Considering Breast Augmentation Sydney

Considering Breast Augmentation, Enlargement, Implants & Boob Job

The breasts define a woman. Breast size and shape have a profound effect on a woman’s self-esteem. Many women rightly need breast augmentation as a way of enhancing their femininity.

If you have ever thought one or more of the following you may be a good candidate for breast augmentation:

  • It bothers me that my breasts are small. I am uncomfortable when undressing in the bedroom with my partner.
  • I feel inadequate when I wear a swimsuit or a fitted top.
  • Clothes that fit me well around the hips quite often gape around the breasts.
  • My breasts are smaller and not as firm after having children.
  • I have lost weight and the size and shape of my breasts have changed.
  • One of my breasts is noticeably smaller than the other.

It is not recommended for:

  • The very lean.
  • Extreme obesity.
  • The “I want to be the biggest in the block”- using breasts as statements.
  • Planning to have babies soon.
  • Significant medical problems. E.g. serious diabetes, malignancies etc.
  • Unstable personality. Patients who cannot accept their body image whatever the outcome.
  • Frequent recreational drug abuse especially acid (LSD)
  • Already had 2 or more breast operations.

The ideal candidate is:

  • In good health.
  • Has no hang ups.
  • Has realistic expectations.
  • Has some breast tissue with good symmetry and anatomy. The base of the breast is large enough to accommodate an implant of choice.
  • Has done all the necessary research.
  • Has no serious misgivings or guilt.
  • Able to make correct and appropriate decisions on choice.
  • Has seen a previous patient and has been informed of what to expect.
  • Has a supportive and empathetic partner or friend who accompanies her to the consultation and will be the vital, essential support person for after surgery care.

Research Subjects

By being prepared with this information we can better customise specifications to your needs.

Saline vs Silicone Implants

Silicone Cohesive Gel-Filled Implants:
All silicone gels in use today are “cohesive”. The silicone molecules are long and crossed linked which makes the gel sticky and stops it “running”. This silicone gel is described as having a Turkish Delight-like consistency.

These implants have a silicone textured or smooth covering. The design and construction of silicone implants has improved immensely in the last decade:

  • This implant is made up of a cohesive gel and the whole mass of the implant remains in tact. If it is pulled or compressed it can return to its original shape.
  • Leakage is a few in 1000 over the years. Some cohesive gels are softer than others.

With the Cohesive Gel Implants there is also reduced risk of:

  • Wrinkling / folding.
  • Movement.
  • Rupture.

Saline Filled Implants:
These implants are filled with a saline (salt water) solution.
The implant envelope is implanted first as part of the breast augmentation procedure. The saline solution is then inserted into the implant envelope through a small cannula via a valve.
Points to note when considering this type of implant:

  • The saline implants are more likely to wrinkle and this may be noticeable on the surface of the skin when you are lean.
  • There is the possibility of a waterbed effect.
  • The valve in the implant envelope will be sealed, but because a device exists, the saline implants are prone to deflation and leakage. This averages out at 2% over 5 years.
  • If the saline-filled implant leaks, the body will absorb the saline.
  • There is the insecurity of impending rupture and cost of further surgery. All manufacturers want the faulty implants returned and will replace the implant under warranty.

Smooth vs Textured:

Most old breast implants have a smooth surface. These were associated with about 70% of capsule contracture (implants feel hard). The current smooth implants have a low capsular contraction rate similar to the textured. Current clinical impressions for both smooth and textured are about 5-7% capsular contracture rate.

Teardrop vs Round Base

Round Implants:
Give your breasts a fuller, natural shape. Most women are more likely to consider these implants. Generally, round base implants are preferred should the configuration fit the shape of the base of the breast. This style is suitable if you:

  • Have some breast tissue.
  • Want fullness in the upper part of your breasts.
  • Want to create the illusion of cleavage.

Symmetrical implants are generally trouble free, give a more rounded configuration i.e. upper and lower pole fullness is the same. These are suitable when a patient has a breast shape.

Teardrop, Contoured, Anatomical shaped Implants:
Follow the body’s contour. Women most likely to consider these implants have:

  • Very little or no breast tissue.
  • Lost breast tissue due to weight loss or breast feeding.
  • No breast shape at all.
  • Who want a more natural shape.
  • To reduce or avoid double bubble.

Contoured implants can rarely rotate.

