One or more of the following feelings or conditions may indicate that you are a good candidate for breast augmentation:
A woman feels her breasts are too small
The breast size is not proportional to the rest of the body
To balance the size and shape of the breasts if they are unequal
To improve contour and size of the breasts following pregnancy, breast-feeding or weight loss.
What happens when I see Dr Lim?
Your consultation with Dr Lim will take about 45 minutes and you are most welcome to bring a friend or your husband/partner along to your consultation. During the consultation Dr Lim will take the time to discuss the procedure with you, the breast size you desire and any issues related to the appearance of your breasts that you feel are important. This will help Dr Lim understand your expectations and determine if they can realistically be achieved.
Dr Lim will explain the risks of the surgery and discuss the types of implants and their use and you will have the opportunity to discuss any questions you may have. During your consultation your breasts will be assessed and a few measurements and photographs will be taken. You will have the opportunity to try implants of different sizes so that you have some idea of what the final result may look like. Please bring a fitted top to the consultation to assist with the trial of the implants. You will be given a written quotation and information to take home to read.
How will Dr Lim evaluate me for surgery?
Dr Lim will examine your breasts and consider such factors as the size and shape of your breasts, the quality of your skin and the position of your nipples and areolas. You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, any medications that you are currently taking, any drug allergies that you have, other medical treatments you have received and any previous surgery you may have had. You will also be asked whether you have a family history of breast cancer and about results of any mammograms you may have had.
It is important for you to provide complete and correct information. If you are planning to lose a significant amount of weight, you will need to discuss this with Dr Lim. He may recommend that you stabilise your weight before undergoing surgery. If you think you may want to become pregnant in the future you should mention this also. There is no evidence that breast implants will affect pregnancy or your ability to breast feed but if you have any questions about this you should discuss them at the time of your consultation. A second consultation (at no extra cost) is usually required if you wish to proceed with surgery.
How should I prepare for surgery?
In some cases Dr Lim may recommend a base line mammogram before surgery if you have not had one in the past. Following breast augmentation you will still be able to perform breast self-examination and should do so every month after your periods. You will still be able to have regular mammograms following surgery.
It is advisable to stop smoking at least two weeks prior to surgery. Aspirin and certain anti-inflammatory medications can increase bleeding and should also be avoided two weeks prior to surgery. You will be given all pre-operative instructions prior to your operation and the staff from Dr Lim’s rooms will be in touch with you before your operation to discuss any further last minute questions you may have.
Where will my surgery be performed?
Dr Lim performs the surgery in fully accredited hospitals: Castle Hill Hospital, Holroyd Private Hospital, The Hills Private Hospital and Westmead Private Hospital. Breast augmentation surgery is usually performed as a day surgery procedure although you may wish to have an overnight stay. The surgery is performed under a general anaesthetic.
What will the day of surgery be like?
You will need to contact the hospital a day before surgery to confirm your admission and fasting time. On entering the hospital you need to report to the admissions desk and the staff will direct you through the admission process. Dr Lim and the anaesthetist will both see you prior to surgery and Dr Lim will make some markings on your breasts. Post procedure you will spend some time in the recovery room where you will be closely monitored until you are fully awake. You will have firm bandaging around your breasts and this will be removed by Dr Lim or the nursing staff and you will be placed in a supportive bra with an implant stabiliser before your discharge.
How will I look and feel initially?
The first day or two after surgery are usually the most uncomfortable and your breasts will be slightly bruised and swollen. The top of your breast may appear quite swollen and your breast implants may appear to be sitting quite high. During the first month the swelling will subside and the implants will settle into a more natural position.
It is also normal to feel tired and a little slow for a day or two after an anaesthetic. You will have tapes covering your incisions and will be able to shower 48 hours after surgery. If you have bruising this will resolve in the first two weeks. Most swelling will resolve within a month. You may also be provided with a breast stabiliser to wear for two weeks. Dr Lim will advise you regarding your individual situation.
When can I resume my normal activities?
The recovery period following this procedure varies from person to person. The time at which you are able to return to normal activities also depends on where the implant is positioned. An implant placed behind the muscle tends to cause more discomfort than placement in front of the muscle. You should avoid activities that involve lifting your arms above your head for two weeks after surgery and you should be able to drive one week after surgery. For duties that are strenuous and involve a lot of lifting, two to three weeks recovery may be required. For less strenuous duties such as secretarial work, one week may be sufficient. Any sexual activity should be restricted for the first week at least. The breasts will be sensitive for around one month following surgery and they should be handled according to your own level of comfort.
How is breast augmentation performed?
Individual factors and personal preferences will help you and Dr Lim to determine your appropriate breast size, the location of the incisions and whether the implant will be placed on top or underneath the pectoral muscle. An incision is usually made underneath the breast in the crease or in some cases in the armpit or around the nipple. After making an incision Dr Lim creates a pocket either in front of the muscle or behind it into which the implant is inserted. The length of the incision will depend on the type of implant used and is normally around five centimetres for silicone implants and slightly smaller for saline implants. Once the implants are in place Dr Lim takes care to ensure that the implants are evenly placed before closing the incision and does not usually use drains for this procedure.
What type of implant will be used?
Breast implants fall into two broad categories: saline or silicone. While some people feel more comfortable with saline due to negative implications associated with silicone a number of years ago, silicone gel implants are still the most popular because they achieve a more natural result. (Implants filled with saline are often associated with a "rippling" effect that can be seen through the skin.) Silicone implants are now TGA (Therapeutic Goods Association) approved.
Modern silicone-gel implants are far more robust and less likely to leak than the old fashioned variety containing liquid silicone. The actual shell or membrane of the implant comes in either a smooth or textured surface. The current belief is that implants with rough surfaces can minimize the amount of scar tissue that forms around them, causing hardening or "capsular contractures". Implants come in various shapes ranging from round to tear-drop.
Dr Lim will discuss the benefits and risks of both types and after careful discussion you will be able to choose which type you prefer.
I understand that all surgical procedures have risks involved but how do I find the information to make an informed decision?
Dr Lim will discuss with you the risks involved and the potential complications. We endeavour to have our patients as fully informed as possible and while some of the potential risks seem frightening it is important for you to be aware that they can occur. Some of the potential complications that will be discussed with you are:
rippling of the implant
accumulation of blood (haematoma) in the breast which requires drainage
shifting of the implant
rupture of the implant
How long will the results last?
Breasts are normally slightly different in size and this persists after the procedure. The immediate effect of this surgery is dramatic and while initially, the breasts will be slightly swollen and it may take several months to see the ultimate result of the surgery, the benefits will be immediately obvious to you. Although the reduction in breast volume will be permanent, your breast size and shape will continue to be affected by the changes that ageing, pregnancy/breastfeeding, weight loss and weight gain can produce in all women.
In years to come, if you become dissatisfied with your breast shape and contour, you may choose to undergo a mastopexy (breast lift) procedure to achieve a more youthful position and contour.
How long do I need to see Dr Lim for following my surgery?
Dr Lim will monitor your progress carefully and the staff will stay in contact with you during the post operative period. You will be seen at frequent intervals over the first twelve months and be required to have periodic checkups after this at yearly intervals.
Your relationship with Dr Lim and the nursing staff does not end once you have had the procedure. If you have any questions or concerns after your operation you are always welcome to call and discuss these with us.
What is Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)?
Read all about Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) in this FAQ sheet released by the Therapeutic Goods Administration (TGA)