Procedures

The complications of breast augmentation are of critical importance and must be fully understood prior to your surgery. The most serious complication is infection. Infection in a breast augmentation can be life threatening and Dr Sam Cunneen uses an array of techniques to reduce the chances. All implants should be changed every 10 to 15 years to reduce the chance of rupture and capsular contracture. This is an expensive secondary surgery which needs to be budgeted for in planning surgery. ALCL is a very rare form of Lymphoma which has been linked to breast implants and will be discussed at any implant consultation. Hematoma is bleeding post operatively. The most common time for this is in the 2-4 week period after your surgery when the body is starting to repair. Bad scars are very uncommon as is loss of nipple sensation and chronic pain.

There is always a degree of asymmetry, animation when the implant is under the muscle and you will always be able to feel the implant in the lower part of the breast.

Tear drop implants give more options in terms of their base size than the round implants. This is critical if a shorter lady is trying to achieve ‘side boob’ to offset larger hips. The big disadvantage of tear drop implants is rotation. This leads to a quite odd looking breast and generally leads to further surgery to correct the rotation. Interestingly studies have found that in comparing women with tear drop implants to women with round implants, plastic surgeons are unable to tell the difference. Because of this I tend to use round implants unless there are compelling reasons to do otherwise.

There are pros and cons to both approaches. I tend to favour under the muscle as the implant is held a little better with more tissue covering it giving a more natural look and feel. However it is a little more uncomfortable and associated with increased swelling. If you are after a very fake look, this is best achieved by placing the implant on top of the muscle.

We help you choose your volume by measuring your chest to see how much volume is possible for your breast width. Based on this assessment we ask you to try various breast implant sizers placed inside a sports bra so you can feel the weight of the extra volume and see the different shape that it creates. Once we have an agreed approximate size, we use 3D photography which enables us to show you a representation of you with your chosen sized implants (cosmeticdesign.com.au).

Intra operatively local anaesthetic is placed around the breast which allows the surgery to be performed as a day case. Depending on pain tolerance, size of implant and implant position, the first night can be uncomfortable. Our anaesthetist makes sure you are sent home with the best regime of analgesia to make your evening tolerable. Ladies are usually back at work 5 to 7 days following surgery, although this is quite variable between patients. I recommend a snug surgical bra to be worn for 6 weeks following the augmentation and no jogging for that first 6 weeks.

ALCL stands for Anaplastic Large Cell Lymphoma which is a rare white blood cell (WBC) cancer associated with breast implants. It's a complicated discussion and crucial your surgeon thoroughly explains its implications prior to you having surgery. In summary there are three factors which increase your risks of disease A family history of lymphoma A special type of bacteria can get onto the implant which causes the WBC to attack it. The bug is very resistant however, so the WBC keep replicating until over years there can be enough DNA changes in the WBC that they start proliferating uncontrollably starting the lymphoma. The breast implants with very thick textures have been found to have higher rates of lymphoma. These implant types have now been removed from the Australian market. This leaves only very thin textured and smooth implants available for use.

Part of the operation cost is covered by most private health funds if you have breast fed more than 1 year ago but less than 7 years ago, and your nipples are the lowest part of your breast. This is unfortunately very uncommon.

The types of incisions and therefore scars vary depending on how much skin needs to be removed. The most common incision is one around the areolar with a vertical line down to the breast fold and then a smaller horizontal line along the breast fold. For smaller reductions some ladies are able to get away with just an incision around the areolar.

If you don’t want any extra volume then you don’t need a breast augment and you can simply have a lift. If you would like volume in the upper pole then a lift can achieve this for a short time but an implant will maintain volume in this area for longer. For a number of reasons I tend to prefer to stage lifts first and perform the augmentation at least 3 months later if required. The reasons for this are that 1) I find the operation is safer 2) The scars heal better 3) Often the patient decides that they don't actually need an implant once their own breast tissue is squeezed into a tighter skin envelope. 4) If an implant is decided upon sizing is much simple with less errors made.

The types of incisions and therefore scars vary depending on how much breast tissue and skin needs to be removed. The most common incision is one around the areolar with a vertical line down to the breast fold and then a smaller horizontal line along the breast fold, like for a breast lift. For larger reductions the horizontal incision is longer to allow removal of the extra skin and breast tissue.

Part of the operation cost is covered by most private health funds.

Most women are back at work within 2 weeks of surgery. there is a natural variation in this however with some returning much earlier and some a little latter.

The best results are seen in people who are not overweight as the surgeon is able to remove more tissue with less fear of wound healing problems. If you are very overweight then most surgeons will only perform removal of large overhanging ‘aprons’ for hygiene reasons. Generally if someone is very overweight we recommend them seeing a specialist bariatric surgeons. Once they are lighter they should come and see a specialist plastic and reconstructive surgeon for their tummy tuck.

Depending on the amount of skin which requires removal, the scar can be as small as a caesarian section scar or from hip to hip. We always plan the scar to be hidden under which ever bathers or underwear the patient likes to wear, so very few people will ever see the scar. If there is a c-section scar this is usually removed as part of the procedure.There may also be a small scar around the belly button if this needs repositioning. If you have had massive weight loss then a vertical midline scar may be required to remove the skin that a horizontal scar is unable to address.

Immediately following surgery the tummy is quite tight so for 2-3 days the patient needs to walk in a slightly bent position while everything stretches up. Usually they go home on day 2 or 3 and are off work for 2 weeks. Some people require a few more weeks off work depending on their activities.

There are not many areas of the body fat hasn't been injected into to provide extra convexity to a surface. The most common areas for injection in our practice is in the breast. This can assist with achieving better symmetry when there is a smaller breast, or when there is a tuberous breast and the infra mammary fold needs to be lowered. It can also provide more tissue coverage over an implant when there is thin skin or around the cleavage area to create better curvature.

Yes, but it provides a very different appearance, is less reliable than an implant and doesn't have the structure of an implant.When fat is injected it must be injected into tissue which is able to be expanded.

The ideal candidate is a lady with a small amount of deflation after breast feeding who only wants a small size increase. These patients have previously had their breasts expanded giving the fat an area to be injected into. As more fat is injected it is increasingly difficult for that fat to find an area with blood supply, which means that large volume changes are not possible with fat alone.

The injected fat is more liquid than silicone so it tends not to hold the same structure as an implant.

Finally it's impossible to know how much of the fat will be retained, so it's slightly less reliable than silicone as the actual size difference one will achieve is unpredictable.

No, fat grafting takes longer than an augmentation, so while you save money on the implants, you are paying a significant amount for the theatre time, which ends up making the costs quite similar.

Also fat grafting can need to be repeated as some of the fat always absorbs, which is another cost to take into account.