Deciding to go ahead with Breast Augmentation Surgery, or any cosmetic procedure is a big decision that should not be taken lightly. It is important that you do your research and do not commit to anything until you are sure that you are able to make an educated decision. We have put together some of the most frequently asked questions that patients have at their consultation.
- How long do breast implants last?
We use high quality, German-made implants. It is recommended to remove and replace your implants every 10-15 years, as they age. It is advised to regularly have your implants checked for ruptures. If you are not having any issues and your checks show no issues with the implants you do not need them replaced after 10 years. However, after 15 years you should seriously consider replacing the implants to reduce the risk of complications occurring. Complications are more expensive and harder to repair than a standard removal and replacement.
- Are saline or silicone implants better?
In our opinion, the new cohesive silicone implants are a big improvement on saline implants. They give a more natural look and feel. In regards to safety, if they a rupture, the sticky cohesive gel helps them to maintain their shape. This is an improvement on PIP implants, which were filled with a low-grade gel that would leak out like treacle instead of sticking together like Turkish delight.
- Is the above the muscle or below the muscle placement better?
This debate was well covered at recent lectures at the American Society of Cosmetic Breast Surgery Conference that Dr Murray attended. Under the muscle was very popular a few years ago, however, there was an increased rate of bottoming out, double bubble and wide cleavage, this was seen as a problem even up to 9 years later.The newer dual plane technique, where the top part of the implant is covered by the muscle and the bottom part is not, seems to be the favourite option. The newer polyurethane implants being placed above the muscle but under fascia has also increased in popularity. The reason for this is often smaller implants can be used and the risks of snoopy deformity or floppiness are lower. There is more information about breast implant placements available on our breast augmentation page. Some studies have shown that placement below the muscle gives a lower rate of capsular contracture. This has been strongly contested as sometimes you just feel it a little later and by then it may be too late to use medications. It is important to consider all options as there are pros and cons to all placements.
- Should I get round or teardrop implants?
A very interesting study has recently shown that when photographed people could not tell the difference between round implants and teardrop implants. Our Polytech implants are very interesting as they have a semi teardrop shape, although they are round so if the implant turns, which can be up to 8%, no visual abnormality will be present.
- Should I get smooth, textured or polyurethane implants?
There are advantages and disadvantages with all implants although macro textured, a very coarse implant, should be avoided. We use smooth and polyurethane implants. Polyurethane implants will adhere, giving more support to the breast and they are reported to have a lower capsular contracture rate. Our rate of capsular contracture is less than 1% with any type of implant, this is considerably lower than the average (reported as between 4 and 6%). Due to less support, smooth implants can drop faster but the risk of lymphoma is very low. We use Polytech implants, worldwide there have been no reported cases of lymphoma with smooth implants and there has only been 1 reported case with polyurethane implants.
- Is Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) a breast cancer?
The simple answer to this question is no. BIA-ALCL can occur when there is a local irritation caused by the breast implant. This can cause lymphoma cells to collect in a swelling. If ignored, this can spread to the rest of the body and prove fatal, although this is very rare.
- Is breast implant illness a real condition?
The FDA has recently released a statement that no well-performed study has shown that breast implant illness is possible, however, it needs further investigation. It must be remembered that worldwide reports of breast implant illness are very low. Hundreds of thousands of people have breast implants world=wide have breast implants with no issues. There are Facebook communities of people who have similar symptoms, however, while these communities may seem large, this is a very small minority of people with breast implants. In our opinion, this needs more investigation as it can possibly be a low-grade infection. Capsular contracture is possibly related to a low-grade infection, this infection may not have caused hardening of the implant but has caused the patient to feel unwell.
- Where is the best place to have an implant inserted?
It is commonly agreed that the axilla and areola region have a higher rate of capsular contracture and possible bleeding. Therefore, the crease under the breast seems to be the best place to insert the implants.
- What is the risk of needing a lift after implants?
Worldwide, this runs at approximately 2% and can occur in the first year or as late as 18 – 20 years later, depending on a few characteristics plus activities and pregnancies that occur. Sometimes this can be unpredictable and patients will need a lift unexpectedly. The new Polytech implants that have the polyurethane coating seem to have a lower risk of this.
- When can I resume exercise?
This is variable but in the first 2 weeks post-procedure you must be very cautious as bleeding may result in being taken back to theatre, incurring obvious inconveniences and expenses. Our rule is for the first-week post-procedure only walking around the house is permitted. Week 2, light exercise or bike riding is allowed and from 3 weeks working up from 1kg upper body exercise, slowly but carefully. By 6 weeks a normal gym routine can be possible but extreme exercise should be delayed for 3 months
- What can I do to help have a successful procedure?
