Augmentation Mammoplasty – Breast Enlargement

Augmentation, technically known as augmentation mammoplasty but commonly called breast enlargement, or “boob job” in Australia, is a surgical procedure performed to create larger breasts.

Breast implants have been around for a very long time, since 1963. In the past 10 years, breast augmentation has become more common than any other cosmetic procedure. Until a decade ago, the use of autologous fat injection to enlarge breasts was thought irresponsible. The technique uses a modified liposuction procedure to harvest your own fat, which is then purified and injected into the breasts. It was thought irresponsible because on a mammogram, the injected fat can resemble breast cancer. Nowadays, modern imaging techniques easily distinguish the two. In my view, autologous fat injection has many advantages over breast implants.

There are a few common misconceptions about breast enlargement that should be discussed before you look any further;

• Breast implants do not significantly lift breast tissue and therefore do not avoid the need for breast lift surgery (mastopexy). See the Mastopexy section of our website if you have a low nipple position or sagging breasts.
• Breast implants will not change the shape of your chest. By using the very best implants available, we can give you the most natural look possible. However, you will always have your unique chest shape.

Therefore if you are happy with your breasts and you just want them to be bigger, then breast augmentation is perfect for you!

How old do I have to be to have breast enlargement?

Queensland law actually prevents us from doing cosmetic surgery on a minor (under 18 years in Queensland).

Once you have turned 18, it is your decision what you do with your body.

Should I wait until after I’ve had kids to have my breasts enlarged?

If you are thinking of having kids in the next year, absolutely wait.

If however, kids are planned for a few years’ time, why wait?

Pregnancy and breastfeeding take their toll on breasts and can cause sagging and all sorts of other problems. The fact that you have had breast surgery is not going to increase or decrease your risk of these problems.

Having breast enlargement surgery does not interfere at all with breastfeeding. The fat has been transplanted well behind the milk ducts etc.

My breasts are different sizes ..

Many women actually have asymmetric breasts – which means that one breast is larger or smaller than the other.

When your breasts are very small, this may not be obvious, and many females have not noticed this difference until it has seen pointed out to them by a qualified surgeon.

Most doctors ignore this fact, as they figure you have had it all your life.

Dr. McGovern does not! He does almost as many asymmetric breast enlargements as he does symmetrical breast surgery.

Different volumes of harvested fat can be injected into each breast to achieve symmetry.

If your breasts are considerably asymmetric – eg an A cup on one side and a C cup on the other, you may require a lift or reduction on one side and a fat transfer to the other.

As we are dealing with humans, we know that no one is perfect or completely even on both sides. However, Dr. McGovern does a lot of surgery to correct asymmetric breasts.

What should I look for in a surgeon?

Firstly, that they are a qualified surgeon!

You would assume that to call yourself a surgeon or say that you “specialise in cosmetic/ breast surgery” , that you would be qualified. Unfortunately, not so in Australia!

Look for the initials FRACS (Fellow of the Royal Australian College of Surgeons) behind their name. This is the only surgical qualification recognised in Australia.

Look for someone that doesn’t travel – if you are a great surgeon, people come to you and you don’t need to move from town to town! This also means that they are there for you after surgery- always.

Ask your GP for recommendations. Not just what they have heard, but the results they have seen.

What are the advantages of autologous fat injection over breast augmentation using implants?

Breast Implants are a foreign body, which like all foreign bodies, become encapsulated in scar tissue.

Whilst most ladies achieve an excellent result without complications, many potential complications exist.

These include:

• capsular contracture (hardening of the wall around the implant)
• implant displacement (shift in implant position)
• implant infection
• implant shell rupture (leaking out of the silicone contents)
• a rare type of lymphoma (white blood cell cancer).
• Many of these complications require further surgery, and expense.

Because autologous fat transfer uses your own tissue, none of the above complications can occur. I believe autologous fat transfer to be inherently safer and more natural.

