Breast Implants Sydney
In its very accessible location in Sydney’s central CBD, our highly-experienced team of Cosmetic & Specialist Plastic Surgeons at Breast Excellence® can offer patients the full spectrum of Cosmetic Breast Surgery – from straightforward Breast Augmentations right though to more complex surgeries such as Implant Replacements, Breast Lifts, Breast Reductions and the correction of Breast Implant complications such as Capsular Contracture, Implant Displacement and Implant Ruptures.
We also regularly receive requests from new patients who already have Breast Implants but simply wish to “go bigger”.
The simple reason that Breast Excellence is able to offer the full spectrum of Breast Augmentation procedures and all types of Breast Implants is due to the versatility and expertise of its experienced team of Surgeons each of whom has a special area of interest.
Our Surgeons are:
- Dr George Mayson, Certified Cosmetic Surgeon
- Dr Sawjin Tew, Australian-trained, female Specialist Plastic Surgeon
- Dr Bobby A. Kumar, Cosmetic & Restorative Surgeon
Breast Excellence has now been performing Breast Augmentation Surgery for over 20 years and we are proud of our results over that entire time.
And, very importantly, we never dictate to patients what type of Breast Implant they must have. Instead, we explain the differences between all the different types of implants, and although we may offer our recommendations, we always allow the patient to choose whichever type and size of Breast Implant she prefers.
The choices we offer every patient at the Initial Consultation are:
- Choice of Breast Implant Filler: Saline or Silicone.
- Choice of Breast Implant Shape: Round or ‘Tear-Drop’ .
- Choice of Breast Implant Surfaces: Textured (‘Rough’), Smooth, and Polyurethane Foam-Covered Breast Implant Surfaces.
- Choice of Breast Implant Placement.
- Choice of Technique; AND most importantly…
- Choice of Breast Implant SIZE!
Let’s now look at each of the above patient choices:
Implant Filler Material: Saline Breast Implants have never proved very popular in Australia due to their less natural ‘feel’ and the risk of deflation through leakage. Additionally, all Saline Breast Implants are Round in shape, never ‘Tear-Drop’. Saline Breast implants only really came into popularity in America during the early 1990’s when it was thought that Silicone could trigger various auto-immune disorders. When that was disproven, Silicone-filled Breast Implants once again became the preferred implants simply because they have a more natural ‘feel’. Currently, the only advantage of saline breast implants is that they can be inserted in a rolled-up, empty state through a tiny incision around the nipple or through the navel, and once in place, filled to the desired size.
Breast Implant Shapes: Both ‘Tear-Drop’ and Round Implants are equally popular. Round Breast Implants give more fullness at the top of the breast and so can be the better choice if much upper breast volume has been lost after breast-feeding or weight loss. On the other hand, ‘Tear-Drop’ Breast Implants offer a more natural shape because they taper towards the top of the implant and so deliver a more natural breast profile by delivering a straight-line drape of skin from the collar-bone down to the nipple. Basically, the choice between these two shapes is a personal one depending on the particular ‘look’ a patient is after.
Breast Implant Surfaces are currently a controversial and much publicised media topic owing to the issue of BIA-ALCL (Breast Implant Associated – Anaplastic Large Cell Lymphoma) – a rare tumour of the cells of the immune system that can occur in association with some types of breast implant surfaces more so than others.
Although quite rare with an average incidence of 1 in 5,000 women with breast implants, it has been reported to be more likely with Textured (‘Rough’) Surface Breast Implants. However, the FDA (Foods and Drugs Administration) in America has now reported some cases of BIA-ALCL in Smooth Implants. So, it would now appear that no breast implant surface can be considered immune from developing BIA-ALCL.
Currently, the theory is that BIA-ALCL may be due to a bacterium getting into the crypts of a textured implant surface at the time of insertion. However, this theory does not explain why some cases of BIA-ALCL have now been found with Smooth Surface Breast Implants.
Currently, the facts of BIA-ALCL, as we best know them, are as follows:
- BIA-ALCL is rare with an incidence between 1 in 1000 women and 1 in 10,000 women, the average being 1 in 5,000 women. This means that even in the worst-case estimate of 1 in 1,000 women, 99.9 % women with Textured Surface implants will not get BIA-ALCL.
