The decision to have breast augmentation surgery is the first important decision you will need to make following careful consideration. The next decision is the type of implant, size of implant, choice of surgeon and the hospital where the surgery will be performed. One of the factors which can influence how happy you will be with the outcome of the surgery is the choice of breast prosthesis or breast implant.

This article explains the four criteria you need to consider in choosing the breast implant that will provide you with the results you are looking for.

The choice of implant depends on the proportions of your breasts in relation to your chest wall, how much breast tissue you already have, its position on the chest wall and how you want your breasts to look. Your surgeon will guide you and show you before and after pictures from previous clients to help you make your decision.

Once your individual anatomy and the “look” you want to achieve has been taken into account, the four issues to be considered in regard to your breast implants are: Size, Shape, Texture and Fill.

1. Size – while selecting an implant which is too small can result in a disappointing result, implants which are too big can make you self-conscious. Breasts that are too large can sometimes cause back and neck pain.
2. Shape and profile – breast implants can be either round or teardrop (anatomical) in shape. While round implants provide fullness of the upper pole of the breast which can result in the appearance of wearing a bra even when you are not wearing one, anatomical implants typically produce a more natural appearance of the upper pole of the breast by preferentially filling the lower pole of the breast. The various profiles of breast implants determine how far the implant and the breast project outwards from the chest wall. Implants can be low, medium, high or extra high in profile. You will have the opportunity to trial different implants by “trying them on” which will give you a good idea of how different sizes and profiles can appear on your chest in addition to the different “looks” which are achievable.
3. Texture - the coating of the implant envelope may be rough (textured), smooth or coated with polyurethane foam. Smooth implants generally feel more “natural” and while textured implants may feel more rigid that normal breast tissue, the textured surface is thought to reduce the risk of capsular contracture. The lowest rate of capsular contracture is thought to occur with implants coated with polyurethane foam which integrates with tissue surrounding the implant thereby reducing the risk of capsular contracture.
4. Fill - implants can be filled with either saline or silicone:

• Saline (salt water) filled implants: These implants can result in “rippling” due to slow deflation over time as a consequence of evaporation of saline or can result in a sense of “water sloshing” as the volume of saline within the implant reduces. In the unlikely event of the implant shell leaking or rupturing, the saline will be absorbed by the body and the breast suddenly “deflates” in volume.
• Silicone gel filled implants: Implants filled with silicone gel feel similar to natural breast tissue. In the unlikely event of a silicone implant leaking or rupturing, the “cohesive” gel will generally stay within the implant shell and the capsule of soft tissue surrounding the implant. Only occasionally does the gel leak outside the capsule and into the breast tissue.

What is capsular contracture?

Capsular contracture occurs when the capsule of soft tissue forms which forms around the implant contracts or “shrinks” thereby compressing the implant and making the breast feel unnaturally firm or appear rippled. In advanced cases, the implants may have to be removed along with the capsule and a new implant placed in a fresh pocket. Polyurethane coated breast implants are thought to have a lower risk of capsular contracture due to the manner in which the foam integrates with the breast tissue.

Breast augmentation surgery has the ability to make a real difference to a woman's confidence and self-esteem, but there are many factors to consider when choosing the 'look' that you will be most satisfied with. Your choice of surgeon is important, so it's important to speak to more than one surgeon before making your decision. The right surgeon will make the whole experience easier, and give you confidence that your procedure will go smoothly and you will be happy with the final result.

Choice of Surgeon and hospital – who will perform your surgery?

Ideally, your Surgeon should make you feel comfortable and have significant experience in performing breast augmentation surgery. In Australia, any medical doctor can perform cosmetic surgical procedures without specialist training. Plastic and Reconstructive surgery is a recognised specialty and requires several years of specialist training in a dedicated training program after having completed a basic medical degree.

Your choice of Surgeon should be a plastic surgical Fellow of one of the Royal Colleges of Surgeons, including the Royal Australasian College of Surgeons and Royal College of Surgeons of England. Such Fellows have completed post graduate training in plastic surgery and work under strict professional and ethical guidelines. However, training in plastic surgery does not necessarily mean training in cosmetic surgery, so always specifically ask your surgeon if they have undertaken dedicated training in cosmetic surgery. In Australia, the Australasian College of Cosmetic Surgery is the only College that offers formal training and accreditation in cosmetic medicine and surgery.

Choice of hospital – where should your surgery be performed?

Only accredited hospitals offer the facilities necessary to safely perform breast augmentation surgery under general anaesthetic. As breast augmentation surgery performed under twilight sedation has been associated with serious medical complications, it is important to check that your Surgeon will be performing your surgery under general anaesthetic administered by a specialist Anaesthetist in an accredited hospital.

Next Step

If you are considering breast augmentation surgery and have questions you would like to ask, or if you would like to book a confidential consultation at a cost of $140, click below or call (03) 9088 5000 for the Melbourne practice or (07) 3180 3400 for the Brisbane practice. The Cosmetic Surgery Co-ordinators of NorthEast Plastic Surgery will organise a consultation with Mr Tansley or Dr Seneviratne who are highly qualified and experienced surgeons. They will assess your individual requirements and discuss your preferences in regard to breast augmentation surgery.