You can begin to do some light exercises such as picking up children and driving, as long as you aren’t straining your body too much.

Between 4 to 6 weeks after the procedure:

You can begin returning to normal activities with care, such as mild exercise. After 6 weeks’ recovery, you should be able to resume a normal level of physical activity.

After breast augmentation surgery, you will be required to wear a supportive surgical bra (compression garment) for 4–6 weeks to provide support and reduce post-operative pain or swelling, which generally subsides about two weeks after the surgery.

A customised pain relief program will be created for you and issued before you leave the hospital. If circumstances change at any stage during the recovery period, we can adjust the pain medication accordingly.

Price Guide

The financial aspects of your surgery are as important as the medical elements when planning for surgery. At Avery, the surgeries we offer fall into three different financial categories: Self-funded – aesthetic surgery; self-funded – plastic and reconstructive surgery; and health insured – plastic and reconstructive surgery.

To make sense of these three financial categories, we have created a detailed price guide to help you understand what may or may not be covered by your health insurer/Medicare and your out of pocket expenses.

To download this guide, please click here.

For more information or to book a consultation, please contact our team on 02 4002 4150.

Breast Augmentation FAQs

Do I need a referral for breast augmentation?

All people considering breast surgery must obtain a referral from their GP or specialist before your initial consultation. If your breast surgery is considered medically appropriate you will be eligible for a rebate of $78.05. If your breast surgery is considered cosmetic in nature you will not be eligible for a rebate, and the Australian Medical Board mandates that we have a referral from you before your first consultation.

Will my private health insurance cover the operation?

Typically, if your surgery is considered cosmetic in nature and does not have a related item number, private health insurance does not cover this surgery. If the surgery is being considered to address significant developmental differences, changes from previous trauma, or to relieve nasal obstruction, then a Medicare item number may apply to the surgery and there may be some cover of this procedure through private health insurance.

Can I breastfeed after the operation?

Being able to breast feed should not be affected following breast augmentation, particularly when it is performed with an incision in the lower breast fold. The breast tissue maintains its normal connections to the nipple and it should be possible to breastfeed. There is a risk that breastfeeding will not be possible. To find out more about the risks associated with breast augmentation surgery, please view the risks section on this page.

Will my nipples lose sensation after the breast augmentation surgery?

It is possible that your nipples and/or breast skin might lose sensation partially or completely after surgery. For many women any change in sensation will be temporary, but in some cases, there can be a permanent change in nipple sensation. This is a risk with breast augmentation surgery. For further risks associated with breast augmentation surgery, view the risks section on this page.

Is there an increased risk of breast cancer after having breast augmentation?

There is no increased risk of breast cancer following breast augmentation with implants. A relatively new finding is a type of lymphoma known as BIA-ALCL (Breast Implant-Associated – Anaplastic Large Cell Lymphoma). This is a rare condition associated with some types of implants. Although there is no increased risk of breast cancer in women having breast augmentation with implants, it is still possible to get breast cancer. It is still recommended to have routine breast screening if you are above the age of 50 and at any age, if there are any changes noted such as finding a new lump then this should be examined by a doctor such as your GP or Specialist just as would occur without breast implants.

Can I suntan after I have healed?

Sun exposure can adversely impact early wound healing and have an adverse effect on the pigmentation and long-term quality of you scar(s). All scars should be protected from sun until they are mature, which may not be until one-year post-surgery. A spray tan is okay after a few weeks (once the wound is healed).

What happens when I'm pregnant?

Implants do not interfere with pregnancy. Breast size can increase with pregnancy, so the skin of the breasts can have a looser appearance post-partum. However, this can occur regardless of whether you have breast implants or not.

What are the causes of implant rupture?

There is a chance of implant rupture with all types of implants, and the chance of rupture increases as the implants age. At times it may be significant trauma that causes implant rupture, but most often no particular cause for this can be identified. When a silicone gel implant ruptures, the silicone gel stays in the breast, mostly contained by the scar tissue known as the capsule. The body tries to contain this rupture, which may cause inflammation, potential pain or change in the breast appearance. When saline implants rupture, the saltwater leaks out into the surrounding tissue, which is harmlessly absorbed into the body. For further risks associated with breast augmentation surgery, please visit the risks section on this page.

How will I know when my implant has failed or leaked?

