Breast Augmentation

ARE YOU AN IDEAL CANDIDATE?

You may be a candidate for a breast implant surgery if you answer “yes” to any of the following questions:

•  Do you wish to increase your breast size?
•  Do you desire enhanced cleavage and upper pole fullness?
•  Do you wish to improve your breast and torso proportions?
•  Do you feel your breasts are different in size or shape?
•  Do you feel a breast enhancement could boost your confidence and self-esteem?

There are certain factors that should also be considered when determining if you are a good candidate for breast augmentation surgery. Generally speaking, candidates should:

•  Be in generally good health, with no medical conditions that impair healing or increase surgical risk
•  Be at a stable weight
•  Be a non-smoker
•  Be positive and have realistic expectations about what a breast implant can achieve

YOUR BREAST IMPLANT SURGERY

Breast implants have advanced significantly since the days of runny, liquid silicone or saline breast implants. Combined with improved surgical techniques, the refinements in the composition of the inner silicone gel with more resilient outer implant shell have made breast augmentation surgery safer with more reliable and natural results.

Prior to your breast augmentation surgery, it’s essential that you have a clear understanding of the procedure and are confident in your decision. To help you choose, you can get hands-on to touch and feel the breast implants, so you have a better idea of what they will be like on your body.

Before having a breast augmentation, you’ll need to consider the following factors.

WHATS THE RIGHT BREAST IMPLANT SIZE

One of the most important aspects for women seeking breast augmentation is choosing the correct breast implant volume to achieve their desires. Dr Turner will guide you through this difficult and often confusing process. During your consultations, Dr Turner will help choose an implant that suits your breast, rather than making your breast fit an inappropriate implant with the potential long-term complications that result from this. There are a number of tools that Dr Turner utilises to assist with this process.

TISSUE BASED PLANNING

Accurate measurements of your breasts, including width, height, volume, nipple position and skin elasticity are recorded. Next an analysis of your chest wall shape and the breast-torso ratio is performed to determine the dimensions of the breast implant that best suits your body shape.

IMPLANT SIZING SYSTEM

With our dedicated Implant Sizing System, we can simulate what your augmented breast will look like in clothing. By utilizing a series of unique implant sizers that fit over the natural breast, we can accurately estimate the volume of your ideal breast implant size.

3D COMPUTER IMAGING

With the latest VECTRA 3D camera system, we can preview what your breasts may look like after surgery with different sizes and shaped breast implants. Thus, giving you ultimate control and confidence that your breast implant selection is right for you.

WHATS THE RIGHT BREAST IMPLANT SHAPE

Women come in all shapes and sizes and so do their breasts. With this in mind, it only makes sense to have different breast implant shapes. During your consultation with Dr Turner, we will show you both round and anatomical (teardrop) breast implants and make a recommendation on the best options for you.

ROUND IMPLANTS

Round breast implants continue to be the most widely used breast implants worldwide. It is a common misconception that round breast implants are only used to give an augmented or fake cleavage and so women seeking a natural or subtle breast augmentation should choose an anatomical implant. However, with the latest, next-generation round implants placed correctly, they can achieve similar results to anatomical breast implants without the fear of implant rotation.

Some of the benefits of a round breast implant are:

•  Can achieve a natural breast shape with softer silicone gel breast implants
•  Can achieve a fuller cleavage / upper poles with firmer silicone gel breast implants
•  Lower revision rate due to a decreased risk of breast implant rotation and avoidance of high textured surfaces

ANATOMICAL IMPLANTS

Anatomical breast implants have been very popular over the last few decades due to its natural-looking teardrop shape. These implants achieve excellent cosmetic results, with a very natural breast shape and subtle breast cleavage.

Some of the benefits of anatomical breast implants are:

•  Good correction of mild breast ptosis post breastfeeding
•  Good correction of tuberous breast lower pole deficiency
•  Achieve natural breast shape with subtle cleavage

WHATS THE RIGHT BREAST IMPLANT SURFACE

While breast implants may be either silicone or saline to give the implant volume, they all have an outer shell made of silicone. Now traditionally over the last 50 years of breast augmentation surgery we have classified the shell of the breast implant as either;

•  Smooth Breast Implants
•  Textured Breast Implants
•  Polyurethane Breast Implants

However, as with all areas of medicine, breast augmentation has advanced and so this classification is now too simplistic and needs updating.

