Are breast implants or augmentation surgery right for you?
- The right breast implants: innovation that works for your safety & appearance
- The safest & most reliable surgical technique (Rapid Recovery): minimise the risk of complications and infection
- The best position: sub glandular implants reduce complications and give a great long-term look
- State-of-the-art post operative aftercare: for confidence and peace of mind
The most common request from patients enquiring about breast implant surgery is to increase breast size. But there are many different aspects of the breast apart from size. These include shape, chest and breast dimensions, skin quality, nipple position, position of the breast crease or fold and the amount of breast tissues present which will cover the implant. Dr Konrat will review with you the various types of breast implants available and the different benefits and features of each type and style of implant. Every consultation is personalised to ensure the best outcome.
Dr Georgina Konrat
BSc BSc (Hons) MBBS FACCS Cosmetic Surgery Cosmetic Medicine
Information about breast augmentation, breast enlargement and breast implant surgery
Breast augmentation with MOTIVA implants, the lastest technology combined with expert, proven surgical techniques.
Make the right decision for your breast enlargement.
- The right implants: innovation that works for your safety and appearance
- The best position: reducing complications and giving a great long-term look
- The safest & most reliable surgical technique: minimising the risk of complications and infection
- State-of-the-art aftercare: for confidence and peace of mind
Is Breast Augmentation surgery right for you?
- Are your breasts smaller than you would like?
- Are your breasts asymmetrical (one larger than the other), or not quite the shape or size you would like them to be?
- Have your breasts lost their shape and fullness following pregnancy breast-feeding, or weight loss?
If you answered “Yes” to any of these questions, and you want to improve the way you feel about your body, you may be a candidate for breast enlargement surgery with breast implants. Breast enlargement not only increases the size of the breasts; it can also be used to address problems of shape to give a more natural form, or to help restore natural fullness lost due to breast-feeding or loss of weight.
It is critical that you are fully informed about this procedure: the information on this website has been written and is regularly updated by Dr Konrat. It was designed to provide as complete an informative experience as possible, but it does not take the place of a personal consultation.
You should never make a decision by reading a web page alone, no matter how comprehensive the information is. We encourage you to book a personal consultation with Dr Konrat, where she will assess you, explain the procedure in detail and help you to understand all the benefits as well as the risks and complications of surgery in general and breast surgery in particular. Your decision to have breast implants is a very personal one, and you must make it understanding both the potential benefits and risks. At the consultation, Dr Konrat will also fit you with a ‘sizer’ and sample implants to help you visualise your eventual ‘look’.
Choosing the Right Implants For You
What we do for you: At Brisbane Cosmetic Clinic, we do our research. Our preferred breast implants must meet our stringent criteria, and we’re constantly reviewing the market to make sure we use the very best. Dr Konrat believes that because every woman is different, it’s important for patients to have access to the widest possible range of implants. She has samples of all the available implants, all of which are officially approved by the TGA (Therapeutic Goods Association of Australia). Because individual requirements have such a strong impact on the choice of implant, Dr Konrat will conduct a thorough examination before recommending the best implant for your body shape, type and your desired result. This enables surgeon and patient together to choose the right implant for the best result.
Implant Surface: Smooth or Textured
- Smooth implants move freely in the surgical pocket and their shells are thinner. They can be inserted through a smaller incision, but there can be a problem with rippling, especially if a woman has a very thin upper body.
- Textured implants were originally designed to prevent Capsular Contracture (there is still some debate as to whether they achieve this). Overlying tissue grows towards the implant and ‘grabs’ the textured surface, to prevent the implant moving freely in the pocket.
Implant Shape: Round or Shaped/Anatomical or Tear-drop
- Shaped implants (sometimes called anatomical or ‘tear-drop’ implants) are fuller at the base than the top. This mimics the natural shape of a woman’s breast by providing more fullness in the bottom half of the breast whilst still ensuring that the whole breast has a full volume natural look.
- There can be specific technical reasons for using this type of implant, and Dr Konrat will discuss this fully with you at your consultation if you are a candidate for this type of implant.
Shaped implants can turn or flip in the pocket (surgical cavity), so they usually have a textured outer cover to help maintain their position.
- This describes how far the implant projects from the chest wall.
