BREAST IMPLANT SURGERY: UNDERSTANDING THE BASICS

Before any Breast Implant surgery procedure, your surgeon must assess and consider multiple factors. In particular, there are three key considerations:

Types of breast implants
Incision or scar location

Implant position/pocket placement

TYPES OF BREAST IMPLANTS

Breast implants come in a wide variety of shapes, sizes, widths, profiles and materials. For example, there are silicone and saline breast implants. Dr Dona prefers silicone breast implants, made of a firm or soft silicon gel, as the results are more lifelike with better long-term aesthetic outcomes and possibly less likely to form capsular contraction. Breast implant shapes can vary. There are teardrop breast implants (aka (anatomical-shaped) and round breast implants. Similarly, the surfaces of the implants can differ, with some being textured (rough surface) and others smooth. Each has its benefits, depending on the patient’s anatomical requirements.Choosing the correct implant profile (not just the implant size) for you is vital. This refers to how far forward the implant projects. Implant profiles can be:

Low profile
Moderate profile
High profile
Extra high profile (aka extra full)

INCISION OR SCAR LOCATION

Dr Dona creates the incision within your lower breastfold. This position is the most popular incision placement with most plastic surgeons. However, the breastfold is not the only option. For some, an incision may be made in the crease of the armpit or around the lower areola border. It all depends on the individual’s anatomy, preferences and the surgeon’s opinion.

BREAST IMPLANT POSITION (POCKET PLACEMENT)

Pocket placement refers to where the implant will sit. This is defined as either:

Over the muscle implant positioning
Behind the muscle implant positioning

Sometimes, the implant is placed on top of the pectoral muscle. At other times, it is placed behind the muscle. However, it’s vital to understand that the implant is never entirely under the muscle. Approximately the lower third of the implant will sit below the muscle border.

UNDERSTANDING ‘BEHIND THE MUSCLE’ IMPLANT POSITIONING

One type of pocket placement below the muscle is the ‘dual plane technique’. This is a variant of the ‘under muscle technique’.
Once again, there are pros and cons to each technique. The most appropriate techniques for you will be discussed in detail with your surgeon during your initial consultation.

FAT TRANSFER BREAST AUGMENTATION

An alternative to Breast Implant surgery is Fat Transfer. Fat Transfer (aka Fat Grafting) involves transferring fat from another area of your body and injecting it into the breast. Although Dr Dona performs this procedure, he does not recommend it as a first choice. This is because only a small percentage of the fat receives enough blood supply to survive, and the body breaks down much of the fat. Predicting the size and symmetry with a Fat Transfer is difficult, so several follow-up procedures may be required to achieve your desired aesthetic result.

BREAST IMPLANT FREQUENTLY ASKED QUESTIONS

HOW LONG DO BREAST IMPLANTS LAST?

Potentially, your breast implants could last a lifetime — they can stay for as long as they continue to look and feel good. The common myth is that implants must be changed every 10 years, but this is not true. Implants do not have an expiry date.
However, your body (whether you have implants or not) will change over time. Factors such as gravity, weight fluctuations, lifestyle, breastfeeding, pregnancy, genetics and time cause body changes. These changes may affect the appearance of your implants, and you may decide to have further surgery to address any issues.
The size of your breasts, irrespective of whether there are implants or not, also has an impact on your breast shape. Larger-breasted women will have breasts that succumb to the effects of gravity more so than smaller-breasted women. Therefore, you must always wear a good, supportive bra as often as possible.

WILL MY BREAST IMPLANT SCARS BE VISIBLE?

With Implant surgery, there are three choices regarding the incision point. They can be underneath the armpit, around the areola or under the breastfold. While these decisions can produce scarring, the scarring becomes hardly noticeable over time.

DO I NEED TO HAVE GENERAL ANAESTHESIA FOR IMPLANT SURGERY?

When having Breast Implant Surgery, you will need to have general anaesthesia. However, you usually do not require an overnight hospital stay.

WHICH TYPE OF BREAST IMPLANT MATERIAL FEELS THE MOST NATURAL?

Dr Dona only uses silicone breast implants because they feel the most natural — and provide the best long-term results. These implants are made of an inert silicone gel suitable for long-term use in the body. Because it is a gel (and not water, like saline implants), it moves differently and feels more like actual breast tissue.

WHAT’S THE DIFFERENCE BETWEEN BREAST IMPLANTS AND BREAST AUGMENTATION?

Breast implants are medical devices inserted into your body during surgery. They come in a variety of shapes, sizes and materials. ‘Breast Augmentation’ is simply the name of the procedure to increase the size of the breasts

HOW LONG CAN BREAST IMPLANTS LAST?

Most implant manufacturers typically provide a lifespan of around 10 to 15 years, but this is just an estimate. Some individuals have had breast implants for over 20 years. However, it’s essential to understand that breast implants have no expiry date. Sometimes, physical changes occur in or around your implants, which may need breast revision surgery.
For example, the breast implant may move, there may be noticeable rippling or creasing of the implant, the individual may gain or lose a lot of weight, or the implant may rupture, which would typically warrant removal or replacement.

CAN YOU NURSE WITH BREAST IMPLANTS?

Breast Implant surgery — either above or below the muscle — does not affect your potential ability to breastfeed. However, there is one exception. If your implants were inserted via an incision along your areola edge, some of the milk ducts will be cut, which may reduce your potential to breastfeed.

DO BREAST IMPLANTS CAUSE BREAST CANCER?

