Breast augmentation is a procedure which involves placing an implant behind the breasts to increase their size and enhance their shape. There are several reasons why women choose to have breast implants. Some may never have been happy with the size of their breasts, whilst others may have once been happy with their breasts but have lost volume or feel their that breasts have deflated with hormonal changes, weight loss or breast feeding.
Things to consider before surgery
The outside shell of all the breast implants are made of solid silicone. Most breast implants are filled with a type of silicone gel (Cohesive gel). Silicone used in this way has been proven to be safe and is not associated with any known long term health risks. Some breast implants are hollow and can be filled with saline (salt water) though these are rarely used in Australia as they may not feel as natural as silicone gel breast implants and tend to ripple more.
The implants may be placed behind the breast tissue and in front of the Pectorals major muscle (Subglandular) or beneath the Pectoralis major muscle (submuscular/dual plane). Both positions have their advantages and disadvantages. Generally in women without much of their own breast tissue to cover an implant, a submuscular position will be advised so that the breast implant edges are well concealed at the top of the breast providing a more natural appearance than the sub glandular method.
The implants can have a smooth or a textured surface and are either round or tear-drop shaped (anatomical). Smooth implants may be inserted through a smaller incision in some cases and are all round.
They are usually placed by the plastic surgeon in a sub-muscular position rather than sub-glandular as this has been shown to reduce long term problems such as “capsular contracture”. Round breast implants provide more fullness at the top of the breast and a deeper cleavage whilst anatomical breast implants usually appear more natural with a gentle slope to the upper part of the breast. They may also help to camouflage early sagging in the breasts by pushing the nipple outwards more in the lower part and therefore making the nipple look higher when viewed from the front (Pendulum effect).
Both round and anatomical breast implants are available with varying degrees of projection, depending on the volume the patient is seeking for their breast augmentation and will have the effect of either a subtle appearance or bolder and full appearance. In Perth, Mr Hanikeri utilises temporary sizers placed inside a bra as well as 3D computer generated images to help patients assess their options and make decisions about which implants will help them achieve the breast size and shape they desire.
The initial breast augmentation consultation in Perth is usually to determine the “look” the patient is after and to make sure the breast augmentation surgery is appropriate and can be safely performed. Dr Hanikeri recommends a second appointment which focuses on answering any questions, completing the paperwork and making sure the surgical plan is clear and well understood. It is rare to require more than two consultations before breast augmentation surgery, however if required, Mr Hanikeri is happy to see the patients as many times as they require.
After the breast implants procedure - what to expect
Breast enlargement patients in Perth will be mobile immediately and can resume driving, light activities and light exercise such as walking with two weeks. They can usually return to normal activities and exercise within four to six weeks after breast augmentation surgery. Most patients are recommended to take around one to two weeks off work after the breast augmentation surgery depending on the physical demands of their job.
Whilst breast augmentation scars are not completely predictable, most are barely visible and easily concealed in time. They may appear pink and slightly thickened for a few weeks to months after the breast augmentation surgery but will usually fade to be pale and soft by around three to six months. Their final appearance may take up to eighteen months to achieve. Most patients experience very minimal scarring in the longer term.
Breast enlargement surgery usually takes between one and one-and-a-half hours, and is most safely performed under general anaesthesia. Whilst some (Usually non surgically trained) surgeons offer the surgical procedure under a local anaesthetic or twilight sedation, this is often to save money or to perform the surgery outside of an accredited hospital, rather than offer a benefit from a safety point of view.
The procedure involves making an incision of approximately five centimetres in the crease under the breast. Whilst other incisions may be used, the incision under the breast provides the greatest degree of control and predictability for the breast implant placement and orientation and is therefore Mr Hanikeri’s preference for breast augmentation surgery. This incision is used to create a pocket into which the breast implant is placed before the wound is sutured closed with hidden sutures under the skin that slowly “dissolve away” as the wound heals.
Patients are usually able to go home the same day, but in many instances patients who have had a submuscular procedure may be advised to spend one night in hospital because drains are inserted in these patients to remove any fluids that may otherwise build up around the breast implants. If not removed, this fluid may influence the longer term results and risks. Patients may go home with drains and return for removal of the drains if they would prefer not to stay in hospital. Post-operative pain is usually controlled with tablets prescribed by the anaesthetist who is present for the breast implant surgery.
Risks of breast augmentation