Breast Augmentation
Dr Beryl Tan

Dr Beryl Tan - Breast Augmentation

The breast augmentation or enlargement, also known as an augmentation mammaplasty, is a surgical procedure that increases the volume and size of the breasts. It can be performed with breast implants, the patient’s own fat, or a combination of both (hybrid).

Read on to learn more about the breast augmentation procedure as offered by Dr Tan to see if this may be suitable to achieve a look you have been considering.

Dr Beryl Tan Plastic Surgery - Professional Affiliations

The Breast Augmentation Procedure

Why do women seek breast augmentation?

Dr Tan always stresses the importance of women having a breast augmentation for themselves, not for someone else. Your body and comfort levels within it are a very personal thing. 

Most women consider this procedure for the following reasons:

  • Improved confidence and self-esteem
  • A better overall aesthetic
  • Improving post-pregnancy and breastfeeding breasts that may become saggy or deflated

What are breast implants?

Breast implants are prostheses made of a shell and “filling” available in different shapes and sizes. The ‘shell’ is made of silicone with a surface that can be smooth or textured. Most textured implants are no longer offered in Australia due to their association with Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Most plastic surgeons in Victoria now use smooth surface or nanotextured implants due to their very low risk of ALCL.

Aggressively textured implants can result in a Velcro-like adherence hence are more form-stable. The different types of textured surfaces differ in their interaction with the tissue capsule that forms following implantation. Smooth and nanotextured implants are only available in round shapes and do not integrate with the native tissue. They tend to move and may settle in a lower position over time.

Implants are generally available in two shapes; round and anatomical (teardrop). The latter is only available with a textured surface as we do not want the implant to move. This is useful in slim women and patients with developmental breast deformity, where we want to ‘manipulate’ the shape. 

The implant’s fill can be either saline or silicone. The saline breast implant is easier to manage in cases of rupture or deflation but can often result in easier palpability and visible rippling when compared to a silicone implant which also feels more natural.

Dr Tan will discuss and guide you in choosing the right implant for your wants and needs during your consultation.

Where is the implant placed?

The placement of the implant, or implant pocket, can lead to different results. The best location of the implant pocket depends on how much breast tissue you have. There should be adequate tissue to cover the implant to ensure it is not palpable or visible. However, with time, the tissue stretches and becomes thinner.

The most common placement option is under the muscle, which offers the following benefits:

  • Better camouflage of implant edges in the upper pole
  • Lower capsular contracture rate (there are conflicting studies on this)

The cons of this placement include:

  • Wider cleavage as the pectoralis muscle inserts onto the lateral aspect of the sternum
  • More breast distortion with muscle contraction
  • Higher risk of developing “double-bubble” deformity

Do I need a breast lift (mastopexy)?

Your breast shape and where your nipple sits determines this. We use the inframammary fold (IMF) or the crease below the breast as a reference point. 

If the nipple is at or below the crease, you will likely benefit from a breast lift. However, if you have a lot of breast tissue sagging lower than the nipple, this tissue may have to be removed. This is known as the “plus-minus” approach.

A breast implant creates added weight. With time, it often descends, causing your breasts to appear lower than before. Considering this, Dr Tan does not recommend implants larger than 400g, as there is a higher risk of developing problems as your body ages.

The benefits of a Support Matrix

There is now an additional prosthesis called a Support Matrix that adds support to the implants to reinforce the boundary of the implant pocket. Much like an internal bra, this can be made of a biological matter (human or animal skin/pericardium) or synthetic. 

The gold standard is a Human Acellular Dermal Matrix (ADM), which is essentially cadaveric human dermis (the deep layer of skin) that has been processed, removing all cells leaving a layer of collagen. However, this is very expensive and not used frequently in cosmetic augmentation.

There are several synthetic options, some of which dissolve after a few years and others that do not. These will integrate with your skin and tissue and provide additional strength. 

Dr Tan often uses the Support Matrix in revision surgery, especially in exchange for a breast implant after capsulectomy. It can also be used for women with saggy breasts, as the tissue is often not strong enough to hold the implants.

Do implants last forever?

In most cases, no. With time, wear and tear occur and the rupture or capsular contracture rate increases. The breast tissue also behaves and ages independently from the implant. As you age, the tissue may drop over the implant and cause a “waterfall” deformity. As a result, most women require revision in 15-20 years.

Can I avoid wearing a bra after having implants?

Never underestimate the effects of gravity! The heavier the breast and implants, the more support you need. A good supportive bra is highly recommended, especially during physical activities like running and jumping.

What is a fat graft?

Another breast augmentation option involves the transfer of fat from one body site to another. Dr Tan may use a person’s own fat to improve the body’s appearance by removing it from another area (usually the thighs or abdomen). It is then used to create a natural look and feel while enhancing an area with lost tissue volume due to aging, surgery, congenital disabilities, trauma or other causes.  

For cosmetic augmentation, a fat transfer to the breast may require additional surgical procedures to obtain your desired breast size. Only a limited amount of fat can be injected per procedure to maintain viability.  

Typically, the transferred fat results in an increase in the volume of the breast, as opposed to their projection. This method is often used for ‘touch-up’ procedures like camouflaging the upper part of the implant or improving and softening the cleavage.

Does fat last forever?

As the graft is your own fat, it becomes part of you once again but still acts like the fat where it was harvested from. This means it increases when you gain weight or becomes smaller if you lose weight. 

Not all of the fat will survive the transfer. We estimate to lose about 20-30%. There are techniques to improve its survival, but the larger the volume injected, the higher chance of fat graft loss. 

Are there any risks or complications associated with breast augmentation?

Yes. Like all surgeries, breast augmentation comes with general and specific risks of complication. It is important to understand these risks and Dr Tan will provide written and verbal explanations about them.

Book a consultation for a breast augmentation review with Dr Tan today

Find the best option for your breast augmentation procedure by booking a consultation with Dr Tan today. With over fifteen years of experience, Dr Tan will apply her in-depth skills and knowledge to ensure you achieve your desired look, be it with this procedure or another. Boost your physical and mental confidence with Dr Beryl Tan today at Brighton, Cabrini or PRSM in Donvale and Drouin.