One of the most significant components of the female self-image, in addition to softer features and curves, is the shape and projection of the breasts. The appearance of cleavage in a formal dress or swimwear is very important to many if not all women. If you are considering breast augmentation, it is likely that you have been thinking about this for some time and may even have sought some advice. This is indeed the best way to approach any elective procedure. It is in equal parts a personal journey of self-discovery and a search for the options that suit your needs best. This may be appropriately addressed with breast augmentation surgery.
Breast augmentation is one of Dr Farhadieh’s areas of special interest and expertise. He brings excellence in surgical art, and uses techniques that are grounded in the best up to date scientific knowledge and experience. As an internationally recognized plastic surgeon he has both provided invited expert commentary for international plastic surgery journals as well as authored a chapter on this topic in an international plastic surgery textbook: Plastic and Reconstructive Surgery: Approaches and Techniques.
Breast augmentation is the most common aesthetic surgery procedure undertaken in the Western world. The population of women seeking breast augmentation is broad. The procedure may be used to:
- augment the natural projection of the breasts;
- accentuate contours;
- help restore loss of breast volume and/or correct sagging following breastfeeding, weight loss or advancing age; or
- help correct a noticeable asymmetry in shape and size of the breasts.
Breast augmentation involves placing implants on the chest wall behind the breast tissues. Depending on your body habitus, appearance and needs, the implants may be placed behind the breast gland and in front of the pectoralis major muscle (one of the main muscles that covers the front of the chest wall). Alternatively, they may be placed under a variable amount of the pectoralis major muscle.
Implants are traditionally classified according to the materials used for their outer shell and the filling content. The outer shell is made of silicone and may be smooth or textured. More recently, a polyurethane coating has been reintroduced in the hope of reducing the risk of capsular contracture. Some of the initial results are encouraging, but long-term study results are needed to confirm these. For the filling content, materials used are either silicone, which comes in multiple forms and yields different consistencies (softer versus more form stable), or saline.
The shape of the implants differs as well. Historically, implants were round and symmetrical in shape. More recently, ‘tear-dropped’ or ‘anatomical’ implants have been designed, which accentuate the lower breast pole once inserted, giving a more natural appearance. The breast implants we use are of the highest quality and come with a lifetime guarantee supplied by the manufacturer.
Many operative approaches have been described for the placement of breast implants. Axillary incisions in the armpit are best suited to saline implants; periareolar (around the nipple) and inframammary (below the breast) incisions are the main access incisions for silicone implants. Although in theory different surgical schools of thought offer support for each of their preferred techniques, more recent results from pooled studies indicate that the best approach, reducing risk of capsular contracture, is an inframammary incision, just below the breast on the chest wall. This incision has the advantage of being hidden by the new breast fold.
During your consultation Dr Farhadieh will discuss all the options available to you and how they may be tailored to your needs and wants. The risks of the operation will be fully explained. Smokers will be asked to cease smoking at least 3–6 weeks prior to surgery, and to abstain from smoking (at the very least) in the immediate 3–6 week postoperative period. Any medications, supplements or herbal remedies that cause increased bleeding should be avoided at least 2 weeks prior to and 1 week after surgery. Depending on your age, medical and family history, you may be asked to have a screening mammogram prior to surgery.
On the day of surgery, your breasts are marked while you are awake and any final questions answered. Surgery will be performed under general anaesthesia. Patients may be discharged on the day of surgery or may stay overnight. Long-lasting local anaesthetic injected into the surgical sites at the time of surgery helps alleviate any immediate postoperative discomfort. Paracetamol can be taken to help with any discomfort during the remaining early postoperative period. The incisions are closed with absorbable sutures and covered with tape. Any discolouration or swelling will disappear quickly and any residual swelling will be resolved by 6 weeks. Straining, bending or lifting must be avoided during this time. A supporting bra should be worn as directed by Dr Farhadieh. Following surgery, you may go back to work within a week. The breasts will find their final shape within 3–6 months.
As with all surgery and anaesthesia, there are general risks and complications, but fortunately the reported complication rates with breast augmentation are low. Dr Farhadieh will discuss these with you at length during your consultation.
‘Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.’
Frequently Asked Questions
Is the surgery painful?
There is some discomfort associated with surgery. Most patients report a ‘tightness’, rather than pain, due to the excellent pain control regime we use, which includes local anaesthetic for the immediate postoperative period as well as powerful analgesics.
Will the shape of my breasts change during the recovery phase?
The breasts will not only heal during the first 6 weeks, but will also gradually find their natural postoperative position. Gravity, healing and surgery drive this process. The final shape is usually reached by 3 months. The incision scars will fade over the first 12 months and will often be barely visible beyond the first year.
When will I be able to resume normal activity?
Within 2 weeks you will be back at work and able to resume most normal activities. During the subsequent weeks you will return to your pre-surgery levels of activity. We have a postoperative regime to help you through this time.
where will the scars be placed?
Your scars are routinely placed under the breast fold, hidden from view. Not only do bras or swimwear hide the scar, in time it will fade and be barely perceptible. Dr Farhadieh commonly uses a short scar mastopexy approach, which entails an incision around the nipple and extending down the breast vertically.
What will my follow up include?
Dr Farhadieh believes that the relationship between doctor and patient is sacred and privileged. Our practice is based on compassion, honesty, transparency and, above all, patient welfare. We pride ourselves on making sure that you feel supported at all times. We will be available during each stage of your journey and will schedule short-, medium- and long-term follow-up appointments as part of our overall practice.