Achieving a natural breast augmentation in Sydney

Dr Simone Matousek offers all the options available for the most natural looking breast augmentation in Sydney. All major types of breast implants are available and the decision for the best breast implant to use is made in conjunction with the patient. Breast augmentation can be done with breast implants alone, breast implants and fat grafting or fat transfer alone. Dr Simone was one of the first surgeons to perform large volume fat transfer to the breast in Australia and therefore is one of the most experienced surgeons in combining this with your breast augmentation with implants if necessary or beneficial.

Which breast augmentation procedure is best for you will depend on a number of factors including age, body type, patient preferences.

You will be measured up in the office and be able to try on sizers to simulate the final result. The most accurate way to determine the best final size and shape are by use of intraoperative sizers once the breast implant pocket has been created. The patient is sat up whilst asleep to simulate the final result. Small refinements like this help make sure that you get the most natural looking breast augmentation.

The most important aspect in achieving a natural looking breast augmentation is choosing the correct shaped implant for the person’s chest wall dimensions so the implant does not end up to wide, the implants are not too close together in the midline. For example two implants of exactly the same volume can have completely different shapes. Other factors depend on where the native inframammary crease sits and if there is constriction (tightness) of the native breast or a congenital problem known as a tuberous breast which makes breast augmentation more complex.

Many patients fear breast augmentation with implants looking unnatural. Correctly chosen implants should be imperceptible in all positions and clothing. The overriding reason most patients end up with an operated look is because of poor technique and having implants placed that are way too big for their physique and chest wall. There are limits to size for certain patients with tight tissues or extremely thin tissue cover. You will be advised as to the best size range for you during your breast augmentation consultation.

In certain cases of breast asymmetry or people without much body fat on their chest and breastbone area, breast fat grafting can enhance a breast augmentation procedure with implants.


Breast augmentation can look very natural with the correctly chosen implants. Sometimes combining a breast augmentation with fat transfer can give a superior result in certain cases.

Implants with impercetible edges and takeoff of the implant and natural cleavage lines

Many shapes and sizes are now available to ensure a soft, natural look.

The most cutting edge implant technology and surgical technique to minimise complications and enhance results

Implant technologies and meticulous surgical technique that ensures you have the lowest possible risk of hardening or capsular contracture. Combination with fat grafting for certain cases to enhance results.

Sizing tailored to each patient in rooms and intraoperatively

You will get to trial various sizes during your consultation. Intraoperative sizers are used to ensure you achieve the look you want.

Rapid recovery and return to exercise and work

Contrary to popular belief, implants are available that allow a rapid recovery and early return to an exercise program.

 Breast augmentation

Most frequently asked questions.

Breast implant selection-the options

Which is the best type of breast implant?

With so many different implant sizes and shapes available, breast implant selection is an important part of the pre-operative planning process to ensure the best shape for your body type is chosen.

Breast implant shape


anatomical (teardrop)

Breast implant fill and shell

polyurethane-coated silicone

textured silicone

smooth silicone

saline with a textured shell

saline with a smooth shell

Silicone feels more natural and is less prone to rippling than saline. It is important to note that saline implants have a silicone shell as there is the common misconception that saline implants don’t contain any silicone. In any case, silicone has been proven to be safe in large multicentre trials in tens of thousands of patients. There has never been any proven association with joint disease, autoimmune disease or any other illnesses.

Dr Simone is not affiliated with any implant manufacturer. Whilst she will advise during the breast augmentation consultation which implant would be best for a particular body size and shape the ultimate decision as to which implant a patient ultimately wants rests with them. Whilst Dr Simone can give you guidance, she does present you with more than one option. No implant is perfect and without risk or complication, it’s about working out the advantages and disadvantages of the options presented.

Breast implant under or over the pectoral muscle?

In patients with adequate tissue to cover the breasts, it is better to place the implant on top of the pectoral muscle.

Many patients presenting for breast augmentation, however do not have enough tissue to cover the implant and this can lead to visibility. When placed under the pectoral muscle (it is actually the upper part of the implant that is under the muscle) Dr Simone uses the dual plane technique. The lower part of the implant sits directly under the breast tissue or lower pole of the breast.

Which patients may be better served with a breast fat graft rather than with breast implants?

Patients with breast asymmetry may not want to have breast implants, especially if one breast is an adequate size. It is rare to be able to achieve a good correction of breast asymmetry with an implant on the smaller side only. A breast implant always sits higher than the non implanted side, therefore the majority of patients who have breast asymmetry corrected with implants end up having one in both breasts.

Patients who are in their teens with a constricted or tuberous breast who have severe asymmetry in clothing and swimwear may benefit from early release and correction with breast fat grafting without committing to a big decision such as breast implants at such a young age.

Breast augmentation incisions and scarring

Where is the best place for breast augmentation incision?

In the majority of patients, Dr Simone places the incision in the inframammary crease (the crease under the breast). This incision is around 5cm and when it fades, is the least visible place for a scar.

In some patients the periareolar (around the nipple) approach is used. This is preferable if the nipples are large or asymmetrical.

Dr Simone does not use the armpit incision as this is the only socially visible scar, implants cannot be placed easily through this incision and all revision surgery needs to be performed through an incision in the crease or the nipple.

What is done to minimise scarring following breast augmentation surgery?

Dr Simone uses the smallest possible incision to place your implant. Following surgery, you are given a scar management regimen. Your scars are closely monitored in the months following your breast augmentation to ensure if you are prone to more significant scarring due to genetics or other factors, extra scar management is instituted early to give you the best possible result.

