Breast augmentation, also known as breast enlargement or breast enhancement, is a procedure that uses implants to enhance the size and shape of the breasts. Women choose to have breast augmentation surgery to enhance smaller breasts, lift a sagging bustline and/or create breasts that are more symmetrical.
Breast augmentation can also be performed to correct a reduction in breast volume following pregnancy or for enhancement after breast removal, which is also referred to as breast reconstruction.
Breast augmentation is a very personal choice. Great breast augmentation is artistry creating desired aesthetics, symmetry and balance with natural-looking results.
Breast Augmentation / Breast Implant Info
Since the advent of breast augmentation surgery in the 1960s, millions of women have enhanced their bodies with silicone and saline implants. Breast augmentation has become one of the most commonly performed cosmetic plastic surgical procedures. Today, women enjoy the benefits of this experience with results that look and feel natural.
Breast augmentation, also known as augmentation mammoplasty or breast implants, is a surgical procedure to enhance a woman’s breast size and breast shape.
Breast augmentation is sought out at our clinic for a number of reasons:
1- to enhance the body contour of a woman who, for personal reasons, feels her breast size is too small
2- to correct a reduction in breast volume after pregnancy
3- to balance a difference in breast size
4- or as a reconstructive technique following breast surgery, mastectomy.
5- Breast augmentation surgery can have a positive effect on a person’s self-image when performed for the right reasons.
Breast augmentation can enhance your appearance and your self-confidence. Before you decide to have breast augmentation surgery, think carefully about your expectations and discuss them with your plastic surgeon.
The best candidates for breast augmentation are women who are looking for improvement, in the way their breasts look. If you are physically healthy and realistic in your expectations, you may be a good candidate for breast augmentation surgery.
Planning Your Breast Augmentation Surgery
In your initial consultation will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, you may also require a breast lift. Be sure to discuss your expectations frankly with your plastic surgeon. Dr Barnouti will discuss all the options available including alternative treatments, risks and limitations of each technique.
You may want to ask your surgeon for a copy of the manufacturer’s insert that comes with the implant chosen, just so you are fully informed about it and for your future records.
Your surgeon will also explain the type of anaesthesia to be used, the type of facility where the surgery will be performed, and the costs involved.
Preparing for Your Breast Augmentation Surgery
You will be given instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.
While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.
Where your Breast Augmentation surgery will be performed
Day surgery or an inpatient hospital. You can go home the same day or stay in the Hospital overnight.
Types of Anaesthesia for Breast Augmentation Surgery
Breast augmentation can be performed with local anaesthesia and some sedation which is also known as twilight sleep or can be done under general anaesthesia; it depends on what you prefer. The Plastic Surgeon and the Anaesthetist will help you to make the right decision.
The Breast Augmentation Surgery
The method of inserting and positioning your implant will depend on your anatomy and the surgeon's recommendation.
The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.
Working through the incision, a pocket will be created by lifting the breast
tissue and skin. The implant is then inserted either directly behind the breast tissue or underneath your chest wall muscle (the pectoral muscle). A dual plan, combining both techniques is also sometimes used to reshape the breast. The implants are then cantered beneath your nipples.
You’ll want to discuss the pros and cons of these alternative techniques with your plastic surgeon before surgery to make sure you fully understand the implications of the procedure.
The surgery usually takes 1.5-2 hours to complete. Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to help with healing.
After Your Breast Augmentation Surgery
You will go home the same day and will be up and around in 24 hours. Most of your discomfort can be controlled by painkillers.
You will be seen in the clinic one week after surgery for a wound check. The bruises and swelling should start to subside gradually.
The entire swelling may take three to four weeks to disappear fully.
Getting back to normal after Breast Augmentation Surgery
You should be able to return to work within a few days, depending on the level of activity required for your job.
Follow your surgeon’s advice on when to begin exercises and normal activities; normally you can resume sporting activities in 4 weeks' time.
Your scars will be firm and pink for four-six weeks. Then they will begin to fade and become less visible.
Mammograms and Breast Screening after Breast Implants
Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the mammographic technician should use a special technique to assure that you get a reliable reading.
Satisfaction rate for Breast Augmentation Procedure
This procedure has a high satisfaction rate. Patients experience a renewed sense of self-confidence and an enhanced self-image, allowing them to lead happier lives.
Final Thought about Breast Implants
Your decision to have breast augmentation is a highly personal one that not everyone will understand. The important thing is how you feel about it. If you’ve met your goals, then your surgery is a success.
Breast Surgery ‘Average Costs’
Breast Augmentation Package
Total Cost: $10,900(including Surgeon’s fee, Assistant Surgeons fee, Anaesthetist’s fee, Hospital, operating theatre and all follow-up visits cost).
Cost covers: your choice of teardrop or round implants or any other implant you desire.
Combined Breast Lift and Breast Augmentation Package
Cost: $11,900 (including Surgeon’s fee, Assistant Surgeons fee, Anaesthetist’s fee, Hospital, operating theatre and all follow-up visits cost).
This price assumes hospital coverage with a private fund and that your operation attracts a medical item number 45556 x2 or 45557×2. If fund cover does not apply in your situation, plan for additional costs of $4,000.
Medicare and/or Private health insurance will refund you some of the above total cost if applicable.
This price assumes top hospital cover with a private fund and that your operation attracts a medical item number. If fund cover does not apply in your situation, plan for additional costs of $4,000.
