By Dr Scott Turner

Who’s it for

Breast augmentation is one of the most frequently requested and performed procedures at Dr Turner’s clinics. It remains the most common cosmetic surgical procedure performed worldwide. Many women seek breast augmentation to help themselves feel more feminine and improve their self-confidence, while each has their individual reasons for undergoing breast augmentation, some of the most common reasons include:

  • Feel their breast are too small
  • Feel their breasts are disproportionate to the rest of their body
  • Want larger, fuller and rounder breasts
  • Lost volume after pregnancy or weight loss
  • Have one breast larger than the other (asymmetrical)

Women who are physically and emotionally healthy, have realistic expectations about the results of the surgery, and understand the risks and benefits of the procedure are ideal candidates for breast augmentation.

What to expect at my appointment

Firstly, you are fully informed of the normal surgery process, plus possible complications (quite rare). After a thorough history and discussion about your desires, Dr Turner will examine you to assess you are a good surgical candidate. Measurements are then made of your chest wall and breasts, and routine pre-op photographs are taken.

Dr Turner understands that every woman is unique in both her desires and body shape. Dr Turner will expertly guide you through the selection process of implant type (round or anatomical), incision location (under breast, around nipple or axilla), implant placement (under or above muscle) and finally implant size that best suites your anatomy.

Dr Turner sees each patient personally for a minimum of two consultations (no patient representative) before surgery and gives you the time during these preoperative consultations to answer all your questions and alleviates any concerns to make sure that surgery is the right answer for you. During the consultations you will have the opportunity to try on various implants along with utilizing the latest in 3D imaging technology to simulate your new breasts after breast augmentation surgery. In this way, you will enjoy a completely customized treatment designed with your specific goals in mind.

After the consultation, a quote will be prepared that will include your implant, surgical, anaesthetic, and hospital fees. If you wish to proceed with breast augmentation surgery a deposit is required to confirm your surgery date. At this time a consent form is completed and hospital admission paperwork is given to you.

Your surgery

Breast augmentation is performed under general anaesthesia in a fully accredited hospital with the assistance of a qualified anaesthetist. Expect the operation to take between one and two hours, and generally you are discharged the same day – no overnight stay required.

Implant advancements

Breast augmentation surgery has advanced light years since the days of runny, liquid silicone implants. Combined with improved surgical techniques, the refinements in silicone implants composition and shell structure have made breast augmentation surgery safer with more reliable and natural results.

Modern-day form stable / cohesive gel technology, where the implant contains semi-solid silicone gel, gives you important advantages like:

  • Better preservation of breast shape
  • Minimal gel bleed or seepage
  • Minimal risk of implant rupture
  • Lower risk of capsular contraction

Incision Location

There are three common incision sites for the insertion of breast implants:

  • under or in the breast fold – inframammary fold
  • around the nipple – periareolar
  • through the armpit – transaxillary

Each of these incision sites has advantages and disadvantages in terms of how well the scar is finally hidden and the ability to position the implant accurately. My preference is to use an incision at the inframammary fold as it provides optimal exposure to the underlying breast tissue and pectoralis muscle to allow accurate placement of the implant for predictable and reproducible results. In the vast majority of patients the final incision is barely visible after six months following surgery.

Implant Placement

There are two common locations for the placement of breast implants:

  • Between the pectoralis muscle and the breast tissue – subglandular
  • Below the pectoralis muscle – submuscular

What about dual plane?

Dual plane is a technique in which the upper half of the implant is behind the pectoralis muscle and the lower half of the implant is directly behind the breast tissue. This technique combines the benefits of both the subglandular and submuscular techniques without their shortcomings.

In women with thin covering of the chest wall or breast ptosis, a dual plane technique is ideal to control breast shape with a smooth transition from the chest onto the upper pole of the breast for a natural appearance. While in women with thicker covering, a subglandular technique gives the quickest recovery, with a beautiful appearance and optimizes upper pole fullness.

Implant Type

Modern silicone implants are far superior to saline implants in terms of feel, shape and longevity. In Australia, silicone implants are used in the vast majority of breast augmentation.

Silicone breast implants differ in shape, shell surface and volume:

Shape – Round or Anatomical (teardrop)

The decision about implant shape can be confusing for women seeking breast augmentation as both shapes can achieve natural and beautiful results, however there are subtleties that Dr Turner can assist you in selecting the right implant for you.

A round implant is ideal for those with well-shaped natural breasts who desire enlargement or for women who desire enhancement of the upper poles of their breasts.

An anatomical (teardrop) implant is beneficial in women with mild breast ptosis (droopy), tuberous breasts or for women who want less fullness of the upper pole for a very natural (un-operated) result.

It is worth highlighting that with anatomical implants there is a small risk (2%) that the implants can rotate in the first few weeks after surgery (leads to abnormal breast shape) which requires revision surgery to correct this deformity. The use of round implants is not affected by rotation concerns.

