Breast Augmentation – Breast Implants

Why choose Cosmetic Image Clinics for Breast Augmentation (Breast Implants) surgery?

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At Cosmetic Image Clinics, we pride ourselves on delivering the highest levels of personal care while providing both surgical and non-surgical options for people seeking cosmetic rejuvenation and cosmetic plastic surgery.

Our selected team of doctors, plastic and cosmetic surgeons, clinical nurses and administrative team, have a wealth of experience caring for men and women undergoing cosmetic treatments.

By selecting our multi-award winning Cosmetic Image Clinics in Aquarius Health and Medispa, you can be assured that your comfort and satisfaction is our highest priority.

Your consultation will be conducted in the strictest of confidence and you will receive professional care and expert advice from our highly trained team.

What is Breast Augmentation surgery?

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Breast Augmentation surgery is designed to enhance the size and shape of a woman’s breasts using implants. Most women usually experience a complete self-esteem makeover when receiving breast implants with results tailored to your specific desires.

What type of breast implants are offered at Cosmetic Image Clinics?

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Cosmetic Image Clinics offer the best quality and affordable Natrelle® brand silicone implants which are supplied by Allergan.

The science of Breast Augmentation and enhancement has improved considerably over the past several years. The Natrelle® Collection is the result of over 25 years of experience and represents today’s most current Breast Augmentation and enhancement technology. It is reassuring to know that implants in the Natrelle® Collection are safe. Every option is FDA-approved, and women can be confident that their implants have been rigorously tested for safety.

The Natrelle® philosophy is: “Your body is unique, so choose the best fit”.

The Natrelle® Collection makes it possible for each woman to choose a breast implant with her plastic surgeon that is right for her augmentation or enhancement and our experienced team at Cosmetic Image Clinics will hold your hand every step of the way to achieve your desired look.

Why choose silicone gel implants?

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Cohesive Silicone Gel Implants have become available in Australia in recent years are most commonly used. Health authorities have determined that cohesive silicone gel implants are safer for use because the cohesive gel does not seep, run or shift. If it ruptures, the implant itself maintains its shape and integrity. Silicone gel implants give a more natural appearance than saline implants. They feel and move like real breast tissue.

They have been designed to increase cleavage and breast size without producing undesirable and unnatural upper breast fullness. There is a range of models with respect to height, projection and base width, each model having a variety of sizes. Experienced staff will advise you as to your options for a suitable shape and size. Cohesive silicone gel implants do not normally ripple or fold as saline implants sometimes do.

Who performs the Breast Augmentation surgery and where is it done?

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At Cosmetic Image Clinics surgery is performed by a qualified Plastic Surgeon and Anaesthetist and our Clinical Director Dr Ingrid Tall in an accredited hospital of the highest standard.

Breast augmentation is one of the most common surgical procedures and all of our surgeons have had many years of experience performing this surgery.

What are some of the indications that you may be a good candidate for Breast Augmentation?

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The following are some reasons and indications that you may be a good candidate for Breast Augmentation surgery:

• If you are bothered by the feeling that your breasts are too small
• If clothes that fit well around your hips are often too large at the bust line
• If you feel self-conscious wearing a swimsuit or form-fitting top
• If your breasts have become smaller and lost their firmness after having children
• If weight loss has changed the size and shape of your breasts
• If one of your breasts is noticeably smaller than the other

What is involved in Breast implant or Breast Augmentation surgery?

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Breast augmentation is usually performed within a hospital facility using general anaesthesia. The procedure takes about one to two hours. An incision is first made, a pocket is then carefully created and an implant is inserted. The pocket is then modified to accommodate the implant. The incision is then closed with suture.

The pocket for the implants can be placed either:

a) Submuscular: under the pectoralis muscle (see Diagram I), or
b) Subglandular: on top of the muscle, behind the breast tissue.

As long as the nipples are above the level of the fold under the breast, placement of the implant is often under the pectoralis muscle. This tends to give a softer result over the long term. However, if the nipples have become lower over time (from pregnancy and breast-feeding), and now rest at or below the level of the breast fold, then there is an advantage to placing the implant on top of the muscle (subglandular).

The sub-glandular placement position lifts low-lying nipples more effectively than the submuscular position. Your doctor will advise about positioning.