- Implants come in many profile styles. The reason why one implant profile style will be chosen over another will depend on your body shape (e.g., size and width of rib cage, how far apart your breasts are), the current shape and size of your breasts, and the final shape you want to achieve.
- Low profile is wider in its diameter and flatter in how far it projects from the chest.
- Moderate profile provides the most usual combination of width and height.
- High and Ultra-high profiles describe how far the implant makes your breasts ‘stick out’ in front. Rather like a hill that is narrow around the base but very steep and high. Compare that with a hill that takes a long time to walk around the base and has a very gentle slope and is not very high.
The latest breast implants technology can be found in the Silk Surface Nano TechnologyTM MOTIVA IMPLANTS;
- Motiva implants come in a wide variety of shapes and sizes, so we can ensure that you achieve the look you desire.
- Motiva implants’ Silk SurfaceTM Nano Techology is uniquely biocompatible, and has very low frictional properties. This means it’s unlikely to interact negatively with your body tissue to cause capsular contracture or other related problems.
- MOTIVA MonoBlocTM High Performance Shell has been specially developed to provide outstanding strength and elasticity. This is important to help protect your implant against the possibility of rupture, and also helps it feel most like a natural breast.
Choosing the right implant size and shape for you, for the rest of your life:
You have significant choices to make in order to achieve your best outcome from your breast enlargement surgery. You should establish clear goals for your breast implant surgery and be ready to discuss your desired size and shape with Dr Konrat.
- Implant sizes: These range from 120 to 900 grams. That’s a very wide range, and it’s important that you have a clear understanding of the result you want. What size do you want to be? Also, unless you’re prepared to undergo revision surgery in the future, are you choosing a size you’ll be happy with 5, 10 or more years in the future?
- Implant shapes: These are either round or ‘tear-drop’. Tear-drop shapes mimic the shape of natural breasts, but in the past, there has been a risk they will rotate. However, MOTIVA ErgonomixTM implants solve this problem by adapting their shape after implantation to give a very natural look. MOTIVA TrueTissue TechnologyTM combines a specially engineered covering (elastic elastomer) shell with a filling of ProgressiveGel UltimaTM to give the most natural breast implant yet seen.
- At your consultation, you will have the opportunity to test various sizes and shapes in a ‘sizer’ bra. However, it is a good idea to consider this question very carefully prior to your consultation. Remember that breast size looks most natural when it is in proportion with your overall body shape and size.
- The final implant size will also be influenced by factors which Dr Konrat will explain to you:
- The size and fullness of your breasts before surgery;
- The length of your body from shoulder to waist;
- The width of your chest;
- The shape of your chest;
- Your height without shoes.
- Apart from your choice of surgeon, the size of your implants is your most important personal decision, and you are welcome to visit our clinic for re-sizing as often as you need prior to your surgery. We believe it’s essential that you are comfortable with your choice. Remember that the most common reason women give for requesting implant replacement surgery is dissatisfaction with their size (either too small or too big). You can avoid this inconvenience and extra cost by choosing carefully and considering this from every possible angle.
Where to Place your Implants
Above or below the muscle? This is the big question!
There are three options for the placement of the implant:
- Sub-muscular – completely under the pectoralis muscle:
- This may give less interference with mammography examination of the breasts;
- It can result in less obvious implants in women with very little breast tissue, or who are very thin; however, with the choice of the right implants, even very thin women can have their breast implants placed under the breast tissue (sub-glandular) with success;
- Tensing the chest muscles can pull across the top of the implants causing a visible change in the shape of the breasts, particularly when exercising the upper body;
- Weight gain or loss, or breast changes associated with pregnancy or breast-feeding may lead to ‘sagging’ of the breast tissue over the implants, causing a ‘snoopy’ effect.
- To insert the implants below the muscle, the surgeon must cut a powerful muscle that’s needed every time you move your arms and parts of your body. When it’s cut, part of the muscle bleeds then dies. It contracts, forms scar tissue, and eventually can cause a range of complications:
- Muscular animation defects usually occur when implants are placed under the muscle. This happens because the muscle pushes against the implant, and the original breast tissue become visible. (Picture)
- Snoopy or Waterfall Effect can occur when the original breast tissue drops with age, and the implant remains in its original position behind the muscle. (Picture)
High Riding Implants leave their position behind the muscle and breast tissue, and migrate further up the chest towards the shoulder. (Picture)
- Partially sub-muscular (Dual Plane) – a combination of sub-muscular and sub-glandular for specific circumstances. Dr Konrat will discuss this in detail at your consultation if it is a viable option for you.
