Procedure Spotlight
- Performed to increase the size of the breasts, improve their shape or correct asymmetry
- For women 18 years and over with realistic expectations
- Breast Augmentation will generally leave an unnoticeable scar, hidden in the breast fold
- Choice of either tear drop or round implants
- Dr Safvat uses newer 5th generation breast implants from well-established and reputable companies
There are many factors that make women consider breast augmentation surgery apart from it being purely about size. Some women lose volume in their breasts after pregnancy and breastfeeding and wish to regain a more youthful breast appearance. Insufficient development of the breasts can leave some women unsatisfied with their breast size and shape. Significant weight loss can also change the look of the breasts.
Technique
During the breast enhancement procedure, an incision is placed under the breast (Infra-mammary fold), which is Dr Safvat’s preferred incision site as it is the safest, yet less conspicuous option. The breast implant can be positioned most accurately into its pocket with this method. Also, any form of breast implant (round-shaped or tear-drop) can be used. It will generally leave an unnoticeable scar, hidden in the breast fold. The scar involved usually heals to an almost imperceptible line.
There are many decisions to make when considering breast implants for breast augmentation, including the implant type and size, the pocket where it is put and the incision placement.
There are two broad categories of implant pocket. Implants are placed either under the pectoralis/chest wall muscle (sub-pectoral) or over (sub-glandular) the pectoralis. A combination of both can also be used which is referred to as the dual-plane technique.
With breast augmentation, the breast implants are either tear drop (anatomical) or round shaped.
The implant type and pocket position depend partly on your build, the volume and position of your breasts, and the thickness of your skin. These are thoroughly discussed with you in the decision-making process and the best option is reached in consultation with Dr Safvat.
There are also choices with implants types
Silicone vs Saline – Saline implant have a silicone shell anyway but are filled with salt water. They were commonly used in the United States a decade ago as the US FDA had a ban on the use of silicone. However as the FDA ban was lifted in 2006, Saline Implants have fallen out of favour almost universally. Dr Safvat has always used Silicone implants in his patients.
Smooth vs Textured implants – Dr Safvat will go through the different implant options with you during your consultation.
Dr Safvat uses newer 5th generation breast implants from well-established and reputable companies. This is because we believe there is no room for compromise here as patient safety and quality is paramount.
Procedure Snapshot
The procedure is done under a general anaesthetic in a fully accredited hospital to minimise the risk of complications.
| Anaesthetic Type: | General Anaesthetic |
| Length of Surgery: | 2-3 hours |
| Stay in Hospital: | Day Only |
| Downtime: | 1 week |
Recovery
Upon discharge following the breast augmentation, the patient is required to wear a surgical garment (bras) for 4-6 weeks and should have about 1 week off work to rest at home (depending on the type of work).
Initially after the breast augmentation surgery, the breasts will be swollen and slightly bruised. This will settle over the next few weeks and Dr Safvat will guide you through the scar management process after your operation. It will take several weeks before the breasts settle into their final shape.
Walking is actively encouraged post-operatively but avoid strenuous activities and heavy lifting for 3-4 weeks.
Preparation
Smoking and being overweight have been shown to cause more complications after surgery. We will insist that you stop smoking 3–4 weeks before your breast augmentation surgery and have a healthy and stable weight. It is also important to have realistic expectations about the outcome of the surgery.
Breast augmentation surgery is one the most common procedures done in cosmetic surgery. Unfortunately, because of the high demands, there are a lot of doctors who are not properly trained as plastic surgeons, who perform this procedure. Make sure that your surgeon is a properly trained specialist plastic surgeon and has the ability to look after you in the event that a complication arises. We will continue to see you on a yearly basis to monitor the health of your breasts and implants.
Scars
There is no way to prevent scars completely after surgery and everyone can scar differently. However, the techniques Dr Safvat uses to suture his wounds are designed to minimise scarring. What’s more, any scarring will fade over time, especially if they are cared for correctly.
Patients who have followed Dr Safvat’s protocol for scar management diligently have been very pleased with their progress in reducing and fading of scars. Dr Safvat will also include LED Light Therapy sessions (available in Miranda only) which will assist with wound healing, scarring and recovery.
Dr Safvat will provide you with his specific protocol for scar management that will help you protect and care for your incision in a way that will minimise scarring.