Silicone implants do not cause breast cancer. They have been safely used for approximately 50 years, and extensive research shows that they do not increase the risk of breast cancer. However, a woman’s lifetime risk of developing breast cancer is approximately one in eight. This is why women must have regular breast cancer checkups dictated by their age and family history. These mammograms or ultrasounds are also an excellent way of checking to see if there are any implant ruptures.

BREAST IMPLANT COSTS

The cost of your Breast Implant surgery (Bilateral Augmentation Mammoplasty) depends on many factors. Therefore, we cannot quote a specific fee online. For example, your fee will depend on whether we are replacing old implants with new — or performing a Breast Lift at the same time. There will also be hospital and anaesthetist’s fees. All these issues will be discussed with you at length during your Initial Consultation. After your consultation, you’ll receive a detailed quote outlining Dr Dona’s fees, anaesthetic fees and hospital cost.

RECOVERY AFTER BREAST AUGMENTATION SURGERY

IMMEDIATELY AFTER SURGERY

Your Implant surgery will be completed under general anaesthesia within a couple of hours and typically will not require an overnight stay. When you wake from surgery, you’ll be wearing a post-surgical cotton bra. You are likely to feel sore, drowsy and possibly nauseous. However, these sensations will pass in a couple of hours — and you’ll be given strong medication to manage the pain.
The pain after Breast Augmentation surgery is often described as a tightness or heaviness across the chest. With most of his implant procedures, Dr Dona places the implants underneath the muscle, which can be slightly more painful than placement over the muscle. In his opinion, however, this placement provides much better long-term results.
You’ll need to arrange for someone to drive you home and stay with you overnight to care for you.
You’ll be sent home with a waterproof dressing, a surgical bra, antibiotics and pain medication. You’ll be encouraged to walk gently every hour — nothing strenuous, just light walking. For example, gentle, slow walks around the house are acceptable and encouraged. We do not recommend you lie in bed all day.
It’s important not to do anything strenuous and avoid lifting or moving your arms upwards. Keeping your elbows by your side is beneficial.
You may find that your implants appear high and tight. However, they will slowly settle and soften.

Showering

Showering is allowed the day after surgery. It’s okay to have water run over your dressings, but leave them intact and gently pat them dry afterwards. Do not submerge yourself in water, such as a bath or swimming pool, until three weeks after surgery. By then, you’ll no longer have any wound dressings, and your wounds should be dry and healing nicely.

Sleeping

You’ll find that sleeping on your back is the most comfortable position. Alternatively, you may find that sleeping in a reclining chair (or propping yourself up in bed with a couple of pillows) for the first couple of nights is more comfortable for you.
Put simply, there is no right or wrong sleep position after Implant surgery; listen to your body and sleep in the most comfortable position.

THE FIRST 10 DAYS POST-SURGERY

During your first week of recovery, the pain of Breast Augmentation Surgery is at its worst, peaking on the second or third day. Swelling and bruising are likely to increase throughout the week. Avoid all activities that engage the pectoral (chest) muscles, as these can be very painful. During this time, you’ll need help to perform many day-to-day activities.
Continue to take your prescribed pain relievers and anti-inflammatory medications as directed to alleviate any pain or discomfort.
During this time, you’ll see Dr Dona for a review, where your incision will be examined and dressings changed. Additionally, one of our caring nurses will administer (LED) Light Therapy Treatment, which helps reduce inflammation and optimise your recovery.
After a week, provided Dr Dona approves, you may gradually ease into daily activities. You can also perform some lower body exercises or light walking, provided that all activities keep tension away from the wound.
You can start driving one week after surgery, provided you feel comfortable doing so.
You can return to light office-based desk work after one week.

2 TO 3 WEEKS POST-SURGERY

After two weeks, you can start more vigorous cardio exercises such as walking on a treadmill or uphill. Your discomfort should be minimal at this point. Still, all labour-intensive jobs, activities, and exercises, like going to the gym, should be avoided.

4 TO 6 WEEKS POST-SURGERY

By four weeks post-surgery, you will not need pain medication. By six weeks, you’ll no longer have to wear a surgical bra. Most swelling would have gone, so you can now be fitted for new bras to wear daily. Everyday physical activities can also be resumed, provided there is no pain.

3 MONTHS POST-SURGERY

At the three-month mark, your breast tissue and pectoral (chest) muscles will slowly relax to loosen up and accommodate your implants comfortably. Your breasts will start to settle and soften. You should also be resuming most regular activities.

6 MONTHS POST-SURGERY

It takes a full six months for your breasts to settle and soften and for you to see the final result.
NB: Dr Dona will analyse you at each of the above milestones to see how you are healing. He will examine the incision, breast and scar tissue, ensuring that all are healing correctly. Your six-month appointment is where your results are critically assessed.

POTENTIAL RISKS AND COMPLICATIONS

Whenever someone is having a general anaesthetic, no matter what it’s for, things can potentially go wrong. That is why no surgery should be considered ‘minor’. While the chances of the following potential problems are minimal, you still need to be informed.

Anaesthetic issues – these can affect the heart and lungs or cause strokes.
Allergic reactions – these can be very mild to life-threatening.
Clots
Superficial vein clots – a complication of the cannula or drip placed in your vein.
Deep vein clots – these can potentially spread to the lung and be life-threatening. We take several precautions during and after surgery while you’re in hospital to minimise the risk of developing these.
Wound problems – such as infection and breakdown.
Bleeding – early or late.
Death – while the chances of this are exceedingly rare, any of the previous issues can result in this complication.

The above issues are standard for any operation. However, some operations and patients have an increased risk of developing them.

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