Sub-glandular – on top of the Pectoralis muscle, but under the breast tissue: THIS IS DR KONRAT’S PREFERRED IMPLANT PLACEMENT POSITION
- This provides the most distinct cleavage line, with the fall and drape of the breast likely to appear more natural in most women;
- In some very thin women there may be a risk of ‘rippling’ with sub-glandular placement, but this can usually be avoided with the right choice of implants and the most recent advances with Autologous Fat harvesting and grafting to the thinnest areas of the chest and breasts.
- Sub-glandular may make surgery and recovery times shorter; it is definitely much less painful (because there is no need to cut through the muscle), and it may be easier for access if re-operation is ever required.
- More importantly, the subglandular or “on top of the muscle” approach eliminates the risk of “snoopy”, “waterfall effect”, animation defect, high-riding breast implants and muscle necrosis and scar formation.
- When breast implants are placed above the muscle and just beneath the breast tissue, none of the complications described above occur.
- If you are more mature, have very little breast tissue, or are very lean, you might be told that “under the breast” implants will be too visible, and could cause rippling. However, using the latest technology in breast implants, these concerns are dramatically reduced.
- This means that women, regardless of age or size, can have soft, natural, mobile “under the breast” implants with minimal risk of any of the above complications. In some circumstances, Dr Konrat can combine breast implants with the use of Fat Harvesting and Grafting, as this can add a little more fullness to your own breast tissue. She can discuss this with you at your consultation.
Safe, reliable surgical techniques minimise the risk of complications and infection
We now know that bacterial biofilm poses a significant threat to implanted medical devices, such as breast implants. Chronic infections occur when bacteria grow in a slime-enclosed ‘biofilm’. They can be life-threatening and almost impossible to eradicate.
Dr Konrat uses the Keller FunnelTM method of inserting the implant into the pocket. This allows for the implantation of the breast implant via a ‘no-touch’ technique. It delivers the implant into the surgical pocket with less friction and also helps to minimise the risk of infection. The incision size and the resulting scar are smaller.
Many surgeons today have adopted the “14 Point Plan” designed to help avoid the development of bacterial biofilm during breast implant surgery. Dr Konrat uses this plan for every surgery. You can read details of this plan here.
THE 14 POINT PLAN
- Use intravenous antibiotic prophylaxis at the time of anaesthetic induction
- Avoid peri-areolar incisions
- Use nipple shields to prevent spillage of bacteria into the pocket
- Perform careful atraumatic dissection to minimize devascularised tissue
- Perform careful hemostasis.
- Avoid dissection into the breast parenchyma. The use of a dual-plane, subfascial pocket has anatomic advantages
- Use a dual-plane pocket
- Perform pocket irrigation with correct proven triple antibiotic solution or betadine
- Minimise skin-implant contamination
- Minimise the time of implant opening, reposition and replacement of implant
- Change surgical gloves prior to handling the implant. Use clean or new instruments that were not used in the pocket dissection
- Avoid using a drainage tune, where possible
- Use a layered closure
- Use antibiotic prophylaxis to cover subsequent dental or surgical procedures that produce bacteremia, and have lifelong follow-up
State-of-the-art aftercare: for confidence and peace of mind
At Brisbane Cosmetic Clinic, your safety is our Number 1 priority. Your breast implant surgery is just the beginning of your journey. Here’s how we’re involved in your post-surgery journey to full recovery and enjoyment of your enhanced breasts:
- Day 1 after surgery: you will receive a call from our Registered Nurse, who will review your progress, answer any questions, and ensure your recovery is fully normal.
- You will be provided with a Post-Operative instruction sheet, which will list the symptoms that should be reported immediately. Should you experience any of these symptoms after normal hours, there will be an emergency number you may call.
- You may call Brisbane Cosmetic Clinic during normal business hours if you experience worrying symptoms. These are very rare, but occasionally may occur.
- Day 7 after surgery: you will attend the Clinic for your first post-operative check-up.
