Many women are unhappy with the size or shape of their breasts for various reasons. Surgery of the breast is a reliable and safe option for thousands of women who wish to change the appearance of their breasts, whether they are looking for larger breasts more in proportion with their figure, a reduction in the size and shape of too-large breasts after a mastectomy, or an lift of the breasts for breasts that have drooped whether it be due to aging, breastfeeding, weight loss or weight gain. For these women, surgery of the breast is often the long-term answer.

The female breast lies between the 2 nd and the 6 th ribs. The major muscles under the breast gland are the pectoralis and serratus anterior muscle. The pigmented portion of the breast which surrounds the nipple is called the areola. The sensation to the nipples comes from nerves arising from the fourth rib space. The development of the female breast begins during puberty. The preadolescent breast consists of a small elevated nipple with no elevation of the underlying breast tissue. Between the ages of 8 and 15, secondary characteristics become apparent. Breast buds appear, and further enlargement of the breasts and areola follows. After pregnancies, the areola of the female breast will further enlarge in size.

The Breast Has Three Principal Components:

  • The glandular tissue is organized into 12 to 20 lobes, each of which terminates into a duct that opens on the surface of the nipple.
  • The glandular tissue is supported by fibrous tissue, including suspensory ligaments that are connected both to the skin and the tissue underlying the breast.
  • Fat surrounds the breast and predominates both superficially and peripherally. The proportions of these components vary with age, the general state of nutrition, pregnancy, and other factors.
Considering whether you are a good candidate for breast augmentation

Breast Enlargement is one of the most common cosmetic surgery procedures performed on women in the world.

Women frequently consider breast enlargement for the following reasons:
  • A dissatisfaction with their breast size
  • A wish to regain or improve breast shape or size after having children or after significant weight loss.
  • A congenital absence or deformity of one or both breasts.
  • A wish to correct uneven breasts (Asymmetry)
  • To achieve a cleavage to improve their appearance in clothes or bikinis

Breast Implant surgery can provide both psychological and physical benefits for women. Patients who have undergone Breast Enlargement frequently report that they feel more feminine, experience increased confidence and self esteem, enjoy buying clothes and lingerie to suit their new figure and have an improved confidence in establishing and maintaining relationships.

It is important for all prospective patients to have realistic expectations of the improvements that can be achieved through breast surgery. Your surgeon will take into account your age, skin texture and the existing shape and position of your breast tissue and nipples when predicting the outcome of your results. It is therefore essential to have a thorough consultation with a surgeon who specialises in breast surgery before you make a decision to go ahead with a procedure.

Size

This is why the vast majority of women have breast augmentation, because we want to increase our size and/or have our breasts more proportionate to the rest of our bodies. This can be very distressing, because we tend to obsess over getting the perfect size, which is about not going big enough. "Trying on size" prior to your consultation with your cosmetic surgeon is a very good idea. If you're very flat-chested, ANYTHING seems big, but you will be amazed at how quickly you adjust to the new, larger size. It also gives you an idea of what you'd like to look like, as well as a rough idea of how many cc's it may take to get that result. You can try the Rice Test which is a "do it yourself" sizing method. It's not 100% accurate, but it's pretty close.

To do the rice test, do the following

Use thin socks/stocking, and fill them with the desired amount of cc's. (cc conversions are available below). Once you have them filled, try them on under a sports bra. The sports bra is helpful, especially if you plan on having your implants placed under the muscle. The sports bra compresses the "pretend breast implants" much like the muscle will compress the real implants.

How to measure for cc amount / Rice Test

The conversions below, which are approximate, will help you when doing the "rice test."

  • 1/8 cup = 30cc
  • 1/4 cup = 59cc
  • 1/3 cup = 78cc
  • 1/2 cup = 118cc
  • 2/3 cup = 156cc
  • 3/4 cup = 177cc
  • 1 cup = 236cc

The amounts above can be used in different combinations to achieve the cc amount you desire.

