Breast augmentation is a procedure to increase the size of the breasts and is one of the most commonly performed cosmetic operations performed around the world. This can be performed unilaterally in the case of breast asymmetry or bilaterally. Breast implants are inserted under the breast tissue or under the pectoral muscle. This pushes the breast tissue forward to give the appearance of larger breasts.
I most commonly use silicone breast implants as they feel more realistic and are less prone to rippling, but some patients prefer to have saline implants for a variety of reasons. This is something we will discuss at your consultation.
The procedure is performed under a general anaesthetic, takes about 1 hour and is usually followed by an overnight stay in the hospital. This will be at Cabrini hospital in Malvern. Some patients choose to have this operation as a day case procedure.
The breast implants are inserted via an incision hidden in the crease under the breast or alternatively in a scar around the nipple.
All incisions are closed with dissolving sutures buried under the skin and then covered with surgical glue and tape. The dressings can be wet in the shower immediately. Surgical drains (tubes) are sometimes inserted under the implants at the time of surgery - these are usually removed the following day. You will need to go into a supportive post-surgical or sports bra following surgery which you should continue wearing day and night for 6-weeks.
You will be able to return to sedentary activity (i.e. an office job or light duties) within a week, depending upon how you feel, but strenuous exercise, running, gym work or lifting should be avoided for 6 weeks.
Considerations
Asymmetry in breast volume can be corrected by using different size breast implants. However, asymmetry of breast or nipple position will not be corrected by this procedure alone. In fact, difference in nipple position may look more noticeable following breast augmentation. Likewise, if your breasts are widely spaced apart to start with, they will remain widely-spaced.
Patients with very little breasts to start with will have less tissue to hide the implants. It may be possible to feel the implants and in some people the edge of the implant is visible.
Breast-feeding is still possible (and safe) following breast enlargement.
Breast implants do not increase the risk of breast cancer. In fact, women with breast implants have a slightly lower risk of breast cancer (not because breast implants protect against cancer, but because most of these women have less breast tissue compared to women without implants).
Breast cancer detection by mammography, ultrasound and MRI is still possible with breast implants. However, it is important to alert the radiographer to the presence of implants before the test.
Complications
There will be a permanent scar either in the crease under the breast or around the areola. In most people this scar fades to a faint white line over 6-12 months. Some people produce thick, raised scars that may become hypertrophic or keloid.
There may be some bruising / bleeding. If there is excessive bleeding inside the breast it may be necessary to return to the operating theatre to have the haematoma washed out. This bleeding is not life-threatening but may affect the ultimate cosmetic outcome.
With all surgery there is a risk of wound infections. In breast augmentation there is also the risk that the implant may become infected. To reduce this risk all patients are given antibiotics during surgery and to take home afterwards. If the implant does get infected it may need to be removed at a later operation and left out for several months whilst the infection settles.
Capsular contracture is the tightening of the scar tissue that the body creates around the implant. Everyone produces a capsule but in some women this capsule becomes very thick and tight. The result is hardening of the breast and often the implant sits high on the chest. The treatment is replacement of the implant and release of the capsule at another operation.
Recently there have been reports of a very rare type of blood cancer forming next to some breast implants. Anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin’s lymphoma. It is not a type of breast cancer. The risk of developing this is very rare, probably in the order of 1 in 100,000. To put this in perspective, the risk of an Australian woman developing breast cancer at some stage in her life is approximately 1 in 10.
Further information about this procedure can be found here
http://www.plasticsurgeryfoundation.org.au/patient-information/procedures/cosmetic-surgery/breast-augmentation/
