Breast Augmentation
Breast Augmentation Sydney
Breast Augmentation
Breast augmentation is the aesthetic procedure modifying the shape, size and texture, giving the breasts a more full appearance.
There are various reasons why women consider breast augmentation. Some feel their breast don’t have enough volume, some due to post-pregnancy loss of volume, weight loss, or to become more proportional to body frame and some have asymmetrical breasts, where the breasts differ from each other in size, shape and position.
Every patient has their own unique breast profiles, aesthetic goals and surgical qualities. Dr Kwei will tailor the attributes of the surgery to these goals, optimising the best aesthetic outcome.
The ideal patient for breast surgery is healthy, of sound body and mind, and has already done some preliminary research into the surgery.
If you are anticipating body changes in the next few years, such as planning to lose weight or have children, it is best to wait until post-pregnancy or when your weight has been steady for 6 months, as these body changes can influence the breast size and shape and affect the outcome of your surgery.
At the practice, your breast augmentation discussion commences with a 60 minutes one to one consultation, tailoring the surgery that fit your body shape, lifestyle and goals. Dr Kwei will detail all aspects of breast augmentation, from implant types, sizes, shapes, the position of incisions, ideal pocket placement, and what they can achieve with the best options for your body type and goals.
Types of Breast Implants
Silicone vs saline implants: Why are there 2 types of implants? How are they similar, and in what ways do they differ?
Understanding the qualities of the implant materials and their limitations will allow Dr Kwei to aim for the best outcome.
Important Patient Information on Breast Implants – Please read:
Texturing of Breast Implants
Textured vs smooth implants: Why do the 2 types of texturing exist? What is the history behind them? Understanding their limitations and potential benefits. What are the latest trends in the type of texturing in Australia and overseas, and why?
Motiva Implants are not the type of textured implants that are associated with ALCL and are fully approved by the Therapeutic Goods Administration (TGA) in Australia.
Shape of Breast Implants
Both types have their advantages, but it is important to know which one will best suit your goals.
Teardrop implants are form stable and maintain their shape due to the silicone gel’s cohesive quality. There has been a common misconception that anatomical implants are the only shape of implant that can achieve a natural-looking result. This is incorrect.
Round implants achieve more upper pole fullness, with better definition to the medial cleavage.
Size of Breast Implants
This varies between patients and is partly determined by your pre-existing breast footprint (the width and height), but also the degree of skin ‘stretch’. Remembering that breast augmentation is a 3-dimensional surgery, the amount of soft tissue available to cover the implants is also important in determining the size of implant used.
Respecting these limitations will minimise the possibility of less than ideal results.
Other important considerations include the geometry of your chest anatomy, your body frame proportions (chest vs abdomen) and your infra-mammary crease definition.
All these factors will be explored between you and Dr Kwei during your consultation.
Incision Site for Breast Implants
Pocket Placement for Breast Implants
Frequently Asked Questions
Post-augmentation, there may be changes in how your tissue feels. Natural-feeling outcomes are typically observed in fat transfer augmentations and breast lifts without implants. The type, size, material, and placement of the implant can influence the patient’s feelings in the case of implant-based augmentations. Recovery time may also vary as your tissue adjusts to the new implants. Nipple sensitivity, numbness, or soreness during recovery are possible but typically temporary.
The size of a breast implant can vary in appearance depending on individual factors such as existing breast tissue and musculature. Some patients may achieve the desired results with a breast lift without an implant. Trying on implants and reviewing pictures of desired outcomes can aid in visualisation. It is important to choose an implant that matches your specific proportions to achieve a balanced and natural-looking result.
The incisions required for implant insertion vary based on the type of implant selected. Factors such as natural breast shape, skin tone, age, sun exposure, and lifestyle choices like smoking may influence the visibility of scars after healing. Small incisions are made in inconspicuous areas such as the areola, fold beneath the breast, or armpit, with the resulting scars typically small and difficult to notice.
The internal bra technique is an innovative surgical method in breast surgery that help deliver a better surgical result by providing better support for the lower part of the breast. Often compared to that of a surgical under-wire bra, the internal bra surgical technique provides for better breast shape, better breast position control and also stabilise the position of the breasts to give longevity of the breast rejuvenation surgery results.
The internal bra technique is a technique that focuses on the inferior pole of the breast, after breast augmentation, breast lift and breast reduction surgeries.
