Breast Augmentation Surgery
Breast augmentation surgery is performed under general anaesthesia in a fully accredited hospital with the assistance of a qualified anaesthetist. A breast implant surgery take between one and two hours, and generally you are discharged the same day – no overnight stay required.
BREAST IMPLANT INCISION LOCATION
To perform 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 – under or in the breast fold
• Periareolar – around the nipple
• Transaxillary – through the armpit
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 placement of the implant for predictable and reproducible results. In the vast majority of patients the final incision is barely visible after six months following surgery.
BREAST IMPLANT PLACEMENT
There are two common locations for the placement of breast implants:
The breast implant is placed between the pectoralis muscle and the breast tissue, and is frequently chosen if you have adequate soft tissue coverage of the implant in the cleavage area of your breast.
Advantages of subglandular placement include:
• Quickest recovery
• Enhanced breast cleavage
• Reduced lateral malposition
• Improved shape with constricted breast or breast ptosis
• Eliminates animation issues with subpectoral placement
The breast implant is placed between the pectoralis muscle and rib cage, and is chosen in women that have thin or little breast tissue as the muscle improves coverage of the upper portion of the implant so that it is not seen or felt.
Advantages of subpectoral placement include:
• More natural upper pole of the breast
• Reduced inferior malposition
• Less interference with breast imaging – mammogram
• Reduced palpability and rippling concerns
DUAL PLANE TECHNIQUE
Dual plane is a technique in which the upper half of the 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.
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.
KELLER FUNNEL 2
The Keller Funnel has been one of the simplest and most significant advances in breast augmentation surgery over the last decade. It is a sterile, cone shaped device that allows a ‘no touch’ technique of placing the breast implant into the surgical breast pocket during a breast augmentation surgery. This simple device has been shown in many studies to reduce the risk of the two most frequent complications of breast implant surgery: capsular contraction and implant rupture.
As a goal of eliminating revision procedures after breast augmentation, the recommendations by the Australian and American Plastic Surgery Society (ASPS) have recommended that as part of a detailed 14-point plan that an introduction sleeve such as the Keller Funnel is used to minimise contamination of the implant during insertion. Dr Turner uses a Keller Funnel with all his breast implant procedures.
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 into 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 six weeks to assist wound healing and settling of the new breast shape. Very infrequently we may require a drain to be placed in each breast to drain off excess blood and fluids for the first day or two.
Patients report minor 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.
RISKS ASSOCIATED WITH BREAST AUGMENTATION SURGERY
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.
General Risks with Breast Augmentation Surgery
• Postoperative infection
• Bleeding or haematoma
• Poor Scarring including keloid scars
• Loss of sensation to the nipple
• Revision surgery to correct or improve outcome
Specific risks with Breast Implants
• Capsular Contraction• Breast implant malposition
• Breast implant rotation
• Rippling within cleavage
• Breast implant palpability
• Animation deformities
• Breast implant rupture
• Breast asymmetry
• Anaplastic Large Cell Lymphoma (ALCL)