Breast Lift with Implants

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.

The surgery for a breast lift combined with breast implants (augmentation mastopexy) involves removing excess skin, inserting a silicone implant, reshaping the breast tissue and tightening the remaining skin. Large areolae may also be reduced during a breast lift.

The procedure followed in each breast lift and breast augmentation surgery depends on several variables including:

• The amount and shape of existing breast tissue
• The size and type of implant
• The incision area
• Where the breast implant is being placed

There are three techniques for breast implant placement during the procedure:

• Subglandular Placement (overs)

The implant is placed directly behind the glandular tissue but in front of the muscle.

• Partial Submuscular Placement (partial unders)

The implant is placed partially behind the pectoralis muscle, with the lower part of the implant not covered by the muscle. Partial submuscular placement is performed using a ‘dual-plane’ technique to optimise the interaction between the breast tissue, chest muscle and implant.

• Complete Submuscular Placement (full unders)

The implant is placed completely behind the pectoralis muscle and connective tissue. Complete submuscular coverage is generally used in reconstructive cases only.

Taking the other variables into account, Dr Avery will help you determine the best implant placement technique that is right for you.

Breast lift combined with breast augmentation can be performed as day surgery or may involve an overnight stay in hospital. The procedure can take anywhere between 1–3 hours if performed as day surgery, and another 2-3 hours for recovery is usually required before being taken home by another responsible adult.

As with all surgical procedures, breast lift with implant 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

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

• Bleeding/haematoma requiring surgery
• Discoloration/swelling
• Asymmetry of breasts and/or nipples
• Sores or numbness around nipples
• Change in nipple and skin sensation
• Discomfort (pain/sensitivity)
• Delayed healing
• Excessive firmness of breast
• Permanent and noticeable scarring
• Wound separation
• Infection
• Disappointment/unsatisfactory result
• Recurrence of sag, stretching/loosening of skin
• Further surgery required (revision surgery)
• Skin or nipple/areola loss requiring further treatment
• Further recovery time if further surgery is required
• DVT (deep vein thrombosis) – clot in legs or PE (pulmonary embolus) – clot in lungs
• Allergic reactions to tape, suture material, topical preparations
• Nipple retraction/poor contour
• Different size than expected

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

Depending on your individual circumstances, an overnight stay may be required post-surgery to aid with recovery. 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 lift combined with breast implants, 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 also encourage our patients to have another adult stay with them during the first night after surgery.

After breast lift surgery combined with breast implants (augmentation mastopexy), you will be supplied with a supportive post-surgical bra to wear for 4-6 weeks to provide support and reduce post-operative pain or swelling, most of which generally subsides about two to four 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.

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.

Most women retain normal nipple sensation after breast surgery. Generally, the chance that there will be a change in nipple sensation increases with the extensiveness of the surgery. Some women may experience reduced sensation in the nipples that can be temporary or permanent. They may also find their nipples hypersensitive for a short time after surgery.

The extent of the scars will be dependent on the technique used to perform the breast lift. The surgical breast lift component usually requires at least a scar around the areola and then often down from the lower aspect of the areola toward the lower breast fold. Common descriptions of typical scars form a breast lift procedure (with or without implants) are either a lollipop or anchor scar.

The scars from the incisions should look like a thin line, initially a bit raised above your skin. Their appearance will vary depending on the technique used to reduce the breasts and your genetics. There are people more prone to hyperpigmentation and hypertrophic scars or keloids. As the scars heal, they will flatten and eventually fade and they will usually not be visible in clothing.

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.

Breastfeeding after breast lift surgery combined with breast implants is possible. In most cases, although the position of the nipple is changed it remains attached to the breast and there is no damage to milk ducts. However, any surgery to the breast can potentially divide connections of the breast tissue and ducts and reduce the ability to breastfeed in the future.

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

There is no set time that implants need to be replaced, but in general the longer an implant has been in place, the more likely you are to experience issues leading to implant removal or replacement. These may be issues with the implants, such as rupture or a change in the breast size, position or appearance. Breast implants are not considered lifelong devices.

For further risks associated with breast implant replacement, visit the risks section on this service page. Please also visit the Australia Government TGA website for further information.

There is always a chance of rupture with all types of breast implants. Intense physical pressure caused by something such as a car accident or other trauma, or an aged implant may rupture. When a silicone gel implant ruptures, the silicone gel stays in the body. The body tries to contain this rupture, which may cause inflammation, potential pain or change in the breast appearance.

When saline implants rupture, all that leaks out is saltwater, which is harmlessly absorbed into the body.

There is always a chance of rupture with all types of implants. Intense physical pressure caused by a car accident or other trauma, or an aged implant may rupture without trauma. When a silicone gel implant ruptures, the silicone gel stays in the body. The body tries to contain this rupture, which may cause inflammation, potential pain or change in the breast appearance. When saline implants rupture, all that leaks out is salt water, which is harmlessly absorbed into the body. For further risks associated with breast augmentation surgery, please visit the risks section on this service page.

There is a chance of implant rupture with all types of implants, the chance of rupture increases as the implants ages. 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.

If your implant has failed or leaked, you might notice a change in the size or shape of your breast. You might also feel tenderness or pain in the breast. 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 the breast approximately 10 years after breast implant surgery even without any change in the breast appearance.

For further risks associated with breast augmentation, please visit the risks section on this service page. Please also visit the Australian Government TGA website for further information.

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 this surgery, please visit the risks section on this service page. More information can also be found on the Australian Government TGA website.

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.

Pain following surgery will vary depending on the extent of surgery. 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.