Decision Making for Breast Surgery

The following information is intended as a general guide only. It is useful for the person in early stages of researching a surgical breast augmentation. These points should be considered when having a consultation with the surgeon and prior to making a decision.

Initial Decisions
1. Health Status:
A person’s health has a dramatic impact on their surgical recovery and outcome. It is in the individuals’ best interest to be of a healthy weight with a good diet and exercise regime. The impact of excess weight, disease and smoking can be detrimental to the end result of surgery. These contributing factors may lead to revisional surgery, extra costs and unsatisfactory results to name a few. The surgeon will inform you of your risks and has the right to refuse to operate if you are an unsatisfactory surgical candidate.
2. Size:
An idea of size is not always necessary and can lead to disappointment if it is an unrealistic expectation. A proportionate balance is aesthetically pleasing and a desired outcome. Trialling sizers is helpful and can clarify any recommendations made during your consultation. Ultimately the size limit is determined by your breast/chest width and your skin elasticity. There is a limit! Sizes chosen outside the surgeons recommendation can result in a less than desirable outcome and possible complications.
3. Shape:
Round – most popular and will give a general push up effect (depending on skin elasticity). This shape can balance out other curves.
Teardrop – if you have a thin/lean build, bony chest, tubular breasts or small saggy breasts post breastfeeding, this may suit you.
4. Profile (projection):
This means how far the implant sticks out. There are a variety of profiles and choices are made to balance out hips, project saggy breasts, fill skin and offer a more projected breast to suit each individual. Your surgeon will show you the differences.
5. Under or over muscle (subglandular or submuscular):
This is a technical decision your surgeon will discuss with you. Your skin elasticity, strength and thickness plus the size of the implant will contribute to this decision. Other contributors are your lifestyle, activity/exercise, family history and genetics.
6. Incision site (scar placement):
The most common incision site is the crease under your breast (inframammary fold).
The areolar around the nipple is another site and depends on the size of the implant, lifestyle, potential breastfeeding options and surgeon recommendation.
7. Long Term:
The most common complication is capsular contracture where the scar tissue builds up around the implant causing tightening/hardening of the breast and a less than optimal appearance. There are other complications/risks your surgeon will discuss with you. All surgical candidates must respect the potential of revisional surgery to remove and replace the breast implants at some stage due to complication, age or personal decision.
Further Considerations:
• Lifestyle
Submuscular placement of the breast implants is the preferred technique. This will restrict your exercise/activity for a period of time and must be taken into consideration when deciding on surgery. If you spend a great deal of time in the gym or running, smaller implants are recommended.
• Examinations
Mammograms can be carried out but the technician should be informed that you have breast implants. Your surgeon will recommend that you have a routine ultra sound referred by your GP every 2 years following your initial surgery.
Any lumps, folds or pain should be reported to your surgeon. Early detection may prevent long term complications.
• Future surgery
All surgical candidates in their 20’s can expect up to 2 or 3 more operations in their lifetime. Even older candidates must consider future operations. Statistically, 20% of people having breast augmentation will have repeat surgery within 10 years. The use of larger implants in your initial surgery may cause excessive stretch. The future option to go smaller or remove the implants all together will give a less than optimal appearance.
The ageing process will continue. Weight loss, pregnancy, weight gain, gravity and genetics will impact on your body and your breasts. Some candidates will have to undergo a breast lift with or without implants at a later stage.

What to take to your consultation?
Realistic expectations. Be open minded about possible outcomes. Your friend or sisters results may not be yours.
Understand that not all your questions may be answered at the first visit and it can be a bit overwhelming with so much information. Do a little homework and research your procedure first so the technical terms will be familiar.

Put it all together. Take some responsibility for your decision to go ahead with surgery. If your surgeon has given you a choice; take into consideration your frame, your hips, your expectations and your surgeons experience. Make a decision to suit you, not your partner.
Many candidates feel they should have gone bigger once their swelling has resolved. Keep in mind the long term result, your lifestyle and implant placement.
If you have any doubt, request a 2nd consultation with your surgeon or seek a 2nd opinion.
A prepared patient with realistic expectations makes a good surgical candidate who will recover smoothly.
Be happy and comfortable with your decision and look after your investment.