There are three possible incisions to perform this surgery (see Diagram II):

a) Transaxillary: under the arm
b) Inframammary: under the breast just above the breast fold
c) Periareolar: around the lower edge of the areola

Diagram II:
The most commonly used approach is the inframammary approach. Regardless of the approach chosen, the incisions are relatively small and generally heal extremely well.

What is involved in my post-operative care after Breast implant or Breast Augmentation surgery?

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You will go home wearing a supportive garment that will support the breasts in a comfortable healing position. You will wear this garment only for approximately 2 weeks. It should only be removed for showering. From two weeks post-op it may be removed at night for sleeping. We will provide you with oral medication for discomfort. Most patients do not need anything for pain 6 to 7 days after surgery.

During the first week after breast augmentation surgery, you will need to take life very easy, and avoid heavy lifting and excessive movements of your arms. Activities can be gradually increased after the first week, within your own comfort level. You will be able to shower 24 hours after your surgery. You should be able to return to your work from one week after your surgery.

You will need to avoid aerobics or other strenuous exercises for about 6 weeks after your surgery. It is recommended that air travel be avoided for the first two weeks after surgery. However if you have specific concerns, you should discuss them with your doctor.

For the first few weeks after surgery, you will likely feel that your breasts are “too big”, because of the swelling from the surgery. After a few weeks, this swelling settles. You will also have become more accustomed to your new breast size at that time. Some women report that their nipples become over-sensitive or under-sensitive following breast augmentation surgery. These findings are most common during the first few weeks after surgery. They are usually temporary.

You will be reassessed in our clinic 7 days after surgery when your sutures are removed. You will subsequently be seen at our clinic 6 weeks and 3 months after surgery. For most women undergoing breast augmentation, the results are usually very satisfying.

There is no relationship between breast implants and the development of any medical disease or breast cancer. Similarly, breast implants do not interfere with pregnancy or breast-feeding. Breast implants can interfere with regular mammography of breasts.

However, this problem is minimised if implants are not overly large, if they are placed in the submuscular position, and if special mammography techniques are used. Today, radiology centres are well aware of these techniques.

At Cosmetic Image Clinics within Aquarius Health and Medispa we understand the issues involved in making such an important decision and we are happy to discuss your concerns at any time.

What are some of the reasons women may choose to have Breast Augmentation surgery?

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Augmentation mammoplasty is surgery to enhance the size and shape of women’s breasts using breast implants.

Breast enlargement surgery is chosen by women of all ages from all walks of life for a variety of reasons. Generally, they wish to enhance their appearance by achieving a breast size more in proportion with the rest of their body.

Many women, after raising a family, want to restore what time, gravity and child rearing has taken away. Women are primarily motivated to choose this surgery for their own personal satisfaction and body image, rather than to please a partner. Whilst there are those who opt for large breast implants, as is very much a media focus, the majority of women aim for a natural look. Half of our procedures involve an increase in breast size from an A cup to a C cup.

The psychological and emotional benefits of the procedure can include enhanced self-esteem, a more satisfying body image and increased confidence and sense of well-being.

Your decision will be based on your own needs, desires and expectations. However, before you undergo breast augmentation, you need to be well informed about the procedure, the different choices involved, the results you can expect, and all the potential risks and complications that can occur.

Breast augmentation is one of the most common surgical procedures and all of our surgeons have had many years of experience performing this surgery.

Do you offer a free consultation to ‘test drive’ the breast implants at Cosmetic Image Clinics?

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Yes, come in for a free consultation and ‘test drive’ your new breast implants with a personalised measurement with a nurse so you can choose what size and shape will suit your body type, chest wall width, breast tissue coverage and personal taste.

During your private and personal fitting, the nurse will measure your ‘breast base width’ and discuss with you your preference for your final chest appearance, for instance whether you want either a ‘bit of fullness’, a ‘slight lift’ or if you are more interested in a ‘voluptuous’ look.

We can help you guide you easily through the labyrinth of choices when it comes to choosing the shape and size of your breast augmentation or implant.

What are the risk factors in Breast implant or Breast Augmentation surgery?

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As with any surgical procedure, although uncommon, excessive bleeding following surgery may cause swelling and pain. A small percentage of women may develop an infection around the implant. Whilst the majority of women do not experience complications you should discuss with your doctor any concerns you have in this regard.

Having a full understanding of what potentially can go wrong, even though the risks are not common, is important, during any surgery.  Any good surgeon will point out a list of various complications that you should be aware of. Here is a comprehensive list of potential risks related to breast augmentation or implants.