- BIA-ALCL usually presents as a swelling of the breast, typically 3-14 years after breast augmentation, and is due to the accumulation of fluid within the breast implant pocket. This accumulation of fluid is called a Seroma. However, not all Seromas are due to BIA-ALCL. Less commonly, BIA-ALCL can present as a lump in the breast or armpit.
- In most cases where the BIA-ALCL is confined to the fluid around the implant, the condition is totally cured by simply removing the implant along with the fibrous capsule around it.
- The risk of developing an invasive form of BIA-ALCL that needs chemotherapy and/or radiotherapy and removal of the implant is less than 1 in 10,000. The risk of death from BIA-ALCL does exist but is so small it cannot be reliably calculated and is considered to be less than 1 in 1 million.
- It is believed by some researchers that the vast majority of women in whom these cells are found, have a version of the condition that does NOT behave like a cancer but remains benign.
Choice of Breast Implant Placement
Breast Implants can be placed in any one of four locations:
- Sub-Glandular (‘In Front of the Muscle’): The pocket for the implant is created immediately under the breast between it and the underlying Pectoralis Muscle provided there is enough tissue coverage to hide the edges of the implant and avoid a ‘stuck on’ appearance.
- Sub-Fascial (‘In Front of the Muscle but under its Sheath’): A minor variation of the above placement with the same features.
- Sub-Muscular (‘Under the Muscle’): The most popular placement because the additional coverage of the overlying muscle helps to hide even more the implant edges, thereby delivering a more natural appearance with less risk of Capsular Contracture, less risk of interference with future breast feeding, and less interference with Mammograms.
- Dual Plane Placement: A combination of positions 1 and 3 where the upper half of the implant is located under the muscle and the lower half of the implant is in contact with the breast tissue. A good compromise when there is mild sagging of the breast and there is not enough tissue coverage to hide the implant’s upper edges.
Choice of Technique
Breast Augmentation Surgery can be performed through any of four incision locations:
- Infra-mammary (incision in the fold under the breast): The most popular approach because it affords the surgeon the best visibility of the implant pocket and any type, shape and size of breast implant can be inserted. through it.
- Trans-Axillary (via the armpit): The incision and therefore the final scar is hidden in a skin crease within the hair-bearing section of the armpit, and so the breast appearance is not marred by any visible scar on or under it. Although any size fillable saline implant can be inserted via this route, the small incision size limits the size of a silicone implant that can be inserted. Furthermore, ‘Tear-Drop’ Breast Implants and Polyurethane Foam-Covered Implants – be they Round or ‘Tear Drop’ – cannot be inserted via this route. Smooth, Round Breast Implants are the implants most commonly used in this approach.
- Peri-Areolar (around the areola): The final scar is located around the edge of the areola (the coloured circle around the nipple). Not popular as the small size of the incision limits the size of implants that can be inserted – only fillable Saline Breast Implants or Small Silicone Breast Implants can be inserted through this approach.
- Trans-Umbilical (via the navel): Not popular or commonly performed in Australia. A long hollow metal tube is passed from the navel up to the breast and through this tube a rolled-up, empty Saline Implant is passed up to the implant pocket created. Once in place, the empty saline implant is then filled and the metal tube withdrawn. Only Fillable Saline Breast Implants can be inserted via this route. Disadvantages of this technique are that the metal tube can leave grooves in the abdominal skin and it is difficult to create an aesthetic and artistic implant pocket from such a distant entry point. For those reasons, we do not perform or recommend this approach.
Choice of Breast Implant Size
At Breast Excellence, we never choose the implant size for any patient simply because we believe every woman has a pre-conceived image of how she wants to look. So, rather than choose the implant size for the patient, we prefer to take many breast and chest measurements, and then, based on those measurements hand all the possible implants to the patient for her to insert into a crop-top, one by one, until the patient finds the ‘look’ that she likes best. This is, by far, the most reliable way for any patient to choose the size of a breast implant. At Breast Excellence, we have a huge range of breast implant shapes and sizes for patients to insert into a crop-top and compare each in a mirror. Trying to choose from a limited range of implant samples or having the surgeon suggest a size from a catalogue runs a risk of delivering a size with which the patient is not happy.
Generally speaking, large and disproportionate breast implants can look obviously ’fake’, are more contributory to future sagging because of their heavier weight, and have a greater chance of future problems that require repeat surgery. Although we never choose the implant size for the patient, we do always recommend to patients that they choose an implant size that is proportional to their figure – in other words a size that makes them look ‘great but not fake’!
