Breast Surgery FAQ
Breast Surgery and Augmentation Patient Common Questions
As you decide to undertake your breast surgery journey, you'll no doubt have many questions. I encourage you to ask as many and all of the questions that come to mind to ensure that your mind is at ease as you go through this process.
Below I've answered many of the more common questions patients ask in regards to general breast surgery and breast augmentation.
As you read the below, I have no doubt some questions will remain. I suggest that you write them down to bring during our discussion, your consultation. This way you'll ensure that you don't forget any questions you might have now, at a later date.
Breast Surgery & Breast Augmentation Common Questions
General advantages include; Increases volume and changes shape. Increase self confidence and self esteem. I had a patient come in wanting it done because she has always wanted bigger breasts like her sister since she was in her teens. She's now in her 50s and has finally realised her "dream".
There are always complications associated with every surgical procedure (bleeding, infection, wound breakdown to say the least). In the absence of any existing medical co-morbidities, and besides standard anaesthetic and surgical risks, implants alone can leak/rupture, form problematic capsules which thicken and contract over time (capsular contraction). Capsular contraction may cause an implant to become high riding and uncomfortable after a few years, and some patients may even present with pain. Let's consider the fact that gravity is a very strong force, which tends to win - a lot of the times!
It would be ideal if every breast implant sagged at the same rate as the breast on top of it as time passes (with gravity), but every now and then, one falls with gravity more so than the other. The result may mean that the implant either falls into the lower part of the breast (bottoming out), or remains high on the chest whilst the breast sags and drops below it (waterfall deformity). These are all common reasons which necessitate revision surgery for patients at around the 7-10 year mark post implant insertion - and this is actually the reason behind why implants have a "shelf-life". It's therefore important to note that because of this factor, a breast augmentation procedure is irreversible. The implant stays with you for life, and requires up keeping as time passes.
- Usually performed under general anaesthetic.
- Day stay in most patients - some may stay overnight depending on patient and medical factors.
- In a proper accredited and well equipped hospital in a theatre (operating room) environment.
- Implant choice: smooth vs textured. Round vs teardrop.
- Incisions: in the breast crease, or around the nipple, or trans-axillary (in the armpit) - the pros and cons between these options are in the breast augment page of the website.
- Placement: Under the muscle, or over the muscle (pec muscle)
Under the muscle gives a more discreet look as the muscle covering the top part of the implant blunts the take-off point of where the implant comes off the chest wall. This gives a more "natural" augmented result. This method is the preferred way especially when smooth implants are used as studies have shown a smaller risk of capsular contraction (as supposed to above the muscle).
- Over the muscle gives a fuller, more obvious augmented look without the muscle blunting the take-off point of the top part of the implant.
Having been part of the fitness industry for a long time myself - breast augmentation is something that is heavily sought after in this industry. These dedicated body sculptures train very hard many months of the year in order to achieve the body composition required to step on stage to compete. Position of their implants can be very tricky, as placement under the muscle often results in the implants being displaced downwards and outwards by the overactive (and over-trained) pectoral muscles. Placing them above the muscle is an option for them during off-season, but when "comp prep" time hits, and they then embark on their 3 month "cut" and lose a lot of their body fat, an implant that has been placed above the muscle will stick out like a sore thumb in a bikini on stage. These are often problems not often widely discussed with patients in the fitness industry.
This depends on a number of factors including the brand, the type and the size.
There are lots of different ones on the market and some have been around for a long time (reputable, widely used). Others are more obscure and are not commonly used (although may be cheaper). Some newer ones have different coating properties, and even come microchipped. As a general guide they start around the $500-$1,000 mark just for the implants.
It is impossible for anyone but yourself to measure if breast implants are "worth it". Some women use breast implants to feel more comfortable in their bodies, and it is true that a lot of women feel better about themselves, and have a higher self-confidence and self-esteem after having breast augmentation. Others choose breast reconstruction to re-create a natural-looking breast after a mastectomy.
Once again, it is important to choose to do this for yourself only, and be sure you are not choosing to do this for someone else. It may make you feel better about yourself and the way you see your own body, but will not mend a broken relationship, or make someone fall in love with you.
- Someone who takes your outcomes and wishes seriously.
- Addresses your concerns, fears and takes time to explain the process, benefits and risks of the operation.
- Someone who cares about your safety, and tries in every way to reduce your risks in having complications - and on the same train of thought, if you do unfortunately suffer complications, someone who is well equipped and capable of dealing with them acutely (if it is intra-operative), or have a way of managing them post-operatively (which may range from simple wound problems and dressings to re-admission to hospital if necessary).
Ultimately you need to be comfortable and confident with your surgeon, whomever you end up choosing. Be sure to have a consultation, or two, if that's what you need to do. Surgery isn't something you should feel rushed into.
They are perfectly safe in healthy and fit, young individuals. The disadvantages/risks are listed above in “What are the advantages and disadvantages of breast implants?”
A breast augmentation operation takes 1-2 hours to complete safely, depending on whether a lift is required at time of surgery. Revision breast implant operations are more complex and can take even more time (2-4 hours) to perform, and often require overnight stays.
