ALL ABOUT BREAST IMPLANTS

Sydney plastic surgeon Dr Laith Barnouti explains some of the key elements in choosing the right breast implants in Sydney.

With modern advances in cosmetic surgery, breast size is a matter of personal choice. Now, women who dream of a curvier, fuller figure can increase their breast size and improve their shape. However, what makes an excellent breast augmentation different from the obvious boob job? The aim is to produce a natural looking result by choosing the right implant that suits the individual’s chest dimensions, producing breasts that don’t look augmented but rather natural in appearance.

A successful breast augmentation should look and feel natural. There should be some degree of cleavage, without webbing between the breasts and a certain amount of perkiness.

Some considerations that make for a desirable breast augmentation include: place of incision; type of implant; placement of implant; texture of implant; size of implant; thickness of the breast tissue; presence of sagginess; asymmetry; and desired breast width, height and projection.

Implant shape

Implants can be round, teardrop shaped or a combination, known as ‘natural enhance’ Brazilian implants.

Round Brazilian implants are disc-shaped and exhibit equal fullness in all four quadrants of the breast. See case study 1.

Teardrop, or anatomical, implants exhibit reduced fullness in the upper pole of the breast and increased fullness in the lower half of the breast. These implants are narrower than rounded implants at the superior and inferior poles. See case study 2.

Brazilian ‘natural enhance’ implants are teardrop implants that are round in shape (the height and width of the implants are equivalent). See case study 3. Each implant can be further classified into low, medium and high profiles. A low-profile implant has a broader base and lower height when viewed on a table next to a high-profile implant of comparable volume (a medium-profile implant has base and height dimensions in between the two).

Safety and efficacy of silicone

Silicone is probably the most studied implantable material available today. After more than 35 well-conducted studies from many countries, it seems certain that this material does not cause disease. There is also no hard evidence that a broken implant is harmful. Almost all of the problems that can occur with breast implants, such as infection, hardening, extrusion and malposition, are related to the surgical procedure as opposed to the implant itself.

A great deal of recent safety research combined with more than 40 years of clinical experience has proven the relative safety of breast implants. Aside from the unique adverse effect of capsular contracture, the complication rate of this surgery approaches that of any clean elective procedure. To date, no convincing evidence exists of any systemic disorder that can be attributed to silicone.

Pregnancy and lactation

Using silicon levels as an indicator of silicone content, current studies show no increase in the human milk of implanted women. A small sampling of milk measured directly for silicone has also failed to detect levels any higher than the controls.

Even if milk did contain silicone, the amount would be far less than an infant would receive from a drop full of paediatric milk formulas, in which silicone antifoam is the main ingredient.

The evidence suggests that lactation insufficiency is related either to congenital glandular inadequacy, usually associated with smaller breasts, or with periareolar access surgery that may damage some ductal systems. The inframamary approach (incision made in the breast crease) remains the safest method of breast augmentation in terms of lactation ability.

Breast augmentation: key facts at a glance

Operation length: Around 1.5 to two hours
Anaesthetic: Local with some sedation (twilight sleep) or general anaesthesia
Clinic stay: Outpatient or one night
Post-operative: Around seven days with dressing bandage and four weeks with sport bra. Discomfort is typical for the first two to three days.
Swelling subsides gradually over four to six weeks.
Scarring: Position of the scar depends on the location of the incision.
Generally, the scar does gradually fade and become a fine white line in most patients.
Possible risks: The main risk factors are swelling, bruising, bleeding, infection, scarring and numbness, or change in sensation. Following the surgeon’s advice will help to reduce risks and complications.
Time off work: About one week, depending on the type of work
Sport: Light exercise after around four weeks; strenuous sport (tennis, swimming, jogging) after about four to six weeks

Breast Augmentation Procedure