The main thing is to eat wisely and take basic supplements to ensure good gut health. We have a perioperative wellness product with a prebiotic that is very nutritious and can assist with digestion of antibiotics. Making sure you are your average weight and that you are not going to lose or gain a lot of weight also assists.
- When can I travel?
We recommend that you wait for 2 weeks for any short flights and 1 month for long flights. It is very important to be aware that for the first 6 weeks it is ideal to be close to your doctor and clinic. Within the first 6 weeks, post-procedure is when we see mot complications after overseas surgery. Bleeding, infection, bottoming out, wide cleavage and high riding implants in most places can be prevented or treated early with good care. The NSW Health Departments recently said that if good aftercare is not given by a doctor, they should not be a doctor.
- What will my result be like?
Results from Breast Augmentation can vary depending on the condition of the breasts to start with. It is important to be realistic and work with your body. Breasts with good measurements and in good condition will get a better result on average. If your skin quality and elasticity is poor, then the result will be an improvement but not necessarily as good as a friend who had more favourable anatomy pre-procedure.
- Should I get breast implants before or after children?
This is a very difficult question to answer and really is dependant on your own choices. Some patients say to us they wish they had the implants beforehand.It has been noted that with some patients that polyurethane implants adhere to the tissue and prevent sagging. So, the answer to this is not clear, although what is clear, is most women enjoy having breasts if they have not had them before or filling their breasts up again after they have become empty.
- What size of Breast Implant should I get?
It is very important to realise that the best implant for you will depend on your measurements and body. A friend, or someone who looks very much like you in the breast area, may have very different measurements. The important measurements are between the nipple and the crease, the width of the breast and the distance between the top of the sternum and the nipple.It is also a great idea to go online and look up the pen test to learn how to asses ptosis. Everybody heals differently and one may get a very tight thick scar-like capsule around the implant and another may get a loose capsule that is not as perky. Therefore, it is quite difficult to assess exactly what size you’re going to be.The most common complaint post-procedure is that the patient wishes that they had chosen a larger implant. We often stop partners and family members commenting on the implant size chosen while in the fitting room as we want the patient to choose for themselves. We always advise the patient to choose a size a little bigger to avoid this problem. It is very uncommon for women to say they have gone too large.We offer Crisalix which is a VR system that allows to ‘try before you buy’. Crisalix scans your body and once you select the preferred implants it will create an ‘after’ image of your surgery. This is very accurate, but not 100% and you must be aware of this.
- Can I remove my implants if I don’t like them or feel unwell?
It is very rare to feel unwell due to breast implants and Breast Implant Illness has not been proven. We have had some patients who have thought that they had Breast implant Illness and upon removing their implants we have found that their implants had a small rupture that had been missed by their ultrasound examination. Some women choose to go smaller or have their implants removed. This is a straightforward process in most cases, but the outcome is once again variable. Some tissues bounce back amazingly well and some do not.
- What are the true risks of travel surgery?
We have seen many patients who have complications after overseas surgery even though they had done lots of research. Sometimes this is a tragedy as their problems cannot be repaired. Even worse it is a severe complication can lead to long-term health problems. Many doctors in Thailand are not insured, getting compensation out of them is near impossible. Some people are suing the local travel agents or compensation or even their friends that may have taken a kickback from the hospital for the referral. There are three main components to problems with travel surgery
- The travel itself: You have a higher risk of clots that can develop or travel to your lungs when flying after surgery. These clots can kill you after any surgery in the first few weeks.
- Not having your doctor nearby: This causes a huge amount of problems. Patients often comment on everything going wrong as they struggled to get aftercare
- Many of the places that are cheap are just that: Many of the hospitals make cuts from good patient care to offer lower prices. The cuts made are often in areas that would not be obvious to people outside of the medical field. The third world is the third world, backup medical care is very expensive and the standards are not comparable. Unfortunately, most people find this out once it is already too late.
Complications can happen anywhere and are always risks, not only when travelling overseas. However, the risks are lower when your Doctor is close by and can provide aftercare.
- How long do breast implants last?
For more information on Breast Augmentation at Absolute Cosmetic see our Breast Augmentation page. Dr Glenn Murray has over 20 years of full-time experience in Cosmetic Medicine and has performed hundreds of Breast Augmentations with a very low rate of complication. We offer complimentary consultations with our nursing team, contact us today to book a consultation.
Please note that this information is generalised. If you would like information specific to you please book a consultation.