Breast augmentation with implants

Breast augmentation with implants, also called breast enhancement with implants or augmentation mammoplasty, increases breast size and can alter breast shape and contour. People consider it for a size increase, or to restore size and shape affected by age, breastfeeding, genetics or breast asymmetry.

Me Clinic has over 35 years of experience, and its surgeons have performed over 6,000 breast augmentation procedures. It is the most commonly performed procedure in the clinic's breast surgery range.

How the procedure works

Your plastic surgeon makes an incision in one of three positions:

• Inframammary - under the fold of the breast.
• Periareolar - around the nipple, where the scar sits within darker pigmented skin.
• Transaxillary - under the arm, leaving no scar on the breast itself.

The pre-selected silicone or saline implant is then placed inside the breast, either on top of the muscle tissue (subglandular) or beneath it (submuscular), depending on the result being sought and your anatomy. Incisions are closed with sutures.

The procedure is performed under general anaesthesia in an accredited private hospital. Depending on your circumstances you may go home the same day or stay overnight.

Choosing an implant

A consultation is required so the surgeon can examine you, discuss your requirements and expectations, and recommend which implant type and placement suits your case. The main choices are:

• Saline. Filled with sterile salt water, which allows final volume adjustment during surgery. A rupture typically causes visible deflation.
• Silicone. Generally described as having a more natural feel. A rupture can be silent, which is why periodic monitoring is recommended.
• Round. Provides more fullness in the upper part of the breast.
• Teardrop (anatomical). Gives a more gradual slope and a more naturally contoured profile.

Each type has its own benefits and risks. Which is most suitable depends on your anatomy, your frame, your circumstances and the result you are seeking. Implants do not last a lifetime - replacement is commonly considered around the ten-year mark, and further surgery may be needed in future.

Suitability

A good candidate is physically and mentally healthy, with realistic expectations of what the procedure can achieve. Your breast shape before surgery affects the outcome. Smokers have an increased risk of complications from any surgery, and stopping well before and after surgery assists healing.

If you are planning pregnancy, it is worth discussing timing with your surgeon, as pregnancy and breastfeeding change breast volume and position.

Preparing for surgery

• Provide your full medical history, including medications, allergies and previous operations.
• Tell your surgeon about any medication you take, and adjust dosage where advised.
• Stop smoking well in advance, as nicotine inhibits recovery.
• Avoid aspirin, anti-inflammatory drugs and herbal supplements, which can increase bleeding.
• Arrange for someone to drive you home and stay with you for at least 24 hours.
• Set up a comfortable area at home for your recovery before the day of surgery.

Recovery

The first 24 hours. You may feel drowsy from the anaesthetic, and there may be discomfort and swelling. You cannot drive yourself - you need someone to drive you home and stay with you overnight. Rest that evening. An after-hours direct number is provided in case you have questions or concerns.

The first week. You return to the clinic for your first post-operative check the next day or within a few days. Expect swelling and tightness. Painkillers and antibiotics are often prescribed; take pain relief as directed. A supportive surgical bra is worn to reduce bruising and control swelling. Gentle walking is encouraged to promote circulation.

Weeks two to six. After the initial swelling settles, the shape of the breasts becomes clearer. Strenuous activity is generally avoided for around three weeks. Most people return to work after two to three weeks, earlier or part-time if working from home. Domestic flights are usually fine at around two weeks.

Six weeks onward. Most people can return to their previous exercise routine from around six weeks. Wait six to eight weeks before swimming, and before international or long-haul flights. Further changes can occur over the following months as the body adjusts to the implants, and how long the breasts take to feel natural varies from person to person.

Follow-up. Most patients are seen at seven to ten days, then at six to eight weeks, three months, six months and twelve months. Surgeons and nurses are available between appointments if you have concerns.

Wound care and signs of a problem

Clean your hands before touching the wound area. Clean gently with mild saline or as directed, pat rather than scrub, keep the area dry, and change dressings as advised. Do not apply ointments or creams unless prescribed.

Contact your medical team immediately if you notice increased redness or warmth around the wound, persistent or worsening pain, discharge or pus, a foul smell, or fever and chills. Persistent or worsening pain beyond the expected recovery period may indicate a complication.