• Hematoma (a collection of blood in the pocket around the implant) which may require a return to the operating theatre for its removal under anaesthesia.
• Infection either of the wound itself or within the pocket around the implant. Wound infection is managed as with any surgical wound infection with dressings and antibiotics.  In contrast, when infection occurs around an implant two returns to the operating theatre will be necessary: the first to remove the implant, and the second, several months after the infection has been eradicated, to insert a new implant.
• Oedema (Swelling):  This occurs to some degree after every surgery.  It usually lasts up to three or four weeks, but in some cases may persist for months.  You will be given special instructions or treatment if indicated.
• Capsular Contracture is the commonest cause of breast firmness after augmentation and its correction often requires surgical revision. The incidence varies with the characteristics and placement of the implants.
• Scars:  A scar will always result whenever the skin is surgically cut.  While every effort is made to place scars in areas where they will be minimal or inconspicuous, healing and scarring is very variable in different persons and in different areas of the body of the same person.  How well a person will heal cannot be exactly predicted or controlled.  Pigmented, wide or thickened scars (hypertrophic or keloid) could occur if you are prone to them.
• Numbness:  In cutting the skin small nerve endings are also cut that can result in numbness around or adjacent to the surgical area. Sensation usually returns in a matter of months or years as the small nerve endings re-grow.  It may be unequal between the two sides.  Most numbness goes away in time.  Rarely does an area stay permanently numb.
• Changes in Nipple Sensation:  Some numbness of the nipple can occur after breast augmentation surgery.  Most of the numbness goes away in a period of months or years.  However, sometimes it can be permanent.  Increased sensitivity of the nipples can also occur.
• Asymmetry of the Breasts or Nipples:  It is understood that the two sides of our face and body are different and asymmetrical and this includes the chest, breasts and nipples.  Although we may wish our two sides to be identical, it is understood that it is not possible to make them so.  No two breasts are mirror images of each other and in some women they can be very different.  While breast implant surgery can sometimes reduce those differences it can also sometimes magnify them.
• Rippling or Wrinkling: This refers to the wrinkling or rippling of the implant wall that can be seen on the surface of the skin.  It is more likely to occur with saline implants than silicone gel implants and with textured (rough) walls than smooth wall implants.  If it occurs, it is more visible when the implants are in front of the muscle and if the breast tissue coverage is very thin.  It is usually more apparent when you lean forward without wearing a brassiere.  Further surgery may not fully correct it.
• Discernible Edge of the Implant:  The edge of the implant can usually be felt through the skin with the fingers wherever there is thin tissue coverage over it, especially if the implant wall is textured and thicker.
• Rupture of the Implant:  Implants may rupture at any time after surgery even without apparent cause.  A ruptured silicone gel implant may result in gel migration, inflammation and the formation of silicone granulomas.  A ruptured saline implant will simply deflate and the saline be absorbed without any harmful effect on the body.
• Leaking and Deflation of Saline Implants:  Saline filled implants have a reasonably high incidence of leaking and eventual collapse however nearly all implants are silicone nowadays. It is estimated that noticeable loss of saline will occur in as many as 50% or more persons who have saline implants for seven or more years.  Further surgery is required to replace the implants at additional cost.
• Rejection or Extrusion of the Implant:  The body may recognise the implant as a foreign object and try to reject it.  Theoretically, the phenomenon of capsular contracture could be a form of the rejection process.  Occasionally, the implant may be pushed against the skin from the inside causing the skin from pressure to become very thin and transparent – the so-called “blue window”.  Further pressure against the skin may cause the skin to break with exposure of the implant.  When this occurs the implant needs to be removed and it may be necessary to wait several months before putting a new implant back in.
• Displacement and Distortion:  Implants may become displaced from their original position and appear either too high or too low, too far to the side, or in any other conceivable abnormal and unequal position.  Distortion in breast shape, usually part of the capsular contracture phenomenon, may also occur.  The tissues over the breastbone may eventually lift forward causing an apparent communication between one side and the other.  Problems with appearance may require further surgery.  Not all problems can be corrected.  Many problems in appearance cannot be corrected or improved.
• Descent of the Implants: Implants can descend from their original position and produce an abnormal appearance with the nipple ending up higher on the breast mound and any scar (in the case of infra-mammary incisions) also moving up onto the breast mound.   It is more likely to occur if the supporting tissues are inherently weaker than average, if the post-operative support bra is not worn as instructed, if the breast is subjected to external pressure or you sleep prone or heavily on one side.  Further surgery is required to correct it.
