Breast augmentation combined with breast lift surgery, also known as augmentation-mastopexy, is a procedure that raises, enlarges and firms the breasts. The procedure involves implants being inserted beneath the breasts to enlarge them. The implant type and size depends on factors such as how much bigger you want your breasts to be, your breast anatomy, skin thickness and elasticity, and body type. Excess skin is also removed to tighten the surrounding tissue and to reshape and support the new breast contour. The internal breast tissue is usually reshaped as well.
Breast augmentation and lift surgery is designed to enlarge the breast size and to reshape and tighten the breast contour by removing excess skin. This gives the breasts a larger, more firm and raised appearance. This operation is commonly used to restore breast volume and shape after weight reduction or pregnancy and breastfeeding. This operation can also reduce the size of the areola, which can become enlarged over time.
The two main types of breast implant used in Australia are:
– a silicone envelope filled with varying amounts of sterile salt water (saline). This can affect the shape, firmness and feel of the breast. If the implant shell leaks, a saline implant will collapse and the saline will be absorbed and naturally expelled by the body
– a silicone envelope filled with an elastic gel that feels much like natural breast tissue. If the implant leaks, the gel may remain within the implant shell or it may escape into the scar capsule (area around the implant) or even into the breast tissue. A leaking implant filled with silicone gel may not collapse
Implants are placed behind the breast, not within the breast tissue. Implants can be inserted either:
Each position has its advantages and disadvantages. Your Specialist Plastic Surgeon can provide further details and will recommend which position is likely to be most suitable for you.
Breast augmentation and lift surgery is a highly individualised procedure and may not be suitable for everyone. Always talk to your Specialist Plastic Surgeon before making a decision. Your Specialist Plastic Surgeon will assess your condition and general health, and plan the treatment that is best suited to you.
Before you decide on breast augmentation and lift surgery, there are some important issues to keep in mind:
A breast augmentation and lift may be a good option for you if:
Remember that the shape and size of your breasts before surgery will influence the surgical procedure and the outcome.
Yes, breast augmentation and lift surgery requires either general or local anaesthesia. Modern anaesthesia is safe and effective, but does have some risks. Ask your Specialist Plastic Surgeon and anaesthetist for more information.
Your surgeon and/or anaesthetist will ask you about all the medications you are taking or have taken, and any allergies you may have. Make sure you have an up to date list before the surgery.
Modern surgery is generally safe but does have the potential for risks and complications to occur.
Some possible complications and risks associated with breast augmentation and lift surgery may include:
There have been allegations that implants are linked to the development of connective-tissue diseases such as rheumatoid arthritis, lupus erythematosus, scleroderma and similar auto-immune conditions. While some research has suggested small increased risks, many medical studies have not shown that the implants increase the risk of these problems. A proportion of all women in the community will develop these diseases, including women with implants.. The possibility of the development of connective-tissue and auto-immune diseases, even if remote, should be considered.
Rarely, women with implants have reported general symptoms, including joint pain, general aching, swollen lymph glands, unusual tiredness, greater frequency of colds and flu, hair loss, rash, headaches, poor memory, nausea, muscle weakness, irritable bowel syndrome and fever. The relationship of these symptoms to autoimmune disorders has been suggested but not proven.
mplants may interfere with the detection of breast cancer using mammography, a type of X-ray examination. If you have had breast cancer, a family history of breast cancer or may have other risk factors for breast cancer, tell you Specialist Plastic Surgeon.
There is no evidence that breast implants increase the risk of breast cancer, although the possibility has been considered. It is important that you learn to self-examine your breasts for lumps, in addition to having any regular tests that are recommended by your doctor. Your surgeon may also suggest a regular follow-up appointment for an examination of breasts for lumps and to assess the implants.
Individual cases may vary but generally, mothers can breastfeed after having breast augmentation. However, some women do experience reduced nipple sensation following breast augmentation surgery making it difficult to trigger the milk let down reflex. Some women may also experience reduced milk supply. If you are planning to breastfeed after breast augmentation surgery, talk to your Specialist Plastic Surgeon to get the latest information on this issue.
The Breast Implant Registry (BIR) is a public health initiative focusing on patient safety. The Registry collects relevant patient, surgeon, procedural and implant data relating to breast implants. Choosing to become part of the BIR allows patients to be contacted should there be any concerns regarding breast implants. The Registry is administered by the Australian Society of Plastic Surgeons Inc (ASPS).