If your implant has ruptured or leaked, you might notice a change in the size or shape of your breast(s). You might also feel tenderness or pain in the breast(s). However, some women do not notice any signs or symptoms. An examination and possible ultrasound or MRI is advisable if you are concerned about a potential implant rupture, or if you have detected a new lump in the breast. It is also recommended to have a routine check and ultrasound of your breasts approximately 10 years after breast implant surgery, even without any change in the breast appearance. For further risks associated with breast augmentation surgery, please visit the risks section on this page.

Are silicone breast implants safe?

Silicone is an extremely common substance that has a number of various uses, including the silicone gel used in breast implants for augmentation or reconstruction. Silicone has been used in breast implants for over 50 years. We are currently using 5th generation implants with silicone gel that has a consistency much like turkish delight or jelly that generally holds its form and sticks to itself. Medical grade silicone used in breast implants is safe. However, there are risks associated with its use and some women either do not tolerate the breast implants or may have problems related to the implants several years after insertion. Breast implants should not be considered as lifetime devices. Anyone undergoing breast augmentation with an implant of any sort will require further surgery at some stage in their life. For further risks associated with breast augmentation surgery, please visit the risks section on this page. More information can also be found on the Australian Government TGA website.

When will I be able to exercise?

Simply walking is advised and is recommended during the first 2 weeks after surgery. An increase in activity is encouraged between 2-6 weeks, limiting this increase based on how your body feels and responds. From 6 weeks you can be mostly unrestricted with exercise but it may not be until 12 weeks following surgery that you feel you are back to pre-surgery fitness, or even improved from your pre-surgery fitness if physical symptoms and restrictions have been addressed with surgery.

How do I know what size is right for me?

Breast implant volume is measured in cc’s or ml’s, breast implants also have a width (side to side measurement) a height (vertical measurement) and projection (the amount the implant sits above a flat surface). Determining the ‘right size’ is a combination of some of the physical measurements and position of the current breasts and skin, and the desired breast size and appearance. It is important to note that the size and appearance you might have in mind before your consultation, may not be realistically achieved with surgery. Dr Avery will discuss your expectations of surgery and whether surgery can meet these.

Is cup size the best way to think about and measure breast size?

Thinking about a breast reduction in terms of a change in your cup size can be problematic because all bra brands have slightly different cup size measurements, making it difficult to match your expectations with what surgery can achieve given your unique circumstances. Cup size should be used as a rough guide only.

If I have a lot of Ptosis (medical term for sagging) is a breast augmentation the right surgery for me?

Breast Augmentation with an implant can help to correct some degree of breast ptosis, the volume of the implant fills a somewhat empty or deflated breast resulting in an apparent lift of the breast tissue. There is a limit to how much breast ptosis an implant can address, the additional consideration then becomes is a formal breast lift (with a different pattern of final scars on the breast) also required and if so, can this be done at the time of an augmentation or are they best done as separate procedures.

Will I experience much pain and movement restriction post-op?

Pain immediately after surgery may be reduced by the use of local anaesthetic at the surgical site given during the surgery. The pain will also be managed with tablets or injections as required. Physical measures such as the dressings and supportive garments as well as limited movement and possibly ice packs will all help minimise any pain. Pain is usually well tolerated within a few days after surgery with all these measures. If your pain is increasing following surgery this is usually a sign that you may need a review to ensure your recovery is proceeding as expected.

Dressings and supportive garments will offer support to the wounds and the areas of your body that are still recovering. You will be also be advised to restrict excessive movement of the surgical area in the first two weeks after surgery. A good general rule throughout your recovery is if an increase in movement or activity does not increase any discomfort or swelling, then it is probably safe and this gradual progression back to ‘normal’ will be encouraged.

Will I have a general or local anaesthetic for breast augmentation surgery?

Breast augmentation surgery is performed under a general anaesthetic given by a specialist anaesthetist in an accredited private hospital.

Your initial consultation

During your initial consultation we welcome the opportunity to have an open conversation with you to understand the changes you are looking for with your surgery and talk through any concerns or specific goals you may have.

Your initial consultation will include an examination of the area of concern and we'll work with you to determine if plastic surgery can achieve what you hope it will, and which specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.

The procedure may be combined with other aesthetic surgical procedures on the breast such as breast lift, breast reduction and breast implants.

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Anne-Marie, our Care Team Manager - and member of our Care Team.