Complications
While all care and diligence is taken by Dr Safvat to minimise or avoid complications, any surgical procedure can be associated with some general complications and/or specific complications related to the surgery you are having. Choosing a Specialist Plastic Surgeon such as Dr Safvat and having your procedure done in an accredited hospital minimises risks as does using an accredited Anaesthetist.
Some general surgical potential complications are:
• Infection that may require antibiotics (Dr Safvat prescribes all patients antibiotics after surgery to minimise this risk). He will also follow a multitude of steps to minimise contamination and infection of the implants. These steps are sometimes referred to as the “14 point plan”.
• Fluid build-up under the skin (seroma).
• Allergic reaction to dressings and other items used during the procedure.
• The formation of blood collection (haematoma) which could require additional surgery.
• Scars heal differently in different people. Some people are genetically prone to develop keloid scars. Hypertrophic scars develop when there is a complication in the healing process. Whilst not ideal, there is no threat to your health if you develop these.
• Anyone can have a heart attack or stroke from a clot. This risk is slightly increased with anaesthetics.
Some potential complications related to Breast Augmentation surgery specifically are:
• Blood and fluid can build up around the implant causing pain. A further operation may be needed to remove the blood and fluid.
• It is common to have changes in the sensation around the nipple and areola, however normal sensation usually returns after a few months. It is uncommon, but not impossible for this to be permanent.
• Breast implants can leak or rupture due to injury, during mammography, with capsular contracture or for no known reason.
• Capsular Contracture – There is scar tissue (a capsule) around any implant, this is normal. This capsule can become thickened and pathological. In its severest form it can even make the implant hard, distorted and painful. This can occur at any time and in severe cases the implants will need to be removed and/or replaced.
• An implant can potentially move from its original position or rotate (in the case of tear drop implants) which can distort the breast shape and cause discomfort.
• It is also possible to have a lot of spasm of the Chest muscles (pectoralis muscle) if the implants are inserted underneath the muscles. This is more common in thin athletic women. Fortunately it is temporary until the muscles get used to the implants under them. Dr Safvat might prescribe you some muscle relaxant and organise some physiotherapy if needed.
• Most women do not have completely symmetrical breasts even before breast augmentation surgery. If the asymmetry is significant, this can be improved with different size breast implants but it is not usually possible to make them 100% symmetrical.
• All implants (breast implants, artificial joints, pacemakers etc.) are foreign material and therefore more likely to get infected. You will be discharged on antibiotics to minimise this risk. There is accumulating evidence that “bacteria” are associated with complications of Breast implant surgery such as the risk of capsular contracture and BIA- ALCL (explained below). Dr Safvat follows the 14-point plan which is evidence-based steps developed to minimise “bacterial” load around the implants at the time of Surgery therefore reducing risks of infection, Capsular Contracture & BIA-ALCL. Dr Safvat does not take shortcuts or rush the Surgery as infection control standards are extremely important in Breast Implant Surgery to ensure safe and best outcomes.
• Textured breast implants have been associated with Anaplastic Large-Cell Lymphoma (BIA-ALCL) which is a rare form of non-Hodgkin lymphoma (blood cancer). Implants must be monitored annually for BIA-ALCL. This will present as a lump or fluid around the implant which manifests as increase in size of the affected breast. You need to contact Dr Safvat as soon as possible if these happen. But bear in mind that in most cases, fluid around the implants or even lumps are benign and from other causes.
Cost
Breast augmentation is considered a cosmetic procedure (except in the case of mastectomy, tuberous breasts and significant breast asymmetry). There are several factors that contribute to the final cost including Dr Safvat’s fee, hospital fees, anaesthetist fees and breast implant costs. Medicare and Health Insurance are not able to be used for this procedure.
Detailed information regarding costs will be provided to you after your initial consultation.
Frequently asked questions
Is breast augmentation surgery the right choice for me?
Breast augmentation is a personal procedure – everyone chooses to undergo surgery for different reasons. To begin with, you should always consult with a qualified and experienced plastic surgeon before making any final decisions about breast implants. There are a number of factors that need to be considered, including your medical history, the health of your breasts and your expectations being some of them.
Breast augmentation surgery could be right for you if you’re in good physical health, have fully developed breasts, and want to enhance the shape and size of one or both breasts. The procedure is very popular amongst those who have lost weight, recently had children or are experiencing some of the common signs of ageing.
Before you consider this procedure, keep the following in mind:
- While there’s no way to determine this, augmentation may affect your ability to breastfeed.
