Breast Augmentation Sydney

Breast Augmentation has long been the most popular Cosmetic Procedure being sought by females in the 19-50 year age group. And Breast Augmentation owes its immense popularity to the boost in self-confidence and self-image it delivers, not to mention the ability to be able to buy dresses and swimming costumes that can then be filled at the top!

The commonest groups of women seeking Breast Augmentation that we see fall into three main groups:

  • Developmental Hypomastia: those that have always had less than an adequate amount of breast tissue.
  • Involutional Hypomastia: those who previously had adequate breast tissue but then lost much of it though pregnancy/breast feeding or major weight loss.
  • Those women who simply desire a larger breast size.

Breast Augmentation can be achieved by either of two possible methods:

  • Breast Implant Surgery by far, the most effective and popular method.
  • Fat Transfer – the removal of fat from one part of your body and its injection into the breasts. With only the patient’s best interests in mind, we do not recommend this procedure. Many surgeons consider this a flawed procedure because it can only deliver a small increase in breast size AND also because of the likelihood that the injected fat cells will not survive with the result that any increase in breast size will be partially or temporarily  lost within a short period of time.

Breast Augmentation using Breast Implants

As mentioned above, the most popular and effective way to increase  breast size is by  inserting  implants. Breast implants can deliver whatever breast size and shape a woman desires. Moreover, they can be combined with a ‘Breast Lift’ (known as an Augmentation Mastopexy) in those women who have suffered significant sagging of the breasts following breast feeding or major weight loss.

Nowadays, Breast Implants and Breast Augmentation Techniques come in such a variety of brands, types, shapes and sizes that they offer patients the choices of numerous combinations as follows:

Breast Implant Fill Types

Basically, breast implants may be filled with either Saline (Salt Water), Silicone or a combination of both. Saline Breast Implants are far less popular because of their less natural ‘feel’ and their risk of leakage and deflation. Although Silicone Breast Implants can also rupture, they still are a far more popular choice for patients because of their more natural ‘feel’ and the many different shapes they offer.
As a case in point, at Breast Excellence we have only ever had one request for a Breast Augmentation with Saline Implants but this particular patient returned after 14 years wanting them replaced with Silicone Breast Implants for a more natural ‘feel’.

Breast Implant Shapes

Breast implants basically come in two shapes: Round and ‘Tear Drop’. Each shape delivers a different ‘look’ with Round Breast Implants delivering more fullness in the upper breast. In contrast, ‘Tear Drop’ Breast Implants taper towards the top and thereby deliver a more natural breast profile with a straight-line drape of skin from the collar-bone down to the nipple.

Breast Implant Surfaces

Choices are:

  • Smooth Breast Implant Surfaces
  • Textured (‘Rough’) Breast Implant Surfaces
  • ‘Tear-Drop’ Shape Silicone Implants

There has recently been  much media-publicity in regard to  the ability  of each of these surface types to cause  the rare condition known as BIA-ALCL (Breast Implant Associated – Anaplastic Large Cell Lymphoma) – a rare tumour of the cells of the immune system – and the profession is currently awaiting the decision of Australia’s Therapeutic Goods Administration as to whether some of these surface types should be suspended or banned.

That aside, one indisputable fact remains: of all the above surfaces, only the ‘Tear-Drop’ Shape Silicone Implants have been reported  to dramatically reduce the risks of  two of the commonest reasons for repeat surgery: Capsular Contracture (the commonest reason) and Implant Displacement (implants moving away from their original position).

Breast Augmentation Incisions

Breast Augmentation can be performed through any of four possible incision locations:

  • Infra-mammary: the incision is made in the natural crease under the breast. This is, by far, the most popular of all locations because it affords the surgeon the greatest visibility of the implant pocket and any shape or size of breast implant can be inserted.
  • Trans-Axillary: the incision is located in a skin crease within the armpit, so there are no scars on or under the breast to mar the appearance of an otherwise beautiful breast augmentation. However, only fillable Saline Breast Implants or Round Smooth/Textured Silicone Breast Implants can be inserted via this route. ‘Tear Drop’, ‘Tear-Drop’ Shape Silicone Implants and large silicone-filled implants of any type are not suitable for this route.
  • Peri-Areolar: the incision is located half way around the areola surrounding the nipple. Owing to the small incision size possible in this location, only fillable Saline Breast Implants or small Silicone Breast Implants can be inserted.
  • Trans-Umbilical: the entry point is through the navel. This technique’s only advantage is that it avoids any scar on or under the breast. Its disadvantages, however, are that the long tube passed under the abdominal skin from the navel up to the breast can leave a permanent groove in the skin, it is difficult to create a perfect pocket from such a distant entry point, and  only a fillable Saline implant can be inserted. Not popular or commonly performed in Australia.

