Things to Consider When Undergoing Breast Enlargement Surgery

During your consultation for breast enlargement, Mr Karri will discuss three key aspects to the surgery;

1. Where the incision will be made
2. Where the implant will be placed i.e. above or below the chest muscle
3. What type of implant will be used i.e. size, shape and profile

These decisions are largely determined by your breast anatomy and desired outcome.
Deciding implant size is a personal choice with some women opting for a modest increase and others preferring a significant increase. Regardless, Mr Karri will explain all your options and what is achievable and what is not.

For implants placed under the muscle, Mr Karri uses a dual-plane approach in which the implant is placed partly under the muscle and partly under the breast gland. This provides multiple advantages including better coverage of the implant, reduced risk of capsular contracture and reduced risk of bottoming-out. Implants placed above the muscle is not necessarily an inferior option and for some women with sufficient breast tissue, provides a superior result.
For the majority of patients Mr Karri uses an inframammary fold incision as it provides the best visualisation of the implant pocket and the scar is inconspicuous. For some women with small breasts, a periareolar incision may be an option.

As with any surgery, breast enlargement does have some risks associated with it. Very rarely some of these risks can result in a second operation and/or removal of the implant.

Scar / poor scarring – the inframammary fold incision usually heals to leave a inconspicuous scar. In some patients the scar can thicken and remain red. The scars from breast augmentation can usually be hidden by bras and swimsuits.

Infection – very rarely a severe infection can arise which may require removal of the implant. It may be a number of months before a new implant can be placed to restore symmetry.

Haematoma – excessive bleeding into the breast can occur (known as a haematoma) and may require drainage. It is important that you you do not take any products containing aspirin, anti-inflammatories, blood thinners or vitamin E for 14 days prior to your operation as these medications can greatly increase the risk of bleeding.

Changes in nipple or breast sensation – while sensation typically returns within several weeks, some loss of feeling may be permanent.

Implant malposition – the implant may not remain in the correct position after breast enlargement. The implant may sit up too high, off to the side, or too low. The breast implant needs to sit properly behind the breast itself. It is important to remember that breasts come in many different sizes and shapes.

Capsular contracture – this describes a thick scar forming around the implant causing deformity and pain. There are varying grades of capsular contracture, from the breast feeling slightly firm to the breast becoming hard, deformed and painful.

Limited lifespan of breast implants – breast implants are not designed to last forever. Therefore all women should expect their implants to be replaced during their lifetime.

Difficulty with breast cancer detection – although there is no increased risk of breast cancer from breast enlargement, interpretation of mammograms may be more difficult. As such, further investigation with ultrasound or MRI may be necessary.

Implant rupture or leakage – an implant may rupture for a variety of reasons such as, improper manufacture, damage to the implant at the time of surgery or trauma to the breast.

Difficulty breast-feeding – some women might have difficulty producing enough milk for breast feeding after breast augmentation.

Need for revision surgery in the future.

Implant-associated Anaplastic Large Cell Lymphoma (ALCL) – there is some evidence that breast implants can cause a very rare cancer of the immune system called anaplastic large cell lymphoma. There is very limited data and the risk appears to be around 1 in 50,000 to 1 in 300,000. ALCL usually presents with rapid swelling of one breast some years after the implants were inserted. Treatment usually requires complete removal of the implant and the capsule around it.

Risks of general anaesthesia, such as feeling sick and vomiting, deep vein thrombosis, shivering and sore throat.