cosmetic surgery procedures

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Dr. Jayne Bambit is a Fellow of the Australasian College of Cosmetic Surgery. Please visit the College's website at www.accs.org.au or call the College on 1800 804 781 if you wish to verify
Dr Bambit's credentials.

This website page contains information on Breast Augmentation, along with what to expect should you wish to attend for a consultation. It can't answer all of your questions since alot depends on individual assessment.

Please call the clinic on (07) 5452 5222 or contact us online if you would like further information on breast augmentation or if you would like to arrange an appointment for a consultation with Dr Bambit.

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Breast Augmentation - Breast Enlargement

BREAST AUGMENTATION is simply the enlargement of one or both breasts by the surgical insertion of specially designed implants.

The procedure is generally carried out to enlarge & enhance small or underdeveloped breasts, to balance asymmetry (i.e. unequal size/shape), or to improve sagging or loss of breast volume following childbirth & breast feeding.

Choosing Breast Augmentation is very personal. Naturally you have goals and expectations. Whether your aim is to improve self-confidence, restore your figure or balance your proportions, there are several important aspects to consider. Apart from such factors as size & shape, it is also very important for you to understand and be fully informed about the potential risks & complications involved.

Most adult females who are in good general health and are not breast-feeding are suitable for Breast Augmentation, provided that their expectations are realistic.
During your first consultation, Dr Bambit will take a thorough medical and surgical history and carry out a general medical assessment. She will then ask you what your main concerns are and what you wish to achieve.

Treatment recommendations will be tailored to your individual needs and desires. The aim is to give you a very attractive and natural result which is in proportion to your build and your figure.

As with all Cosmetic Surgery procedures, it is most important to understand that the final result or look after Breast Augmentation surgery is predominantly determined by your shape or how you look before surgery.

Dr Bambit will explain any proposed procedure/s in depth, including any alternatives.
She will discuss the procedure thoroughly including:

Pre-operative preparation:
Medications to avoid, blood tests, mammogram (where indicated)
How the procedure is carried out: anaesthesia, incision site, the operation
What to expect: immediately after surgery, and during the first few days, weeks and months after surgery

Post-operative period:
Surgical bra, medications, recovery time, activity, time required off work

WHAT ARE THE OPTIONS AND CHOICES?
There are many different options when considering Breast Augmentation and it is most important that you understand these options in detail, along with their limitations. Don't worry if you are initially confused, most are! Remember that we are here to help you all the way. Dr Bambit will inform, advise, guide & assist you with regard to the various options, and enable you to make the choice that is right for you:

• Size of implant
• Shape of implant - round/teardrop (anatomical)
• Texture of implant - textured/smooth
• Contents of implant - silicone/saline
• Incision site
• Position of implant - behind or in front of the muscle.

Limitations are predominantly based on: the current size & shape of your breasts, nipples, areola & chest; your build; skin extensibility; lifestyle.
The technique or approach recommended is generally that which will give you the best and most natural result, with minimal scarring.

HOW DO I CHOOSE THE SIZE OF THE IMPLANTS?
The size of implants is predominantly determined by what breast size you would like to aim for. But there are limiting factors which I will discuss in due course. You will probably choose a size that gives you a natural look, which flatters your shape and is in balance with your body as a whole.
We will help you.

I measure and take into account your breast width, your height, the size of your body frame including the width of you shoulders and hips. I also assess your existing breast tissue and your skin elasticity. Implant size may be limited by these characteristics.

Do not be concerned about choosing the wrong size. Between you, myself & my staff we are able to choose between 1 or 2 different sizes. We have a great deal of experience in sizing and are there to guide and assist you. You are always more than welcome to attend for further consultations at no extra charge to clarify any aspect of your surgery.

WHAT ABOUT SHAPE, TEXTURE, & CONTENTS OF IMPLANT?
There are several different types of implant available. In my experience the most natural and attractive result is achieved by using round, silicone gel implants with a textured surface.
Naturally I am very happy to discuss your preferences with regard to these aspects which determine implant type and shape.

