Breast Augmentation
Breast augmentation using implants is a very common and highly satisfying procedure if you have concerns about the shape or size of your breasts. In most cases, women simply wish to increase the size of their breasts to improve their overall appearance and body shape. In cases where the breasts have become smaller and less shapely because of pregnancy/weight loss or where the breasts have developed differently in terms of shape or size, breast implants can help restore confidence in your appearance Your breast shape, size and symmetry will influence decisions regarding the optimal surgery required to enhance your breast appearance. Breast implants consist of a silicone bag containing silicone gel or, rarely, saline and are most commonly used to help correct breast shape, size and cleavage. We are fortunate in Australia to have extremely high standards when it comes to implant quality. Dr Kollias will take time in assessing and discussing your preferred breast implants and anticipated surgical outcomes. The consultation includes discussions about the volume, projection and shape of the breast implants. Dr Kollias tends to prefer the use of smooth-surfaced gel implants in preference to the textured breast implants which are associated with a rare risk of malignancy (breast implant-associated anaplastic large-cell lymphoma). The breast implants may be positioned behind the pectoralis muscles (submuscular or dual plane) or between the breast tissue and pectoralis muscles (sub-fascial) to create more youthful and natural-looking breasts (Figure 1). Dual plane refers to the position of the implant in relation to the pectoralis major muscle and the breast gland; the upper half of the implant being behind the muscle and the lower half of the implant being directly behind the breast tissue. This is the most common position for breast implants. Each position has advantages and disadvantages. In the end, the final recommendation will be one that is tailored to the best possible cosmetic outcome, keeping in mind your requests and requirements.
The Consultation
During the consultation, Dr Kollias will take a focused history and examination based on your general health, breast shape, breast size and symmetry. You may try on a variety of breast implants sizers in your bra (preferably a non-padded crop top or similar) to help you decide which implants you prefer. Dr Kollias will take time in providing you with information about the nature, effects and risks of the procedure. A second consultation is usually recommended to allow you time to discuss any specific aspects about the surgery and your desired outcome
The Operation
The 60-minute procedure is undertaken at St Andrew’s Hospital and requires general anaesthesia. A 4-5 cm incision is made in the lower breast fold to help insert the implants. This incision is preferable to other sites to allow complete exposure of the implant pocket and position the implants to allow for the most predictable long-term results. In the end, the scar is very well concealed within the lower breast fold.
Dr Kollias prefers his patients to stay overnight where they can be monitored closely by the breast nursing staff, be provided adequate pain relief and antibiotics and be fitted for a surgical bra before discharge. His patients find this level of care optimal in terms of safety and satisfaction.
Follow-up
A follow-up appointment is made for two weeks to assess the wounds and positioning of the implants. A final follow-up appointment is required at three months at which time, you will be informed of the long-term safety and management of your implants.
Breast Augmentation FAQ’s
How much does breast augmentation cost?
For most patients choosing smooth, round, cohesive gel implants (Mentor, Nagor, Motiva brands), the total cost of the procedure is approximately between $10,500-$11,000.00 (although the final price is regulated by the type of implant is chosen and differences in fees by the varying anaesthetist). This pricing includes the overnight stay at St Andrew’s Hospital, surgeon’s fee, anaesthetist’s fee, Assistant’s fee and cost of implants.
Are there any risks with surgery?
Unfortunately, all surgical procedures are associated with some risks. Dr Kollias takes every precaution to avoid any sort of complications. He will provide you with information to prepare you for the operation and to make sure that the final outcome is to your satisfaction and expectation. Complications can be avoided by adhering to the recommendations made prior to and immediately after surgery. If you do notice anything unusual, you should contact us immediately if in the off chance there are complications.
Some possible complications and risks associated with breast augmentation may include:
- Risks involved with any surgery such as bleeding or infection
- Changes in nipple sensitivity
- Temporary or permanent areas of numbness around the scars
- Fluid accumulation, which is called a seroma, around the implant after surgery
- Implants moving from their original position
- Capsular contracture, where firm scar tissue forms around the implant causing it to lose shape and softness. Occasionally a capsule contracture around an implant can be painful.
- Wrinkling of the skin over the implant
- Keloid or hypertrophic scarring, especially if you have a history of poor scarring
- Implant rupture
- Lumps in local lymph node tissue formed by leaking silicone. This does not pose a health risk to you.
- Small reduction in the effectiveness of breast cancer screening as the implant could hide breast tissue and tumours. Modern imaging has made this far less of a concern.
Revision surgery is sometimes necessary to treat complications, or if the final cosmetic outcome is not optimal. Although this is uncommon, this may be associated with cost implications for women who do not have private medical insurance.
How long should I take off from work?
It will be necessary to take time off work for your recovery so that your body can begin the healing process. The time off work required will be 1-2 weeks, depending on the type of work you perform. You will be instructed about the do’s and don’ts of physical activity by Dr Kollias and his team.
How long before I can return to normal sporting activities?
You should be able to resume vigorous exercise after six weeks. The use of good support bras and sports garments will be discussed.
How long will the implants last?
The average lifespan of implants is 20 years (some have been known to last up to 40 years!) On average, only about one in five women who have undergone breast augmentation opt to have their implants replaced or removed within the first 10 years of their initial surgery. With high-quality implants, most women should only require one to two follow up surgeries.
Will implants affect future mammograms?
Unfortunately, breast implants do have the potential to interfere with mammography readings in certain patients. Implants placed behind the muscle (sub-muscular) are less likely to interfere with mammogram readings. This is a particularly important consideration for women who have a family history of breast cancer who are likely to require regular breast cancer screening.