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Breast Augmentation

Women who feel that their breasts are too small or lack fullness may experience self-consciousness or dissatisfaction with their appearance. They may find that clothes do not fit properly or they may be frustrated by a reduction in breast volume after pregnancy or weight loss. Fortunately, breast augmentation, or enlargement, with the use of breast implants is available from our plastic surgeon here at our Gold Coast practice in Queensland and at our clinic in Ballina, New South Wales.

What is a breast augmentation?

A breast augmentation, also called an enlargement, is a procedure designed to produce larger and more shapely breasts. It involves the placement of breast implants filled with either silicone or saline behind the breast or chest wall muscles in order to achieve the desired result. Breast augmentation surgery is performed under general anaesthetic and normally done as a day case.

*Disclaimer:
These before and after photos are of patients that have had surgery performed by Dr Layt. These patients have consented to the photos to be shown. These are the actual photos and the photos have not been altered or digitally enhanced. Every patient is an individual and therefore final surgical results will vary from patient to patient.

Breast Augmentation Photos

Before*After*

*Disclaimer:
These before and after photos are of patients that have had surgery performed by Dr Layt. These patients have consented to the photos to be shown. These are the actual photos and the photos have not been altered or digitally enhanced. Every patient is an individual and therefore final surgical results will vary from patient to patient.

Who is a candidate?

Candidates for breast enlargement include women who desire larger breasts and women with a moderate degree of breast sagging and smaller breasts. We can also assist women who have one breast that is noticeably smaller than the other.

What does the process involve?

The most important parts of the operation are the consultations beforehand which enable a decision to be made regarding the suitability of the surgery and the type of procedure which will suit you best.

It is important that breast augmentation is being considered for the correct reasons. Ask yourself if the operation is being considered to make you, rather than someone else, happy. If so, then you are probably making the right decision.

Next, there are a few decisions which need to be made. These relate to the size and shape of the breast implants, the positioning of the implant either in front or behind the chest wall muscles, the incision used to place the implant, and the exact type of implant to use. These are all decisions that Dr. Craig Layt will guide you through. The following are some of the choices that patients undergoing breast augmentation or enlargement will have about their implants. At our offices on the Gold Coast of Queensland and in Ballina, New South Wales, we are committed to helping patients through the decision-making process.

Every patient is an individual and therefore final surgical results will vary from patient to patient.

What size do you want to be?

The final size after breast augmentation is a result of your breast tissue plus the implant. This means that placing the same implant size in two different people will give two different results. We will discuss the size you are aiming for and help you make a decision on what size of breast implants to use. Your breast shape is largely determined by the shape you already possess. The use of shaped implants can sometimes be an advantage. This will be discussed with you.

Where do you want the implant placed?

Breast implants can be placed in front of or behind the chest wall muscle. Placing the breast implant behind the muscle tends to give a smoother line and less chance of feeling the edge of the implant. There is also evidence that it reduces the incidence of hardening of the implant. It is particularly useful in women who have very little breast tissue. Positioning the breast implant in front of the muscle is advantageous in women who do a lot of chest exercises.

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Where do you want the incision?

The IMF (inframammary fold) approach will leave a scar in the crease under the breast which is usually hidden while you are standing and is not seen whilst you are dressed in standard clothing. With modern planning techniques the scar remains in this position in most cases.

Using the periareolar (around the nipple) approach results in a semicircular scar around the areola. This will not be visible when you are clothed. Depending on your skin, it will tend to settle to a white line around the lower border of the areola. The visibility of this depends on how dark your skin is.

Placing the implant through an axillary (armpit) incision results in a scar which is hidden in the armpit creases. This approach is only suitable in certain cases.

The choice of approach will be discussed at length with you. Each of these approaches have positive and negative reasons for choosing.

What type of implant do you want?

There are numerous different types of breast implants for augmentation and enlargement available to our patients. All silicone implants are filled with a ‘cohesive medical grade’ silicone gel.  The implant shell can be either smooth or textured. They reflect the different approaches taken to limit the risk capsular contracture also know as implant hardening. The breast implant can be filled with either saline or silicone. Silicone, in general, feels more natural than saline, saline also has a 1% deflation rate per year.

Allergan has been involved in medical innovation for over 50 years and in breast aesthetics for over 30 years.  The Natrelle collection offers over 600 breast implant selections.  Allergan is largely involved in peer-review publications and research into their products.