It's important to remember that you should not solely rely on cc amounts. For instance, if you like the way 400cc looks on one person, that does not mean that 400cc will give you the same look. This is due to several things, including, but not limited to: amount of breast tissue, shape of chest wall and weight to name a few. Basically, your existing breast tissue and anatomy dictate how many cc's you will need. Therefore, you should do the rice test to give you an idea of how many cc's you may need to get the size you want. Again, this is just a rough estimate, as the "rice test" is not an exact science.

Measuring your ribspan

To measure your ribspan, use a soft measuring tape. Measure from where the breast begins on one side (at the outer portion, toward the arm), all the way across the chest to where the breast tissue of the other breast ends. The measuring tape should be placed in the "crease" area of the breast, as shown in the picture below. This is your ribspan measurement.

Measuring your ribcage

Ribcage measurements are taken in much the same way. The only difference is that you will measure all the way around your chest. Again, the measuring tape should be placed in the crease of the breast, as shown in the picture.

If your ribcage measurement is an odd #, add 5" to get your band width. Example: 29" ribcage + 5" = 34" band.

If your ribcage measurement is an even #, add 4" to get your band width. Example: 28" ribcage + 4" = 32" band. Measuring cup size:

Using a soft measuring tape, measure from where the breast begins (in the cleavage area) to where it ends, towards the arm. This is your cup size. See photo below. Breast Implants: Placement and Incision Sites

The breast consists of milk ducts and glands, surrounded by fatty tissue that provides its shape and soft feel. Skin elasticity also contributes to breast shape. Factors such as pregnancy (when milk glands are temporarily enlarged) and the inevitable effects of gravity as you age combine to stretch the skin, causing the breast to droop or sag.

The breast implant can be placed either partially under the pectoralis major muscle (submuscular) or on top of the muscle and under the breast glands (subglandular) depending on the thickness of your breast tissue and its ability to adequately cover the breast implant. You should discuss with your surgeon the pros and cons of the breast implant placement selected for you.

The submuscular placement may make surgery last longer, may make recovery longer, may be more painful, and may make it more difficult to have some reoperation procedures than the subglandular placement. The possible benefits of this placement are that it may result in less palpable implants, less capsular contracture, and easier imaging of the breast with mammography. The subglandular placement may make surgery and recovery shorter, may be less painful, and may be easier to access for reoperation than the submuscular placement. However, this placement may result in more palpable implants, more capsular contracture, and more difficult imaging of the breast with mammography.

To permit the smallest possible incision, the breast implant is typically inserted empty, and then filled with saline. You should discuss with your cosmetic surgeon, the pros and cons for the incision site specifically recommended for you. There are three common incision sites: under the arm (axillary), around the nipple (periareolar), or within the breast fold (inframammary).

If the incision is made under the arm, the surgeon may use a probe fitted with a miniature camera, along with minimally invasive (very small) instruments, to create a "pocket" for the breast implant.

Periareolar

This incision is most concealed, but is associated with a higher likelihood of inability to successfully breast feed, as compared to the other incision sites.

Inframammary

This incision is less concealed than periareolar and associated with less difficulty than the periareolar incision site when breast feeding.

Axillary

This incision is less concealed than periareolar and associated with less difficulty than the periareolar incision site when breast feeding.

Umbilical / endoscopic

This incision site has not been studied and is not recommended.

Telephone

Please telephone the clinic the day before your scheduled surgery to confirm the time of your arrival for bed allocation and costs.

Diet

Do not eat or drink any fluids after midnight the evening before your surgery, regardless of type of anesthetic: local / general , if surgery in am or after 6.30am for pm surgery.

Medications

If you are taking regular medication check with dr regarding taking your medication on the day of surgery. If dr instructs you to take your medication on the morning of surgery, do so with a sip of water

Do not take any vitamin e once booked for surgery and after surgery for two weeks.

Do not take aspirin or any medication which contains aspirin for 10 days before and after your surgery. Please check the labels of any medications you take (even those available without a prescription) to make sure they do not contain aspirin (or acetyl salicylic acid).

