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BREAST AUGMENTATION SURGERY IN SYDNEY & CANBERRA

Art has always depicted breasts as the most defining feminine characteristic, from antiquity to modern era. Correction of shape, volume and size are most reliably addressed with breast implants. At Panthea Clinics Sydney & Canberra our academic standing translates to you achieving your desired aesthetics.Dr Ross Farhadieh  literally wrote the book on this topic as you will see below.

When considering any elective surgery, it’s best to put a lot of time and thought into deciding what you want. It is both a personal journey of self-discovery and a search for the options that suit your needs best. At our Sydney and Canberra locations, we provide recognised World Class surgeries for a wide range of procedures, including breast augmentation, breast reduction, and breast lifts. Get in touch with us today to learn more about how we can help you reach the best version of yourself.

(2:22) | Breast Augmentation: Leading Sydney Plastic Surgeon Dr Ross Farhadieh Explains this Procedure
(1:20) | Breast Augmentation: World Renowned Sydney Plastic Surgeon Dr Ross Farhadieh
(3:53) | Teaching textbook primary dual plane breast augmentation by Sydney plastic surgeon Dr Ross Farhadieh

WHY CHOOSE DR ROSS FARHADIEH FOR YOUR BREAST AUGMENTATION?

Dr Ross Farhadieh literally wrote the book on this topic, with two textbook chapters (2015 & 2021) in international reference plastic surgery textbooks used around the world by training and practicing plastic surgeons. Breast augmentation is one of his areas of special academic interest and peer recognised expertise.  Dr Farhadieh has provided both expert commentary for international plastic surgery journals, as well as, accruing ongoing world wide recognition for authoring two chapters on this topic in two internationally critically hailed plastic surgery textbooks: Plastic and Reconstructive Surgery: Approaches and Techniques  (2015, Wiley UK) & Plastic Surgery: Principles & Practice (2021, Elsevier US). He has triple board certification fellowships from the Royal Australasian College of Surgeons, Royal College of Surgeons (England) and the European Board of Plastic Reconstructive and Aesthetic surgery. In addition he has three separate subspecialty clinical fellowships including a cosmetic fellowship from some of the World’s leading institutes in London. With this level of expertise guiding everything he does, you can have confidence in Dr Farhadieh’s ability to provide World Class care tailored to your needs.

When considering any elective surgery, it’s best to put a lot of time and thought into deciding what you want. It is both a personal journey of self-discovery and a search for the options that suit your needs best. At Panthea Clinics in Sydney and Canberra, we provide World Class services for a wide range of surgeries, including breast augmentation, breast reduction, and breast lifts. Get in touch with us today to learn more about how we can help you achieve the look you’ve always wanted.

WHAT IS A BREAST AUGMENTATION?

Breast augmentation – or ‘breast implants’ as they are more commonly referred to – are the most common cosmetic surgery procedure throughout the western world. From antiquity to modern era breasts have been defined by art as the most feminine feature of the  female  form. There are many reasons why you might want to consider this surgery:

  • To augment the natural shape of their breasts,
  • To accentuate existing or define their contours,
  • To help restore breast volume that was lost during breastfeeding, weight loss and/or ageing,
  • To correct a noticeable difference in size between the two breasts or asymmetry

During breast augmentation surgery, implants are optimally placed on the chest wall partially behind the pectoralis major muscle and partially under the breast gland for the best and longest lasting results.

Implants are created using various different materials for both the outer shell and the inner material. The outer shell is made of silicone and can be either textured or smooth. For the filling content, either silicone or saline may be used. The shape of the implants can differ also, with some being round and symmetrical in shape, while more recent innovations offer tear-dropped or anatomical shaped options. The latter accentuate the lower breast pole once they are inserted, which aims to give a more natural appearance. It is worth noting that tear dropped implants only come in the textured shell for. They have recently been implicated in Breast Implant Associated-Anaplastic Cell Large Cell Lymphoma (BIA-ALCL). Most plastic surgeons have moved away from textured breast implants for this reason. Dr Farhadieh recommends use of smooth breast implants in the upcoming chapter on breast augmentation to all plastic surgery trainees and plastic surgeons. Dr Farhadieh has authored many informative blogs on breast augmentation in our blogs section. Here are some of the topics and links:

At Panthea Clinics in Sydney and Canberra, Dr Farhadieh uses only the highest quality breast implants available. With a lifetime guarantee, this gives you complete confidence knowing that the risk of complication is low and you’re covered if something does happen to go wrong.

