Article medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
Breast augmentation is one of the most popular cosmetic surgeries. The augmentation of the breasts uses a soft implant behind the breasts to project forwards and upwards.
Dr David Topchian has more than 15 years of experience in this type of surgery and has performed over 1000 breast implant operations. Victorian Cosmetic Institute, lead by Dr Gavin Chan, was established in 2005, and has its own accredited surgical centre in Melbourne. Breast enhancement is an intimate and personal procedure. Experience is reassuring and a great builder of confidence. VCI offers a vast history of case studies to help each woman determine if this procedure is right for them.
Breast augmentation provides a boost to self-confidence and a consequent lift in social interaction. As with any voluntary surgical procedure, the best-informed decisions are made with full knowledge of the potential risks. This means a period of quiet consideration of the risk/benefit ratio before making any decision to proceed. The vast experience of our team helps each woman find what she is looking for in this procedure. We are proud of our many satisfied patients.
Different methods of breast augmentation
Using ‘implants’ or ‘prostheses’
This is the most common technique of projecting the breasts forwards, usually by the placement of an implant behind the breast itself or behind the pectoralis muscle on which the breast rests. With careful matching of patient and the particular implant, it can produce highly satisfying results.
Fat transfer from elsewhere in the body to the breasts
This technique is an alternative to the traditional option of silicon implants. With this method fat is removed from an area where it is unwanted and then transferred (transplanted) to the breasts though 3mm incisions. It results in about a 50% increase in breast volume – typically a cup size – and is therefore less predictable than implants. But it may be an option for women who are certain they don’t want implants.
Where are the scars in breast augmentation ?
What about scars?
Research (the FDA Core Study) has shown that the safest technique for this operation involves making a small incision in the crease under the breast. Other methods (around the nipple or through the armpit) have more complications and therefore are less safe for patients.
After a few months the scar is very hard to see; it is hidden in the fold and shadow of the breast.
A summary of the techniques:
Inframammary – In the crease beneath the breast,this is the safest technique. For women considering breast feeding it is the best method of retaining the ability to breast feed in the future. By controlling where the scar and therefore breast crease is going to be it allows optimal implant selection and positioning for a consistently excellent result.
Transareola – Through a semicircular incision around the nipple area. This is not a favourite with either surgeons or patients. The placement of the implant requires dissecting through the breast itself in order to place the implant behind the breast. It leaves a scar around the nipple area which, although often fine, is usually obvious simply because of its prominent position.
Transumbilical – Through the ‘belly button’ or umbilicus. The scar is hidden in the umbilicus. This technique was thought to be a clever way of avoiding a scar on the chest wall or breast. The theory was good, but it only had a brief popularity before falling into disfavour. It was soon found that there was an unacceptable difficulty for the surgeon in controlling the formation of a pocket of suitable size and shape for the implant. It is only suitable for saline implants.
Transaxillary – Through a natural crease in the armpit. This can result in a excellent scar, however if the scar isn’t that good then it can be visible when the patient is fully clothed and lifts their arm. It also has the highest rate of complications of the different breast implant techniques and is therefore not recommended.
The different types of breast implants
The differences are in shape and the nature of the outside covering (shell).
The Content (fill) of all silicone implants has been a cohesive gel since 1994. Prior to that it was liquid silicone, which occasionally caused significant problems.
There are two basic shapes: round and ‘tear-drop’(anatomical, or shaped)
The most common breast implant shape is still the round shape. This means that the base width of the implant is the same as it’s base height. For some women who want the ‘fuller’ look (without a bra) this can work well, however this needs to be discussed during your consultation to achieve the result you’re after.
Tear-drop implants have slightly less fullness at the top part of the breast – and so tend to look more ‘natural’ – but their real benefit is that the implant can be tailored to the women’s breast dimensions. So most women have a breast base that is wider than the height and these implants allow for this. Tear-drop implants also provide a better ‘lift’ effect for women who have some sag or skin looseness.
The surface of an implant can be either smooth, slightly rough (‘textured’), or covered with polyurethane-foam.
There is reliable data to show that both smooth and textured implants have a higher complication rate than the much safer polyurethane covered implants, so Dr Topchian recommends the use of these implants. He is the most experienced Dr in Melbourne in the use of these implants.
How and where is the procedure performed and what is the post-operative course?
Breast augmentation or augmentation mammaplasty is most comfortably done under general anaesthesia in hospital and approved day surgery facilities usually as a day procedure. It is completed within 1.5 hours.
Dr Topchian performs the Rapid Recovery technique, which results in less inflammation and therefore a quicker return to normal activities.
You are reviewed after surgery at one day, one week, one month and then 3 months. All of these appointments are included in the surgical package costing.
Return to work and physical activities – You may return to work one week after operation except if your work requires significant lifting or repetitive arm movements, in which case another few days may be beneficial.
What should be avoided after operation – physical activity should not be excessive for at least one month. Any movement that causes the breasts to ‘bounce’ should be avoided for a month.
Why choose Victorian Cosmetic Institute for your breast augmentation?
Our surgeon specialises in breast augmentation, and in particular the use of polyurethane-covered silicon implants using the Rapid Recovery technique. We take the time to listen to your concerns, and to help determine the best options for you.
Our facility includes an accredited day surgery, where we can perform your treatment.
The first step is simply contacting us for your initial consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your treatment.
Making that first phone call about any cosmetic procedure can be a confronting task – many of our patients have preferred filling out our online enquiry form. We can then contact you and gain an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.
It’s as easy as clicking either of the buttons below and completing the provided form. Otherwise, you can phone us directly on 1300 863 824.
What are some of the potential risks and complications?
As with any surgical procedure bleeding or infection can occur.
Loss of integrity of the implant shell can occur, but since the content nowadays is a silicone gel (unlike the pre-1994 implants which contained liquid silicone), the silicone can not ‘run’ into thebreast tissue as could occur with the liquid silicone implants. Loss of integrity of the shell is termed ‘rupture’ which gives the quite erroneous impression that the implant ‘bursts’. It does not.
In response to the presence of any foreign body, including all implants, the body coats it with a layer of collagen. This becomes a continuous ‘bag’ around the implant by about 4 weeks. This ‘capsule’ is normally both thin and strong and is closely applied to the surface of the implant. If this capsule becomes irritated or inflamed, it thickens and contracts (shrinks). In major degrees of contracture, the breast becomes round and firm. It is both unaesthetic and uncomfortable. Capsular contracture is the single most common ‘event’ to spoil an otherwise good result (see above). The use of the polyurethane implants to reduce capsular contracture by 20-times has been a major benefit to patients in the past 9 years.
Any surgical or invasive procedure carries risks. You should discuss these with your surgeon.
How and where is the procedure performed and what is the post-operative course?
Breast Augmentation (Augmentation Mammaplasty) is most comfortably done under general anaesthesia in hospital and approved day surgery facilities usually as a day procedure. It is completed within 1.5 hours.
You are reviewed after surgery at one day, one week, one month and then 3 months.