As a bonus, most ladies have no trouble selecting a donor site for liposuction! Approximately a one cup size increase can generally be achieved, and asymmetries or localised defects such as lack of upper pole fullness are easily addressed.

Autologous fat transfer is less painful than breast augmentation using implants, as no muscle division is necessary.

We hope the above has helped you understand breast augmentation using your own autologous fat transfer and breast augmentation a little better. Feel free to call us for more information, or to make an appointment with Dr. McGovern.

Breast Augmentation Using Your Own Body Fat

With the recent controversy surrounding the safety of breast implants and their association with the rare condition of Anaplastic Large Cell Lymphoma (BIA-ALCL). More women are asking about using their own body fat to enlarge their breast size, or in medical terms – autologous fat grafting. Autologous meaning using your own tissues.

The following information is designed help you to understand the benefits and the limitations of fat grafting to enlarge the breast

• Fat grafting has been used since the 1960’s to treat many parts of the body, particularly defects created by trauma.
• It was only a decade ago that its use in enlarging breasts breasts began.
• This was because the appearances of the injected fat on mammography (breast screening for cancer) are similar to the appearances of breast cancer.
• Nowadays, newer medical imaging techniques can easily tell the two apart.

Autologous Fat Grafting of the Breasts Information in General

• Is performed under general anaesthesia
• Is performed at a the Sunshine Coast day Hospital
• Is a day procedure only
• has far less post-operative discomfort than breast implants.

How is Fat Transfer to the Breasts performed?

• A modified liposuction technique is used to harvest fat.
• The fat must be treated very delicately, as it can die easily (believe it or not!).
• Small incisions are made in areas that will be not noticeable.
• The fat is gently placed through these incisions into the breast.

Where is the fat taken from, to then inject into the breast?

• Any area where you have a reasonable amount of fat to harvest – eg hips, abdomen, inner thighs.
• As an ancillary benefit, you get improved contours there as well as larger breasts.

How much enlargement can I achieve from fat transfer procedure?

• The main reason this is not performed more commonly is because it is only possible to achieve on cup size larger than your current breast.

Is fat transfer a safe procedure?

• All surgery carries some risk
• Fat transfer doesn’t have any of the short or long term complications of breast implants.

Am I suitable for fat transfer breast augmentation?

The women most suited are those with:

• A contour deformity of the breasts following lumpectomy
• Breast asymmetry
• insufficient fullness to the upper pole of the breast and/or mild degrees of sagging or ptosis
• Insufficiently tight cleavage.

 

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.

The 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.

You’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.

If you have a problem of hardening around your breast implant, this is called capsular contracture. We hope you find the following information helpful.

What is capsular contracture?

• When anything foreign is implanted into the body (whether deliberately or otherwise), scar tissue will form around this foreign object. This scar tissue, or capsule, is formed by your body as a protective measure.
• When we place a breast implant, the body’s natural reaction is to form this capsule, or scar tissue around it. So every implant has a level of capsular contracture which is considered normal
• In some instances, and for reasons that no one truly understands, occasionally this capsule can contract and become hard.
• If left for many years this contracture can actually involve breast tissue and the breast may become very firm and painful.
• Capsular contracture used to be the most common complication of breast augmentation surgery, but with new technology and textured implant surfaces, this has reduced the number of problems occurring.
• In the past rates of capsular contracture have been quite high (up to 60% with older smooth shelled implants). But with the advent of more sophisticated textured outer shell, this rate has reduced to almost nothing (1 – 1.7% shown in most studies )
• Capsular contracture can happen at any time, but seems to be more common in the first few months after surgery.
• Dr McGovern likes to follow you up at around 3 – 4 months following breast implant surgery to check that you’re healing well, without problems of capsular contracture.
• If there seemed to be a problem of capsular contracture at this early stage, we can instigate a regime of massage to prevent the problem becoming long-term.
• These follow up visits are free of charge to you.