Please check our additional list. If you are not sure ask your doctor or pharmacist. Taking aspirin will increase your tendency to bleed at the time of surgery. Hormone replacement therapy should also be stopped before surgery. You will be instructed when to restart it.

What to wear

On the day of surgery, wear loose fitting clothes which do not have to be put on over your head and Do not wear make-up or nail polish or cosmetics. Bring scarf and sunglasses to wear after your operation.

Contact lenses cannot be worn in the operating room, wear glasses.

Leave all valuables and jewellery at home. the Hospital cannot be responsible for any valuables or jewellery misplaced or lost.

Smoking

Smokers should try to stop smoking from the time of the surgery booking. Smoking irritates nasal passages and causes coughing which might bring on a bleed several days after your operation. It is also a contraindication with General Anaesthesia. Smoking also slows healing due to a decreased blood supply to the operated area.

Pre & Post Operatively

Report any signs of cold, infection, boils or pustules, fever, appearing before surgery.

Transport Instructions

YOU MUST NOT DRIVE HOME AFTER YOUR OPERATION. You should make arrangements for a responsible person to accompany you home after your operation. If you live more than an hour's drive from the hospital, we recommend you arrange to stay in Sydney for your post-operative night.

AFTER surgery do not remove bandages or splint unless instructed to do so. 14. SUNLIGHT: You must not expose fresh scars or swollen, red bruised skins to the sun or tanning booth. Sunlight may cause swelling or the skin to 'stain' due to excess deposition of pigment which can stay long-term.

The Night / Day before Surgery
  • Nothing to eat or drink AFTER MIDNIGHT / 6.30AM IF PM SURGERY.
  • Shower and wash your face with mild soap, shampoo your hair. Remove all make-up.
  • Do not cream your face afterwards.
  • Remove all jewellery.
The Morning of the Surgery
  • No make-up. This includes MASCARA. Make sure that all mascara is removed from the eyelashes and lid margins as the material can get into the scar and may perennially stain the scar. It may irritate the eyes if the eyes are taped.
  • Nothing to eat or drink.
  • Your pre-operative medication will be given to you after arrival and ordered.
  • Take medications as prescribed. Check with the surgeon and the anaesthetist.
  • Plan to be at the clinic at the time required.
  • Please do not hesitate to call during regular office hours if you have further questions about these instructions.
  • Do not take anything valuable to the hospital.
  • Take something to relax you while you wait e.g. magazine, book, Walkman.
Pre - Operatively

Pre-operatively please attend to the following highlighted points.

  • Blood tests-as adviced
  • Chest X-ray (45 years and over, history of heart/lung disease or smoker).
  • ECG (45 years and over).
  • Mammogram/Ultrasound for breast surgery.
  • Consent forms signed and returned to Dr chaudhari
  • Admission form signed and filled in then returned to the appropriate hospital.
Pre - OP Drug Instructions

TAB CIPROLET 500 MG TWICE A DAY=10 DAYS

TAB NISE TWICE A DAY=10 DAYS

N.B. If you have any questions about drug instructions please call the office.

Check with your doctor or nurse regarding regular medications.

TAKE ABOVE DRUGS ONLY IF PRESCRIBED

*Disclaimer - Results may vary from person to person.

INSTRUCTIONS FOLLOWING SURGERY

Immediately After Surgery

  • After surgery rest quietly for the first 48 hours.
  • Stay in the company of a responsible adult.
  • You will have a bandage / dressing on the breasts and you may have drains inserted. The drains are removed before you leave the hospital.
  • Ice packs should be applied to the breasts for the first 48 hours.
  • Lie on your back, not on your side, preferably at a 45? angle. Do not sleep on your stomach for four weeks.
  • You may feel some pain/pressure: this will gradually subside and prescribed medication will help.
  • Diet as tolerated. Start with clear fluids and increase as tolerated.
as

