Breast augmentation

Breast augmentation (breast implants)

What is breast implants?

Breast augmentation is a form of cosmetic surgery that may change a woman’s appearance by giving her larger breasts or reconstruct the breast after mastectomy. It is sometimes called breast enlargement, breast reconstruction or breast implant procedure.

Some women have breast implants as part of reconstructive surgery following breast cancer. If this applies to you, please find further information about breast reconstruction on the Breast Cancer Nurses Association website. This article concentrates on surgery for cosmetic reasons.

The Therapeutic Goods Administration (TGA) continues to review and assess breast implants available in the Australian market. For more information and the latest updates, see the TGA’s online breast implant hub.

What is breast augmentation?

breast augmentation
breast augmentation

Breast augmentation involves placing implants made of a silicone shell filled with either saline (salty water) or silicone gel under the breasts or under the breast muscles on the chest.

Women have a breast augmentation for many reasons, but these reasons are generally around wanting to feel more physically attractive or to feel better about themselves.

The implant can be positioned between the chest muscle and the breast tissue itself or under the chest muscle. Your doctor will help you decide which method is right for you.

If you are thinking about breast augmentation

It is recognised that society places a great deal of pressure on women to have a certain body shape. Breast augmentation may not be the solution for everyone, and there are alternatives.

If you are concerned about your appearance, then getting advice about exercise and diet might help. If you feel inferior because you believe you have small breasts, counselling might help you accept your body shape. Some women have found that wearing a padded bra has improved how confident they feel about the way they look.

Some cosmetic surgeons offer fat grafting, where fat is transferred from elsewhere (such as your buttocks) to your breasts. Other types of surgery that do not involve implants are also available.

The cosmetic result obtained from fat grafting is less certain than with implants, partly because it is not known how long the fat will last.

You should also be aware that:

  • Generally, Medicare does not cover the cost of cosmetic surgery, and often private health insurance does not either. Before considering undergoing cosmetic surgery, discuss any costs with your treating doctor and, if appropriate, your private health insurance provider.
  • It is not clear how long your implants will last – some women need them replaced within 10 years, and others within 20 years.

Choosing a surgeon

If you are considering breast augmentation, it is important to choose a surgeon you feel comfortable with, and who will speak to you honestly about the benefits and risks of any surgery.

The Australian Health Practitioner Regulation Agency (AHPRA) has a register of medical practitioners. You can check this register to ensure your surgeon is a Fellow of the Royal Australasian College of Surgeons (RACS). You can also check if the surgeon has had any serious disciplinary action taken against them.

Questions to ask before surgery

There is a lot to consider before deciding to have cosmetic surgery. You can ask your doctor questions about surgery in general, and there are others you could ask your doctor about breast augmentation, such as:

  • What type of breast implants do you recommend for me? Why?
  • Will I lose any sensation after having implants?
  • Can I breastfeed in future?
  • How will the surgery change the position and appearance of my nipples?
  • How much bruising, swelling, or pain would you expect me to experience? What should I do about this?
  • How long until I can return to my normal activities after surgery?
  • How many of your patients have had a ruptured or failed implant? What will it mean for me if this happens?
  • How likely am I to need further operations because of problems?
  • If I need further surgery due to complications or if I am not satisfied with the result, will there be extra costs?

You can also use the Question Builder tool to create your question list for the appointment. Prepare your list, then print or email it so you remember what you want to ask.

How to prepare for a breast augmentation procedure

If you decide to go ahead, get as much information about the procedure as possible and know what results you can expect.

If you smoke, try to quit, as smoking slows down your recovery. You should also check with your doctor if you need to make any changes to any medication you are taking.

What happens during a breast augmentation procedure?

You will most likely need a general anaesthetic. The surgeon will make an incision alongside the breast then place the implants between the breast tissue and the muscle, or behind the large chest muscle under the breast.

There are different ways of doing the operation, and they have different effects on your recovery time.

There are also different types of implants. Some women prefer the feel of silicone implants to saline implants. Saline implants cause fewer problems than silicone implants if there is any leaking.

What to expect after breast augmentation

You might be in the hospital for a few days – read about what to pack. You might have tubes to drain blood and other fluid away from your chest – if so, these will be in place for a day or two.

You will have swelling and bruising around your chest, which will take a week or two to go down. Unfortunately, you will have pain and discomfort. You may be prescribed pain relief to help.

You will probably need to wear extra support for a few weeks until your breasts heal. It can take this amount of time for you to get back to normal, so expect some time off work and more time when you will need extra help with daily activities.

You will also need to return to the hospital or to see the surgeon to have your stitches taken out. It will probably take several months for all swelling and scars to settle down.

Risks of breast augmentation

Like any surgery, breast implant surgery comes with risks. You should discuss the risks in detail with your surgeon.

You should also discuss the risks of anaesthetic with your anaesthetist. Some of the more common problems that occur in at least 1 in 100 women include:

  • bleeding, or a collection of blood (haematoma)
  • infection
  • changes to a sensation of the breast skin or nipple, including numbness
  • swelling or collection of fluid around the breast
  • injury to surrounding tissue
  • rupture.

There are other rare but serious risks to consider including:

  • an allergic reaction to the anaesthetic
  • blood clots in the legs, which can travel to the lungs and cause serious illness.

Some women find that after surgery, their breasts do not look how they had hoped. Sometimes, breasts can be uneven, dimpled, hardened, or feel lumpy. Sometimes, the nipples are uneven and this can cause problems.

The implants can also make it harder to see breast cancer during screening checks. Some women with breast implants can breastfeed after surgery, but others cannot.

You should consider that you may need another operation. The younger you are, or the longer you have breast implants, the more likely you are to eventually have problems. And if you have them removed but not replaced, your breasts might be scarred and dimpled.

Cost

The cost of breast augmentation varies from patient to patient and includes:

  • surgeon’s fees
  • anaesthetist’s fees
  • clinic or hospital fees
  • the implants
  • medication, dressings and support garments.

You should discuss all fees with your surgeon before the procedure.

Sources:

Australasian Foundation for Plastic Surgery (Breast augmentation (implants))Therapeutic Goods Administration (PIP breast implants: Consumer questions and answers)US FDA (Breast implant surgery)Zuckerman, DM, Kennedy, CE and Terplan, M (Breast Implants, Self-Esteem, Quality of Life, and the Risk of Suicide)US FDA (Risks of breast implants)Australian Society of Plastic Surgeons (ASPS media resource folder)Australian Health Practitioner Regulation Agency (Register of practitioners)

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