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Breast augmentation surgery (or augmentation mammoplasty) is a surgical procedure performed to increase the size and volume of the breast and modify the breast shape by inserting implants beneath the breast tissue. This surgery will enlarge breasts that have always been small, but can also be used to fill 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.

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.

How breast augmentation surgery can restore your breasts to a more balanced shape

Breast augmentation or breast enlargement surgery can often help women achieve a more balanced figure, by producing fuller, firmer 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. Larger breasts that sit higher on the chest can also create the illusion of a smaller, slimmer waist; although the torso dimensions may have an impact on how the augmentation interacts in terms of the harmony of the overall physique.

Natural looking breast augmentation is a priority for many women. That is the reason why augmentation mammoplasty is used to restore breast volume after weight loss or pregnancy, even up asymmetric breasts or reconstruct a breast after mastectomy or injury.

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. You can discover some of our wonderful patients' journeys here.

Wherever you are on your personal journey, we would like to assist you. Dr Avery will listen to your concerns and what you want to achieve with surgery. 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.

Procedure

Breast augmentation or breast enlargement surgery can typically take between one to two hours, and is usually performed under general anaesthetic. The operation involves accessing and creating the pocket into which the implant will be placed.

Inframammary Incision

The most common incision placement is within the inframammary fold, which is the horizontal crease where the breast meets the body (breast fold). This incision offers a direct access to the submuscular, or subglandular planes; allowing the surgeon to accurately create the desired pocket boundaries.

All implant sizes can be placed through this incision and there is a lower risk of breastfeeding difficulties and changes in nipple sensation. Drawbacks of the inframammary incision is that the resulting scar may not be as hidden as other incisions.

Regardless of the incision used, the patient’s breasts may appear higher placed than planned with the skin appearing tight, immediately after surgery.

This tends to settle down over the first six weeks after the operation as a more natural shape emerges.

The nature of the scars will depend on the technique that has been used and the patient’s genetics. Scars tend to be quite red in the first six weeks, changing to purple over the following three months and then fading to white. Abnormal scarring is rare in breast augmentation surgery.

Breast Implants

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.

Consultation

There are two main pathways to a consultation with a Specialist Plastic Surgeon. Your GP or another health practitioner can make a referral to Dr Avery. Alternatively, it is possible to refer yourself for a consultation. This decision 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 both your concerns and your goals. It is an opportunity to openly communicate what you want to change, alleviate, improve, restore, enhance, 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 front-desk 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 process.

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 generally impact both physical appearance and your psychological response to the new changes in your body. Besides all the advantages to 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 possible complications 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.

After your consultation, our support 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.

Recovery

Breast augmentation is usually performed as a day procedure, and depending on the complexity 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.

After breast augmentation surgery, you will be required to wear a supportive surgical bra for 4–6 weeks to provide support and reduce post-operative pain or swelling, which generally subsides about two weeks after the surgery. After 6 weeks’ recovery you should be able to resume a normal level of physical activity.

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.

Breast Augmentation FAQs

Do I need a referral for breast augmentation?

A referral is not required for a consultation or surgery for breast augmentation.

Can I breastfeed after the operation?

Typically it is possible to breastfeed following breast augmentation when it is performed with an incision in the lower breast fold. Dr Avery generally uses this technique.

Will my nipples lose sensation after the breast augmentation surgery?

It is possible that your nipple and/or breast skin might lose sensation partially or completely after surgery. For most women any change in sensation will be temporary, but in some women there can be a permanent change in nipple sensation.

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.

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 the scar. All scars should be protected from 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.

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 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. 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.

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

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.

When you come for your initial consultation, Dr Avery will discuss the different implant options and the risks associated with them.

Are silicone breast implants safe?

Silicone is an extremely common and useful 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 a small number of 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 may require further surgery at some stage in their life.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Dr Avery is a member of the two leading professional associations for plastic surgeons in Australia, ASAPS and ASPS. Their websites provide additional information regarding plastic surgery in Australia that you might find useful, please visit ASAPS and ASPS.