Breast Augmentation Placements

Breast Implants can be placed in any one of four specific locations:

  • Sub-Glandular (also called Pre-Pectoral) – the implant is placed under the breast between it and the underlying Pectoralis Muscle. This placement should only ever be used if the patient has ample tissue coverage to hide the edges of the breast implant, otherwise an unsightly ‘stuck on’ appearance would result.
  • Sub-Fascial – is similar to the foregoing. The implant is still ‘in front of the muscle’ but now under its sheath. The same comments apply.
  • Sub-Muscular – the implant is placed under the Pectoralis Muscle between it and the underlying ribs. This is Dr Mayson’s preferred  placement because of its various advantages, not the least of which are that it produces a more natural appearance as opposed to a ‘stuck on’ look, there is a reduced risk of Capsular Contracture, and there is less risk of interference with future breast feeding.
  • Dual Plane – a combination of Sub-Glandular and Sub-Muscular placements where the upper half of the breast implant is placed under the muscle, and the lower half of the implant is in direct contact with the breast tissue to give it a degree of ‘lift’ – useful when there is mild sagging.

The Easy Steps Involved in Having a Breast Augmentation at Breast Excellence®

1. Book a detailed Consultation with one of our highly-experienced Cosmetic Breast Surgeons:

  • Dr George Mayson, Certified Cosmetic Surgeon
  • Dr Bobby A. Kumar, Cosmetic & Restorative Surgeon
  • Dr Sawjin Tew, Australian-trained, female Specialist Plastic Surgeon

Each of our Surgeons has a particular area of interest, so with such a versatile team we can offer patients the full spectrum of Breast Surgery from simple Breast Augmentation right through to Corrective Breast Surgery and Post-Mastectomy Breast Reconstruction.

At your Consultation, our Surgeon will assess you and then offer you the various implants that suit your chest and breast measurements for you to choose from.

Once you have selected your preferred breast implant style, shape and size, our Surgeon will give you an Information Brochure on Breast Augmentation to take home as well as an itemised quotation as to costs.

2. Schedule Your Breast Augmentation Surgery

Once you book your procedure, we will send you detailed Pre-Operative Instructions as to how to prepare for your surgery along with any referrals for Pre-operative pathology tests or Mammograms/Breast Ultrasounds that your surgeon has considered necessary. In the best interests of patient comfort and safety, all Breast Augmentations are performed under General Anaesthesia in an accredited Hospital.

At the hospital on the day of surgery, you’ll be seen by your Surgeon and then the Anaesthetist before going to Theatre. The procedure usually takes between 1½ and 2 hours. After another 1-2 hours in Recovery, you can go home. Straightforward Breast Augmentations do not require a stay in hospital. However, you cannot go home alone. You must be accompanied by a responsible adult who can also be with you for the first 24 hours.

However, those patients having an Augmentation Mastopexy (Breast Augmentation plus a ‘Lift’) are required to stay overnight.

Reassuringly, our Surgeons are available 24/7 after your surgery.

3. Post-Operative Recovery

Immediately after your surgery you may feel a little drowsy and feel some chest discomfort but you will not have agonising pain. This discomfort can be relieved with the pain-relieving medications your Surgeon will have already prescribed for you. Most patients find that they don’t need pain-relievers after the first 4-5 days although it is not uncommon to feel an occasional ‘twinge’ over the ensuing months on some movements or if you over-exert yourself physically.

Most patients in sedentary occupations find they can return to work after 10-14 days. However, you may need 2-3 weeks off work if your job is more physically demanding. Our Surgeon can provide you with a Medical Certificate if you need more time off or you  need light duties initially.

Asian Breast Augmentations – Special Considerations are Necessary

At Breast Excellence®, we have always maintained that special considerations are essential when planning Breast Augmentations in Asian patients. Over years of operating on Asian patients, we have found that while many Asian women would like to have a Breast Augmentation, many are understandably concerned that:

  • They may end up looking disproportionately too big and therefore ‘fake’; or
  • Their final incision scars may end up a pigmented brown colour.

Breast Implant Sizes for Asian Patients

Unfortunately, some surgeons approach Asian Breast Augmentation in the same way they do for Western women. Instead of taking into account the generally smaller figures of Asian women, they recommend breast implant sizes the same way they do for Western women, the result being that their Asian patient then ends up with implants that are disproportionately too large and look unnatural and ‘fake’. At Breast Excellence®, even though we leave the final choice of size up to the  patient, we always recommend they choose implant sizes that are proportionate to their figure and make her look great but not ‘fake’!