- Your Post-Operative instructions will also offer a list of simple care and lifestyle recommendations to maximize your outcome.
- You will also have check-ups scheduled at three and six months after your surgery.
- If, after the swelling has resolved, you decide your implants are too big or too small, you may decide you want to have the implants replaced with a larger or smaller size.
- The cost of replacement will be similar to that of the original surgery.
Patient journey for breast enlargement / breast implant surgery
A consultation (approximately one hour long) with Dr Georgina Konrat will include a comprehensive presentation of information about breast augmentation / breast enlargement surgery. She will listen carefully to your description of your reasons for wanting breast implants, and the results you want to achieve.
- A consultation (approximately one hour long) with Dr Georgina Konrat will include a comprehensive presentation of information about breast augmentation / breast enlargement surgery. She will listen carefully to your description of your reasons for wanting breast implants, and the results you want to achieve.
- Dr Konrat will ask important questions about you and your health (your medical history).
- Dr Konrat will examine your breasts, noting their size and shape, the quality of your skin and other physical details necessary to assist in the planning of your breast implant surgery.
- You will have the opportunity to have fun planning your post-surgery ‘look’ by putting on a special elastic bra (a ‘sizer’), and different sizes and styles of implants will be tried on to assess the style, size and shape that will achieve your ideals.
- You will be given an information kit to take home. We understand that you may not remember or understand everything you hear in the consultation, so we encourage you to make notes as soon as possible after the consultation, and call or email the clinic with any concerns or questions you may have about the surgery.
- At least one week prior to surgery, blood tests will be taken and pre-operative mammogram screening is recommended.
- In order to have the best healing result, Brisbane Cosmetic Clinic recommends:
- Eat a diet rich in vegetables, fish, fruit and salads;
- Commence taking Vitamin C and D, Zinc and Selenium.
- Do not take aspirin or anti-inflammatory drugs ten days before and ten days after your operation. These medicines can thin your blood and aggravate bruising or bleeding.
- You must discuss any use of ‘leisure drugs’ with Dr Konrat at the time of your consultation, as these could also have an impact on the success of the surgery.
- If you smoke, you must cease for at least two weeks before and one month after your surgery.
- Pre-operative and post-operative instructions are provided in the brochure given at the time of the pre-operative appointment, or are sent to you once you have booked a date for your surgery.
- Brisbane Cosmetic Clinic staff are pleased to answer any questions after your consultation, and you are encouraged to return for a second consultation or ‘sizing’ any time you feel it would be useful.
- Breast Implant surgery is done in an accredited and licensed Day Surgery Hospital under general anæsthetic.
- The procedure usually takes between one and two hours.
- Dr Konrat makes an incision in the agreed spot, elevates the breast tissues, surgically creating a pocket or space into which the implant of choice is placed. There are four options. At your consultation Dr Konrat will advise which incision choice will be right for you and discuss her reasons for her advice.
- Infra-mammary fold (crease under the breast): this is Dr Konrat’s preferred incision as it hides the scar well. It also provides the easiest and safest approach for the surgeon and is the one most commonly used. Experience has proved that the lowest rate of complications is associated with this type of access.
- Peri-aerolar (around the pigmented or coloured area of the nipple): this leaves a very thin scar on the edge of the nipple, which is always visible. The biggest risk of this type of incision is loss of sensation in the nipple.
- Axillae (underarm): This is most often used when the implant is placed under the muscle, but it can be used for over the muscle implants as well. There is an increased risk of asymmetrical placement of the implants and riding or descending of the implants, as well as an obvious scar under the arm.
- Through the Navel: Due to the risks and complications involved and the need for the use of saline-filled implants, Dr Konrat does not use this approach.
- The coverings of the pocket are then closed with stitches and the skin stitched or sutured closed. The wound is covered with a small surgical dressing, which is left in place until your post-operative appointment.
- A complete list of instructions will be given to you prior to your surgery. You will also be able to read about the post-operative period in the information brochure given to you at your first consultation.
- After a short recovery period, usually about two hours, you can go home. You must have a relative or friend drive you home from the hospital and you should under no circumstance take public transport. Be prepared to rest in bed for two hours after you get home, and it is best that you are not alone at home for the first 24 hours after surgery.
