Breast augmentation is a surgical procedure performed under a general anaesthetic to increase the size of the breast using a silicone implant. Women of all ages and backgrounds seek augmentation for differing, personal reasons. Whatever your reason for undergoing the procedure, here is some information to help you navigate your first consultation with your plastic surgeon.

1. Breast augmentation is elective surgery. This means that your surgeon will require you to be as fit and healthy as you can be before surgery. If you are currently smoking, you must have quit at least 6 weeks prior to surgery. Likewise, if you have a serious medical condition that makes having a general anaesthetic dangerous, your surgeon may not agree to perform the surgery. During your consultation you must also provide a list of any medications or herbal supplements you are currently taking as well as informing your doctor of any allergies you have. Many medications and supplements can increase your risk of bleeding and need to be stopped several weeks prior to surgery.

2. Implant size selection is your choice.Your surgeon will examine your breast footprint (where your breast starts and stops on the chest) and give you a range of options that will suit these measurements. They will also discuss with you the positioning of the implants (under vs over the muscle) and the shape of the implant (round vs tear-drop shaped). There are pros and cons of each of these options and the multiple combinations that can ensue. The final choice rests with you. Your body, your choice. Be informed and comfortable. If you are unsure, ask for another sizing session. To enable good communication between you and your surgeon consider bringing images of the look you are hoping to achieve. Every woman’s body is different. The implants that will be perfect for one woman won’t be right for another. However descriptors such as ‘natural’ and ‘fake’ mean different things to different people. Images can help avoid confusion in this regard.

3. Be informed of your risks.

All surgery carries with it a certain degree of risk and your surgeon will discuss this with you. Specific risks pertaining to breast implants include infection (which can result in the removal of your implant), rupture (requiring removal and replacement), capsular contracture (the gradual tightening and hardening of your implant) and Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Ensure you have had a lengthy discussion with your surgeon about these risks and feel well informed prior to signing your consent form. In addition to these risks it is important to consider the impact your implants may have on your ability to breastfeed (if you choose to do this), how they may affect your breast cancer surveillance and whether you will need ‘maintenance’ procedures in the future. Discussing these issues before your surgery will enable you to feel more confident about the decision you are making now and into the future.

4. An explanation of the surgery.

Breast augmentation is usually performed as day surgery. You will arrive at the hospital the day of your surgery having not had anything to eat or drink for several hours. Prior to going into the operating room your anaesthetist will discuss your anaesthetic plan with you and your surgeon will make several markings, using a pen, on your breasts and chest. This is used as a roadmap for your surgeon whilst you are asleep. You will then be taken into the operating theatre and put to sleep. The surgery will start after a final check is performed. Your surgeon will make a small cut underneath each breast and then create a pocket for the implant to go into. The pocket can be under the breast tissue (subglandular placement), under the pec major muscle (sub muscular placement) or partially under both (dual plane). The pocket will be checked to ensure there is no bleeding. It will then be washed with a solution that usually includes betadine and antibiotics. The pocket may be checked with a temporary sizer prior to the permanent implant being inserted. The implant will be washed in a solution of (usually) betadine and antibiotics and inserted using a special funnel to reduce the risk of contamination. The surgeon will then sew up the cut with stitches and apply a waterproof dressing. Compression and support are important factors in the recovery after this procedure and a surgical bra will be fitted either at the conclusion or surgery or shortly after.

5.Rates of recovery and experiences of pain are individual and personal.

Most women will be discharged from hospital the same day as the surgery. You will be sent home with medications for pain and antibiotics to prevent infection. It is important that you are able to rest and recover. By the end of the first week you will be feeling more comfortable and the swelling will be starting to subside. However, premature resumption of strenuous work or exercise will increase your risk of serious complications. Follow the post-op recovery protocol set out by your surgeon to ensure this risk is minimised as much as possible. This is a time for self-careand self-love. You will usually be seen in your surgeon’s rooms 2-3 times in the first 6 weeks. It can take up to 12 months for the implants to settle and you will notice your breasts change quite dramatically in this time.

 6. Ensure you choose a plastic and reconstructive surgeon.

Get to know your surgeon and ask about their experience and qualifications. Ask to see some before and after photos and ensure you feel comfortable that all of your questions have been answered and concerns addressed. If your surgeon is a qualified plastic and reconstructive surgeon you will see FRACS (Plast.) after their name indicating that they are a Fellow of the Royal Australasian College of Surgeons and have undergone the appropriate training to perform surgery in the subspecialty of plastic and reconstructive surgery in Australia.