Breast Implants – What you need to Know for Sydney Cosmetic Surgery Patients.

Breast Augmentation or Breast Enlargement is the most frequently performed Cosmetic surgery on women in Australia and the U.S. today. Over 300,000 women undergo breast augmentation every year, with the popularity of the procedure ever increasing, especially amongst female body builders.

Breast implants are most commonly used as an aesthetic enhancement in an individual who is lacking in natural breast tissue due to genetically predisposition or environmentally induced factors. Because breast tissue is primarily composed of fat cells, physicians in the past have attempted to inject fat (obtained through liposuction) into the breast. However, today, this is completely unacceptable due to calcification (complete hardening of the breast). Hormonal therapy may increase the natural breast size, slightly, but not enough for the majority of women.

Currently, the most common procedure to increase breast size is via breast implants. A breast implant is a sac of silicone elastomer that is either filled with saline or silicone, and is surgically implanted under the breast tissue. The proportion of the breast to body height and weight is taken into consideration, as is the chest width, location of nipple/areola complex, and cleavage. Because the concepts of aesthetics are constantly changing, there are many factors such as implant type, size, and site that should be tailored to the individuals’ specificity.

TYPE OF BREAST IMPLANT (Saline or Silicone ):
Silicone vs. saline? This discussion is going to remain for many years. The advantage of silicone implants is that it is softer and appears more natural. However, leaks may be found in secondary tissue. Generally, saline is a bit firmer, but it is without the supposed health risks because a leak is simply absorbed by the body. The decision should be made after consultation with an experienced Cosmetic surgeon.

The breast implant can be placed either under the pectoralis major muscle (sub muscular) or on top of the muscle and under the breast glands (sub glandular). Sub muscular implants are more popular because they are less palpable, have lower risk of capsular contracture, and do not inhibit mammography. However, it requires more invasive surgery and longer healing time. Bodybuilders prefer sub-glandular insertion because the heavily developed pectoralis muscle might flatten the implant and there will be less projection of the breast. Women with sagging or drooping breasts may opt for a sub glandular placement to utilise the increased projection. Disadvantages of sub glandular implants include impairment of adequate mammography and an increased risk of capsular contraction.

There are four areas of incision:

1. Periareolar (lower part of areola 1-1/2 inches)

2. Inframammary (on the lower breast crease)

3. Axillary (armpits)

4. Transumbilical (from the bellybutton)

Each has advantages and disadvantages but the preferred incision is Inframammary because it is less noticeable. Arguments against the other approaches are that they are harder to perform; there is decreased sensation of the areola and violation of the breast tissue when approached via the Periareolar technique, there is increased risk of rupture, Infection and Capsular contracture with these other techniques.

Most surgeons have experience with teardrop (natural implants) and with the round implants. Preference is toward the round implant because it appears more natural. Previously, there were high profile implants (which projected more) and low profile implants (less projection). Recently, medium profile implants were introduced.

There is no expiration date for implants. You should be checked by your Cosmetic Surgeon if there are any symptoms or changes that are not expected including deflation, infection, change of location, etc. Mammography, ultrasound, or MRI should be performed if any of these symptoms or signs occurs. Patients over the age of 50 years of age should have their standard Breast checks. Typically many women will consider replacing their Implants or having revisional surgery for breast changes that have occurred by 10-12 years; such as breast droop or a change in Implant size.

RISKS (not common but possible):
1. Capsular contraction: Scar tissue forms around the implant to form a hard shell. There are several steps to prevent it, such as, size and location of the implant.


3. Shifting (moving) of the implant. The pocket for the implant should be adjusted for the patient (this will usually, prevent shifting).

4. Scars: Less conspicuous in the Inframammary incision.

5. Sensation: May be initially decreased. Usually 90% of sensation will return within 1-2 years of surgery.

6. Breast Feeding: About 50% of women won’t be able to successfully breast feed, particularly those with Periareolar incision.

7. Synmastia (also known as “kissing breast”), sometimes related to technique.

In general complications occur less when using an experienced and certified Cosmetic surgeon.

Cosmetic Surgery is an art form in combination with science. Each patient and surgeon has a different sense of what is aesthetically pleasing (although the basics are common). During a consultation with a Cosmetic Surgeon, the goals of both the patient and surgeon should coincide and be realistic. The results are not entirely dependent on the surgeon. It is important to understand that everybody starts with differing anatomical breasts (some patients are better candidates than others) and there are always unforeseen factors.

Dr. Bobby A Kumar is a board certified cosmetic surgeon and is experienced in Breast Augmentation surgery. He has used all types of Breast Implants and is skilled in choosing the appropriate Implant to provide the optimal and aesthetically pleasing result for each patient and therefore does not prescribe to the “one size fits all” approach.

Interested in the next step?
Please get in touch to arrange an appointment
Contact us