The Commonest Reasons For Repeat Surgery After Breast Augmentation
- Capsular Contracture: This is, by far, the commonest reason for repeat surgery after Breast Augmentation and it usually occurs years after the original surgery. Around every Breast Implant, the body forms a thin fibrous envelope called the ‘capsule’. EVERY breast implant has a ‘capsule’ around it. Capsular Contracture occurs when this normally undetectable capsule contracts – much like ‘shrink wrap’ does – which then squeezes on the implant causing the breast to feel firmer and change in shape. There’s nothing wrong with the breast tissue itself or the implant, it’s simply the shrinkage of the fibrous capsule that produces those changes. Treatment involves removing the breast implant, incising or excising the shrunken capsule (called a ‘Capsulotomy’ or ‘Capsulectomy’ respectively), and then re-inserting the same or a different implant. This form of corrective surgery is more involved and takes longer than the original Breast Augmentation, so is therefore costlier.
- Implant Displacement (Implants moving away from their original position)
This also is a not-uncommon reason for repeat surgery. Some breast implant surfaces have a lesser risk of moving out of position and our Surgeon will explain all these to you in detail at your Initial Consultation.
- Implant Wall Rupture:
- In the case of Saline Breast Implants, a slow leakage through the filling valve or sudden rupture will simply result in a deflation of breast size. The leaked saline is simply absorbed into the surrounding tissues without any harmful effects and the patient is alerted to the leakage by the resulting reduction in breast size.
- In contrast, rupture of a Silicone Breast Implant does not cause a deflation of the implant and so the patient does not notice any reduction of breast size. A ‘silent’ rupture of a Silicone Breast Implant is diagnosed either on a routine Breast Ultrasound or the patient may detect a lump in the breast (called a Silicone Granuloma) or an enlarged lymph gland in the armpit due to silicone migration.
The Easy Steps Involved in Having a Breast Augmentation at Breast Excellence:
- Book your detailed and informative Consultation with one of our Surgeons. At your consultation, our Surgeon will:
- Explain all about Breast Augmentation
- Take detailed chest and breast measurements
- Show you the various breast implants that suit those measurements
- Give you a written and itemised quotation as to costs
- Give you printed information on Breast Augmentation to take home.
- Book the Date of Your Procedure
- Pre-Operative Preparations: Your surgeon will give you specific instructions on how to prepare for your surgery. You may also be given referrals for Pre-operative pathology tests and a Mammogram/Breast Ultrasound if clinically indicated.
- On the Day of Surgery: At the hospital, you’ll be seen by your Surgeon and then checked by the Anaesthetist before going to Theatre. A Breast Augmentation 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 and then go home the next day after our Surgeon checks them.
Reassuringly, our Surgeons are available 24/7 after your surgery.
- Post-Operative Recovery is relatively easier and quicker than many other forms of surgery. Unless your occupation involves physically strenuous work, you should be able to resume work within 10-14 days. Reassuringly, our Surgeons are available 24/7 after your surgery should you have any questions or concerns.
- Follow-up Appointments will be arranged after your surgery.
Breast Augmentation, when performed in association with a Mastopexy (‘Breast Lift’) is known as an Augmentation Mastopexy. A breast implant is first inserted, usually in the sub-muscular plane, and then the skin envelope of the breast is tightened around the inserted implant to create ‘lift’.
Augmentation Mastopexy is the only appropriate procedure when the breast has lost volume and sagged considerably. Understandably, it does take longer than a straightforward Breast Augmentation and therefore the individual fees of the Surgeon, the Anaesthetist and the Hospital will be higher. However, if you meet each of Medicare’s three criteria of eligibility for a Rebate, you can claim a portion of your Surgical and Anaesthetic costs from Medicare. Medicare’s three criteria are:
- Your surgery must be performed not less than one year or more than 7 years since your most recent pregnancy; and
- At least two-thirds of your breast mound must sit below the level of the crease under your breast; and
- Your nipple must also sit below the level of the crease at the most dependent part of your breast
Most importantly, if you DO qualify for a Medicare Rebate and you have Private Hospital Cover, you can also claim a variable portion of your Hospital Fees depending on your Fund and Level of Cover.
Do Breast Implants Carry a Manufacturer’s Warranty?
Yes. However, this does vary with each implant manufacturer and the reason(s) for the implant’s replacement.
For full details, please refer to each manufacturer’s online Product Warranty Policy.
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.