Pain & Medications

  • Pain/discomfort experience varies considerably from person to person.
  • Medication to relieve pain will be prescribed if necessary.
  • Use Panadeine Forte 1 or 2 tablets every 3 - 4 hours; no more than 8 tablets per day.
  • If pain persists, see the Doctor. Call the office (tel: 3287044) if one breast becomes more painful or swollen.
  • Do not take Aspirin or Aspirin containing products or Vitamin E for 2 weeks.
  • Do not smoke during this period and to prevent coughing and possible bleeding.
  • Recommence Hormone Replacement Therapy under Doctor's instructions.
  • No alcohol for a week after surgery.
  • Do not make any legal decisions while under the influence of medication.
  • Take any additional medication as prescribed.
as

Wound Care

  • Dressings shall be removed approximately 48 hours post-operatively.
  • Shower as normal.
  • Clean all incision lines thoroughly with Hydrogen Peroxide 3% on gauze or cotton buds.
  • Dry thoroughly with gauze.
  • Apply antibiotic ointment to incision lines.
  • Tape incision lines as instructed with wide steri-strips.
  • Cover with gauze or non-adhesive dressing (e.g. Telfa pad).
  • Tape breasts as instructed with 'Hypafix' tape, then put on bra.
  • Follow this routine daily for 7 - 14 days as instructed.
  • Sutures will be removed in 10 - 14 days.
as

One Week - Six Weeks

  • No heavy exertion or exercising is permitted during the first six weeks. No lifting, bending or exercise.
  • Do not raise your arms above shoulders or do any lifting for two weeks e.g. Do not wash your hair, hang out washing, or do the ironing.
  • Expect that you may feel tired, restless during the first 10 - 14 days, so get adequate sleep/rest.
  • Only moderate activity is advisable during the first six weeks in order to avoid stretching the scars. You should avoid exercise of the shoulders and arms.
  • Do not sit in the sun or heat for 4 weeks since this could cause excessive swelling and cause problems.
  • Nipple sensation may be adversely affected temporarily or for an excessively long period of time.
  • Allow 1 month to 6 weeks for major swelling to subside and for basic healing to take place.
  • Do not drive a car for at least one week post-operatively and then drive with the arms kept low.
  • Your bra should be worn day and night for 4- 6 weeks or as instructed.
as

Call If You Have

  • Severe pains not responding to pain killers.
  • More swelling and/or pain in one side than the other.
  • If bandages seem too tight.
  • If one breast becomes more swollen.
  • If any other question or problem arises.
  • Please call the office for routine questions and to schedule follow - up visits.
*Disclaimer - Results may vary from person to person.
  • What kind of implants are used to augment the breast tissue?

    For the past several years, the vast majority of patients have chosen to use saline breast implants, but some women continue to choose silicone implants. Silicone implants, even though the FDA temporarily recalled them several years ago, are available on the market today. Each type of implant has different advantages and disadvantages; it is a choice that is best made after discussing all of the details with a qualified surgeon who has experience with both implants. At our Center, we offer both types to all of our patients.

  • What is the difference between placing the implant over the muscle and under the muscle?

    The question of where to place the implant is one of the biggest decisions in planning your breast augmentation surgery. Placing the implant over the muscle provides a slightly fuller result, especially on top, whereas placing the implant under the muscle provides a slightly more natural effect with a slightly longer recuperation time.

  • Will the results look natural?

    It is very important that you talk over with your surgeon what your goals are prior to surgery. This way, the surgeon will know exactly what the patient desires and will best be able to provide excellent results.

  • Where are the incisions made?

    Today there are several different options as to where to make the incisions for breast augmentation., we most commonly will make the incision either through the nipple, at the edge of the areola, or under the crease of the breast and torso. Other surgeons may offer different incision sites, but these three options are the most common and the most tried and true. Of course, every person is different and every body requires different techniques, so the doctor can only give a final answer after examining the patient.

  • How long do the breast implants last?

    The exact length of time that a breast implant lasts is unknown. It is very rare that an implant will fail (rupture) within a year. The estimated time they will last probably ranges from ten to twenty years.

  • What happens to me if the implants fail (rupture)? Am I in any danger?