The Risk of Pigmented Brown Scars in Asian Patients

It is a  fact that Asian skin has a higher risk of healing with pigmented brown scars. Not all do, but it is a risk. Accordingly, if this risk is of concern for an Asian patient, the Surgeon should be able to offer the Trans-Axillary technique which would locate any brown scars within a skin crease in the armpit and not mar the appearance of an otherwise beautiful result.

Our Experiences with Asian Patients over 20 Years

Interestingly, even though we always discuss the foregoing issue with each of our Asian patients, most still choose to have the incision in the fold under the breast for any or all of the following reasons:

  • It is by no means certain that the final scars will end up pigmented. In fact, more of our Asian patients end up with inconspicuous, fine whites scars than pigmented ones.
  • If a brown scar did develop in the armpit with the Trans-Axillary approach, the scars could be easily noticeable when raising the arms in a sleeveless top or swimming costume.
  • A brown scar under the breast does not prevent the wearing of sleeveless tops or swimming costumes.
  • But most importantly of all, the infra-mammary approach under the breast allows the patient to choose any shape or size  of implant she desires. In contrast, the small size of the ‘Armpit’ incision only allows the insertion of fillable Saline Implants or small Round Smooth/Textured Breast Implants.

Routine Breast Implant Replacements

A question we regularly get asked is:

Do I have to routinely replace my Breast Implants every 10 years?

Our short answer to this is  NO!

Although it is unrealistic to expect that all implants will last forever, we can never predict the life span of any implant.

In truth, some women may need to replace their implants within a relatively short period of time if an unexpected problem arises but there are also women who have had the same breast implants in place for many years without any problems.

For those reasons, we do not advocate routine implant  replacements when there is no valid reason to do so. We cannot see any justification in subjecting every woman every 10 years to the repeated costs, inconvenience, downtime and general risks of surgery when there is no problem.

What we do advocate, however, is that patients check the integrity of their implants with a simple Breast Ultrasound every 1-2 years. If an Ultrasound ever suggests a possible rupture, and it is subsequently confirmed on MRI Examination, removal and replacement is then certainly indicated and justified.

Augmentation Mastopexy

If the breasts have suffered considerable volume loss and significant sagging – usually as a result of pregnancy/breast feeding or major weight loss – a Breast Augmentation may need to be combined with a ‘Breast ‘Lift’. This combined procedure is called an Augmentation Mastopexy. In an Augmentation Mastopexy, an implant is first inserted into the sub-muscular position and then the stretched breast skin is trimmed to produce a tighter skin envelope.  The implant increases the size of the breast and the subsequent tightening of the stretched breast skin has the effect of lifting the now-enlarged breast to a more normal and pleasing position on the chest wall.

An Augmentation Mastopexy is the appropriate procedure when the breast has suffered volume loss and significant sagging. Naturally, an Augmentation Mastopexy is a longer procedure than a simple Breast Augmentation and does require an overnight stay in hospital. Accordingly, the total cost is greater than a straightforward Breast Augmentation but if you satisfy each of Medicare’s three criteria you should  qualify for a partial Medicare rebate on both the Surgical and Anaesthetic fees.

These three criteria are:

  1. Your surgery must be performed not less than one year or more than 7 years since your most recent pregnancy; and
  2. At least two-thirds of your breast mound must sit below the level of the crease under your breast; and
  3. Your nipple must sit at the lowest part of your breast below the level of the crease.

In addition, if you do satisfy each of the above criteria and  qualify for a Medicare rebate, and you also have Private Hospital Insurance, you may be able to claim a variable portion of your Hospital Costs depending on your Fund and Level of Cover.

How to Come To Us

If Coming By Public Transport:

  • If Coming By Train: 8 minutes’ walk from Town Hall Station, 5 minutes from Museum Station.
  • If Coming By Bus: Disembark at a stop around Town Hall, Queen Victoria Building, or as close as possible to the corner of Park and Elizabeth Streets.
  • If Coming By Ferry: From Circular Quay take any bus that travels along Elizabeth Street, disembark at Park Street or the stop closest to Park Street.

If Coming By Car

Parking Station Locations:

  • Wilson’s Car Park: directly opposite the Clinic, enter via its Castlereagh Street entrance.
  • Queen Victoria Building (enter via York Street) – 10 minutes’ walk to Clinic.
  • Domain Parking Station: the cheapest – simply park and take a 10-minute walk diagonally through Hyde Park.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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