Saline vs. Silicone
Silicone implants look and feel softer and more like natural breast tissue than saline implants. Silicone is very safe and there have been several studies on the medical and surgical uses of silicone. There has been no evidence of toxicity, poisoning, or cancer associated with its use.
Saline implants impart a water-bed appearance and feel, which in simple terms I describe as sloshing. There is often obvious rippling through the skin on standing up or lying down. They have a very unnatural appearance & feel because the weight of the saline shifts with gravity. Cohesive silicone gel is a semisolid and maintains its shape against the effects of gravity.

Saline implants may spontaneously rupture. This is because there may be a fold along the edge of the implant. With time, wear & tear along this fold may cause breakage with immediate leakage of the saline. Obviously this generally necessitates replacement.

Round vs. Tear-drop
Teardrop or anatomically shaped implants may shift or rotate within the tissue pocket over time causing obvious asymmetry, therefore round implants are most commonly recommended. A very natural result can be achieved using round implants, provided that the surgical technique is precise and the pocket that is created is of the appropriate dimensions.
Anatomical implants may be recommended in certain patients.

Textured vs. Smooth Surface
According to the latest literature, the incidence of capsular contracture is approximately the same whether smooth or textured implants are used. Smooth implants are recommended in very thin ladies to reduce the possibility of the edge of the implant being visible.

Implant Projection
Projection of the implants refers to the amount that they stick out. There are low, medium, high and ultra high profile implants, and usually one is more suitable for each individual. We will discuss this at the time of sizing.

ARE THE IMPLANTS SAFE?
Yes. Dr Bambit only uses implants which are approved by the Therapeutic Goods Association (TGA) and are very safe.

WILL THERE BE ANY SCARS?
Incisions are placed in the fold under the breast (inframammary fold) and measure
approx 4 - 5 cm. Incisions are closed with dissolvable sutures (stitches), and are covered with a light dressing. Surgical incisions cause permanent scars but these are very fine and are concealed in the natural crease under the breast. Initially the scars will be pink, but once they heal they will be less obvious. The scars usually fade over a period of 3 - 12 months, and in most patients they become barely visible.

WHERE WILL THE IMPLANT BE PLACED?
The breast implant is inserted either under the breast tissue (pre-pectoral or sub-glandular) or under the pectoralis major muscle (sub-pectoral / sub muscular)The choice of implant position depends predominantly on the patients anatomy, including the thickness of the breast tissue and its ability to adequately cover the implant. When there is a significant degree ptosis (or sagging) the implants will usually be placed under the breast tissue.

WHAT DOES THE PROCEDURE INVOLVE?
The procedure takes approximately 1.5 to 2 hours and is carried out under general anaesthetic or twighlight sedation and local anaesthetic, given by a specialist anaesthetist or qualified GP anaesthetist. Surgery is performed in fully accredited surgical facilities, and is usually performed as a day procedure.

WHAT SHOULD I EXPECT AFTER SURGERY?
Please note that this is a general outline, and detailed instructions are given to each individual according to personal circumstances.

Rest - with regular light activity - is recommended for the first few days after surgery.
You must have assistance at home for the first 24-48 hours, or longer depending on your personal circumstances.

You will experience moderate discomfort (relieved by oral painkillers) over the first 24 - 48 hours, subsiding over a week.

If the implants are placed in front of the muscle, recovery usually takes 5-7 days. If the implants are placed behind the muscle the discomfort lasts a little longer and recovery may take up to 2 weeks.
Your breasts will be swollen and tender to touch, which may last as long as a month. You may have a feeling of tightness in your breasts. There may be some slight bruising. You will be given strong oral painkillers to take and sometimes some valium to relax the tissues.