    If the implants rupture, you will notice that one side of your chest will become deflated. Since the implants are filled with normal saline, the ruptured implant fluid will not be of a danger to you. Your body will absorb the fluid (saline), similar to drinking a glass of water.

  • What are the risks of Breast Augmentation?

    While any surgery entails certain risks, including bleeding, infection and scarring, Breast Augmentation in particular is no more risky than any other cosmetic surgery.

  • When can I return to work?

    Most patients are able to return to work in 3-4 days after Breast Augmentation Surgery. Everything depends on your pain tolerance, and every person is different.

  • How long will I be in the Surgery Center?

    All surgeries and procedures performed are done on an outpatient basis, meaning you will be able to return home the same day that you arrive. Breast Augmentation surgery takes between 1 and 3 hours, depending on a variety of factors, and recovery time takes 2-3 hours before you are released to go home.

  • Can I drive myself home?

    Due to the after-effects of anesthesia, you will not be allowed to drive yourself home after surgery. It is required that you arrange for somebody to bring you to the surgery center an hour before surgery is scheduled to begin and pick you up when you are released to go home. We have very comfortable waiting areas available if your ride wishes to wait at the Center, and we are happy to contact them as to when to return if they wish to drop you off and pick you up.

  • When can I resume normal activity?

    Most patients return to work 3-4 days after surgery. Patients are able to drive a car 4 days after surgery. The most important thing to avoid for several weeks after surgery is any stress to the pectoral muscles, so patients may not lift more than 5kg . for four weeks after surgery. Activities that stress the pectoral muscles, especially tennis, weight-lifting and carrying children must be avoided for at least four weeks.

  • When do I begin to massage the breasts?

    Therapeutic massage of the breast is a very important preventative technique for all women who have undergone Breast Augmentation using Smooth Implants (ask your doctor which type of implants you have or will use). Your doctor will explain and demonstrate proper massage technique. Breast massage helps to avoid capsular contraction, a hardening of the breast following Breast Augmentation surgery, which is the most common side effect of breast implantation.

  • Am I still able to breastfeed after I have breast augmentation surgery?

    You should be able to breastfeed safely after having breast augmentation surgery.

    Breast Enlargement Using a Woman's Own Body Fat

    Women have always wanted to move fat from their waist or thighs to their breasts.. Surgeon uses fat grafting to the breasts as an alternative to implants for augmentations, to fine tune breast reconstruction, and to disguise the edges or rippling of existing silicone gel and saline implants.

    Fat grafting to the breast consists of two procedures performed on the same day: first harvesting the fat and then placement into the breasts. To begin, a substantial amount of fat is removed with a cannula connected to a small syringe. Then, the harvested fat is injected meticulously through four tiny 1/8 inch incisions using blunt infiltration cannulas

    Fat grafting to the breasts has many advantages over implants, but the major advantages are:
    • Fat is completely natural substance that comes from your own body
    • Harvesting of the fat can be used to enhance your shape
    • The breast can be sculpted and shaped
    • There are minimal incisions with this procedure, which reduces the possibility of scarring
    • Fat grafting to the breasts can be used to disguise breast implants that do not look natural

    Breast enlargement by using the Lipostructure technique takes much longer than traditional breast augmentation.. The fragile fatty tissue must be harvested slowly and gently. The fat is then placed into the breast not only so that it will create as aesthetic, natural appearance, but also so that the newly transplanted fat has a chance to survive.

    As with any breast procedure, calcifications and lumps can occur. Breast studies including physical examination and mammograms, should be used to monitor every patient diligently. However, there is no evidence that fat grafting to the breast is less safe than any breast surgery. Large studies have begun over the last few years to study fat grafting to the breast.

    Obviously, surgeons with extensive experience in grafting large volumes of fat to the body are most likely to obtain the best results.

  • Who is a candidate?
    • Any woman who is healthy
    • A woman who has enough body fat to have the procedure done
    • Reconstruction candidates
    • A woman who is considering saline or silicone implants
    • Has normal mammography