The Natrelle breast implant collection is manufactured by Allergan, is TGA approved and is manufactured in a FDA approved facility in Costa Rica, Central America.

Mentor was founded in 1969 and is a leading supplier of medical products worldwide.  Mentor conduct research, development and manufacturing throughout Europe and the United States.  Their breast implants are manufactured in a FDA facility in Leiden, The Netherlands and are also TGA approved.

The selection of the implant is a joint decision between the patient and Dr Layt.  Dr Layt will discuss the pros and cons of the various implants, including the appropriateness of size, shape, placement, implant filling and implant shell in relation to the individual patient.

PIP Breast Implant and rupture of PIP Implants

PIP implants are a French made implant which were used a number of years ago and had been given TGA approval when introduced into Australia. In 2010, it was discovered by French authorities that the PIP Company had started to use a different type of silicone gel to that which was approved in many countries.

It was then reported that this difference also led to an increased rupture rate of that particular type of implant. The TGA in Australia and a team of medical doctors have been evaluating this situation since it came to their attention. The latest update by the TGA in May 2012 is that “The Australian Government’s advice remains that removal of PIP breast implants in the absence of evidence of rupture is not routinely required.”

The expert panel also reiterated that patients that have had PIP implants undergo a full clinical assessment, including MRI.

For further information regarding PIP implant removal please contact our friendly staff.

What can you expect after the operation?

Rapid recovery from the surgery is possible with modern techniques involving careful planning, gentle surgical technique, post-operative exercises and medications. It is important to stretch the chest muscles a little to stop spasm which may cause pain after surgery. This involves gentle chest exercises which is demonstrated in the video below. Drains are rarely required.  Your pain will be controlled by oral medications. You will have an appointment to see us 24-48 hours after the operation for review of dressings, medications and exercises. If distance is a problem we can often address this over Skype, FaceTime or phone.  You will also be seen approximately 7 days post surgery to change dressings and review your surgical progress. Light activities can be resumed as tolerated. Aerobic activities can be started in about 3 weeks. We are always available to help should concerns arise. You are expected to attend 3 month and 12month reviews with Dr Layt.

What are the potential risks?

Modern breast enlargement surgery is safe. There is, however, no such thing as risk-free surgery. The important thing is to understand any potential risks and take steps to minimise their occurrence.

Any surgical procedure carries some risk of infection, severe bruising, or reaction to anaesthesia. In the case of breast augmentation, there is also the possibility of complications related to the breast implant, such as rupture, rippling, or capsular contracture. All of these potential risks will be thoroughly discussed with you during your pre-surgical consultation and you will be given a comprehensive list of pre- and post-operative instructions. Following these instructions carefully will reduce the chances of complication, speed healing, and improve your chances of a successful surgery.

There has been a recent news article regarding contaminated breast implants being linked to the cancer known as Anaplastic Large-Cell Lymphoma (ALCL). For more information regarding this risk, please click here.

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Specific Pre-operative Instructions

WASHING: Wash the evening prior to surgery and the day of surgery paying particular attention to the breast region. This decreases the bacterial count and should decrease the risks of infection. Do not shave or wax under your arms in the three days prior to your surgery. This is best done prior to this.

PRODUCTS: Do not apply moisturisers, make-up, perfume/deodorant, nail polish or hair products after washing. Remove all jewellery.

CLOTHING: Wear loose, comfortable clothing and footwear. A shirt with a button or zipper opening is ideal for removal.

SMOKING: Smoking increases the risks of complications significantly and should be ceased 6-8 weeks prior to surgery.

FASTING: You should have nothing to eat or drink for 6 hours before your operation. If you are required to take medication during this time please speak with your physician to check if this can be taken before the 6 hour fasting period or after your procedure.

MEDICATION: If you are having the operation as a day case, you will be given a script for antibiotics and pain relief tablets that you will need to purchase from the chemist and bring with you on the day of your procedure. Do not take these prior to surgery. The nursing staff will advise you and your carer after your procedure on how to administer them.

