Also known as bilateral augmentation mammoplasty, breast enlargement or breast implants.
Breast augmentation involves the placement of an implant to boost the size and improve the shape and contour of the breasts.
An implant can be placed either directly behind the breast tissue (subglandular or subfascial), or more deeply under the pectoralis major muscle (submuscular or subpectoral) or using a combination of the above (dual plane technique).
Patients also have a choice of :
- Incision location - inframammary (under the breast), Periareolar (under the nipple) and through the armpit (trans axillary)
- Implant position - submuscular, subglandular/ subfascial, or dual plane
- Implant surface - smooth, textured or polyurethane (Brazilian furry)
- Implant fill - saline or silicone gel.
Dr Belt would normally see patients for two consultations to ensure that their aesthetic goals are met with respect to shape and size.
Dr Belt uses the Vectra. This is a specialised three dimensional photographic computer program that enables a patient to see a simulation of their predicted final outcome. This machine also calculates an accurate assessment of breast volume and is a useful adjunctive tool in planning surgery and implant choice for breast asymmetry cases.
Multiple different size and shape options can be trialled both on the computer simulation, as well as using trial implants placed under a bra or T shirt (supplied by Dr. Belt), before a patient commits to the final size of their implants. The use of trial implants which a patient places in a tight bra complement the Vectra to give a patient realistic expectations.
Surgery is performed under a general anaesthetic. Surgery is normally performed as a day case.
Patients are discharged home after surgery on oral pain relief and seen for post-operative reviews at 24 hours and 7 days after the procedure.
Patients are requested to avoid vigorous physical activity and wear a support bra for a period of at least six weeks after surgery.
It is possible to combine a breast augmentation with a mastopexy (breast lift).
This is a common procedure that is used to correct the loss of volume and the sagging skin associated with the changes that occur during breast-feeding (lactation).
The advantage of combining the procedures is that it may reduce the costs and it is also possible to reduce the size, length and number of scars involved.
Not all cases are suitable to undergo a combined procedure.
It may be necessary to perform the mastopexy three months prior to performing an augmentation.
When a combined procedure is performed, only a moderate projection implant can usually be employed. Furthermore, it is very difficult to perform the surgery as a single stage procedure if very large implants are used.
The mastopexy scar may be a circular scar around the nipple (periareolar), a circumvertical scar which is a lollipop type scar with the scar running around the circumference of the nipple with an extension running from the nipple to below the breast fold. In extreme cases, it may be necessary to employ an anchor pattern scar (or Wise pattern) which consists of a circular scar around the nipple, a vertical scar from the nipple which connects with a small horizontal scar running underneath the breasts.
The breast implant may be able to be inserted through any of the above three types of scar.
Dr Belt would be happy to advise if he feels you are appropriate to have a single or two-stage procedure.
Complications and Risks
All Procedures have potential complications and risks. These can be divided into general complications and those specific to each procedure. The latter are listed in the FAQs below.
General complications include:
- Wound complications - bleeding, bruising, collections under the skin of blood (haematoma), pus (abscess), serous fluid (seroma), infection, wound breakdown, suture extrusion, sensory loss;
- Aesthetic complications - poor scars, stretched scars, raised scars (keloid or hypertrophic), contour irregularities, need for revisional procedure;
- Anaesthetic complications
How do I select the correct implant?
The Vectra 3 dimensional planning technique is employed. Patients will also use trial implants placed in a tight T shirt. Photographic examples of similar cases of Dr Belt are also shown to show the realistic results than can be obtained.
Dr Belt will always personally see you at least twice before proceeding with the surgery. If you are unsure as to the size, he is happy to see you for more consultations if necessary.
How long do implants last?
Dr Belt has only had one episode where an implant has ruptured over the last ten years. It should be noted that implants are not lifelong devices and may need to be replaced in the future.
Furthermore, Dr Belt has audited the first ten years of his consultant practice and no primary breast augmentation patients, to his knowledge, have experienced grade III or IV capsular contracture.
Is silicone safe?