Placement of the breast implant
One of the great debates in plastic surgery has focused on whether to place breast implants over the muscle, under the muscle (pectoralis major muscle) or a combination of the two.
- Submuscular (under the pectoralis muscle),
- Subglandular (above the pectoralis muscle and below the breast tissue) or
- Dual Plane: a combination of the two techniques. The implant will be placed under the muscle on the top part and under the breast tissue on the lower part of the breast
Submuscular augmentation (under the muscle):
Advantages of Submuscular augmentation:
- The muscle covers the implant, thus any capsular contracture (breasts that feel hard) is less common
- For the same reason, the rippling (wrinkling) of the implant is less apparent
- Mammograms are more accurate
- In very small-breasted women, the outline of the implant is less visible
Subglandular augmentation (under the breast tissue and above the muscle):
Advantages of the sub-glandular augmentation
- The breast is obviously over the muscle, thus the implant belongs there
- Because of this, sub-glandular placement most often looks more natural
- If any degree of ptosis or sagginess is present, a sub-glandular implant lifts the breasts much better
- A properly performed mammogram shows 95% of breast tissue. Magnetic resonance imaging, however, can visualize 100% of the breast and will, eventually, be the criterion standard for cancer detection
- less postoperative pain occurs
The Dual plane technique (under the muscle on the top part of the breast and under the breast tissue on the lower part of the breast)
Is a combination of the above 2 techniques. It has the advantages of both of the above techniques. It is the technique of choice for Dr Barnouti.
Placing the scar
Inframammary approach
An inframammary incision is the most common approach for the placement of a breast implant. This approach, which entails a 3- to 4-cm incision, attempts to place the incision in the inframammary crease. The inframammary approach provides the most direct route and facilitates implant placement.
Periareolar approach
Implants placed by an incision within the pigmented areolar tissue, referred to as a periareolar incision, often result in the least conspicuous scar. However, dissection of the pocket required for implant placement is more difficult with a periareolar incision. Dissection must proceed through a portion of the breast tissue or in the subcutaneous plane.
Transaxillary approach
In the transaxillary approach, incisions is placed in the axilla, which avoids placement of the scar on the breast. However, the transaxillary approach provides the worst exposure for the placement of the implant. This may be avoided using special instrumentation, including endoscopes and specific surgical instrumentation designed to aid the dissection.
Periumbilical approach
A periumbilical approach, involving implant placement through the umbilicus, can also be used for augmentation. it usually requires the use of an endoscope.
Possible complications with breast surgery
Despite the extensive list of potential complications, breast augmentation remains one of the safest and most predictable procedures performed. Breast surgery provides a balance between the size and shape of the patient’s breasts and the rest of her body. The low incidence of complications and the predictability of surgical outcomes have prompted an increasing number of individuals to undergo Breast Implant Surgery.
Hematoma
The frequency of hematomas is less than 0.5% after breast implant surgery by Dr Barnouti. Associated symptoms of hematoma are unilateral pain, swelling, and, occasionally, fever. Hematomas may develop slowly without symptoms or rapidly with symptoms. Small hematomas may resolve without intervention, but large hematomas require drainage. Often, delaying drainage until liquefaction of the clot has occurred is preferable. However, if the hematoma is painful or large, Dr Barnouti would recommend draining it.
Infection
The incidence of infection is approximately 2% after breast implant surgery. Infection typically becomes apparent 7-10 days postoperatively but may manifest at any point.
Sensory Changes
Postoperative changes in nipple-areolar sensation are common in patients who have undergone breast augmentation. Most patients exhibit a temporary dysesthesia, which tends to resolve in a period of months.
Scars
Hypertrophic or keloid scar formation is uncommon following breast augmentation.
Asymmetry
Asymmetry of the implant position may result from shifting of the implant.
Contour Irregularity and Implant Extrusion
Contour irregularity and implant extrusion may rarely be associated with the placement of implants. The most common cause of contour irregularity is a tight capsular contracture that develops around the implant. The incidence of capsular contracture following breast implantation appears to be approximately 3-5%. Classification of the contracture is highly subjective. In 1980, Little and Baker developed a classification system for capsular contracture following breast augmentation; it remains the standard for evaluating this complication. The grades of capsular contracture are divided into the following 4 types:
• Grade I: Capsular contracture of the augmented breast feels as soft as an unoperated breast.
• Grade II: Capsular contracture is minimal. The breast is less soft than an unoperated breast. The implant can be palpated but is not visible.
• Grade III: Capsular contracture is moderate. The breast is firmer. The implant can be palpated easily and may be distorted or visible.
• Grade IV: Capsular contracture is severe. The breast is hard, tender, and painful, with significant distortion present. The capsule thickness is not directly proportional to palpable firmness, although some relationships may exist.
Stem cell solutions for breast implant
The new era of Breast augmentation is through fat injection and stem cell technology, what is also known as lipofilling, or adipocyte-derived stem cells breast augmentation. The fat will be harvested from the abdomen or thighs through liposuction, purified and injected into the breast tissue to enhance its shape and augment its size.
The other non-invasive method of breast augmentation is through the injection of a biosynthetic Hyaluronic acid known as Macrolane.
The advantage of these procedures is that they can be done in the office under local anaesthesia and/or sedation. The patient is able to visualise the results and ask for more to be injected if required. It is a less invasive procedure than conventional breast augmentation and gaining popularity.