Breast Augmentation Surgery
The classic ‘boob job’ has come a long way, allowing for the most natural results possible. As a Specialist Plastic Surgeon, Dr Turner focuses on each individual in terms of their exact needs and desires. Naturally, breasts are composed of three key components — skin, fat and glandular tissue.
WHAT TO EXPECT FROM BREAST AUGMENTATION SURGERY?
Before your procedure, Dr Turner will make sure that you are comfortable and don’t have any last-minute questions. Dr Turner will draw on your breast to plan the ideal placement of the breast implant, as well as the intended incision used to place the breast implant.
Breast augmentation is performed under general anaesthesia in a fully accredited private hospital with the assistance of a qualified anaesthetist. Breast Implant surgery takes between one and two hours, and generally, you are discharged home the same day, no overnight stay required.
When you wake up, you may feel slightly woozy due to the general anaesthetic. Although some swelling, discomfort, or soreness may occur, these are all completely natural post-operative symptoms that you’d experience after any surgery.
Breast Augmentation Surgery
To perform a breast augmentation, a small incision is required to allow the creation of the breast implant pocket where the implant is finally placed. The incisions are made in inconspicuous places to minimize scar visibility.
There are three common incision sites for the insertion of breast implants:
Inframammary Fold (IMF)
While each of these incision sites has advantages and disadvantages, Dr Turner’s preference is to use an inframammary fold incision as it provides optimal exposure to the underlying breast tissue and pectoralis muscle to allow accurate and safe placement of the breast implant for predictable and reproducible results.
With a standard 4cm incision in the breast fold, while standing and in clothes, the scar is well hidden but may be visible when you are lying down or wearing a small bikini.
This incision takes place around the areolar, allowing scars to often be concealed by the shape and colour of your areola. This approach for breast augmentation surgery is less common now due to the risk of contamination of the implant to bacteria that is around the breast tissue and increased risk for revision procedures.
This incision will be through the armpit, which means no physical scaring will take place on the breast itself. However, the scar will be visible when your arm is elevated. While this incision location is common in countries like Korea due to the risk of poor scarring in Asian populations it is not recommended as a standard technique due to its increased risk for revision procedures.
BREAST IMPLANT PLACEMENT
The breast implant can be placed either in front of the pectoralis muscle under the breast gland or behind both the breast gland and pectoralis muscle
Also known as subfascial, if you have enough soft tissue coverage around your cleavage area, this placement will likely be the best option. The breast implant will be placed between the breast tissue and the pectoralis muscle.
Advantages of subglandular placement include:
• Quickest recovery
• Enhanced breast cleavage
• Reduced lateral malposition
• Improved shape with constricted breast or breast ptosis
• Eliminates animation issues from subpectoral placement
Also known as submuscular, this involves the breast implant being placed between the rib cage and pectoralis muscle. This is the ideal choice in women who have thin or very little breast tissue, as the muscle enhances coverage of the upper area of the breast implant.
Advantages of subpectoral placement include:
• Natural upper pole of the breast (round implants)
• Reduced inferior malposition
• Less interference with breast imaging (mammogram)
• Reduced palpability and rippling concerns
Customized Dual Plane Placement
The customized dual plane is a new technique in which the upper half of the breast 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. The customized dual plane is Dr Turner’s preferred technique for most patients undergoing breast augmentation surgery.
In some women with only mild breast ptosis, a dual plane technique may be an alternative to a breast lift procedure to restore a natural youthful breast shape without the added scars associated with a breast lift surgery.
MODERN ADVANCES IN BREAST AUGMENTATION SURGERY?
Over the last five years, a condition called ‘Breast Implant associated Anaplastic Large Cell Lymphoma’ (ALCL) has been linked to breast implants in women who have undergone breast augmentation surgery. While this condition is extremely rare, and breast implant surgery is still considered to be a safe procedure, it is important that we follow the highest standards possible in modern breast augmentation surgery.
Bacterial contamination of breast implants either during surgery or in the early healing phase has been linked to the development of capsular contraction, one of the most common reasons for breast implant revision. Bacterial contamination has also being implicated as a causative agent in patients potentially developing ALCL. So, to minimise the risk of bacterial contamination leading to capsular contraction and potentially ALCL, world leaders in plastic surgeons across the globe developed the 14-point plan.
The 14-point plan is employed by Dr Turner in all breast implant surgeries includes;
• Use of intravenous antibiotics at the time of anaesthetic induction
• Avoid peri-areolar incisions (Dr Turner preference is the inframammary fold incision)
• Use of nipple shields to prevent spillage of bacteria
• Perform meticulous dissection of the breast implant pocket
• Performing careful control of any bleeding
• Avoiding dissection into the breast tissue
• Using a dual plane pocket if required
• Cleaning the breast implant pocket with a betadine solution
• Minimising skin-implant contamination (Keller Funnel)
• Minimising the time of implant opening, reposition and replacement of implants
• Changing surgical gloves prior to handling the implant
• Avoid using a drainage tube
• Closing the wound in layers
• Recommending our patients use antibiotic prophylaxis to cover subsequent dental or surgical procedures that produce bacteraemia
AFTER YOUR BREAST AUGMENTATION SURGERY
At the completion of your surgery, Dr Turner will apply specialized dressings to the incision site to aid wound healing. All sutures used self-dissolve, so no post-op suture removal is necessary. You will be placed in a surgical garment in the recovery room when you are fully awake and comfortable. It is important to wear the garment full time for the first month to assist wound healing and settling of the new breast shape.
Patients report mild post-operative pain, which is treated with oral medication. You will be given a prescription for pain management. Have someone fill the prescription, drive you home and take care of you as you recover during the first few days after your surgery.
You can return to your normal activities at a slow and gradual pace. You may be back to work as soon as one week after breast augmentation surgery and may begin light exercise at two weeks. Most activities can be resumed fully at six weeks following your procedure.
You will have an appointment to see Dr Turner within the first week after surgery to check that your wounds are healing as expected and to review your new breast shape. Dr Turner will see you frequently over the first year to monitor your progress and will give you advice on scar management, wearing garments and resuming normal activities.
It is extremely important to your final result that you follow all post-operative instructions given to you by Dr Turner.
BREAST AUGMENTATION RISKS AND COMPLICATIONS
As with any surgery, it is important that you are fully informed of the potential risks associated with breast augmentation surgery. While all care is taken to minimize these complications, they may and do occur despite the best medical care.
It is important that you carefully read and understand the potential risks and they will be discussed in further detail when you have your consultation with Dr Turner.
• Postoperative infection
• Bleeding or haematoma
• Poor Scarring including keloid scars
• Loss of sensation to the nipple
• Revision surgery to correct or improve outcome
• Inability to Breastfeed
• Interference with breast imaging
• Capsular Contraction
• Breast implant malposition
• Breast implant rotation
• Visible rippling within the cleavage
• Breast implant palpability
• Animation deformities
• Breast implant rupture
• Breast asymmetry
• Anaplastic Large Cell Lymphoma (ALCL)