Every operation will carry both general surgical and anaesthetic risks and will be discussed with you during your consultation. If you are overweight, taking any blood thinning and heart or lung related medications, this may be an indication that you are not as fit as you can be, for this type of cosmetic surgery. Which may place you at a higher risk of post-operative complications (eg. bleeding, wound breakdown and blood clots in your legs/lungs).
In most cases a general anaesthetic is required (unless it's something as simple as a nipple reconstruction, or a tiny skin adjustment, which may be able to be done under a local anaesthesia).
Recovery will depend on how much work has been performed. Generally speaking if there has been any manipulation/re-arrangement of muscle or breast tissue planes, the wound will take a couple of weeks to heal, and return to heavy manual work and exercise at 6 to 8 weeks.
Minor skin tightening procedures only without breast gland or tissue re-arrangement may return to full activities earlier on a case by case basis.
You will most likely have swelling after any kind of breast surgery and a soft compressive (no underwire) bra is often necessary for a few weeks (6-8 weeks) post-operatively.
Common Concerns Around Breast Surgery & Breast Augmentation
Depending on the type of operation you are having, altered sensation (increased or decreased) may occur. This will be discussed with you at the time of your consultation.
Typically there is a risk of this occurring if you are having:
- Implants inserted via an incision around the nipple instead of in the crease under your breasts. (A straightforward breast augmentation via a cut in the crease under your breasts theoretically should not cause altered nipple sensation).
- Breast lift or reduction procedures which require an incision around the nipple for skin tightening.
Implants should not affect the ability to breastfeed as the glandular and ductal network of the breast gland is not disturbed (the implant goes under the breast/gland whether it is on top or under the muscle).
If having a breast lift/reduction - 30% of women may have trouble breastfeeding after this operation. But the same proportion (30%) of women in the community who have NOT had breast surgery usually have trouble breastfeeding anyway - so technically speaking, having the operation is not likely to make a difference. However there is the possibility, which will be discussed with you during your consultation.
Many women are born with uneven breast volumes and shapes, and some may suffer this as a consequence of breast cancer. In fact, it is rare for someone to be born perfectly symmetrical. Having breast augmentation can sometimes make these imperfections more noticeable - and this will be discussed with you during your personalised consultation.
Sometimes patients may present with unevenness which requires a reduction on one size to match the volume on the other side, and some may even need surgery on the smaller size to correct a shape discrepancy after balancing out the volume. This can all get pretty complex, which is why as a plastic surgeon we have tricks, wisdom and experience up our sleeves to help you solve these complex problems. It is not uncommon for these patients to undergo multiple stages of surgery (not just a single operation to fix everything in one setting), and it is useful to note that you might be eligible for government medicare and health fund rebates if your problem is of a congenital or breast cancer related cause.
Your wounds will usually have a few layers of tape over them. These stay intact until your post operative visit ~ 1 week later. You may shower directly over them and pat these dry, but do not soak them in a bath/pool/spa. Regardless of the outer covering of your wounds, all dressings can get wet in the shower (unless specified otherwise by your surgeon). If the tapes lift or fall off, please notify our rooms. Usually this is not an issue as there is a secondary layer of glue dressing beneath, but you will be guided by the practice staff.
You may be eligible for government medicare or health fund rebates if your problem is of a congenital or breast cancer related cause.
Breast reduction may be covered if you suffer from large pendulous breasts which cause you pain in the neck or shoulder region, however surgery cannot be associated with the insertion of any implants.
In saying that, there are stringent guidelines for medicare funding for having a breast lift procedure not in association with implant insertion. You may qualify for this on a case by case basis which will be discussed with you during your personalised consultation.
Because your breast shape changes with pregnancy and lactation, it is crucial that we address your concerns with sag and loose skin after you are finished with pregnancy. If surgery is done prior to pregnancy and lactation, the breast volume will often increase with hormonal changes and cause recurrent sag and loose skin to form again. The ability to breastfeed is discussed above.
So in conclusion breast surgery (reduction/lift, with or without implant) after breastfeeding, after baby, after pregnancy, is safe, and often yields a longer lasting result than if you had it done beforehand.
The Food and Drug Administration (FDA) has not approved breast augmentation in patients younger than 18 - despite this clause, cosmetic breast augmentation in someone younger than 18 years of age is fraught with many consent, ethical and moral concerns and is therefore not recommended.
You will require a general anaesthetic, and hence someone to drive you home after your procedure. It is usually a day stay but may need to stay overnight depending on patient and medical factors
Your recovery will be a couple of weeks for the wound to heal, a few days before you are ready to get behind the wheel to drive (3-5 days depending on how you feel and how much pain and swelling you have). You'll be able to do heavy manual work and exercise at 4-6 weeks.
You will most likely have swelling after any kind of breast surgery and a soft compressive (no underwire) bra is required for 6-8 weeks after your operation.
You will be seen 1 week after your operation for a wound check and then 3 months to ensure all is tracking well.
Procedure Specific Patient Information / FAQs
Have a question that's unanswered?
I encourage you to write any questions you have down for your consultation. This way we can ensure that every thought and concern that you have is addressed and answered for your piece of mind.
If you have questions following your surgery, please contact the clinic on (03) 9988 1838 so we can address them for you promptly.