Depending upon your general health and the extent of the procedure, breast augmentation and lift surgery can be performed either as a day case or alternatively with a short hospital stay. Your Specialist Plastic Surgeon will advise on the best option for you.
What do I need to do before the surgery?
Before undergoing surgery, it is important that you:
You will also be asked to provide a complete medical history for your Specialist Plastic Surgeon including any health problems you have had, any medication you are taking or have taken, and any allergies you may have.
You may be advised to stop taking certain medicines such as non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, and medicines that contain aspirin. You may also be asked to stop taking naturopathic substances such as garlic, ginkgo, ginseng and St John’s Wort as they may affect clotting and anaesthesia. Always tell your surgeon EVERYTHING you are taking.
You may be given medicines to take before the surgery, such as antibiotics.
Your surgeon will also advise you if any other tests are required, such as blood tests, X-ray examinations or an Electrocardiograph (ECG) to assess your heart.
Prepare a “recovery area” in your home. This may include pillows, ice packs, a thermometer and a telephone within easy reach. Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic. Someone should also stay with you for at least 24 hours after you return home.
Your surgeon should give detailed preoperative instructions. Follow them carefully.
Following your surgery, dressings or bandages may be applied to your incisions. You may be wrapped in an elastic bandage or a supportive garment to minimize swelling and to support your operation site as it heals. A small, thin tube may also be temporarily placed under the skin to drain any excess blood or fluid that may collect.
You will need to take at least a few days off work to rest. Avoid heavy lifting, strenuous exercise, swimming and strenuous sports until advised by your surgeon.
If you experience any of the following symptoms, notify your surgeon immediate:
Your surgeon will give you specific instructions on post-operative care. These instructions may include:
Be sure to ask your surgeon specific questions about what you can expect during your individual recovery period, such as:
When do I return for follow-up care?
Scars are an inevitable part of any invasive surgery. Your Specialist Plastic Surgeon will endeavour to minimise scarring and to keep your scars as inconspicuous as possible. Most of the scars are hidden in the crease underneath the breast but there but there will always be a scar visible around the areola following a breast lift. Scars may fade with time and become barely noticeable over time.
This is unusual initially. However, as with all surgical procedures, revisional surgery may occasionally be necessary. Implants do not last for ever and revisional surgery because of implants should be expected at some stage.
Cost is always a consideration in elective surgery. Prices for individual procedures can vary widely between Specialist Plastic Surgeons. Some factors that may influence the cost include the surgeon’s experience, the type of procedure used and the geographic location of the office.
Costs associated with the procedure may include:
Your surgeon should welcome any questions you may have regarding fees.
Areola: Pigmented skin surrounding the nipple
Augmentation mammoplasty: Breast enlargement by surgery
Breast Augmentation: Also known as augmentation mammoplasty; breast enlargement by surgery
Breast Implants: Medical devices placed in your body to enhance an existing breast size or to reconstruct your breast. Breast implants can be filled with either salt water (saline) or silicone (elastic gel)
Capsular contracture: A complication of breast implant surgery which occurs when scar tissue that normally forms around the implant tightens and squeezes the implant and becomes firm
General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness
Haematoma: Blood pooling beneath the skin
Inframammary incision: An incision made in the fold under the breast
Intravenous sedation: Sedatives administered by injection into a vein to help you relax
Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain
Mammogram: An x-ray image of the breast
Mastectomy: The removal of breast tissue, typically to rid the body of cancer
MRI: Magnetic Resonance Imaging: a painless test to view tissue similar to an x-ray
Periareolar incision: An incision made at the edge of the areola
Saline implants : Breast implants filled with salt water
Silicone implants: Breast implants filled with an elastic gel
Submammary or subglandular placement: Breast implants placed directly behind the breast tissue, over the pectoral muscle
Submuscular or subpectoral placement: Breast implants placed under the pectoral muscle, which is located between the breast tissue and chest wall
Sutures: Stitches used by surgeons to hold skin and tissue together
Transaxillary incision: An incision made in the underarm area
Ultrasound: A diagnostic procedure that projects high frequency sound waves into the body and records the echoes as pictures
Visit the Plastic Surgery Glossary for more medical terms.