BREAST IMPLANTS PROCEDURE

The scientific literature reflects that inframammary approach is the most commonly utilised, the safest and the best approach. This is the approach Dr Farhadieh takes for breast augmentation. There are however, a few different approaches to breast implant surgery. Axillary or armpit incisions are suited to patients getting saline implants, while periareolar (nipple) or inframammary (below the breast) incisions are usually used for silicone implants. An umbilical incision has also been described albeit it is more a theoretical approach rather than a practical approach. You can see Dr Farhadieh’s videos of this surgery prepared for his textbook chapter and teaching on top of this page and our YouTube channel

During your initial consultation with Dr Farhadieh at either our Sydney or Canberra clinics, we will discuss all options available to you in order to formulate a plan for your individual wants and needs. During this session, the risks associated with the surgery will also be explained and smokers will be asked to cease smoking for at least 3-6 weeks prior to surgery and 3-6 during the postoperative period. You will also be required to stop taking any medications, herbal remedies or supplements that cause increased bleeding for at least 2 weeks prior to and 1 week following your surgery. Depending on your age, medical and family history, you may be asked to have a screening mammogram prior to surgery. Preoperative photographic images will be included in your medical records.

Once your surgery day arrives, your incision lines will be marked while you are awake and you will be able to ask any remaining questions as we go through our checklist with you. Breast augmentation surgery is performed under general anaesthesia and patients will usually be discharged either the same day. Long-lasting local anaesthetic is injected into the surgical area, alleviating any immediate discomfort postoperatively.

The incisions are closed using absorbable sutures before being sealed with dermal glue and covered with tape. There may be some discolouration or mild swelling, however this will disappear quickly and will be completely resolved within 10-14 days. Throughout this healing time, straining, bending or lifting should be avoided and you should wear your supportive bra for at least 8 weeks. You will be able to go back to work within a few days of surgery and your breasts will find their final shape within 3 months. You will receive comprehensive postoperative instructions.

Although the risk profile of breast implants surgery is low, all surgery carries a risk of complications. Dr Farhadieh will discuss these risks with you, during your consultation for implants. With Panthea Clinics, however, you can have complete peace of mind knowing that you are being cared for by a team of dedicated specialists at our Sydney and Canberra locations.

Before proceeding make sure that you have read all the information sheets and have your questions answered.

SPEAK TO US ABOUT BREAST IMPLANTS IN SYDNEY & CANBERRA

Be sure that you get the latest and detailed information about breast augmentation surgery, the best outcomes from your breast augmentation surgery is our only aim. Contact Panthea’s Sydney or Canberra clinics today to book your initial consultation or have your questions answered by our dedicated team of surgical professionals.

Frequently Asked Questions

All implants are silicone inside and outside (ie the shell). They have gone through multiple generations of evolution. The first silicone breast implant was invented and clinically used by an American company called Dow Corning an American chemical company in 1962. Fun fact Dow Chemical company was military company contracted to make agent orange used in the Vietnam War. These were the first generation of implants. They were tear shaped in nature and in fact had a patch (Velcro like) to position the implants and prevent from the spinning. This first generation was clinically successful but a second generation was made which were rounders and softer. These implants ubiquitous in the 1970s felt soft and natural. They did however have a high complication rates of rupture and gel bleed. This later is a phenomenon where the molecules of the silicone gel are small ( as they have small cross linkages) and they can “bleed” overtime through the shell that is containing them. All Plastic surgeons of a certain age would have vivid recollections of removing ruptured second generation implants from patients.