What causes capsular contracture?

Currently, the exact causes for capsule contracture are still unclear. The following are thought to put you at greater risk for developing capsule contracture:

1. Transient germ contamination.
   Bacterial contamination of the implant shell can cause an inflammatory reaction which in turn leads to the capsule shrinking.

2. Placement of the implant in front of the pectoral muscle.
   There seems to be a higher rate of a hardened capsule forming if the implant is placed on top of the pectoral muscle rather than underneath it. This could be because the implant has more space to move when placed on top of the muscle and therefore the body tightens the capsule surrounding it to prevent this movement.

3. Seroma or hematoma following surgery
   It seems that a capsule is likely to form if you have suffered a post-surgery seroma (build-up of fluid around the implant) or hematoma (build-up of blood around the implant).

4. Smoking..

We know that smoking causes delayed healing. Nicotine is a vaso-constrictor, which means it causes the vessels to contract and restricts blood flow. Reduced blood flow to a healing wound results in a slower healing process and in some cases, the death of the tissue. If this occurs where an implant has been placed, it very well may result in more scar tissue forming than normal, and a problematic capsular contracture.

What is the Baker Grading system?

You may hear Dr McGovern talking to you about the Baker grading of your capsular contracture. Here is how the grading system works.

Baker Grade I: The breasts are normally soft and natural looking as a normal capsule has formed around the implant. This is considered normal.

Baker Grade II: The breasts are firm but appear natural looking. This is considered normal after breast augmentation

Baker Grade III: The breasts are firm and now beginning to distort in shape.

Baker Grade IV: The breasts are now very hard to the touch and appear much distorted. One breast may be contracted either higher or lower than the other causing obvious asymmetry. There may be pain and discomfort associated with this degree of contracture.

Some women, regardless of what type of implant is used, have a predisposition to producing a contracted capsule, for reasons that no one can tell. If a problem of capsular contracture occurs and requires removal of the implant.

If you have any problems with hardening of your implants, please call us on 18000 80001

What is the Cost of Breast Augmentation?

The costs of breast enlargement vary according to the following variables:

1. The Implants you choose to use
2. The qualifications of the doctor you choose to perform your surgery
3. Where you have the procedure performed.
4. The qualifications of the person performing your anaesthetic

The old adages of “you get what you pay for” and “ caveat emptor” which means “buyer beware” are never more important than when you are deciding to have surgery performed on your body.

In this case you want to do the surgery once and you want to do it right – you certainly don’t want problems!

Choosing the very best on all of the above points is paramount if you want a good result.

At Vie Institute we do not compromise on quality. Dr McGovern is a qualified Specialist Plastic & Reconstructive Surgeon who has been performing breast augmentation on Sunshine Coast since 1994.

1. Implants . Dr McGovern has always chosen to use only the very best implants available on the market. When you’re implanting something into your body you only want the best! If you can’t afford the best, then don’t do the procedure until you can afford the best, or you take a huge risk and highly increase your risk of problems occurring.
2. Qualifications . Please see our page “The Difference between a Plastic and Cosmetic Surgeon”. Most people are not aware of the difference, and you can see that it is important to do your homework. You wouldn’t employ a gardener to build your home, so why would you chose a GP or someone from overseas that you don’t understand is a qualified surgeon?
3. Surgical Facility. Dr McGovern only performs breast augmentation in a dedicated operating theatre at either the Sunshine Coast Day Surgery or the Sunshine Coast Private Hospital. We don’t run the risk of infection etc that is more likely if the procedure is done in a doctors rooms or similar.
4. Anaesthetic Used. We use a qualified anaesthetist who chooses to do breast augmentation under general anaesthesia as this procedure is painful! A lot of doctors cut costs by cutting corners eg doing surgery in their rooms instead of a hospital, and using GP to give the anaesthetic instead of a qualified anaesthetist. This person is keeping you alive – do you really want someone unqualified doing this?