What is breast augmentation?

Breast augmentation is a form of cosmetic surgery that may change your appearance by giving you larger breasts. It can also be called a breast enlargement, a breast reconstruction or a breast implant procedure.

Some women have breast implants as part of reconstruction surgery after a mastectomy (breast cancer surgery). If this applies to you, you can read about breast reconstruction on the Breast Cancer Network Australia website.

This page relates to breast surgery for cosmetic reasons.

A breast augmentation involves placing implants under your breasts or under the breast muscles on your chest. The implants are made from a silicone shell filled with either saline (salty water) or silicone gel.

Some cosmetic surgeons offer fat grafting, where fat is transferred from elsewhere (such as your buttocks) to your breasts.

Why might I want breast augmentation?

You might consider breast augmentation for many reasons. You might be thinking about breast augmentation to feel more physically attractive or to feel better about yourself.

What should I consider before choosing to have breast augmentation?

Modern society places pressure on people to have a certain body shape or ideal appearance. You may be feeling unhappy with your body shape. Here are some things to be aware of:

• Breast implants do not last for life and might need to be replaced after 10 to 15 years.
• There have been rare cases of breast implant associated cancer that grows in the fluid and scar tissue around a breast implant.
• Some people find that after surgery their breasts do not look how they had hoped.
• Breast implants can also make it harder to detect breast cancer during screening checks.
• You may not be able to breastfeed after surgery.

What are the alternatives to breast augmentation?

Breast augmentation may not be right for you. Some alternatives are:

• counselling to help you accept your body shape
• wearing a padded bra
• other types of surgery that do not involve implants

How do I choose a surgeon?

If you are considering breast augmentation, it is important to choose your surgeon carefully. Find someone that you feel comfortable with, and who will speak to you honestly about the benefits and risks of any surgery.

The Australian Health Practitioner Regulation Agency (AHPRA) has a register of medical practitioners. You can check this register to ensure your surgeon is a Fellow of the Royal Australasian College of Surgeons (RACS). You can also check if the surgeon has had any serious disciplinary action taken against them.

What questions should I ask before surgery?

There is a lot to consider before deciding to have cosmetic surgery. You can ask your doctor questions about:

• surgery in general
• breast augmentation

Some questions that you may want to ask about breast augmentation are:

• What type of breast implants do you recommend and why?
• Will I lose any sensation (feeling) after having implants?
• How will the surgery change the position and appearance of my nipples?
• How much bruising, swelling, or pain will I get? What should I do about this?
• How long until I can return to my normal activities after surgery?
• How often have you performed this procedure?
• How long will the implants last?
• Can I breastfeed in future?
• How many of your patients have had a ruptured or failed implant? What will this mean for me if this happens?
• How likely am I to need further operations because of problems?
• If I need further surgery due to complications or if I am not satisfied with the result, will there be extra costs?

How do I prepare for a breast augmentation?

If you decide to go ahead, get as much information about the procedure as possible. Understand what results you can expect.

Before surgery you can prepare by:

• Being as fit as possible to help the recovery process.
• Staying close to your ideal body weight.
• Trying to quit smoking.
• Asking your doctor if you need to make any changes to your medications.
• Telling your surgeon about any health conditions or allergies.
• Thinking about what to pack for a short stay in hospital.
• Making sure you have someone to drive you home.
• Organising a suitable space at home to recover from surgery.

What happens during a breast augmentation procedure?

You will most likely need a general anaesthetic.

The surgeon will make a cut alongside your breast then place the implants between the breast tissue and the muscle, or behind the large chest muscle under the breast.

There are different ways of doing the operation. The method chosen by your surgeon can affect how long it takes you to recover.

What should I expect after a breast augmentation?

You might have:

• tubes in place to drain blood and other fluid away from your chest
• dressings applied to your surgery sites
• a compression bandage to help reduce swelling
• some pain and discomfort from the swelling and bruising around your chest

To help you manage the recovery, you may:

• be prescribed pain relief
• need to wear extra support for a few weeks until your breasts heal
• need to take some time off work
• need extra help with daily activities
• need to return to the hospital or to see the surgeon for a follow up appointment

When should I see my doctor?

If you have any of symptoms, contact your surgeon right away:

• high temperature (over 38°c) or chills
• nausea, vomiting, shortness of breath or diarrhea
• heavy bleeding from the surgery site
• leakage of blood or fluid that happens more than one day after surgery
• worsening and/or spreading redness around the implant area
• increasing pain or tenderness in your breasts

You should talk to your doctor about the benefits and risks of getting a medical implant.

What are the risks of breast augmentation?

Like any surgery, breast implant surgery comes with risks. You should discuss the risks in detail with your surgeon.

You should also discuss the risks of anaesthetic with your anaesthetist. Some of the possible problems include:

• bleeding, or a collection of blood (haematoma)
• infection
• changes to sensation of the breast skin or nipple, including numbness
• swelling or collection of fluid around the breast
• injury to surrounding tissue
• rupture

There are other rare but serious risks to consider including:

• an allergic reaction to the anaesthetic
• blood clots in your legs, which can travel to the lungs and cause serious illness

You should consider that you may need another operation. The longer you have breast implants, the more likely you are to have problems.

If you have your implants removed but not replaced, your breasts might be scarred and dimpled.

How much does breast augmentation cost?

Generally, Medicare does not cover the cost of cosmetic surgery. Often private health insurance does not cover cosmetic surgery either.

The cost of a breast augmentation varies from patient to patient and includes:

• surgeon's fees
• anaesthetist's fees
• clinic or hospital fees
• the implants
• medication, dressings and support garments

You should discuss all fees with your surgeon before the procedure.

Resources and support

If you are considering a breast augmentation, you should first discuss it with your doctor. More information is also available on the Australian Society of Plastic Surgeons and the Agency For Clinical Innovation websites.

Use the Therapeutic Goods Administration's guide on what to ask. The information is in English, Arabic, Croatian, Farsi, Greek, Italian, Korean, Mandarin, Spanish, Turkish and Vietnamese.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.