Breast Augmentation PERTH – Breast Implants by Dr Mark-Duncan Smith

What Is A Breast Augmentation

Breast augmentation is a surgical procedure by which the breasts are enlarged with implants to improve their size, shape, and proportions. It is known technically as breast augmentation and augmentation mammoplasty.

Who Benefits From Breast Implants?

Each woman has a beautiful shape all her own, breast surgery can help enhance one's appearance and confidence in many ways.
If you're considering Breast Augmentation, our board-certified plastic surgeon, Dr Mark Duncan-Smith, has the training and experience to help you obtain your desired outcome.
With his skill and guidance and the proper breast implants, you are in safe hands. If your goal is to improve the size, shape, symmetry, and proportion of your breasts subtly, dramatically, or somewhere in between, Dr Mark helps you evaluate your options for the best outcome.

At CosMedicWest, we help you achieve a natural breast look, and we want you to feel comfortable and confident in our care at every stage of treatment.

As your surgeon, Dr Mark Duncan-Smith would evaluate your motivation, needs and desired outcome and examine your chest and anatomy. Following this, an individual treatment plan is developed.

As your surgeon, Dr Mark Duncan-Smith would evaluate your motivation, needs and desired outcome and examine your chest and anatomy. From that an individual plan would be developed.

For example, if you have little or no breast, but feel that you should be of a larger and more normal size, for no other reason than your own fulfilment, you would be an appropriate candidate for breast enlargement.

Breast enlargement is not only performed as a purely cosmetic procedure. It also falls under the realm of Plastic and Reconstructive surgery in the treatment of some syndromes that result in the breast being smaller, usually on one side. e.g. Poland's Syndrome is a congenital syndrome in which the breast and sometimes muscles on one side of the body do not develop normally. This results in a very small breast or no breast at all on the affected side. In rare situations, this can affect both breasts.

Breast Implants, when done correctly, are meant to subtly improve your appearance and match your body type. On the other hand, breast enlargement performed to make a patient huge or ridiculous is a rare occurrence. At CosMedicWest we do not offer this.

Please consider: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Breast Implants – Before and After

How is the Breast Augmentation Procedure Done?

I typically perform breast augmentation Perth surgery as day surgery.

The surgery is performed under general anaesthetic. If the muscle needs to be released, I prefer to do this with the muscle relaxed and with gentle electrocautery.

My methods of breast enlargement are performed under vision, with no tearing or ripping of tissues.

Is One Method of Breast Augmentation Surgery Best?

The answer to this question is simply no. There is no best breast augmentation method as it highly depends on the patient's goals and body.

It is not logical to suggest that one method of breast enlargement fits all patients. Every patient is individual and different, therefore, the type of incision, type of implant and placement of the implant needs to be individualised.

Every woman that presents for breast augmentation surgery has her own body, her own anatomy and her own ideas of how she should look.

If you present to a surgeon regarding breast enlargement and you are only offered one type of implant and one type of implant placement this may suggest that this is the method of breast enlargement that they are comfortable with, rather than necessarily what best suits your needs.

• How Much Does a Breast Augmentation in Perth Cost

  Exact costing is highly variable, as it depends on your history and circumstances, the hospital used and specifics of the procedure. Some clinics are trying to compete on price and offer breast implants from $7,999.00. It can be misleading as prices are at times quoted without hospital and anesthetist fees.

  In general, you can expect to pay an inclusive price between $9,000 to $14,000 for breast augmentation in Perth. The demand for the plastic surgeon also plays a role in pricing. Dr Mark Duncan-Smith is the vice president of the Australian Medical Association (WA) and highly regarded among patients and fellow surgeons alike.

What surgical incisions are used?

Many people ask about scars after breast augmentation. Most incisions and hence scars will be hidden with incisions strategically located in areas to make them as subtle as possible. The goal is to make your breasts as scar-free as possible.

There are four types of incisions that are used for breast augmentation:

1. Underarm (Transaxillary)
2. In Breast Fold (Inframmary)
3. Around Nipple (Areolar)
4. Around belly button [Trans-umbilical (TUBA)]  – Not pictured

Each of these incisions has advantages and disadvantages depending on an individual patient's anatomy and the type of prosthesis to be used. The ideal type of incision to be used for any patient is an integral part of the discussion and decision making that occurs between the surgeon and the patient.

Periareolar (around nipple) and inframammary (in breast fold) are the two most common incisions and most surgeons are well versed in these incision types.

Underarm Incision (Transaxillary)

This method of implant insertion into the breasts – where the incisions are made along the armpit areas – can help reduce visible scarring for people with skin tones prone to keloid scarring. It can be a preferred surgical option for placing breast implants into patients of Asian heritage or who have darker skin that shows surgical scars more readily than lighter skin.

Around Nipple Incision (Periareolar)

In the periareolar incision, the surgeon makes an incision near the lower half of the areola, which in turn hides the scar. This type of incision can have an optimal outcome when combined with the breast lift or mastopexy. These are often preferable in patients with poorly defined inframammary folds or in those prone to hypertrophic scarring (thick raised scars).

In Breast Fold Incision (Inframammary)

The inframammary incision is made directly below the breasts, in the crease where the lower part of the breast comes into the contact with the skin of the chest. Dr. Mark Duncan-Smith inserts the breast implant through this incision into a pocket he creates in the breast.

What Do I Need to Know About Breast Implants?

Breast Implants come in different materials, shapes and sizes. It is important to do your research and seek a consultation with an Australian Plastic Surgeon.

What type of implants are available?

There are two different breast implant materials used. In our Western Australian clinic both saline (i.e. water filled) and silicone-filled implants are available.

Saline breast implants

Saline implants are filled with sterile saltwater. These implants are inserted empty and then filled once they're in place.

