Achieving a natural breast augmentation
Dr Simone Matousek offers all the options available for breast augmentation. All major types of breast implants are available and the decision for the best implant to use is made in conjunction with patient. Breast augmentation can be done with breast implants alone, breast implants and fat transfer or fat transfer alone.
This 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 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. Other factors depend on where the native inframammary crease sits and if there is constriction (tightness) of the native breast. For example two implants of exactly the same volume can have completely different shapes.
Decisions to be made for breast augmentation surgery include the following:
Which type of breast implant?
Fill and shell
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.
Under or over the 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.
Where to place the 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.
Breast augmentation surgery
Surgery is performed in a hospital under general anaesthetic with an anaesthetist. It is day surgery in the vast majority of people. Dr Simone does not use drains for primary (first-time) breast augmentation.
Patients usually go home the same day 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. Waterproof dressings are placed over the wounds and patients are placed in a firm bra after surgery to be worn day and night.
Return to work
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.
Lifespan of breast implants
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.
Breast implant warranty
Implant warranties vary slightly according to the manufacturer. All brands used by Dr Simone carry a lifetime warranty against rupture.
Polyurethane-coated implants are the only implants to carry a 10 year warranty against capsular contracture, rotation and movement.
Click here for more information on polyurethane implants.