It usually takes about 6 weeks for the swelling to subside, and a little longer for the breast tissue and skin to relax, allowing the implants to feel like they are a part of you. You will be given a course of antibiotics.You may shower gently when you feel able to, as the dressings are waterproof.
A front opening sports bra or crop-top is worn for comfort and support during the first 1-2 weeks.

Return to work depends on the type of work you do, and varies from two to six weeks.
No more than gentle arm movement is recommended for 2 weeks: no lifting babies/toddlers, carrying shopping, or upper body exercise. It is preferable that you don't drive for 2 weeks; you may drive after 1 week if necessary but only short trips.

You may gradual resume normal activities over 1 -2 weeks, sporting activities not involving excessive upper arm movement over 2-4 weeks, other sporting activities over 4- 12 weeks.
Post-operative follow-up routinely consists of 2- 3 further appointments over a 1- 6 month period, and a final check at 12 months. All patients are encouraged to contact Dr Bambit or her staff by phone at any time should they have any queries or concerns both before and after surgery.

ARE THERE ANY RISKS?
All surgery carries some uncertainty and risk.
When performed by an experienced doctor, complications are infrequent and usually minor. However, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable or controllable.
Complications are unexpected problems that can arise during or after the procedure. Most people are not affected. However, in rare cases they can be severe and even fatal. All attempts are made to prevent complications and reduce risks by meticulous attention to surgical detail and technique along with adequate post-operative care and follow up. Nevertheless, you must be informed about and understand both the general risks of any surgical procedure, the specific risks of the particular procedure/s, and any potential risks which may apply to you as an individual. It is also important to be aware of the �side effects� of a procedure, that is what to expect in the way of bruising, discomfort etc. These expected sequelae are not classified as risks or complications.
This is a brief outline of some potential complications of breast augmentation surgery. I do not wish to alarm you but inform you.

MAJOR COMPLICATIONS OF ANY OPERATION

• Unexpected reaction to the anaesthetic or other medications
• Excessive bleeding during or after surgery
• Wound infection
• Developing a blood clot, usually in a vein in the leg (deep venous thrombosis or "DVT") which may travel to the lung (pulmonary embolus) and may be fatal.
  
  SPECIFIC COMPLICATIONS OF BREAST AUGMENTATION
• Haematoma: A collection of blood under the skin, is uncommon and may require aspiration
• Infection: Wound infection is uncommon but if it occurs it is superficial and requires treatment with antibiotics and wound care. Infection of the implant is rare and requires removal of the implant for 3 months.
• Scars: Usually fade over time and are barely visible; occasionally scars may stay thick, red and irritable for a long time.
• Altered skin and nipple sensation: Usually temporary but maybe permanent
• Stretch marks: may develop after surgery
• Seroma: a localised collection of lymph fluid under the skin that has leaked from traumatised lymphatic vessels
• Capsular contracture: excessive scarring around the implant which causes the implant to look and feel firm.
• Double fold or double bubble: a double roll under the breast when a new inframammary crease is created below the existing one and the old crease persists
  Implant displacement: Implants can move from their original position creating a distortion in breast shape
• Rupture/deflation: Rupture of silicone filled implants is very rare. Deflation of saline filled implants is not uncommon
• Visible or palpable Implant folds/wrinkling
• Asymmetry
• Mondors thrombophlebitis: This is inflammation of a vein of the chest wall and is usually seen just under one breast. It is not common but if it occurs it is not serious. You may be advised to take anti inflammatory medication for a few days.
  Before you decide to have surgery, think carefully about your expectations and discuss them with Dr Bambit. Please be sure to ask if there is anything about the procedure you don't understand.

If you are considering Cosmetic Breast Surgery I can certainly guide and advise you. I want your new shape to be as attractive and appropriate for you as possible. All cosmetic procedures have limitations. Therefore, if for any reason I feel that I am unable to fulfill your expectations I will tell you immediately. I look forward to meeting with you to discuss this procedure. Following consultation I encourage you to take as much time as you need to reach your decision, and either contact me or come and see me for further discussions if desired.