Last updated November 2021
Consultations for breast augmentation are no longer provided at VCI. The below is for information purposes only.
If you are a candidate for breast augmentation, Melbourne contains one of the best surgeries for breast enlargement and plastic surgery. VCI has operated on a number of clients who have been extremely happy with the results. Breast augmentation procedures can include breast enlargement, breast lift or breast reduction.
If you are considering undergoing breast augmentation, Melbourne surgeon 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, led by Dr Gavin Chan, was established in 2005, and has its own accredited surgical centre in Melbourne. Breast enhancement surgery 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.
Benefits of breast augmentation
Breast augmentation can provide 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 the decision to proceed with the surgery. 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.
The possible benefits of breast augmentation surgery include:
- Added volume, helping you fill out your clothes better.
- The ability to re-shape naturally asymmetrical breasts.
- Increased sense of self-confidence and femininity and increased self esteem.
- Restore breasts that have changed over time (as a result of pregnancy or ageing) to their original shape.
Different methods of breast augmentation surgery
Using breast ‘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 the 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 breast implants.
The different types of breast implants
The differences are in shape and the nature of the outside covering (shell).
Breast implant fill
The content (fill) of all silicone implants has been a cohesive gel since 1994. Prior to that it was liquid silicone (saline implant), which occasionally caused significant problems.
Round or teardrop shape
There are two basic shapes: round implants 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 its 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.
Teardrop breast 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. Teardrop implants also provide a better ‘lift’ effect for women who have some sag or skin looseness.
Textured versus smooth
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 surgeon in Melbourne in the use of these implants.
Breast implant placement
The implant will either be placed above the pectoral muscle (subglandular placement) or below the pectoral muscle (submuscular placement). Subglandular placement may be better for women who have a lot of natural breast tissue or who lead active lifestyles as the chest muscle will not be disrupted. Submuscular placement is recommended for women with little natural breast tissue.
Breast implant size
There are a number of shapes and sizes available when it comes to silicone gel implants. You will have a consultation with the doctor before the procedure in which you will discuss the size of the implants. There are very few limits on the size that you can get and your doctor will make sure you are getting the result you want.
There are a number of causes for breast asymmetry that can be resolved with breast augmentation surgery. These include:
- Uneven breastfeeding during pregnancy
- Mastectomy to treat breast cancer
- Weight loss or weight gain
You may need implants in one or both breasts, and the implants may be different sizes. If the asymmetry is severe your doctor may recommend breast enlargement surgery on the smaller breast and breast reduction surgery on the larger one.
What about the scars?
Research (the FDA Core Study) has shown that the safest technique for breast augmentation surgery 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.
Types of incisions
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 breastfeed 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 very well concealed scar, however the scar can be visible when the patient is fully clothed and lifts their arm. It also has the highest rate of complications out of all the different breast implant techniques and is therefore not recommended.
Risks and complications
There are a number of potential risks associated with breast augmentation surgery. It is best to make sure you are aware of all of the possible consequences because breast enlargement is a major surgery. If you change your mind about your breast implants, there are options available such as exchanging the implants or removing them.
As with any surgical procedure bleeding or infection can occur. Other possible short term side effects include:
- An allergic reaction to one of the medical materials
- Fluid build up around the implant after surgery
- A feeling of numbness or change in sensation
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 the breast 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. It is possible for gel to move within the implant or leak out.
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. Before proceeding, you should discuss these with your surgeon.
How and where is breast augmentation surgery performed
Breast augmentation surgery 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.
What to expect after breast augmentation surgery
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.
Immediately after the surgery, you may experience some swelling and discomfort. You may have a bandage on, and for the first couple of weeks, your doctor will advise you to wear a surgical support bra day and night. A sports bra may be worn after that. Underwire bras should not be worn too soon after surgery because they can irritate the scar healing process.
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.
Can I breastfeed after my breast enlargement surgery?
If you plan to breastfeed after getting breast augmentation surgery, you should discuss this with your doctor so that he can advise you. Most women will still be able to breastfeed, and it is perfectly safe to do so.
How much does breast augmentation cost?
Breast augmentation surgery in Melbourne will cost between $11, 000 and $12, 000, depending on the size and shape of the implant used.