- You are likely to feel drowsy or even sleepy after the anæsthetic, but apart from this, if you feel fine, you can expect to be able to undertake normal light activity around the home on the evening of your surgery. You should eat lightly and drink to replenish your body fluids.
- You will be sent home with two small surgical tapes (like Band-Aids) over the stitches. They will remain in place until you return one week later for the removal of the stitches (which is not painful). During this week, you are able to shower, but not bath or swim. After showering, you should pat the tapes dry with a towel. After the stitches are removed, you will be given special tapes to apply to your scars for the next six weeks.
- There are usually no drains or bandages, but patients will have a special support bra, which will be worn for the first six weeks.
- If the implants are placed above the muscle, there is only moderate discomfort after the surgery, which is treated very well with over-the-counter pain relief medications. Mild pain relief medication is usually taken for the first two or three days.There is some swelling and occasionally some bruising immediately after the surgery.
- You do not need to sleep sitting up or lying on your back. Right from the first night, you are encouraged to sleep naturally, turning from side to side as normal. This helps the lymphatic system and veins drain away any swelling and bruising.
- Although you will recover within 24 hours, your breast surgery will take about six weeks to heal. By that time, swelling and bruising should have subsided completely, and your skin and breast tissues will have changed to accommodate your now larger breasts.
- New surgical tape will be placed over the scar and you will change the surgical tape over the wound once a week, each week for 6 weeks. This assists with healing and gives the best chance of the scar healing well.
- You will have post-operative checkups with Dr Konrat at one week, six weeks, 6 months.
What you should know about breast augmentation / breast implant surgery
What it is:
- Capsular Contracture is the most common complication of breast augmentation surgery.
- The result of capsular contracture is breast firmness. As the body heals after the placement of breast implants, it is normal to form a coating or lining of scar tissue (the ‘capsule’) around the implant, which strengthens and shrinks over the first three months post-surgery. In most cases, the pocket containing the implant remains open and roomy, allowing the implant to sit and move normally. In some people, however, this normal capsule will tighten and squeeze the implant. This makes the breast feel very hard and can distort its appearance to take on a ‘ball-like’ look.
- This can occur at any time, but seems to be more common in the first six months after surgery.
- It may occur on one or both sides, or not at all. The degree or severity of tightening might also be different on one side compared to the other.
- Although both breasts never match exactly, varying degrees of capsular contracture may mean that differences between the two breasts may be more noticeable. This is sometimes able to be corrected, but may not be possible.
Possible Causes of Capsular Contracture (these are still very unclear, but the following are thought to put patients at higher risk):
- Infection or transient germ (bacterial) contamination. This could be a result of invasive dental cleaning or dental procedures, urinary tract infections, a previous history of mastitis, wound infection, or Streptococcal throat infection, to name a few. At Brisbane Cosmetic Clinic, it is our policy to prescribe antibiotics for the first week post-op to minimise the chances of infection.
- Seroma: a collection of fluid that sometimes occurs following surgery. This is normal when in small amounts. The body normally produces fluid when it has been injured and is now healing. It only becomes a problem if you produce a large amount of fluid. This fluid is able to be easily drained and may require drainage a number of times before it settles and heals normally.
- Hæmatoma: a collection of blood or large bruises around the healing breast implant pocket. This can cause an inflammatory reaction. This is very rarely a problem, but if a large bruise occurs and there is a collection of blood larger than the size of the implant, then this may need drainage, which will require another visit to operating theatre.
- Smoking decreases the oxygen levels in the blood, which results in delayed healing, and possibly an inflammatory reaction. Brisbane Cosmetic Clinic recommends that, at the very least, you should not smoke for two weeks prior to, and one month after surgery.
Levels of Capsular Contracture (The Baker Grading System identifies four grades of Capsular Contraction):
- Baker Grade 1: Anyone with breast implants will have this level, since there is always capsule formation around an implant. The breast is normally soft, and looks natural.
- Baker Grade 2: The breast is a little firm, but appears natural.
- Baker Grade 3: The breast is firm and is beginning to appear distorted in shape.
- Baker Grade 4: The breast is hard, and has become quite distorted in shape. Pain or discomfort may be associated with this level of Capsular Contracture.
