Feeling self-conscious about your breasts can impact your confidence in a significant way, particularly because they are viewed by many women as a critical component of their femininity and sexuality.
Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breasts. The decision to have breast augmentation surgery should be made on a personal level, not from an emotional vantage. Having realistic expectations and an understanding of the procedure’s limitations are important factors to help you achieve your desired look and feel.
Breast augmentation can help with:
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- Enhancing small or underdeveloped breasts
- Balancing asymmetrical breasts
- Reshaping breasts after breastfeeding
- Increase bra size by a cup or two
Who can have breast augmentation?
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Adults who have fully developed breasts and have considered and discussed the surgery with Dr Zacharia and weighed in the psychology and physiological impact of breast augmentation.
Normally, we do not perform breast augmentations in girls under 18 or women over 55 years of age.
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Dr Zacharia’s years of experience means we can find a solution you will feel comfortable with. After considering all the information that has been made available to you, you will need to indicate to Dr Zacharia your preferences on the following six choices:
- The type of implant (silicone gel or saline)
- The size of the implant
- The texture of the implant surface (rough or smooth)
- The shape of the implant (round or ‘tear drop’ shape)
- The placement of your implants (‘under the muscle’ or ‘in front of the muscle’)
- The location of the incisions
Dr Zacharia will guide and assist you in all the above considerations according to your personal objectives while at the same time taking into consideration your chest dimensions, breast characteristics and lifestyle activities. In order for you to contribute effectively to the planning of your augmentation, it is essential that you carefully read and understand all the information in this brochure and convey your preferences to the doctor before making your final selections.
The entire breast augmentation procedure is generally a day procedure, normally taking around two hours while you are under general anesthesia.
- Through an incision in the skin Dr Zacharia creates a pocket for the implant. The incision is usually made in the crease where the breast meets the chest, although it can be made around the areola (the dark skin surrounding the nipple), or in the armpit. Every effort will be made to insure the incision is placed so that resulting scars will be as inconspicuous as possible.
- After creating the pocket, Dr Zacharia coagulates (‘seals’) all bleeding points and then inserts the implant. This is then repeated on the other side.
- The method of inserting and positioning your implant will depend on your anatomy, your preferences and Dr Zacharia's recommendation.
- Dr Zacharia uses Cohesive Silicone Gel Implants as a preference, which are placed between your breast tissue and your chest muscle (subglandular), or between your chest muscle and your chest wall (submuscular). It is important to discuss the pros and cons of these alternatives with Dr Zacahria before surgery to ensure you fully understand the implications of the procedure.
- After a final check for symmetry from different angles and any necessary adjustments, Dr Zacharia instils an antibiotic to prevent infection plus a long-acting local anaesthetic for your post-operative comfort. The incisions are then stitched closed and covered with a dressing.
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- After the surgery, you will be transferred to Recovery and generally after a further 2 hours you can go home with a responsible adult who should stay with you for the next 24 hours.
- Immediately after your procedure, you may feel a little tired but your chest should not feel unduly uncomfortable because of the long-acting local anaesthetic Dr Zacharia has put around your implants. However, as this local anaesthetic progressively wears off over the next 15-18 hours, your chest will naturally start to feel sorer.
- The amount of pain will vary from person to person but it will abate over the following week. In the meantime it can be effectively relieved with prescribed oral analgesics.
- Generally, there is more initial discomfort with implants under the muscle than in front of the muscle.
- Your breasts will also be swollen and tender to the touch. There may be some light bruising. You may also have a feeling of tightness in your breasts because your skin has yet to adjust to the new breast size.
- After your augmentation it may appear that your breasts are too full in their upper halves. This is not uncommon and over the next 6 months they will gradually settle into a more natural and normal looking position as your tissues expand to accommodate the implants.
- Although dissolving sutures are used to hold the deeper layers of your incisions together, non-dissolving ones are usually used for the skin. They are removed 9 days later.