When the lower portion of the breast is fixed and stabilised, it allows control of the position and give longevity of the inframammary fold. The internal bra technique improves the results by supporting the breast tissue above, like that of the effects of the underwire of a bra. Maintaining the shape of breasts and give longevity to your breast augmentation, breast lift (mastopexy) or breast reduction surgery.
The internal bra technique is utilised in any breast surgery where the control of the position of the breasts, the inframammary fold and support is important.
It is used in breast augmentation surgery, in breast lift (mastopexy surgery) and in breast reduction surgery.
It is also used in breast augmentation mastopexy, where it is important to control both the position of the breast implants and the breast tissue after the breast lift (mastopexy)
The internal bra technique produces an effect like that of an underwire in a bra, nevertheless, due to multiple factors such as ageing, weight changes, gravity, soft tissue techniques such as the internal bra will still stretch over time. Although it will give a very supported result in the period after the surgery it is important to protect these results with a supportive bra whenever you can.
This does not mean you can’t enjoy the results in your swimwear or summer tops, but it is worthwhile investing in a comfortable supportive bra to sleep in long term.
It is important to understand that gravity and ageing are constant forces in life, and other factors such as lifestyle, weight loss, weight gain can all influence the ‘recurrence’ of some of the breast tissue ptosis (sagginess).
The incisions required for implant insertion vary based on the type of implant selected. Factors such as natural breast shape, skin tone, age, sun exposure, and lifestyle choices like smoking may influence the visibility of scars after healing. Small incisions are made in inconspicuous areas such as the areola, fold beneath the breast, or armpit, with the resulting scars typically small and difficult to notice.
- Patient who has significant breast ptosis (breast sag/breast droop)
- Patient requiring breast augmentation, breast lift or breast reduction surgeries
- Enhance implant stability in breast augmentation or augmentation mastopexy surgery
- Patient who would like to have longevity to their breast surgery results
- The right candidate is one that is prepared physically and mentally
- Well supported socially
- Financial independent and stable
- Understand and accepts the post surgery recovery and realistic about possible risks and complications associated with surgery
Consultation
You will have at least two 1-on-1 consultation sessions, each around 1 hour with Dr Johnny Kwei to allow for a discussion of your desires and breast surgical goals, and also the expectation of what can be achieved. These consultations will in depth, and will cover all medical/surgical history, physical examination, some pre-surgical photography, and an assessment of the general landscape of the anatomy of the chest and also that of the abdomen. There will also be an in depth discussion of the risks and limitations of the surgery. Dr Kwei will give some pre-surgical care instructions, like diet supplements, skin health and general skin care as well as, explore other important factors such as stability of weight, work/family demands and social support. Plenty of time will be given for questions in every consultation.
Surgery
Surgery is conducted at an accredited hospital facility, under general anaesthesia with the involvement of a specialist anaesthetist (please refer to Anaesthetist section of the website).
If your surgery require hospital admission, you will be admitted at the hospital under Dr Kwei’s care for the required nights of care, and you will be reviewed by Dr Kwei and his team daily.
Dr Kwei will discuss with you in detail regarding the surgical technique, and any refinements that he has made to enhance your surgical results, improve/minimise your scars, the time required for your surgery, as well as the dressings that will be applied at the end of the surgery.
Often, photos of pre and post surgery examples will be shown as well as photos with the type of dressings applied.
Post Operation
Dr Kwei will advise on the ongoing care of the surgical sites and dressings, with frequent reviews immediate few weeks after surgery, and longer interval review up to 6 to 12 months – for monitoring of long term outcomes.
Compression garment often need to be worn for a period of 6 weeks post surgery.
Summary:
There are quite a few advantages of the addition of this modern breast stabilisation technique to the breast lift, breast reduction and breast augmentation surgeries, all of which reduce the tension of weight of the breasts on the overlying skin and breast parenchyma.
1. Better control of the breast shape and position
The surgical internal bra creates a under-wire scar/bra internally to support the weight and form of the breasts, giving it an excellent foundation.
2. Improved breast shape
The surgical internal bra allows the surgeon to control and create a harmonious lower pole curvature of the breasts, which improves not only the lower breast but translate superiorly to the overall breast profile.
3. Stabilise the lower pole of the breast in place and minimise inferior displacement of breast
The internal bra sutures creates a permanent roll of scar along the inframammary fold of breasts, which is anchored to the deep fascia, infront of the ribs and intercostal muscles; which is a strength and robust boundary that support and stabilise all of the breast tissue above it.