Treatment of Capsular Contracture
- Medical Treatment
- Consult your doctor immediately you notice any firming of your breast. Intervention at this stage could slow or even halt the progress of Capsular Contracture. In particular, investigations for the presence of low-grade infection, signs of trauma, integrity of the implant is of special importance.
- At Brisbane Cosmetic Clinic, we encourage our patients to assist the healing process by adopting a diet with a high nutrient density, and in addition, to take nutritional supplements such as anti-oxidants, Vitamins C and E, Omega Fatty Acids, Zinc and Selenium for at least two weeks prior to surgery.
- Surgical Treatment: Open Capsulotomy/Capsulectomy
- This is the most successful treatment for Capsular Contracture.
- The surgeon opens the existing pocket, removes the implant and either, completely removes the scar tissue, or releases the scar tissue formation in the fibrous capsule surrounding the breast implants. If implant replacement is desired, then new breast implants will be inserted into the pockets. It is thought that patients susceptible to developing capsular contracture have an increased risk of developing capsular contracture again.
- A general anæsthetic or Twilight anæsthetic is required for this procedure.
- Studies to date consistently conclude that breast implants are not associated with increased rates of breast cancer. There is, of course, ongoing research in this area, as these studies require many years of follow-up time to be fully conclusive. Women with breast implants should follow the same breast-screening guidelines as women without implants.
- BIA – ALCL: This is a very rare type of immune cancer and only occurs in patients who have either textured or polyurethane foam (“super furry Brazilians”) implants. Patients notice they have a very large swelling. The fluid from the swelling can be tested and, if positive, the breast implants are removed, along with the fibrous coating “capsule” around the implant. For more detailed information, click on the link and ask Dr Konrat about this at your consultation: https://www.tga.gov.au/alert/breast-implants.
- Calcium deposits can form in the fibrous capsule tissue surrounding the implant and may cause pain and firmness.
- It is possible that calcifications may interfere with mammography, as these deposits need to be differentiated from calcium deposits that are a sign of breast cancer.
Changes in Nipple and Skin Sensation
- Some change in nipple sensation immediately after surgery is not unusual.
- After several months, most patients have normal or near normal sensation.
- Occasionally, partial or permanent loss of nipple and skin sensation or hypersensitivity may occur in one or both breasts.
- Changes in sensation may affect sexual response or the ability to feed a baby.
Risks Associated with Larger Implants
Many surgeons agree that a larger breast implant may carry an increased risk of complications. Some of these risks include:
- Decreased nipple sensation
- Abnormal nipple position (too high or too low)
- Displacement of the breast shape medially or laterally (too close together or too far apart)
- Excessive ptosis (droop) over time
- Internal scarring (Capsular Contracture)
- Skin changes such as thinning, the extreme situation being skin loss and exposed implant requiring implant removal.
- Please refer back to ‘Choosing the Right Implant Size For You’ .
Wound Healing Problems or Tissue Necrosis
- Tissue Necrosis, or tissue breakdown, is the development of dead tissue around the implant. It will delay wound healing, may cause wound infection and may require surgical correction and/or implant removal.
- Some patients experience delayed healing, either of the surgical pocket in which the implant is placed, or of the incision itself, which may open from injury or infection. This can result in an unattractive scar or breast tissue loss.
- If the implant is exposed, further surgery will be required.
- Tissue Necrosis or tissue breakdown has been reported following the use of steroid drugs, chemotherapy, radiation to breast tissue, smoking, or excessive heat or cold therapy. Occasionally, it can occur without any identifiable cause, but this is very rare.
Visible Skin Wrinkling and Rippling
- This can occur when an implant pulls on the overlying tissues, or when the natural folds in the implant are visible through the skin due to certain movements.
- Choosing the correct implant for your particular body characteristics can significantly reduce the risk of visible rippling. Dr Konrat will provide very specific advice for your needs.
- This is an exceedingly rare complication.
- If the skin or the breast tissue covering the implant is very thin and/or there is a problem with healing, the implant may break through the skin and become exposed.
- This will require the removal of the implant, as surgery to correct this condition can result in unacceptable scarring or breast tissue loss.
Chest Wall Deformity
- This is an extremely rare complication.
- The chest wall or underlying rib cage may appear deformed upon removal of implants.
- Chest wall deformity has been reported following the use of tissue expanders in conjunction with breast implants.