- Breast implants won’t last a lifetime, so you may require a second surgery later on in life to replace or remove your implants.
- If you’re a smoker, your healing could be delayed and you have a higher risk of developing complications. Dr Safvat will insist that you stop smoking before this type of surgery.
- You should only undergo this surgery for yourself, not because someone else has convinced you to. Your personal reasons for wanting to receive implants should also be considered.
What can I expect over the long term after breast augmentation surgery?
Breast implants do not last forever. Generally speaking, they have a life of around 10 years. However, in saying that there is no reason to remove the implants after 10 years unless they are causing any issues. The breast shape may change over time with weight gain or loss, pregnancy as well as with the natural aging process.
Do implants make it more difficult to detect breast cancer?
If you have a history of breast cancer, it’s important to bring this up during your consultation. Breast Implants can make it slightly more difficult to do a mammogram. Telling your x-ray technician about the implants will ensure the right techniques are used during testing. We will also show you how to correctly check for lumps and abnormalities in between your check-ups.
What is alcl?
Anaplastic large cell Lymphoma also called Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare form of non-Hodgkin lymphoma (blood cancer), associated with textured or polyurethane breast implants. The incidence for microtextured implants is about 1/18000. The incidence for macrotextured implants are much higher but they have been withdrawn from the Australian market.
ALCL presents with fluid around the implants or a lump. The median time for BIA-ALCL is about 8 years but can happen between 1-37 years after implant insertions.
In most cases the treatment for BIA-ALCL is total capsulectomy (removal of the capsule around the implant and the implants themselves). This is the only time that total capsulectomy is warranted.
So it is important to have regular checks of your implant or see Dr Safvat if you feel a lump or there is a change in the size of your breast.
IS SCARRING SOMETHING I SHOULD BE WORRIED ABOUT AFTER AUGMENTATION SURGERY?
Scarring is unavoidable after any type of surgery, including breast implant surgery. However, steps can be taken to minimise scarring. Incisions are made in areas that will hide scarring under clothing or in the natural folds of the body and skin. We will also provide you with a list of scar management techniques that will ensure they fade as much as possible over time.
SHOULD I COMBINE AUGMENTATION WITH A BREAST LIFT?
It’s very common for women to pair breast augmentation with a lift. You should consider both procedures in the following situations:
- You want to increase the size of your breasts and achieve a more elevated position
- The level of droopiness that’s present can’t be corrected with implants alone
- You want more upper pole fullness, something that can only be achieved with a lift
- Moderate to significant volume loss and excess skin is present due to weight loss or breastfeeding
The best way to determine whether you would benefit from both procedures is to schedule a consultation with Dr Safvat in one of his rooms in Miranda Concord or Bowral.
When will I see the final results of my augmentation procedure?
It can take up to 3 months to see the final results of your surgery, so patience is required. Directly after your surgery, your breasts will appear larger than they are going to be, due to swelling. Your implants also need time to settle in order for the results to look more natural. How long it takes to see your final results will depend on the type of implant that was used, where the implant was placed and your body type. The stronger your pectoral muscles are, the faster you will heal. It’s natural to want to see your results as soon as possible, but giving your body time to heal from a breast augmentation is well worth it.
Where does Dr Safvat perform this procedure?
Dr Safvat does the Breast Augmentation procedure in the Sydney region (Sutherland Shire and Inner West) as well as in the Southern Highlands, NSW. He only operates in fully accredited Private Hospitals, these being Kareena Private Hospital (Caringbah), Strathfield Private Hospital, Southern Highlands Private Hospital (Bowral) and Ramsay Surgical Centre Miranda.
Before and Afters
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Dr Safvat is a fully qualified Specialist Plastic Surgeon. Every patient is unique and results may vary. Any surgical procedure carries risks which need to be discussed with your doctor to ensure you are fully informed and realistic outcomes have been explained. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
These photos are of actual patients of Dr Safvat. Each has given consent for the photos to be used by Dr Safvat only.
DR ANDRE SAFVAT (MED1155201)
Registered Medical Practitioner, Specialist Plastic Surgeon (specialist registration in Surgery – Plastic surgery).
Dr André Safvat – Specialist Plastic Surgeon
Renowned for his dedication to his patients, his attention to detail and impeccable outcomes, Dr Safvat’s unparalleled expertise is reflected in the quality, professionalism and dedication of every member of our team.
