FORM AND FACADE, COSMETIC PLASTIC SURGERY, DR BENJAMIN NORRIS, SYDNEY,NSW, AUSTRALIA FORM AND FACADE, COSMETIC PLASTIC SURGERY, DR BENJAMIN NORRIS, SYDNEY,NSW, AUSTRALIA
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Breast
 Enlargement
 
More on Breast Enlargement (Breast Augmentation/ Breast Implants)
 
 
What happens at the first consultation?

Because deciding to have a breast enlargement is a very personal matter and every woman has her own reasons for making that decision, Dr Norris will focus on your goals, desires and what you hope to achieve from the procedure. There will be a discussion about concerns you have regarding your breasts and ultimately what you would like your breasts to look like. It is important to understand that any discussion about beautiful breasts should consider shape and proportion as well as size.

Dr Norris will evaluate your breasts by assessing your skin tone, condition of breast tissue and fatty tissue, and position of your nipples. He will measure your breasts and photographs will be taken for the medical record. This evaluation helps Dr Norris to discuss with you the best way of achieving an optimal result that meets your personal goals.

Dr Norris will discuss in detail with you how the operation is done, where the scar can be placed, and what types of implants and sizes are available to best give you the result you desire. You will be encouraged to ask questions and voice any concerns you may have. There will be a frank discussion about the risks, complications and consequences of having a breast enlargement procedure.

At the end of this initial consultation you will have a very good idea of what will be possible for you. You will have an information sheet to read at home and Dr Norris will arrange for a cost quotation to be sent to you.

Dr Norris prefers to see you again at a second consultation if you decide to go ahead with the surgery. This allows you to ask any new questions you may have, to discuss anything you are not sure about, make a final decision on the most appropriate implant for you, and give you a date for your procedure.
 
 
What type of implant will be used?

Implants are available in a range of size, shape, profile, and texture. Dr Norris will help you to choose the most appropriate implant for you to achieve your desired goals.

The outer lining of the implant is made of thin silicone, and it is filled with either saline (salt water) or silicone gel. Most women will choose to have silicone gel implants to provide a natural feel. You may have heard stories in the media or from friends and colleagues about problems associated with silicone in the body. Because silicones are widely used in medical devices and are found in common everyday products, including some foods and drink, lipsticks and cosmetics, they have been subject to exhaustive testing to establish their safety for use in the human body. There is currently no scientific evidence that silicone gel breast implants put you at increased risk of breast cancer or autoimmune diseases, and problems when breast feeding. These implants may interfere with interpretation of a mammogram but this can be avoided if special views are done at the time of mammography.

The lining of the implant is either smooth or textured. A textured surface helps to reduce the formation of scar tissue around the implant.
 
 
How is the operation done?
Dr Norris will only do breast augmentation in fully accredited facilities. This is for your safety and to ensure optimum quality of care throughout the operation and the immediate postoperative period. The anaesthetist that Dr Norris works with, Dr Ross Foreman, will in most cases give you a general anesthetic. In some cases a local anaesthetic with sedation can be used – this is more likely when the implants are placed in front of the pectoral muscles. You can expect the operation to take between 1-2 hours.

To insert the breast implant an incision is required. There are three choices for placement of the incision and the scar that results from it:

- Inframammary (hidden in the fold under the breast)
- Periareolar (hidden around the edge of the areola)
- Transaxillary (hidden in the armpit)

The best option for you is something you will decide with Dr Norris after consideration of your goals and desires. No matter what approach is chosen, Dr Norris aims to ensure that the scar is as small and discrete as possible.

After making the incision, the pocket in which the implant will be placed is dissected. This pocket lies either beneath the chest wall muscle (submuscular) or immediately behind the breast tissue on top of the chest wall muscle (subglandular). The pocket used will depend on a number of factors including your preference, thickness of the skin over the breast, the nature of your breast tissue, the presence of breast droop (ptosis), and the type of implant used. Dr Norris most commonly places the implants in the submuscular position as it is easier to hide the implant, lessens the chances of the implant being felt, and gives a more natural appearance. There is evidence that the overlying muscle can reduce the chances of capsular contracture (hardening around the breast implant with build-up of scar tissue) by massaging the implant as the muscle moves.

When the implant is placed into the pocket it will be centered beneath the nipple and positioned to give you a breast that is beautiful. Very occasionally a drain may be placed into the pocket which would be removed the next day. The incisions are closed with absorbable sutures to save you the inconvenience of having them removed. A light dressing is applied over the incisions and you will leave the hospital wearing a comfortable and supportive surgical bra.
 
 
What happens after the surgery? How long until recovery?

Most patients go home the same day as the operation and you will require a friend, family member or partner to drive you as you won’t be able to drive yourself for about a week. You will leave with written postoperative instructions, a prescription for pain-relief and antibiotics, and a follow-up appointment with Dr Norris for one week.

At home you will experience the most discomfort in the first 24 to 48 hours after the surgery. Some degree of discomfort is normal and your breasts and nipples will be bruised, swollen, tender, and sensitive to touch. Most of these symptoms settle quickly so that you can return to most of your usual daily activities by one week. The swelling will take longer to settle – usually up to six weeks.

Many women will be able to start light exercise such as walking 3 or 4 days after the procedure, but more rigorous and strenuous exercise and activities are not usually started for 3 to 4 weeks. Of course some women recover more quickly, and others more slowly.

You will be able to return to work by a week unless it involves heavy use of the upper body or lifting, in which case up to 3 weeks off work should be allowed.

At one week after the procedure you will have a follow-up appointment with Dr Norris in the consulting rooms. This is to check on how you are feeling, make sure the wounds are healing without problem, change the dressing and teach you how to gently massage the breasts.

If at any time before this first follow-up appointment, or at any time after this you note a problem or have any concerns at all please contact Dr Norris immediately.

The scars will be at their most prominent at 6 weeks and may remain this way for a few months. However they will then begin to fade and become much less noticeable. Dr Norris recommends massaging and moisturizing the scars to help this process.
 
 
What can go wrong?
Any surgical procedure will have consequences and potential complications. Despite the best efforts of your surgeon the results of your procedure are not always as predictable as you and your surgeon would like.

Perhaps the least predictable is capsular contracture – the most common complication of breast implants (approximately 6%). This is characterized by hardening around the implant due to shrinkage of the capsule that forms as the body’s natural response to foreign material. All breast implants will have a capsule form around them – but in the vast majority of cases this capsule is undetectable and has no impact on the implant. In a smaller number of cases the shrinkage of the capsule can distort the shape of the implant, become palpable, and cause discomfort or pain. If capsular contracture is to occur it often does so within the first 3 years after the procedure, but this too can be unpredictable.

There are a number of other potential complications of your surgery that Dr Norris will discuss with you at length during your consultations.

 
 
 
 
 
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Dr Benjamin Norris - FRACS