There have been many large scientific studies looking at the safety of silicone. There has been no convincing evidence that silicone causes an increased risk of cancer. You should let Dr. Belt know if you have a family history of breast cancer so he can organise pre operative screening tests. After breast augmentation you need to let the radiographer know when you undergo mammograms.
There has also been no evidence of increased risk of auto-immune diseases with silicone implants.
There is a rare type of cancer (Breast implant associated Anaplastic large cell lymphoma or ALCL) that has been associated with textured breast implants. The risk is low and varies between 1 on 2,800 cases for macro textured and polyurethane implants. Dr Belt has never used polyurethane implants and stopped using macro textured implants in 2009. There have been no cases with smooth implants but these implants may have a higher rate of capsular contracture. Dr Belt uses micro or nano textured implants and the risk of ALCL with these implants is approximately 1 in 36,000 cases.
The following links provide the latest information regarding Anaplastic large cell lymphoma:
What are the risks of breast augmentation?The risks will be discussed with you in detail before you consent to the operation. The risks can be broken down into general risks associated with any operation, and those specific to breast augmentation.
General operative risks include anaesthetic complications, bruising, bleeding, infection, wound breakdown and abnormal scarring.
Specific complications include implant malposition, rupture, capsule formation, capsular contraction, collections of fluid around the implant, wrinkles or ripples in the skin, changes in sensation of the nipple and breast skin, exposure of the implant and asymmetry.
What costs are involved?
- Dr Belt’s surgical fee
- Assistant’s fee
- Theatre fee / day bed, and overnight bed if not a day case
- Specialist anaesthetists fee
- Cost of implants
- Costs of sports bra / crop top
- Registration on Australian Breast implant register (optional)
Please contact Dr. Belt’s rooms and his staff can answer any questions you may have. A personalised quote and information can be sent to you regarding your specific procedure.
The total cost for breast augmentation with round implants at Pacific Day Surgery is $9,845.20 and $10,756 using anatomical implants. Dr Belt also operates at Greenslopes Private Hospital and Brisbane Private Hospital. Surgeries at these locations are $100-500 more than the above quotes. The above quotes are with Mentor implants. Other implant choices may change the quote.
These fees include all of the above costs. Dr Belt will supply 2 post-operative support bras. Dr Belt can arrange for 1 simple easy payment for all of the above. The only costs not covered are the prescription costs for the antibiotics and painkillers.
What happens after the breast augmentation?
Most people will plan to leave hospital on the day of the procedure. You will be given a prescription for strong painkillers after the operation. You will be advised to wear a support bra/ crop top (supplied by Dr Belt) for the first six weeks (day and night). I recommend that you plan a very quiet week immediately after your surgery and avoid driving for 2 weeks and vigorous exercise for 6 weeks.
The stitches are dissolvable and therefore don’t need removing. You will be seen regularly after the operation at one week, two weeks, six weeks and six and 12 months.
What options are available?
The options are :
What the implant is filled with (saline or silicone gel).
Shape of the implant- anatomical (teardrop) or round
Surface of the implant (textured, smooth or Polyurethane or "Brazilian furry")
Low, medium, high or ultra high profile projection
Studies have shown that textured and polyurethane implants have a lower rate of capsular contracture in both subglandular and submuscular pockets.
Incisions can be made in the crease underneath the breast, around the areola/ nipple or in the arm pit. Most revisional cases are approached using an incision or the scar the scar under the breast (inframammary scar). If patients want to have only one scar in the future then this incision should be used for the breast augmentation.
This incision, and subsequent scar, is planned meticulously so that it will end up exactly in the fold under the breast. As such it should not be visible when standing or when wearing a bra / bikini. It is only visible when naked and viewed from the feet.
The implant can be placed deeply underneath the muscle of the chest wall (sub pectoral or dual plane) or on top of this muscle directly behind the breast tissue itself (sub glandular or sub fascial).
Why have a breast augmentation?Breast augmentation will increase the size of the breast. Augmentation can also correct breast asymmetry and help restore breast volume lost with breast feeding and / or ageing. Breast augmentation can help correct minor degrees of breast drooping (ptosis). All of the above will improve a patient’s self esteem.