Breast augmentation surgery

Do I need a general anaesthetic?

Surgery is performed in a accredited hospital under general anaesthetic with an anaesthetist. It is day surgery in the vast majority of people.

Patients usually go home the same day of surgery and must be accompanied by a responsible adult.

Do I need drains?

No drains are needed for a first time breast augmentation. They are only necessary in revision cases.

What is the pain like after surgery and how will I manage it?

Patients go home with regular pain relief prescribed. Local anaesthetic is injected at the time of surgery to help with post-operative pain relief. It is normal for the breasts to be bruised and swollen after the surgery.

With regular pain relief, the pain is manageable. The worst of the pain settles within the first few days. In the uncommon event that pain after the surgery is not under control, Dr Simone and her anaesthetist are available at any time after your surgery to advise about pain relief.

What do I have to do when I go home?

Waterproof dressings are placed over the wounds at the time of surgery and these should remain in place until you come for your follow up. Showering is permitted during this time. A firm bra is to be worn day and night.

Recovery time after breast augmentation

When can I return to work after a breast augmentation?

This depends on the type of work, some patients can be back within a matter of days to a desk job.
For people with an active job, polyurethane implants allow an earlier return to activities.

This depends on the the type of implant used and whether the pocket is under or over the muscle. For a more rapid return to exercise, particularly upper body work, a polyurethane implant has an almost zero risk of rotation or movement.

What are the exercise restrictions after breast augmentation?

One of the overriding advantages of breast fat transfer are due to the tiny incisions and rapid healing time which means there are no major restrictions to exercise after the surgery. Exercise is mainly limited due to pain, which is highly variable and usually dependent on the liposuction sites and volume as breast pain is minimal.

What do I need to do during the recovery phase?

Instructions will vary slightly if a fat graft has been performed and with different pockets or types of implants.

Implants do not require massage or any specific taping. They are precisely placed at the time of surgery.

Lifespan and safety of breast implants

How long will my breast implants last?

Most breast implants are said to last around 10 years. They are a device, and therefore after several years, it is usually a deterioration in cosmetic appearance that brings people to have them removed and replaced. This is usually the result of a capsular contracture, but can also be due to other factors such as changes in the overlying breast tissue, weight changes and ageing of the breast. Rupture is a much less common reason for removal these days as the gel is cohesive (like a jelly baby) therefore does not leak even in the event of a rupture.

What sort of warranty do my breast implants have?

Implant warranties vary slightly according to the manufacturer. All brands used by Dr Simone carry a lifetime warranty against rupture.

Polytech textured implants are the only implants to carry a 10 year warranty against capsular contracture, rotation and movement for a primary breast augmentation.

What about breast implant illness?

There is currently no scientific evidence that breast implants are responsible for symptoms of autoimmune disease, joint disease or other non-specific complaints.

Severe capsular contracture can cause pain and discomfort in patients with breast implants.

There is a very rare form of cancer known as ALCL (Anaplastic large cell lymphoma) which has been diagnosed in just over 300 women worldwide. As numbers are small and research regarding this topic is in its infancy,  it is difficult to make any defintive conclusions at this stage regarding this form of cancer. It usually presents with a mass or a fluid collection which in the majority of cases are visible to the patient as a change in their implants.

Breast fat transfer and breast implants

How can a fat graft be beneficial in patients with breast implants?

Although some very thin patients may not have enough fat for a breast augmentation with fat transfer alone, they may have just enough to be injected into regions where their breast implants are visible. This can often occur in the cleavage area or upper part of the implant if there has been weight loss after surgery. 

Why is fat graft almost always beneficial in patients with tuberous breast reconstruction with breast implants?

Tuberous breasts typically present with not only constriction of the breast (especially the lower pole) and a high tight inframammary fold, and usually some breast asymmetry. Fat transfer helps maintain release of the tight fold and lower pole constriction and assist with maintaining this correction much better than an open release alone with reduced rates of double bubble deformity. This is where tight tissues springs back to their original position following release and indent the implant across its surface creating the appearance of two folds.  Tissue lack in the lower pole of the breast and cleavage area and precise asymmetry correction is helped with a fat transfer even if breast implants are used.

Read more here about tuberous and constricted breasts.

How can fat grafting be beneficial in revision breast augmentation surgery?

Dr Simone Matousek specialises in revision breast augmentation surgery with a combination of fat grafting and breast implants. With each exchange of breast implants, there is a need to remove the capsule and in the presence of scarring and thinning of the tissues, fat can be beneficial in masking the visibility of implants and dealing with small asymmetries. Dr Simone also recommends a special type of polyurethane-coated silicon implant in this situation which has a significantly lower rate of capsular contracture, movement and rotation in the published literature. You can read more about these implants here and why they are an excellent choice for breast augmentation revision.

Breast lift or mastopexy and breast implants

Can I combine a mastopexy or breast lift with breast implants?

Many patients will be happy with the tissue rearrangement and lift provided by a mastopexy alone and not need an implant for volume augmentation.

In some cases, the breast lift and implants may need to be staged in two procedures. Which one is performed first is dependent on the individual patient situation.

Can a larger breast implant compensate for a breast lift?

In patients with more ptosis or breast “droop”, an implant does provide some lifting capacity and can avoid or delay the need for the scars associated with a breast lift.

In some patients, the size of the implant required to give adequate lift may not be acceptable to them or proportional to their body size.

View breast augmentation before and after gallery

Have a question regarding a procedure?

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