Shell surface – Textured or smooth

There are two common breast implant shell surfaces:

  • Smooth: Smooth implants have thinner shells making them softer and also require a smaller incision than textured implants during placement. Smooth implants move freely within the breast pocket, which can increase the risk of implant migration so are only used in round implants.
  • Textured: Textured implants reduce the risk of capsular contracture – abnormal scar tissue encapsulating the breast implant, which can cause pain and distortion of the implant shape. The other important benefit of textured implants has been to reduce the risk of displacement (rotation or bottoming out) to give longevity and reliable breast shape.

What about polyurethane coated implants?

Polyurethane coated implants ‘Furry Brazilian’ are very effective in treatment of capsular contracture (reported 1%). Currently I prefer to use these implants for the majority of revisional cases of capsular contraction and only in selected primary augmentation cases. Polyurethane implants feel much firmer than both smooth and textured implants, although they do soften up after 12 months. Another advantage of polyurethane anatomical implants is they aren’t affected by rotation due to the firm adherence between the breast pocket and the implant.

Volume

While breast implant size is often the most important decision for woman seeking breast augmentation surgery, it is the last factor to be considered during implant selection. While a desire for a certain cup size is helpful in guiding selection of the breast implant size, this needs to be translated to the breast implant diameter and projection.

As part of your consultation, using a combination of measurements and 3D imaging a range of suitable implant to match the diameter of your breasts are selected for you to choose from. It is important to emphasize as implant volume increases so does the diameter of the implant. Choosing a breast implant too large for your natural breast shape is likely to give an unnatural appearance.

When I go home

If your implants have been placed in front of the chest muscle, recovery is very fast, with only moderate discomfort over a few days. Recovery is somewhat slower and more painful for implants placed beneath the chest muscle. In these cases we provide stronger pain relief for you to take home.

Specialised dressings are applied to the incision site to speed wound healing. All sutures used self-dissolve, so no post op suture removal is necessary. A compression garment is applied at the end of your surgery to provide support, minimise swelling and to maintain the position of the implants during the healing phase.

After your surgery, you are advised to avoid any heavy lifting or strenuous activity for one month, as this may lead to malposition of the implant and poor healing which will affect your final outcome. Most women are able to return to work within three to seven days. You will notice the final results from your procedure once the implants have settled and the swelling has subsided completely
.

Costs

Costs associated with breast augmentation varies depending on many factors:

  • Type of implant
  • Private hospital fees
  • Anaesthetic fees
  • Surgical compression bra

After your initial consultation my staff will give you an itemized quote of all costs associated with your procedure.

Costs: $8,500 – $10,500 incl. GST

Cosmetic fees are inclusive of all fees associated with your procedure – surgeon, anaesthetic, hospital, implant, postoperative office visits and garment costs.

Financing can be facilitated by Mac Credit if required.

FAQ

Q: Do I need a referral for Breast Augmentation?
A: A referral is not necessary to see Dr Turner for breast augmentation surgery. There is no Medicare or private health fund rebate available for cosmetic breast augmentation. If however you have significant asymmetry or tuberous breasts than this may be eligible for a Medicare rebate and such a referral from your local doctor would be beneficial.

Q: I don’t want to be too big. Can I choose the size?
A: At the consultation with a combination of measurements and 3D imaging technology we will select a range of breast implants that suits your natural breast dimensions. You will have the opportunity to try different size implants in a bra to get a sense of what your breasts will look like after surgery. We assist you in selecting the right implant to give you the results you desire to complement your natural body shape.

Q: My breasts are empty and droopy after breast-feeding. Can I have breast enlargement or do I need breast uplift?
A: There are two aspects that often need to be addressed with breast ptosis (droopy breasts) after children / breast-feeding; volume loss and nipple position. If you are satisfied with the size of your breasts in a bra than a breast lift (Mastopexy) would be more appropriate. However if like most women there is a combination of volume loss with descent of nipple position than breast augmentation can be a good option to give fuller breasts with mild elevation of nipple position. If the nipples have dropped below the breast fold than a combination of a breast lift with an implant is recommended.

Q: Can I have breast enlargement without scars on my breast?
A: Yes, the implant can be put in through an incision under the breast, around the nipple or through the armpit. The scar in the armpit often fades well into a crease and with this particular technique there are no scars on the breast itself. However not all patients are suitable for this approach.

Q: Am I eligible for breast augmentation?
A: Most people are eligible for breast implants to help enhance the appearance of their breasts for medical or aesthetic purposes.

Q: Will there be scarring?
A: Scars are a part of the breast augmentation process. You will have one, whether it is around the areola, in the armpit or under the breast. Fortunately, breast augmentation scars, regardless of where they are located, tend to heal extremely well. Immediately following your breast augmentation, your scars will be visible and pink but over time, they will fade and become unnoticeable.

Q: Will I have swelling?
A: Swelling is very common post-operatively, so you will most likely have swelling to some degree. The swelling will dissipate within a few days to a few weeks. A surgical compression bra will help in minimizing swelling which helps relieve tension on the breast and improves comfort.