Over the last 5-10 years, there have been some controversies surrounding breast implants that have caused confusion and panic. Some types of breast implants have been associated with the development of a very rare form of lymphoma called ALCL – Anaplastic Large Cell Lymphoma. It is important to highlight that this is very rare – with only 500-600 patients reported worldwide with an estimated 40+ million women with breast implants.

While the research in understanding this relatively new condition is early, there are some factors that seem to be relevant. Firstly, the surface of a breast implant has a strong impact on the development of this rare cancer. It is strongly associated with rough, highly texturized breast implants such as salt loss reduction and polyurethane surfaces. While smooth or very low texturized (nano-texturized) implants have not been formally linked and micro-texturized implants rarely associated.

How do we now classify breast implants?

•  Surface Roughness
•  Surface Area

Dr Turner now only uses either nano-textured (Motiva) or micro-textured (Mentor) breast implants with low surface roughness as these have been shown to be the safest implants available on the market worldwide.

WHATS THE RIGHT INCISION LOCATION

To perform a breast augmentation, a small incision is required to allow the placement of the breast implant. The incisions are made in inconspicuous places to minimize scar visibility and there are 3 common incision locations;

INFRAMAMMARY FOLD (IMF)

This incision in the breast fold, so while standing and in clothes, the scar is well hidden but may be visible when you are lying down.

PERIAREOLAR

This incision takes place around the areolar, allowing scars to often be concealed by the shape and colour of your areola.

TRANSAXILLARY

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.

It is 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.

To minimise revision surgery from complications such as capsular contraction, it has been shown that the inframammary fold incision is the best option. Contamination of the breast implant with bacteria during surgery has been shown to be one of the major factors in the development of capsular contraction. This contamination is increased with both the periareolar and transaxillary incision locations and so are now not recommended. To further reduce the risk of contamination during surgery, Dr Turner will use IV antibiotics, breast pocket irrigation with betadine, nipple shields and either a skin barrier protection sheet or introduction sleeve for no-touch technique.

WHATS THE RIGHT BREAST IMPLANT LOCATION

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

SUBGLANDULAR PLACEMENT

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.

Some of the benefits of subglandular placement are:
•   Rapid recovery
•   Enhanced breast cleavage
•   Reduced lateral malposition (widening of cleavage)
•   Improved shape with constricted breast or breast ptosis
•   Minimal risk of breast animation

DUAL PLANE PLACEMENT

Also known as submuscular / subpectoral, this involves the breast implant is placed between the rib cage and pectoralis muscle. With the customized dual plane technique, it’s only 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. It 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.

Some of the benefits of dual plane placement are:
•   Natural upper pole of the breast
•   Reduced dropping (inferior malposition)
•   Less interference with breast imaging (mammogram)
•   Reduced visibility, palpability and rippling

WHAT TO EXPECT ON THE DAY OF 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.

The 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.

RECOVERY FOLLOWING YOUR BREAST AUGMENTATION SURGERY

At the completion of your surgery, Dr Turner will apply 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.

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 the 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)

Your Consultation with Dr Turner

Your cosmetic breast augmentation surgery consultation begins with a personal one on one consultation with Dr Turner at one of his Sydney or Newcastle clinics. Firstly, you are fully informed of the normal surgery process, plus possible complications. After a thorough history and discussion about your desires, Dr Turner will examine you to assess if you are a good surgical candidate to undergo breast augmentation surgery. During the consultation measurements are then made of your chest wall and breasts. We assess the quality of your breast skin, adequacy of breast volume, nipple position and routine pre-op photographs are taken.

Dr Turner understands that every woman is unique in both her desires and body shape. Dr Turner will expertly guide you through the selection of your breast implants. It is extremely important to precisely match the implant shape, size and placement that will complement your natural body shape to give you the results that you desire.

DR TURNER AND HIS STAFF WILL:

• Review the breast augmentation procedures with you
• Clearly discuss the potential risks of the procedure
• Outline in detail how the surgery is performed
• Explain what you can expect before, during, and after the procedure
• Provide detailed cost and payment information
• Answer all your questions