4. Longevity of results
The internal bra would form a layer of scarring that further stabilise the inframammary fold, this would in turn supported the upper breast tissue in breast augmentation, breast lift and breast reduction surgery.
General:
- Some minor discomfort around the IMF sutures for a few weeks
- Bruising
- Oedema
- Rarely infection
Specific:
- Some changes in sensation around breast
- Scarring (regimented post surgery scar management will be implemented)
Depending on the surgery – Dr Kwei will spend time discussing possible risks of surgery and strategies he uses to minimise/control these risks.
References
- Breast reduction surgery Mayo clinic
- Breast surgery my.clevlandclinic.org
- 14 Point Check Plan in Breast Augmentation surgery, Deva, A. et al (2017)
6 types of dual-plane pockets
Type 1
A lower gland-muscle interface, allows the maximum soft tissue coverage over breast implants.
Type 2
Gland-muscle interface around the level of the nipple and allow the advantages of both sub-glandular and sub-muscular to be recruited in this pocket form.
Type 3
A higher gland-muscle interface is often reserved in a reconstructive type of augmentation such as Tuberous Breasts.
Medially, laterally and centrally-favoured dual-plane interfaces can also achieve an aesthetic outcome for breasts of different shapes, positions and sizes.
The consultation will involve an assessment of your breast dimensions, and its relationship with the torso and the rest of your body.
Dr Kwei will then go through all the above factors and discuss the most suitable implant, shape and size, as well as being fluent in all the techniques of the Dual Plane and Incisions, map out your breast augmentation journey and draw up your aesthetic goals. He will also use the various techniques of liposculpture, fat grafting and glandular modification to achieve the best possible outcome for you.
During your consultation, there will also be a discussion on the various advances and discoveries in silicone gel technology, BIA-ALCL, fat grafting in breast surgery and other news in research and techniques.
The procedure is done as a day surgery procedure. It is done under a General Anaesthetic and there will be an Anaesthetic Specialist Consultant at the surgery.
You will have to fast for 6 hours before the surgery.
The procedure takes about 75 minutes, and you will wake up in the recovery area quite comfortable. Once you are awake, and eating and drinking normally, you can then go home.
Having had a general anaesthetic, someone you know will have to pick you up and be with you that first night after the surgery.
Dr Kwei has a Tailored Recovery Regime, that allows a speedy and comfortable recovery. Utilising the latest technique in regional and local anaesthesia, with a trialled combination of analgesia, ice-pack and exercise allows the patients to wake up with minimal discomfort, and be managed in the subsequent postoperative period quite effectively.
In the first week after surgery, the implants will appear high on the chest and be quite tight. This appearance slowly changes over 6-9 months, with what initially appears quite squared at the bottom of the breast, and then rounding of the medial and inferior poles, developing the cleavage.
You may have some mild central and inferior breast swelling and bruising, which may take a few weeks to settle down. There may also be some areas of numbness.
Your first follow up is at 1 week after surgery, at this stage the discomfort from the surgery would have mostly subsided. Your dressings will be changed by Dr Kwei and be advised on restrictions to daily activities and gradual return to exercise and work. You should not drive for the first week, and you will most likely need 1-2 weeks off work.
By the end of the 6th week, the breasts would have softened and the cleavage lines better defined. There may still be some asymmetry between the breasts, which will further settle in the subsequent months.
Dr Kwei will see you at the practice for follow up 4-5 times in the 12 months post-surgery to make sure all is going well, and help you navigate smoothly through your breast surgery journey.
Risks and Complications Associated with Breast Augmentation
At Johnny Kwei Plastic Surgery, your well-being is our top priorities. While breast augmentation is a commonly performed procedure with a high success rate, it’s important to understand that all surgeries carry some degree of risk. We believe in providing you with comprehensive information to help you make an informed decision about your cosmetic journey. Here are some potential complications and risks associated with breast augmentation:
- Surgical Risks: Like any surgery, breast augmentation carries the possibility of surgical risks such as bleeding or infection.
- Fluid Accumulation: In some cases, fluid may accumulate around the implant after surgery. This can cause swelling and discomfort, but it is typically temporary and can be addressed through appropriate post-operative care.
- Allergic Reactions: While rare, some individuals may experience allergic reactions to suture materials, tape adhesive, or other medical substances used during the procedure.