Low vs High Profiles:

This means the difference in the diameter and projection of the implant (i.e. the amount by which your breasts will protrude in profile).High profile
A high profile implant will give you greater projection for the same volume. High profile implants are best suited to women who have good subcutaneous fat (layer of fat on the breast) and breasts that are broad based. This is because the higher profile implant will give this type of patient good projection without expanding the base of the breasts. High profiles are also better suited to small chest individuals needing more shape. Very high profile implants are almost spherical and can occasionally flip.Low profile
The base of the implant should fit requirements of the chest wall and breast base dimensions. Breasts with good projection needing general augmentation can have a low profile implant.

Subpectoral vs Subglandular Placement

When there is enough subcutaneous fat to cover over the implants and camouflage the detectability of the rim of the implant (not size dependent), subglandular positioning is a good option. The breast tissue should be strong enough to ensure security against rapid descent. When there is little subcutaneous fat and the detectability of the implant rim is a problem, subpectoral placement is preferable. The pectoral muscle covers only the upper and medial half of the implant.
Subpectoral muscle placement – Under the pectoralis major muscle (sub muscular)
Women should consider this type of placement when:

  • They are skinny. This ensures that the implant is sufficiently covered to give a more natural looking result; or
  • They are lean and athletic.

Subglandular muscle placementOn top of the muscle and under the glands.
Women should consider this type of placement when:

  • They have good subcutaneous fat (layer of fat on the breast).

Infra Mammary vs Axillary or Areolar Incisions

  • Inframammary incision – well hidden in new inframammary crease. Most accurate design because of direct inspection.
  • Axillary incision – best scar camouflage, is placed in a crease, indirect and generally blind approach to pocket.
  • Areolar incision ?made around the areolar to make the pocket for the implant.

General Anaesthetic vs Twilight Sedation with Local Anaesthetic

With twilight sedation the medication is lighter, safer, has less side effects, ensuring a faster, simple recovery.

COMMON QUESTIONS AND ANSWERS

  • What is Twilight anaesthesia?
    Twilight anaesthetic is a form of sedation. It is NOT a general anaesthetic. It is administered intravenously by a specialist anaesthetist who is assisted by a trained anaesthetic nurse. The term ‘twilight’ refers to a “dream-like state” where you will be in deep sleep throughout the whole procedure. Intravenous medication is administered along the way according to your needs to keep you at the optimum level of sedation.
  • Will I be in any pain?
    Before surgery commences and whilst you are asleep, you will be given local anaesthetic which will numb the area and you should NOT be in any pain. You are able to communicate if you feel uncomfortable. You are not paralysed and can respond if need be. The anaesthetist will be by your side, to be in touch with you, for the entire operation to ensure your comfort and safety.
  • How else will my memory be affected?
    Most people don’t remember anything about the operation. Sometimes, you don’t even remember how you got home. However, your memory will be back to normal by the following day.
  • Is twilight anaesthetic safe?
    Yes. Twilight anaesthesia is very safe. It is widely accepted to be much safer than general anaesthesia.
  • I have been sick after a general anaesthetic before. Will I be sick after this anaesthetic?
    Please indicate this in your medical history. There is a possibility that you may also be sick after this anaesthetic although the likelihood is much less. The anaesthetist will discuss this with you. We will administer anti-nausea medication which will help to prevent this.
  • How will I feel after the anaesthetic?
    You will feel very relaxed and drowsy for a few hours afterwards. You should sleep off the effects when you get home. You may feel clear and confident but under no circumstances should you engage in activities like driving as your coordination is temporarily impaired.
  • Can I eat afterwards?
    Yes. You can eat and drink as soon as you feel like it. Try small portions for a start. It is particularly important to keep up your fluid intake to stay well hydrated.
  • What if I have any other concerns?
    Please include a full disclosure of your concerns regarding any anaesthetic experiences, during your consultation. Indicate this on your medical history form. Your anaesthetist will see you prior to your operation and will discuss this with you if they have not been dealt with already.

Hospital vs Day Surgery Procedures

Well equipped day faculties should and are fully equipped to manage any emergencies. At our practice our Specialist Consultant Anaesthetist provides excellent service in the environment they work in. Small private day centres have advantage of no hospital infections and the quality of service is extremely high.

Common Myths

  • I have to change my implants every 5-10 years.
  • Contour implants are a more natural shape.
  • My friend had 300cc, I want 300cc.
  • Implants freeze in the cold.
  • Implants explode during flying.
  • Salines are softer.
  • Silicone feels more natural.