The largest concern that women considering implants for the first time have is that they will choose the wrong size – either too small or too large.
Women who have never had larger breasts (for example their breasts have never developed) often find it hard to imagine what larger breasts will look and feel like.
For those women who have had the experience of larger breasts but now find them smaller following having children, weight loss, or normal ageing, do have a better idea of what they would like in terms of final breast size and are often more confident in their selection of an implant at the sizing stage of their consultation.
It is relatively straight-forward to replace the existing (too large or too small) implants, although consideration should be given to skin stretching or retraction and where the nipple will be located with the new implants.
Optimal results in breast implant surgery are obtained when the correct implant is placed in the correct plane (under or over muscle) via the correct incision (we recommend a breast-crease incision for most women).
The reasons for some surgeons choosing to go under the muscle are often historical – they use the same technique they learnt 30 years and don’t see a reason to evolve with the newer implant technologies. In using P-URE implants we can often correct old-style problems with less invasive surgery and obtain a good result for our patient.
A difference between the two sides of the body is normal and natural, and this is especially true of the breasts. Sometimes one side is larger or in a different position to the other breast, so surgery to correct this usually involved just the one breast but can involve improving both breasts.
This is when the waviness of the implant edge is visible on the skin, or can be felt when touching the breast. It is usually experienced in thin women or those who have lost weight and have a thin layer of tissue over the implants that does not adequately disguise the implant edge.
Treatment can vary between changing the position of the implant to changing the implant itself.
When implant are placed under the muscle, as they often are with saline implants (see below), the breast can move in a odd, un-natural way when the pectoralis muscle is contracted.
The only way to address this is to place the implants on top of the muscle, however this can be a potential problem for women with thin tissues in this area as they implant edge or rippling can be seen or felt (see above).
This problem only occurs with saline implants, when the outer (silicon) shell develops a small tear over time – typically 10-15 years – and the water inside leaks out and is harmlessly absorbed by the body. The implants can be removed or replaced with silicon implants that cannot deflate.
(RISK OF THIS IS 1% PER YEAR)
Sometimes an implant can develop a small tear in its outer shell and the silicon gel (in modern implants) can bulge out. This can produce a lump at the spot but is not dangerous.
Although we believe the bulging silicon is not harmful to health, the current recommendation is to replace that ruptured implant at some stage. There is no major urgency in most cases.
This is a rare complication (should be less than 1% in a high standard facility) and may require removal of the implant(s) for 3 months until the tissues heal, and then can usually be replaced. Sometimes specific antibiotics are taken for weeks or months to combat the bug that is causing the problem.
Difficulties arise sometimes when patients have surgery overseas (particularly in Asian countries) and return to Australia with a difficult to diagnose, or difficult to treat bug as these can be resistant to most regular antibiotics. This patient’s right breast is swollen following implants overseas. She is shown 3 months after implant removal and a breast lift.