- The consequence of chest wall deformity is of unknown significance, but is not believed to produce any known health consequences.
- Occasionally a breast implant may rotate or shift position after initial placement.
- This may cause discomfort and/or distortion in breast shape, and additional surgery may be required to correct this condition.
- Excessive sagging or stretching of the lower breast tissue may result in an implant that appears too low, or causes the nipple to point excessively upwards. This is sometimes called ‘bottoming out’.
- The implants can also shift toward the side, widening the apparent gap between the breasts.
- Contracture or tightening of the lower implant pocket may cause an upward displacement of the implant.
- Most women’s breasts have at least some asymmetry. Significant asymmetry can be addressed by using implants of slightly different sizes.
- It is important to be aware that while this can result in an improvement in size difference, it could accentuate differences in nipple-areola angle and position.
- There is no way of accurately measuring breast size, apart from visually, so it is difficult to determine the difference in volume of an implant to correct size differences.
- This phenomenon most often occurs when breast implants are placed underneath the pectoralis muscle. (Dr Konrat does not place implants under the pectoralis muscle.)
- It may not be noticeable in the first months or even years after surgery, but as the breast tissue and overlying skin stretches, for example, with pregnancy, breast-feeding or weight gain, the natural breast tissue can tend to ‘fall’ over the underlying implant.
- The effect can be magnified by placement of the breast implants under the muscle in women who already have a ptosis or an element of sag or droop.
- The implant remains firmly placed beneath the muscle, while the breast tissue and overlying skin fall further with age.
- This can only be corrected by removing the implants and replacing them sub-glandular (above the muscle).
- Infection following breast surgery is very unusual and statistically unlikely. If, however, it does occur, it is taken very seriously indeed, as infection around a breast implant is more difficult to treat than in normal body tissues. For this reason, Dr Konrat believes in taking a strongly preventative attitude to infection. Her directives regarding pre-operation health, and the post-operative course of antibiotics are designed to minimise still further the likelihood of any infection, and as a consequence, the possibility of capsular contraction.
- If, however, a diagnosis of a whole breast pocket infection is made, it is rare that further antibiotics alone will resolve the situation. If the infection does not respond to antibiotics, the implants may have to be removed. In this situation, the patient will need to remain on antibiotics for up to three months to ensure complete resolution of the initial infection. Once the infection is completely cleared up, new breast implants can usually be inserted several months later. Additional costs will be incurred in this situation.
- Hæmatoma is a collection of blood that may occur around a breast implant following surgery. Due to the Rapid Recovery Technique used by Dr Konrat, she has not had a haematoma in 10 years. It is thought to occur in 2-4% of breast implant procedures. It will usually require a general anæsthetic and additional surgery to remove the hæmatoma and stop the bleeding. Commonly a Day Surgery fee and an Anesthetist’s fee will be charged, but there are no further surgical fees charged. Dr Konrat does not charge a surgical fee for revision surgery to correct an immediate post-operative complication.
- Hæmatoma may contribute to capsular contracture and infection.
- Aspirin, and most other anti-inflammatory medications, should not be taken for ten days before and after surgery, as their use may increase the risk of bleeding. Dr Konrat also prefers that you do not take any non-prescription ‘herbal’ remedies or dietary supplements prior to surgery, as these may increase the risk of surgical bleeding.
- After a few weeks, the risk of an early problem with bleeding is low. However, hæmatoma can occur at any time following an injury to the breast. If one or both breasts seem to increase in size quickly, this may be caused by hæmatoma. This rapid swelling is often associated with bruising and discomfort.
- Seroma is the accumulation of fluid, in this case, around the implant, following surgery, trauma or vigorous exercise. Additional treatment may be necessary to drain the fluid accumulation.
- A seroma may contribute to infection, capsular contracture, and importantly should be sent to the laboratory for investigation to exclude BIA-ALCL.
- If one or both breasts increase in size over time, or if it seems that there is fluid around the implant, this may indicate a seroma, and you should consult your doctor.
- A significant number of women without implants experience breast pain at least once per month.
- Pain may develop or persist after breast implant surgery. Some women who did not have pain prior to surgery may have persistent pain after surgery.
- These pain symptoms are unpredictable and in some patients no cause can be found.
