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Augmentation Mammoplasty – Breast Enlargement

augmentationBreast Augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman’s breasts for a number of reasons e.g. to enhance the body contour of a woman who, for personal reasons, feels her breast size is too small, to correct a reduction in breast volume after balance a difference in breast size and as a reconstructive technique following breast surgery.

By inserting an implant behind each breast, surgeons are able to increase a woman’s bustline by one or more bra cup sizes. If you’re considering breast augmentation, this website will give you a basic understanding of the procedure – when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, as a lot depends on your individual circumstances.

Breast augmentation can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you’re physically healthy and realistic in your expectations, you may be a good candidate.

A breast implant is a silicone shell traditionally filled with either liquid silicone gel or a salt-water solution known as saline. The latest and best implants use a soft but solid silicon rubber called cohesive gel. Breast implants were initially round (or hemispheric) in shape, and cheap round implants are still sold to the unwary. All modern implants are anatomically shaped or breast – shaped (like a teardrop).

Breast implants are also available with smooth or textured surfaces. Smooth implants are less expensive and have a thinner wall, but suffer a 40 – 60% risk of capsular contracture (hardening and distortion of the implant). The risk for the textured implants is 3% only. Cohesive gel implants are only available with a textured surface.

Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with all surgery and specific complications associated with this procedure.

The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or surgical “scoring” of the scar tissue. Removal or replacement of the implant may even be necessary.

As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.

Less than 1% of women develop an infection around the implant. In most cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.

Some women report that their nipples become oversensitive, undersensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear with time, but may be permanent in some patients.

There is no evidence that breast implants will affect fertility, pregnancy, or your ability to breast feed. If, however, you have breast fed a baby within a year before augmentation, you may produce milk for a few days after the surgery. This may cause some discomfort, but can be treated with prescribed medications, if persistent.

Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from normal compression and movement of your breast and implant, causing the man-made shell to leak. If a saline filled implant breaks, the implant will deflate within a few days at most and the salt water will be harmlessly absorbed by the body.

Actual patientIf a break occurs in a liquid silicone gel-filled implant, however, one of two things may occur. If the shell breaks but the scar capsule around the implant does not, you may not detect any change. If the scar also breaks or tears, especially following extreme pressure, silicone gel may move into the surrounding tissue. The gel may collect in the breast and cause a new scar to form around it, or it may move to a nearby area. There may be a change in the shape or firmness of the breast. Both type of breaks may require a second operation and replacement of the leaking implant. In some cases, it may not be possible to remove all the silicone gel in the breast tissue if rupture should occur.

In the case of cohesive gel implants, the manufacturers state the risks to be similar to liquid silicone gel. However, these same manufactures are continuing to face a legal witch-hunt, and so are guaranteeing nothing to nobody right now. The cohesive gel implants have been designed to solve this very problem of liquid silicone gel implant rupture, and appear at this early stage of follow up to have done so.

A few women with breast implants have reported symptoms similar to diseases of the immune system, such as scleroderma and other arthritis-like conditions. These symptoms may include joint pain or swelling, fever, fatigue, or breast pain. Research has found no link between silicone breast implants and the symptoms of what doctors refer to as “connective – tissue disorders,” with numerous large studies showing identical or lower than normal incidences of these diseases in women with breast implants.

Breast implants do not increase your risk of breast cancer, with studies showing augmented women to have only 43 – 47% of the normal risk for this killer disease. This presumably arises due to augmented ladies having less than half the normal amount of breast tissue, rather than to any protective effect of silicone!

While there is no evidence that breast implants cause breast cancer, they may change the way mammography is done to detect cancer. When you request a routine mammogram, be sure to go to a radiology centre where technicians are experienced in the special techniques required to get a reliable x-ray of a breast with an implant. Additional views will be required. Ultrasound examinations may be of benefit in some women with implants to detect breast lumps or to evaluate the implant.

While the majority of women do not experience these complications, you should discuss each of them with your plastic surgeon to make sure you understand the risks and consequences of the breast augmentation.

In your initial consultation, Dr McGovern 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, he may also recommend a breast lift.(For more information on this procedure, click Breast Lift or Mastopexy).

Dr McGovern will give you 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.

Dr McGovern performs breast augmentation in a dedicated operating theatre at the Sunshine Coast Day Surgery at Maroochydore.  Most ladies choose day surgery. Occasionally, those with little support or little children at home choose to stay a day or two, in this case, the procedure will be performed at the Sunshine Coast Private Hospital located in Buderim.

Breast augmentation is usually performed under general anesthesia, so you’ll sleep through the entire operation. Some surgeons may use local anesthesia, combined with a sedative, to make you drowsy. However significant discomfort during the procedure is then frequent. Dr McGovern’s anaesthetist will recommend general anaesthesia for this procedure for your comfort.

cnv00039The method of inserting and positioning your implant will depend on your anatomy and Dr McGovern’s recommendation as well as your own preferences. The incision can be made either just above the crease where the breast meets the chest or around the areola (the dark skin surrounding the nipple). Armpit and belly-button incisions carry additional risks, generally give an unsatisfactory and poorly controlled position to the breast implant, and are not recommended.

Every effort will be made to ensure that the incision is placed so resulting scars will be as inconspicuous as possible. Working through the incision, Dr McGovern will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue or more commonly underneath your chest wall muscle (the pectoral muscle).

Putting the implants behind your chest muscle may reduce the potential for capsular contracture.

The implants are then centered beneath your nipples. To ensure accurate placement of implants and symmetry we will be sitting you up and adjusting implant position whilst you are under the anaesthetic. This is not commonly done by other surgeon’s as it adds considerable time to the operation, but Dr McGovern is meticulous, and wants your breast implant position to be exact.

Subpectoral implant placement may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue. Placement behind the muscle however, may be more painful for a few days after surgery than placement directly under the breast tissue.

The surgery usually takes approximately one hour to complete. Absorbable stitches are used to close the incisions, which will also be taped for greater support. These modalities ensure your scar will be fine.

Breast Anatomy - Submuscular

Breast Anatomy – Submuscular

Breast Anatomy - Subglandular

Breast Anatomy – Subglandular

Breast Anatomy - Dual Plane

Breast Anatomy – Dual Plane

Natrelle-smallYou’re likely to feel tired and sore for a few days following your surgery, but you’ll be up and about in 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by your surgeon.

You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades. Your stitches will not need removal, as they are placed under the skin and will dissolve in time. Swelling in your breasts may take three to five weeks to disappear. You should not have new bras fitted or wear any bra for 6 weeks after surgery.

You should be able to return to work within a few days to a week after surgery, depending on the activity level required for your job. Follow your surgeon’s advice on when to begin exercises and normal activities. Your pectoral muscles will be sore when you contract or stretch them, for about one month. Your breasts will be sensitive to direct stimulation for two to three weeks, so you should avoid firm physical contact.

After that, breast contact is fine once your breasts are no longer tender, usually three to four weeks after surgery. Your scars will be firm and pink for at least six weeks. After several months, your scars will begin to fade, although they will never disappear completely.

Routine mammograms should be continued after breast augmentation for women who are in the appropriate age groups, although the mammographic technician should use a special technique to assure that you get a reliable reading, as discussed earlier. (See All surgery carries some uncertainty and risk.). You must inform the technician that you have breast implants before your mammogram.

For many women, the result of breast augmentation can be satisfying, even exhilarating, as they learn to appreciate their fuller appearance. 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.

If you have further questions, write them down and ask Dr McGovern and his friendly staff at your consultation.