Q: When can I expect to return to work and resume my normal activities after my breast augmentation?
A: Most women can return to normal activities after a few days to a week. It is important as part of your recovery that you still get up and move around, however during the first month strenuous physical activity and exercise should be avoided. By six weeks most women can resume all activities without restriction.

Q: How long will the results last after a breast augmentation?
A: Due to the effects of gravity and the normal aging process the size and shape of every woman’s breasts continue to change. If after a period of time you are dissatisfied than you may chose to under go a breast lift (Mastopexy) to restore a more youthful breast shape.

Q: Are breast implants permanent?
A: While many of the current breast implants have lifetime warranties for rupture, they are generally not considered lifetime devices and most women undergoing breast augmentation will require surgery in the future.

Q: One breast is smaller than the other. Do I have one or both done?
A: Most women have small differences in their breast to some degree. If one of the breasts is a satisfactory size and shape than the underdeveloped size can be augmented to match the other breast. Often most women would like to undergo enhancement of both breasts, this is best done using different size implants. This is accomplished by using a variety of gel sizers during your operation to match the breasts to give your breasts symmetry in both volume and shape.

Q: Can I breast feed after the operation?
A: Breast enlargement does not interfere with your ability to breastfeed as the implants are always placed behind the breast tissue and not into the breast tissue. However, some women are unable to breastfeed regardless of whether or not they have had surgery. Studies have shown that silicone in the breast milk of women with any type of breast implants are not higher than in those without breast implants.

Q: How will I know when my implant has failed or leaked?
A: While with older saline implants this was often noticeable with a change in the size and shape of the breast. With new silicone implants, rupture of the implant shell is often asymptomatic due to the form stable silicone used in within the implant – with no change in breast shape or pain. Older silicone implants can leak silicone which can result in pain around the breast or armpit. An ultrasound or MRI scan can be used to detect these leaks or ruptures in breast implants.

Q: What is silicone?
A: Silicone is actually from the naturally occurring substance, silicon. Silicon is a metal-like element that reacts with oxygen to become the most common substance on earth, silica. From beach sand to crystals, silica exists on the earth naturally. With intense heat and carbon, silica becomes silicon, which then can be further processed to become silicone. It is commonly used in lubricants and oils, such as polishes, body lotions, soaps, processed foods, chewing gum, and waterproof coatings.

Q: Are silicone breast implants safe?
A: There is no evidence that silicone implants are responsible for any major diseases of the whole body. Women are exposed to silicone constantly in their daily lives.

Q: When I get a mammography, will breast implants affect it?
A: You should inform the radiologist before your mammography examination as breast implants can interfere with the normal procedure to image the breast. The radiologist needs to use additional views of the breast to see as much of the breast tissue possible. Due to the popularity of breast implants this is a relatively common situation that radiologists are experienced at dealing with.

Q: After I’ve healed, can I suntan?
A: Of course. Sun tanning will not hurt the breast implant, but the implant may become warm while tanning and cool down more slowly. Sun tanning may adversely affect the scar and its recommended to cover the scar or use 30+ sunscreen during the first year after surgery.

Q: When can I start flying or scuba diving again after the breast augmentation surgery?
A: Changes in pressure may cause breast implant shells to slightly expand or contract, causing minimum amounts of air bubbles. There is no concern about breast implants rupturing (or exploding) and implants should return to normal within 24-48 hours.

Q: After the breast augmentation surgery, when can I start wearing under wire bras again?
A: For the first 6 weeks after breast augmentation surgery you will need to wear a surgical compression bra. After this period it is recommend that you wear a non underwire bra / sports bra for another 6 weeks while your breasts are still healing before you go out and buy the many new bras to fit your new shape.

Q: After the breast augmentation surgery, will my nipples lose sensation?
A: Most women experience a change in nipple sensation after breast augmentation, which is temporary lasting 6-12 months before it returns to normal. In 10-15% of woman there can be some permanent alterations in nipple sensation.

Q: What happens when I’m pregnant?
A: Breasts with breast implants will naturally enlarge during pregnancy. All other natural and usual changes will also occur, but to what extent will depend on each woman and the size/type of the implants as well.

Q: What are the risks involved with breast augmentation?
A: Although rare, as with any surgery there are risks involved, and some possible complications from breast augmentation include:

  • Infection
  • Nipple sensitivity
  • Blood clots
  • Interference with mammogram readings
  • Capsular contracture
  • Deflation and rupture
  • Rippling
  • Rotation

Q: When will I be able to drive after breast augmentation?
A: Most women may start driving one week after surgery, if they are no longer taking pain medication.

Dr Scott Turner

Dr Turner has spent a lifetime acquiring the qualifications, education and training and hands on experience to perform superior cosmetic and reconstructive surgery. He is highly regarded amongst his peers, and is highly qualified. His qualifications include - BSc (Anatomy and Pharmacology), MBBS (Hon), Masters of Surgery (Plastic Surgery). He is a Recipient of the John Brookes Moore scholarship for surgery, and was Awarded the John Loewenthal medal for surgery. After a further 8 years of dedicated training amongst all the major teaching hospitals in Sydney, Dr Scott was awarded his FRACS(Plas).

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