• Implant Mobility on Arm Movements:  Implants placed under the pectoral muscle may move whenever the muscle is contracted in normal movements of the arms.  This may also cause visible distortion of the appearance of the breasts.  If such movement is of concern to you the problem can be corrected by further surgery to relocate the implants in front of the muscle.
• Muscle Weakness:  Whenever the implants are placed under the muscle some weakness of the muscle usually results because of the partial detachment of the muscle from the ribs that is necessary to accommodate the implant.
• Stretch Marks:  Stretch marks such as those seen on the skin of the abdomen after pregnancy or major weight loss may also occur on the breasts. The more the person’s skin has to stretch to accommodate the implant the greater the risk of developing stretch marks. Stretch marks may not appear until after pregnancy or many months or years later.
• Abnormal Appearance or “Feel” of the Breasts:  Implants are usually detectable.  The breasts may look or feel firmer.  They may not move or jiggle the same amount as normally.  The implants may be palpable.  The valve on saline implants may be palpable and the implant may be able to be felt though the skin.  They implants may look “stuck on”, too high, too low or unequal.  Other abnormal appearances include but are not limited to nipples pointing up or down or in different directions, too much or too little cleavage, the “ball in the sock” appearance, sagging, and others.
• ‘Double Fold’ or ‘Double Bubble’:  This refers to the persistence of the former crease under the breast along with the newly created crease thereby causing a double bubble appearance.  It may improve over time.  Otherwise it will require further surgery to correct it.
• Interference with Breast-Feeding:  Many patients become pregnant and breast-feed their infants normally after breast implant surgery.  However, breast implants in some patients can interfere with breast feeding in different ways.  For instance, there may be numbness or hypersensitivity of the nipples or there may be tenderness or inadequate milk production, however this is not common.
• Interference with Mammograms:  The presence of breast implants of any type can interfere with mammography and the early detection of breast cancer.  Mammograms may also be more uncomfortable with implants since they require squeezing the breast with pressure.  This pressure of mammography could rupture a silicone gel implant or cause deflation of a saline implant.
• The Armpit Incision:  The armpit incision approach may cause more tenderness and discomfort on movements of the arms immediately after surgery than the other approaches and is rarely performed now. In addition there can be numbness of the arm around the incision or over part of the upper arm, the forearm or the hands and fingers.  There also could be interference with the circulation of the upper arms or hands that may cause a tendency to have numbness, tingling or swelling of the hands.  These problems are uncommon but could occur even when the surgery is perfectly performed.  In addition, you could acquire a different and additional incision site should problems arise at your initial surgery (e.g. for bleeding) or in the future for any revision surgery.
• Sagging of the Breasts:  While women with breast implants may sag no more than those women of the same breast size without implants, implants do have some weight and can over time cause some sagging of the breasts additional to that resulting from pregnancy, ageing and weight gain.
• Synmastia (‘uni-breast’):  This refers to the loss of the normal midline separation of the two breasts.  In its most advanced form the pockets on each side merge to form a single pocket.  Further surgery is required to correct it.
• Post-operative Depression in the immediate post-operative period is not uncommon after cosmetic surgery and is related to the discomfort, possible anxiety over the swelling and bruising and limitation of activities and socialising.  As your appearance improves and you return to your usual activities and interests these feelings should disappear.
• Seroma: Seroma is a collection of fluid in the pocket around the implant as opposed to blood in the case of a hematoma described above. It could possibly represent the body’s reaction to the implant.  If small, it may disappear without any intervention.  Alternatively, it may require treatment in the form of serial aspirations or if persistent could require temporary removal of the implant as described for infection.
• Pneumothorax:  This results from accidental penetration of the thin chest wall muscles during surgery allowing air to enter your thoracic cavity and collapse your lungs.  The treatment would require immediate transfer and admission to another hospital for treatment that would include insertion of chest tubes to drain the air.

In your initial consultation, the doctor will evaluate your health and explain which surgical techniques are most appropriate for you, based on the size and shape of your breasts, skin tone and placement of the nipples. If your breasts are sagging, the doctor may also recommend a breast lift, or mastopexy, to enhance your result.

The doctor will help you select the implants which will best allow you to achieve your desired look. Numerous samples can be viewed at time of consultation.