Scarring

Wherever an incision is made there will be a scar. Incisions for this procedure are placed to be as unobtrusive as possible, and a well-placed incision sutured in fine detail typically fades over time. How a scar heals varies between individuals and depends on skin type and genetic makeup.

Scarring can be minimised by not smoking, eating well, maintaining a stable weight, avoiding sun exposure to the surgical area, keeping incision sites clean and dry, limiting physical strain, and following your surgeon's wound care guidance including silicone sheets or gels for scar management.

Risks and complications

All surgical procedures carry risks and potential complications. These are discussed with you in detail during the consultation process, and you are given written information to take home. Please read our information on the risks and complications of cosmetic surgery before proceeding.

Risks specific to breast augmentation include:

• Capsular contracture - the scar tissue that naturally forms around the implant tightens and compresses it, causing discomfort and changes in breast appearance.
• Implant rupture or leakage - saline implants typically deflate visibly; silicone ruptures can be silent.
• Changes in nipple and breast sensation - most women experience some change in sensitivity after breast augmentation, and around 15% experience permanent changes in nipple sensation.
• Haematoma - a pocket of blood resembling a large, painful bruise, occurring in up to 6% of breast augmentation procedures.
• Infection - sterile technique is used during surgery, and antibiotics are often prescribed, but neither guarantees prevention.
• Asymmetry - the breasts may not be perfectly symmetrical in size, shape or position afterwards.
• Need for further surgery - to address implant malposition, replacement or other concerns.

Breast implants are associated with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a rare cancer of the immune system. This is a recognised risk and should be discussed with your surgeon, along with the specific implant proposed for you, before you decide to proceed. Regular mammograms and, for silicone implants, occasional MRI scans may be recommended to monitor implant integrity.

General surgical risks include bruising, swelling, pain, seroma, nerve damage, anaesthesia complications, blood clots (DVT and pulmonary embolism), psychological impact, and unsatisfactory results.

Outcomes vary depending on individual anatomy, skin quality and the implant used. Individual results may vary.

Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.

Referral and cooling-off period

Since 1 July 2023, all patients are required to have a GP referral before seeing a plastic surgeon or doctor about cosmetic surgery. A valid referral is also needed if you wish to claim a Medicare rebate on medically essential surgery.

For any cosmetic surgery there is a compulsory one-week cooling-off period after your second consultation before surgery can be booked.

Costs

Every patient has different requirements, so each procedure is quoted individually. As a guide, the surgical fee for breast augmentation with implants starts from $12,000. Total cost, which also covers anaesthesia, hospital fees and post-operative care, generally ranges from $14,000 to $18,000.

As at September 2024 and including GST, a consultation with a Specialist Plastic Surgeon is $350. After your consultation you are provided with a quote covering what is involved in your procedure and what it will cost.

Payment for major surgery is due four weeks before the procedure. Cash, EFTPOS, direct deposit and major credit cards are accepted, with surcharges applying to cards. Independent medical finance companies are available.

Medicare and health insurance

Breast augmentation performed for cosmetic reasons is not covered by Medicare and generally not by private health insurance. Where augmentation forms part of breast reconstruction following mastectomy, or addresses a significant deformity, a Medicare item number may apply.

Where an item number applies and you hold the right level of cover, your insurer may subsidise part of the cost. Me Clinic is not a no-gap provider, so a significant out-of-pocket payment remains. Confirm current item numbers and criteria with your surgeon and on MBS Online.

Where surgery is performed

Me Clinic surgeons operate at accredited private hospitals around Melbourne, including Masada Private Hospital (St Kilda East), Epworth Geelong (Waurn Ponds), St Vincent's Werribee, Sir John Monash Private Hospital (Clayton), Peninsula Private Hospital (Langwarrin) and Linacre Private Hospital (Hampton). Your surgeon visits you in hospital after the operation and sees you at the clinic about a week later.

Related procedures

For some patients hybrid breast augmentation may be worth considering, where implants provide the main structure and a small amount of fat transfer refines contour. Where volume is to be added without a foreign implant, see augmentation with fat transfer. Where sagging also needs correcting, see breast lift with implants. See all breast surgery procedures.