Mammography/ Breast Ultrasound
- Women with breast implants should have mammograms or ultrasounds as they normally would do for breast screening. You should inform the personnel that you have breast implants.
- The presence of breast implants may make screening mammography more difficult, as implants can partially block the ability to see all areas of the breast during a mammogram, thus possibly hiding disease.
- To ensure the most complete result from the mammogram, additional mammography views will be taken.
- Breast compression, which is part of the mammogram procedure, presents a risk of rupture of the scar around the implant or rupture of the implant itself, although this is rare. When it does occur, it is usually related to having a very firm internal scar, or capsule, around the implant. However, this risk should not keep you from obtaining a mammogram when your doctor indicates this is appropriate.
- Ultrasound of the breast may be performed to aid in screening for breast cancer.
Risk to Offspring
The presence of a breast implant will have no effect on your ability to become pregnant, deliver a baby, or even breastfeed. Breast implants have not been shown to have an effect on children.
Risk of Breastfeeding
- Breast implants should not prevent you from breast-feeding.
- Choice of incision location could have an effect on your ability to breast-feed: an incision around the nipple could, theoretically, interfere with the breast ducts. While this is not necessarily the case, if you believe you may wish to breast-feed in the future, you should mention this to Dr Konrat when planning your surgery.
Breast and Nipple Piercing Procedures
- If you are thinking of having any body piercing to your breast region after having breast implants, you should consider the possibility that an infection could develop any time following this procedure.
- If an infection does occur, it is possible it could spread to the breast implant pocket.
- If this occurs, treatment, including antibiotics, possible removal of the implant or other surgery may be necessary. In this case, additional costs would be incurred.
- A breast infection with the presence of an implant is harder to treat than an infection in normal body tissues. If an infection does not respond to antibiotics, the breast implant may need to be removed.
GENERAL RISKS OF SURGERY
Because surgery is such a vital part of modern medicine, there is a tendency to forget that there are risks associated with every type of surgery. While these risks are small, every person undergoing surgery should be aware of the risks.
All internal and external wounds need time to heal after surgery. Sutures and other material are used to hold wounds closed while they heal. For specific discussion possible complications with regard to breast surgery, click here
Despite taking precautions, infections can occur during and just after surgery. These may be general, such as pneumonia, or specific to breast surgery. For a discussion of infection risks regarding breast surgery, click here. Because of their generally good health, breast implant patients usually have a lower risk of developing general infections such as pneumonia.
- Patients have a risk of forming a blood clot in the leg (deep vein thrombosis) that breaks off and gets stuck in the lung circulation (pulmonary embolism). This is minimised by the wearing of surgical ‘stockings’ during the surgery, and by getting the patient out of bed as soon as possible.
- You will also be encouraged to breathe deeply when you wake up from the anæsthetic, as this expands your lungs and helps ensure your blood oxygen levels are good.
Risks of Anæsthesia
As a rule, these risks are very low in cosmetic surgery patients, because the patients are generally in good health. Dr Konrat will take a full medical history, will order a number of tests prior to surgery and will make lifestyle recommendations to ensure your health is optimal before the surgery. This will minimise any general risks.
Mental Health disorders and Elective Surgery
- It is important that all patients seeking to undergo elective surgery have realistic expectations that focus on improvement rather than perfection.
- Complications or less than satisfactory results are sometimes unavoidable, may require additional surgery, and can be stressful.
- Please discuss openly with Dr Konrat in your consultation prior to surgery, any history of emotional depression or mental health disorders. If you are unsure whether a matter is relevant, please mention it anyway. Although many individuals may benefit psychologically from the results of elective cosmetic surgery, the effects on mental health can never be predicted and could possibly have a negative influence on emotional stability.
Breast Augmentation & Breast Implants
$ price upon consultation *
You will be provided with an accurate quote during your consultation, so you can be assured that you will be receiving a treatment specifically tailored to your individual needs. Our consultation with you, is the groundwork we do to ensure that you can put your trust in us. We try at all times to keep all our procedures within an acceptable and ethical cost estimate allowing patients the opportunity to make personal life changes they need or desire.
Not sure where to start? Let us help you.
We would love to help you explore your options and realise your vision, so please get in touch and we'll be more than happy to assist you.
Call us on 07 3391 5710 or request a callback using the form below.
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