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.

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.

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.

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 The incidence for macrotextured implants are much higher but they have been withdrawn from the Australian market.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.

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.

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.

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.

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.

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.