- Changes in Sensation: Breast and nipple sensation may be altered following augmentation. Temporary or permanent areas of numbness or increased sensitivity can occur, but these changes are typically mild and improve over time.
- Skin Wrinkling: In some cases, wrinkling of the skin over the implant may occur. This risk can be minimised by selecting the appropriate implant size and placement technique tailored to your unique anatomy.
- Keloid Scarring: Keloid scars, characterised by raised and irregularly shaped tissue, may develop in some individuals.
- Capsular Contracture: Capsular contracture is a potential complication where scar tissue forms around the implant, causing it to become firm and lose its natural shape and softness.
- Inappropriate Implant Size: Selecting the right implant size is crucial for achieving your desired outcome.
- Implant Rupture or Deflation: Although rare, implant rupture or deflation can occur over time. Regular follow-up appointments and periodic imaging screenings are recommended to monitor the condition of your implants.
- Breast Asymmetry: While efforts are made to achieve symmetry, some degree of breast asymmetry may persist following augmentation.
- Calcium Deposits and Granulomas: In rare cases, calcium deposits or granulomas may form in the scar tissue around the implant.
- Breastfeeding Difficulties: Breast augmentation may impact your ability to breastfeed. It’s important to discuss your plans for future breastfeeding with our surgeons during the consultation to understand the potential impact on milk supply and breastfeeding capabilities.
- Breast Cancer Screening: Breast implants may affect the effectiveness of mammograms by obscuring breast tissue. It is crucial to inform your healthcare provider about your implants to ensure appropriate screening techniques are employed.
- Implant Displacement: Although rare, movement of the implants from their original position can occur.
- Further Surgery for Complications: In some cases, additional surgery may be required to address complications that may arise.
- Risks of Anaesthesia: Anaesthesia carries its own set of risks, including allergic reactions or potentially fatal cardiovascular complications.
- Blood Clots: A blood clot in the deep veins of the legs (deep vein thrombosis) is a potential risk following surgery.
It’s important to note that while these risks exist, the vast majority of breast augmentation procedures are performed without complications. Our skilled surgical team is dedicated to providing you with the highest level of care, employing advanced techniques and adhering to stringent protocols to minimise these risks. During your consultation, we will discuss these potential risks in detail and address any concerns you may have. Your well-being and satisfaction are of paramount importance to us at Johnny Kwei Plastic Surgery.
After your breast augmentation surgery with Dr. Johnny Kwei, it is important to follow the proper recovery guidelines to ensure a smooth healing process. To support your healing and minimise swelling, dressings or bandages may be applied to your incisions. You may also be wrapped in an elastic bandage or a compression garment. In some cases, a small, thin tube may be placed under the skin temporarily to drain any excess blood or fluid.
Depending on the extent of your procedure, it is advisable to take a few days off work to allow your body to rest and recover. During this time, it is crucial to avoid heavy lifting, strenuous exercise, swimming, and vigorous sports activities until you receive clearance from your surgeon.
The recovery process depends on your individual profile and other variables. Below, we have detailed some general instructions and possibilities to expect:
- You could experience an elevated body temperature.
- Your breasts may remain swollen and sensitive to physical contact for a month or a longer period of time.
- You may feel tired and sore for several days following the operation.
- You could experience a feeling of tightness in the breast area as your skin adjusts to your new breast size.
- Avoid any strenuous activities for at least a couple of weeks, though you may be able to return to work within a few days once your surgeon approves it.
- Breast massage may also be recommended as appropriate.
- Sleep or rest with your head slightly elevated, avoiding lateral positions.
- Keep your arms close to your body and avoid lifting weights until allowed by your surgeon.
- Do not drive for at least 2 days after your surgery and do not exercise until approved by your surgeon.
- Do not expose your breasts directly to sunlight until approved by your surgeon.
- Topical cream may be recommended by your surgeon.
- Immediately after surgery, your breasts will be swollen and tender, so you will likely need to wear a medical compression bra, also called a surgical bra, without underwires. Your surgeon will provide or recommend the best bra after breast augmentation or reconstruction, along with instructions on how long you must wear it. Most patients wear their medical compression garment day and night for one to two weeks, after which they can transition to a supportive sports bra.
- Pregnancy and nursing after breast implant surgery may cause breast tissue and muscle changes that could lead to ptosis (drooping) and flipping.