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Increasing your breast size

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Thinking about having a boob job? This month plastic surgeon Dr Kippen talks about the different choices and some of the decisions you will have to make before going under the knife.

There are many choices and options in breast augmentation. Careful planning to individualise the best options for you is very important. All methods have advantages and disadvantages and should be understand fully before making the decision to have breast surgery.
Breast implants will make your breasts larger, but the underlying shape of your breasts and chest will influence the final outcome – which could make your underlying shape even more pronounced after the surgery.

Silicone or saline implants

Most patients choose silicone implants rather than saline implants because they have a more natural look and feel. The main benefit of saline-filled implants is that if the implant ruptures, the breast “deflates” and the saline is absorbed by the body.

However, saline implants tend to wrinkle, which can be felt and sometimes seen. To avoid this, saline implants can be slightly overfilled, but this leads to a firmer breast and a more spherical appearance with increased fullness in the upper part.

Saline implants have a rupture rate of one to three per cent. If the implants rupture, you will require another operation to correct it. Modern silicone implants are very different from the silicone implants used in the 1970s and 80s.

The outer shell is now made from three layers of silicone and has a textured surface, reducing the chance of capsular contracture (hardening) of the implant. Modern cohesive silicone-gel implants contain a gel that is similar in consistency to jelly. This retains its shape and does not run like a liquid, as the old silicone gel did.

Another advantage of silicone implants is that they are made in a variety of round and tear-drop shapes, which means it is easier to choose an implant that will have the desired outcome you are looking for. Heights, widths and projection can all be varied.

Silicone implants do not increase the risk of the patient developing cancer, immunologic or neurological problems. This and breast-feeding will be fully discussed in next months article.

Other choices

Implants are placed either behind the breast tissue or under the muscle on the chest wall. Breast implants placed underneath the muscle have a lower chance of capsular contracture (hardening) and is easier for mammography. Those placed in front of the muscle, but under the breast, have greater projection.

There are also choices about where to make the incision: in the crease under the breast, under the areola, or in the armpit. All these have advantages and disadvantages which you should discuss with your plastic surgeon.

The surgery

Breast augmentation surgery takes between one and two hours and requires a general anaesthetic. It is usually performed as a day-stay or overnight-stay procedure. Following the surgery, it is important to have restricted light activities, with no lifting or heavy duties for 7 to 10 days. Most patients may drive again and return to work within 10 days after the surgery. Heavy activities and sport should not be undertaken for one month following the surgery.

Summary

Breast augmentation can enhance your appearance and your self-confidence, by enlarging your breast size, correcting differences in size, increasing projection, and making them more proportional with the rest of your body.

Always choose your plastic surgeon carefully. Make sure that they are a member of the Australian Society of Plastic Surgeons and have full surgical training. This is guaranteed by being Fellows of the Royal Australasian College of Surgeons, the only body recognised for training surgeons, and having the letters FRACS after their names.

Dr John Kippen is a practising plastic, cosmetic and reconstructive surgeon and a Member of the Australian Society of Plastic Surgeons. Dr Kippen has surgeries at Brookvale, Mona Vale and Castlecrag.

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