- Only a light dressing is placed over each incision. You may also find a length of tape above or below your breasts. This is sometimes applied to hold the implants in their desired position in the early healing stages. If so, please do not remove this tape. It will be removed at the time of your suture removal.
- Initially, all scars are pink or light brown but progressively fade to white over the ensuing 12 months.
- During the first week, you must avoid harmful activities such as lifting objects, driving vehicles, bending forward and stretching your arms too much. Also avoid activities such as exercise and stress which could increase your pulse rate and raise your blood pressure. You will be given printed specific instructions on exactly what you should and should not do during your recovery period.
- A good support sports bra must be worn at all times for the first three months after your surgery, even during sleep. This is necessary to support the weight of the implant in the early stages of healing until your tissues have sufficiently strengthened. If the incisions have been placed under your breast, you must not wear any under-wire bras in the first three months after your procedure in order to prevent indentation of the scar.
Complications and Risks
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Like most surgeries, breast augmentations generally proceed smoothly and uneventfully without any of the major or minor complications set out below. However, every surgical procedure has potential risks and breast surgery is not an exception.
- Health authorities have determined that Cohesive Silicone Gel implants are safe for use because the cohesive gel is less likely to leak. Cohesive Silicone Gel Implants with a polyurethane foam surface reduce the risk of capsular contraction to around 1%. The unique surface of the polyurethane foam covered implant grips to the capsule like velcro, reducing the risk of displacement and rotation and significantly reduces capsular contracture, which is one of the most common complications in Breast Augmentation. Silicone products have been subjected to extensive safety testing and have been shown to be bio-compatible, reliable, flexible and easy to sterilise.
- If it ruptures, the implant itself maintains its shape and integrity, similar to a Turkish Delight. 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.
- Please note that permanently brown, pigmented scars commonly occur in Asian patients and those with deep olive or brown skin colour.
- Breast Feeding is viable for many patients after breast implant surgery, providing the milk ducts remain intact. However, breast implants in some patients can interfere with breast feeding in many different ways. We advise patients to try not conceiving at least six months after the surgery to reduce the risk of putting extra pressure on the breasts. Just like natural breasts, they can also sag or droop after breastfeeding and you may need a bigger implant to fill the area of skin.
- Feelings of depression are not uncommon after any form of cosmetic surgery. It is usually related to the immediate post-operative discomfort, possible anxiety over the temporary but normal swelling and bruising, and the limitation of daily and social activities. As your appearance improves and you resume your usual activities and interests, these feelings should disappear.
- Implants in some women may last many years while in others they need to be replaced on one or more occasions for various reasons. Although there are many women who have had the same silicone breast implants in place for many years without any problems, there are also women who have had to replace their implants within a relatively short period of time. Saline implants carry a significant risk of deflation, in which event they would need to be replaced. Silicone Gel implants on the other hand do not deflate and unless there is some specific problem, replacement is not required.
Before you decide to have a breast augmentation, you must bear in mind that the treatment of some of the possible complications may require one or more return visits to the operating theatre at any stage after your original procedure. Naturally, this would mean additional expenses over and above what you paid for your original surgery as the additional hospital, anesthetic and surgical costs are not covered by the original fees.
It is important that you understand the risks involved, some of which include; hematoma, infection, capsular contracture, visibility of the scars, numbness of the breast or nipple, asymmetry of the breasts or nipple, rippling or wrinkling, implant wall rupture, deflation of saline implants, rejection or extrusion of the implant, displacement and distortion, descent of the implants, interference with mammograms, stretch marks, implant mobility or appearance change with arm movement, double fold or double bubble (an extra roll under the breast), unnatural appearance or feel, armpit discomfort or arm numbness from or near incision site, sagging of the breasts, synmastia (loss of cleavage), seroma, gel bleed with silicone implants and pneumothorax.
Breast augmentation is really about you and your body and many women have undergone successful surgery to enjoy the ongoing benefits, both physically and emotionally.
Before & After images
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