Breast Augmentation Surgery

Breast augmentation or enlargement is a surgical procedure to increase the size of breasts, improve symmetry, correct drooping, create symmetry, balance the shoulders/chest and hips and to re-fill the breasts after emptying associated with breast feeding. Augmentation is commonly used to reconstruct breasts following cancer surgery.

Breast Implant Options

There are a number of decisions to be made with breast augmentation. A careful individualised plan will recommend the best option for you based on your body type and preference. The implants can be round or shaped as a teardrop which simulates the breast shape and either smooth or textured on their surface.

The fill of the implants may be silicone gel or saline. It is important to note that even saline implants contain silicone in the shell or envelope of the implant. Silicone is considered to have a more natural feel and look. There is a rupture rate of approximately 1-3% per year associated with saline implants and they may also wrinkle.

Implants are inserted through incisions either under the breasts, around the areola, across the nipple or in the armpit. Breast implants can be placed behind the chest muscle or in front of the muscle but under the breast tissue. The advantages and disadvantages of each of these variables will be discussed and explained by Dr Kippen who will give you various options and guide you in the final choice.

Choosing the Right Size for Breast Implants

Another important decision is choosing the size that is required. Dr Kippen uses trial implants in the rooms. At home you may take a stocking and fill it with rice. It is then tied closed. One baking cup is 250ml. By adding or removing rice you can adjust the size. It is advised that you insert this in your bra to simulate different sized implants. Then, by wearing dark, tight-fitting clothes and using a full length mirror, the effect of the enlargement can be assessed.

A range of different clothes can be worn to asses the size. Light or dark coloured, floral, striped and even trials of swimmers can be tried. It is important to understand that implants are assessed by the volume and not by bra cup size.

Breast Implant Safety

Recent studies and review of previous studies have shown silicone to be safe. There has not been a definitive link shown between silicone and breast cancer, immunologic, arthritic or neurological disease. These days the implants used have three layers in the envelope and this is bonded to the filling. The filling is now thick and viscous “cohesive gel” that does not leak or run. Even if cut, the implant maintains its shape. The outer surface may be textured or rough which helps to decrease the formation of a capsule. This is scar tissue that forms around the implant and may cause hardening. It is still possible to breast feed with implants.

There are advantages and disadvantages of both the round and shaped implants. Dr Kippen will carefully explain these to you.

Breast Augmentation Procedure

Surgery is performed in a hospital or day surgery with a combination of local and general anaesthetic. Supplemental local anaesthetic decreases the pain immediately after surgery. Usually, plastic or silicone drainage tubes are not used. Depending on the incision and implant placement, surgery can be performed as a day-stay or an overnight stay.

Immediately after the procedure breasts will be swollen and may be slightly bruised. If numbness occurs, it usually resolves with time, but may be permanent and involve the breast, areolar or nipple. A graded exercise programme will be formulated for you and it is usually possible to return to work at about 2 weeks post surgery. You will be given a detailed plan of post-operative wound care.

It is still possible to have mammograms after breast augmentation. Alert the radiographer that you have implants and they will perform a displacement technique and an additional view may be required. Implants placed deep to the chest muscle obscure less of the breast tissue.

Consultation with John Kippen

Breast augmentation is a commonly performed procedure with a high degree of satisfaction. At the time of consultation, Dr Kippen will give a far more comprehensive explanation of the procedure and likely recovery. He will give you brochures to read as well as showing before and after photographs.

You should read the information presented here in conjunction with the information contained on the Frequently Asked Questions page of the website.