Certain over the counter products and prescription medicines can cause complications before and after surgery. They can reduce the ability of your blood to clot and could increase your tendency to bleed during and after surgery. Do not take any medication containing or related to aspirin 2 weeks prior to your procedure. This includes NSAID’S, anti-Inflammatory medications,  blood thinning medications. Please check with your doctor regarding the medication and when to cease.d *This is not an all inclusive list*. ADMINISTRATION: Unfortunately, paperwork is a necessary evil. Each theatre complex has its own procedures. We have attempted to make it all easy by providing a simple series of steps to follow titled “THINGS TO DO FOR YOUR PROCEDURE” specific to the surgery center you are attending. Please follow these instructions. If you have any queries about this or anything else don’t hesitate to contact us on (07) 5597 4100.

Also avoid Vitamin E supplements and red wine. Stop all herbal medications before surgery. The most common herbs used are Echinacea, Ephedra, Garlic, Ginseng, Ginkogo, Kava, St. John’s Wort, and Valerian. They may adversely effect anesthetic drugs, prolong bleeding and impair healing after surgery. Please consult your physician before ceasing any medication.

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Specific Post-operative Instructions

POSITION: During the first week, attempt to sleep on your back instead of your side.  We want your implants to stay in a perfect position during the initial healing process.  This is not a “life and death” issue, however. If you cannot sleep on your back, sleep in another comfortable position.

DRESSINGS & DRAINS:   Drains are now rarely used for routine breast augmentation. Light ‘splash proof’ dressings are applied at the time of surgery. These should be left in tact until your one week visit. You will be fitted with a support bra which you should wear day and night for 2 weeks after surgery. (You may, of course, remove it to shower and launder). After 2 weeks, you may sleep without the bra. You should not go braless during the day for 4 – 6 weeks after surgery. Once the swelling has decreased you can buy new bras to fit your new size.  This usually takes 3 months.  It is recommended you not wear an underwire or push up bra for 3 months.

SHOWERING: You may shower, remembering that your dressings are splash proof rather than waterproof.  If water gets underneath the dressing it is best to change it. If you prefer to bathe, do not allow the incision lines to soak for more than a few minutes in the bath water.  It is fine to take off your bra while you bathe or shower.

SUTURES: All sutures are under your skin and self dissolving. There is usually a tail from the suture that will be snipped at your post op appointment.

SUNLIGHT: Scars take at least one year to fade completely. During this time, you must protect them from the sun.  Even through a bathing suit, a good deal of sunlight can reach the skin and cause damage.  Wear a sunscreen with a skin-protection factor (SPF) of at least 15 at all times when in the sunshine.  Be extremely careful if areas of your breast skin have reduced sensitivity.

ACTIVITIES: You may take a gentle walk the day after your surgery. It is advised to try to get up and move about as soon as you feel you can..  Do not return to aerobic exercise for 3 weeks.  You may drive when driving does not cause your pain, your vision, reflexes and thought processes are not impaired and you are confident in your driving ability.  This usually occurs in 4 – 6 days if you have a car with power steering.

TAPE: Dr Layt advises taping the wounds with Fixomull initially then Siltape for 8-12 weeks after your operation for optimal scar healing.  Our nurse will change these dressings 1 week after your operation. You will be given a sample pack of Siltape that will last approximately 6 weeks, after this you will need to purchase the Siltape yourself.

TED STOCKINGS: You may be required to wear TED stockings for compression to prevent DVT (blood clotting) post-operatively.  If required these will be fitted at the hospital on your admission day.  The nursing staff will advise you on how long you need to wear these for.

MEDICATION: Take your pain relief and anti-biotic medication as directed.  Any medication you ceased prior to surgery must not be taken after your surgery until you are completely healed or as directed by your physician.

Post-Operative Exercises

It is important to stop your muscles from going into spasm. To aid in healing and your comfort we recommend you stretch your chest muscles. To do this place your hands on the back of your head and push your elbows back. It is also good to retract or roll your shoulders back. You should try to do this hourly whilst awake starting from within the first 24 hours and going forward until muscles are well stretched and pain is minimal. This will make your recovery much more rapid. Please refer to the video below.

Contact Us

To learn more about breast augmentation (enlargement), or if you have further questions about the cosmetic procedure and the types of breast implants you can choose, contact our practice on the Gold Coast of Queensland today. Our team will also be happy to provide you with information on other breast surgery options, such as breast lift or breast reconstruction, as well as other procedures that can help you reach your cosmetic goals. We will be happy to answer any questions you have or schedule your consultation with Dr. Craig Layt.

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