8 Questions to ask if you are considering breast implants

Many women consider having breast implants because they would like to feel more confident about the way they look. Some women have always been small and long to feel more feminine. Others have seen their breasts lose shape and volume after childbirth. In both these situations breast implants offer you not only  bigger breasts but also an increased sense of confidence and wellbeing. The following are 8 important questions to ask your surgeon at your consultation:

1.  Where will the incision be located?

Breast implants can be inserted through an incision under the breast, around the nipple or in the armpit. Each incision has advantages and disadvantages and it is important that you understand all the implications.

2.  Will the breast implant be placed on top of or behind the muscle?

Placing the implant above or below the muscle can have a major affect on the softness of your breasts and whether or not it is obvious that you have breast implants.

3.  Should I have silicone or saline breast implants?

In Australia implants filled with silicone gel and implants filled with saline are both available. Some people say that implants filled with silicone gel are softer, although studies have shown that when the implants are placed behind the muscle it takes a very experienced surgeon to tell the difference! Breast implants filled with saline have obvious safety advantages which give you peace of mind. Implants filled with silicone gel should be checked every 2 years by an MRI. If a saline implant leaks then no harm is done. When a silicone implant leaks then the silicone can end up in the lymph nodes (especially if the implant is behind the muscle) or can form lumps under the skin (silicone granulomata).

4.  Should the implants be smooth-walled or textured?

Textured implants were introduced in about 1990 to reduce the problem of capsule contracture. We now know that capsular contracture is best prevented by placing the implants under the muscle and by using antibiotics to prevent bacterial growth. Because textured implants adhere to the surrounding tissues there is a greater shearing force placed on the breast implants. Smooth-walled implants move freely within their pockets and some people believe that they provide a more natural result.

5.  Will the surgery be performed as a Day Case or will it require an overnight stay?

A surgeon working as part of a team with a good anaesthetist and knowledgeable nursing staff should be able to insert breast implants with a minimal of trauma and minimal physiological disturbance This means you should be able to go home the same day. If you are required to remain in hospital for overnight (or even a longer period) it may mean that the surgeon is expecting complications!

6.  What are the surgeons qualifications and experience?

In Australia we are fortunate that we have a number of full qualified plastic and reconstructive surgeons who perform breast implant surgery.  These surgeons are all Fellows of the Royal Australasian College of Surgeons (FRACS) and so it is important that your surgeon has these letters after his name.

7.  Is there an alternative to breast implants?

The  first alternative is not to have any surgery at all!  It may be possible just to wear a push-up bra or inserts and if you are happy with these then you can avoid surgery. Another option is to have fat transferred from another part of your body into your breasts. Breast enlargement by fat transfer is a new procedure which utilizes the fact that fat tissue contains lots of adult derived stem cells. These stem cells are long lasting and grow into fat cells. Plastic surgeons have been injecting fat into the face for many years but it is only recently, with the advent of specialized tools for taking and injecting the fat, that breast enlargement by fat injection has become a viable option. Of course you will need a little excess fat (usually the abdomen or thighs). You should expect about ½ – 1 cup size improvement in your breast size (breast implants usually produce at least a 2 cup size increase).

8.  What are the complications?

With an experienced breast surgeon complications after breast implant surgery are rare. However there is a possibility of bleeding, infection, scarring, loss of nipple sensation and other complications that you should be fully aware of.