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Learn the breast implant basics

Dr John Kippen

Eighty five percent of women have unequal breasts. This may be in size, shape or contour and may involve the nipple, areolar or breast. Often the chest wall is different between the sides so the base on which breasts sit may be different. Breast should be considered sisters not twins. They are unlikely to ever be exactly equal. 

Size preferences are often determined by geography and age. In general, the average size of implants are bigger on the Gold Coast than in Sydney. Also, women who are a bit older, completed. The most common size request is a C cup.
A bra’s cup size should never be used to predict breast size. A bra manufactured in the US that is labelled as an A may be the same size as a bra cup manufactured in Asia and labelled as a C cup. Implant volumes should be considered by volume in ml or ccs. It is a ‘look’ rather than a numerical size. Breast, shoulder, waist, hip and chest characteristics vary and mean that 300ml in one person looks very different to 300ml in another. A common request is “My friend had 300ml so I want 300ml and to look like her”. The final look is a combination of the characteristics above and influenced by existing breast volume.

Perceived size is also influenced by clothing. Breast size looks different in vertical stripes, horizontal stripes, loose or fitted clothing, swimmers and casual or activewear. When deciding on a size, it is important to wear a variety of different clothing to assess the size more carefully.
There are various sites of incision. Common sites include the infra-mammary fold (where the lower breast meets the chest wall), peri-areolar (around the nipple) and trans-axillary (through the armpit). Each of these sites have advantages and disadvantages and it is best to discuss this carefully with your plastic and reconstructive surgeon.

An important fact that is often overlooked is all implanted medical devices, including breast implants, have a limited life. In general, the stated average lifespan of breast implants is 10 years. That may sound like a long time, but that is an average, which means half the women will require an operation before 10 years. A woman living in Australia’s life expectancy is about 80 years, which means having implants at 20 years of age may imply a number of subsequent surgeries. 

The most common reason for replacement of implants is capsule contracture. A capsule is the normal scar tissue placed around any implanted device. Over time, this scar may shorten and contract - leading to firmness, visible distortion and even pain or discomfort.

Any surgery should be carefully considered. Benefits should outweigh the risks. Careful consideration should be given to choosing your size, shape, site of incision and implant placement. Choose your surgeon carefully and ensure they are fully trained plastic and reconstructive surgeons.

By Dr John Kippen

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