During the 1980s, there was even more improvement in the third generation of silicone implants. A newer shell type called polyurethane showed promise of infinitely reduced capsular contracture rate. When the basic science caught up and showed that the reason for this was that the polyurethane shell, delaminated like an onion during its life and therefore allowed the implants to remain in the capsule free and soft. The downside was that it was discovered that high concentrations ( well above those in humans ) it was associated with soft tissue sarcomas ( a form of cancer), later they were implicated in the unusual T-cell lymphoma cancers with textured implants.

The textured implants ( made to emulated the pores in the polyurethane )and the return of the tear shaped implants came in the 1990s with form stable gel (one that does not leak everywhere when ruptured). These 5th generations implants have been with us since. Despite the reduction in capsular contracture rates their association with Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) has meant that they are less and less used in favour of smooth shell implants.

Generations of Silicone Implants (Farhadieh RD et al Plastic Surgery: Principles & Practice, US, Elsevier 2021).

 

Form Stable Gen V Silicone implant

From left to right
Macrotextured tear shaped, smooth round, microtextured round and finally polyurethane implant

Classically, silicone implants used to be placed behind the breast tissues and over the muscles. The problem with this approach was that it has been shown to be associated with higher capsular contracture rates. This is is somewhat mitigated by placing the implants behind the pectoralis major muscle. This has been shown conclusively to reduce capsular contracture rates. Initially complete coverage of the implants by muscles were promoted, the issue then was that when the pectoralis muscle contracted the implants often moved up whilst the breasts moved in another direction, so called implant animation. The dual plane technique was a way to achieve the best outcome, muscle coverage over the upper pole of the implant, thereby obscuring the upper pole for the implant, especially in thinner patients and allowing regular muscle movement reducing capsular contractors. This is the technique that Dr Farhadieh uses in his primary breast augmentations.

Dual Plane techniques I-III, (Farhadieh et al Plastic Surgery: Principles & Practice, Elsevier, US, 2021).

 

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.

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.

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.

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.

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.

Let’s start with what Dr Farhadieh has written and teaches in his chapter on breast augmentation in one of the major international reference textbooks in plastic surgery. “Larger controlled augmentation volumes remain in the realm of promising trials. Breast augmentation surgery remains the most popular cosmetic plastic surgery procedure. Since its inception it has endured controversies. The future shows hope for autologous options along with a need for a good understanding of the aesthetics, techniques as well as potential complications facing this patient population which underpins good and safe surgical practice.” (Farhadieh et al Plastic Surgery: Principles & Practice, 2021, US, Elsevier).

It does however have a place in clinical practice provided all the facts are taken into consideration. Fat grafts have become a popular means of soft tissue augmentation and breast reconstruction in recent years Capitalizing on the benefits of pluripotent STEM cells from adipose tissue remains the holy grail of tissue engineering and regeneration. The benefits of fat grafting are diverse, ranging in the reversal of the effects of radiotherapy post breast cancer surgery and scar contracture from burns, to an adjustment for minor defect correction in breast augmentation. Its use has also been described for women who have undergone breast conserving surgery and total mastectomy. There have been many changes in recent years with better under- standing of fat and stem cells as well as better techniques

In regard to meaningful reliable and reproducible breast augmentation, accurate fat-based autologous augmentation remains a goal rather than an attainable outcome. Due to fat graft loss from reabsorption, fat necrosis, and cyst formation, its efficacy remains to be seen. Imaging studies that have explored fat graft retention rates over time have noted graft retention volumes of 0–43%. Rates may be lower post breast cancer surgery. Smaller amounts of fat grafting volumes (10–100 mL) can be a useful adjunct to improve the transition from chest wall to implant and to conceal rippling. In this manner, fat can be grafted into the decolleté and cleavage area, lateral hollows behind the midaxillary line and implant fold.Cohort studies have shown a decrease of capsular contracture (Baker grade from IV to I) using a single fat grafting session.
Results were recorded at 20.3 months’ follow-up. 

So with the above and more in mind it has a very narrow clinical indication and use.

Fat harvested to be prepared for injetction

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