Saline breast implants are available for breast augmentation and for breast reconstruction.

Silicone breast implants

Silicone implants are pre-filled with silicone gel. The gel is a thick, sticky fluid that closely mimics the feel of human fat. Most women believe that silicone breast implants look and feel more like natural breast tissue.

Silicone breast implants are available for breast augmentation and for breast reconstruction purposes.

Breast Implant Shapes

The shape of the implant used can either be round or anatomical (teardrop shaped):

Round Breast Implants

Round implants are, as the name implies, circular. If you have a reasonable amount of breast tissue already or thicker chest wall tissue, then round implants are my preference. Given their uniform shape, round implants do not carry with them the risk of malrotation.

Anatomical Breast Implants (Pear-Shaped) 

They are shaped to closely mimic the shape of the breast. If you have a thin chest wall, the preference is for anatomical implants, as they allow to achieve a more natural look compared with round implants (which tend to look more obvious in this situation).

Although uncommon, malrotation can be associated with anatomical implants where the implant rotates to give an odd shape.

Breast Implant Texture

An implant can either be smooth on the outer surface or textured.

The most appropriate type of implant for you and your anatomy. The implant shape, surface and filler are an integral part of the discussion between you and your surgeon and the development of your individual treatment plan.

Breast Implant Placement

A breast implant can go into either one of two spaces:

1. Behind the muscle (dual plane)
2. Above the muscle

The chest wall consists of the breast, the muscle layer (pectoralis major) and then the rib cage. The majority of breast implants are placed partially behind the muscle layer. This is also called dual plane, behind the muscle or partial retro pectoral.

Dual plane (behind the muscle) is the most common site of placement because a woman presenting for breast augmentation often has very thin tissues of the chest wall. Therefore, in order to protect and camouflage the implant, it needs to be placed below the muscle.
For women that have adequate breast tissue to protect the upper pole of the breast implant or specific activities such as a female bodybuilder then the implant can also be placed immediately deep to the breast tissue, superficial to the muscle.

Why choose the Above the Muscle Placement for Breast Implants?

The above muscle surgery procedure can be less painful than other methods. This method can be used with high profile or low profile implants.

When compared to the dual plane procedure, the recovery from the above the muscle procedure can be quicker as the muscle is not interfered with. Furthermore, complications such as ‘double-bubble’ and implant displacement occur less. The treatment for ‘double bubble’ is often considered replacing the implant above the muscle. Some surgeons consider this less destructive to the muscle as the muscle may lose strength in some cases. 

Why choose the Dual Plane (Behind the Muscle) Placement for Breast Implants?

The dual plane surgical procedure can be beneficial for very slim or petite patients with no breast tissue at all. For these patients, the dual plane is the preferred position.

Specialist surgeons have found problems such as ‘double bubble’ and bottoming out are less seen with this procedure as the muscle does not exert as much pressure on the implant. Also, the problem of wide cleavage is reduced.

There are three grades of the dual plane placement with grade three being most effective in the floppier breast. To be fully informed so that the best choice is made to fit your specific circumstances.

Frequently Asked Questions About Breast Augmentation

What can I Expect From a Breast Augmentation?

You are admitted on the day of surgery fasted from the night before or 8 hours before your surgery.

The surgery is day surgery where you specialist plastic surgeon will attend.

Post-operative instructions and information is e-mailed to you prior to your surgery so you are already familiar with it and can ask any questions at the time.

Antibiotics are given during the operation and take home antibiotics are also given to reduce the risk of infection.

How Long Does it Take to Recover after Surgery?

Recovery with a sub-mammary / sub-breast implant placement can be measured in days and is shorter than when the muscle needs to be released.

If the implant is released, and it is placed deep to the muscle, recovery is several days to a week.

What other cosmetic surgery procedures can be performed at the same time?

Generally, breast augmentation is performed as a solo technique.

Sometimes, if there is a significant degree of droopiness to the breasts, your surgeon may indicate that a breast lift should be performed simultaneously.

What Complications Can Occur?

Although every endeavour is made to avoid complications, sometimes they do occur and it does not necessarily imply an error has occurred. Complications do not necessarily imply an error has occurred, they can be related to the anaesthetic or the surgery.

Surgical complications can include examples such as bleeding and bruising, swelling and infection. All incisions result in a scar that usually fades and is not easily seen.

Changes in the sensation of the breast and nipple can occur.

Capsule formation occurs as the body's response to the implant. It is only if the capsule becomes particularly thick and constricted that this becomes a capsular contracture. Capsular contracture can result over time, with the implant becoming harder and smaller, and maybe a reason for repeat surgery. For textured implants, the risk of a bad capsule is 1.7 % (Bronz 1999).

Malrotation of an implant can occur in non-round implants. In my experience, this is an uncommon event but is the reason shaped implants are used only when they offer an advantage to the specific patient.

Determining whether you are symmetrical, to begin with, is an important part of the initial assessment by your surgeon. If you are not symmetrical, to begin with, and most women are not, then subtle differences are likely to persist after.

This list indicates some examples of complications, surgery should not be undertaken until this has been discussed fully with the surgeon.

What other cosmetic surgery procedures can be performed at the same time?

Generally, breast augmentation is performed as a solo technique.

Sometimes, if there is a significant degree of droopiness to the breasts, your surgeon may indicate that a breast lift should be performed simultaneously.

Does insurance cover breast augmentation?

Item numbers may be applicable to you if you have significantly different sized breasts and this will significantly reduce your overall costs.

If a procedure can be given an item number then rebates will apply. In this scenario, out of pocket costs are typically less than amounts paid for surgery overseas.

A cost guide can be requested from my office on 9228 2188 (+61 8 9228 2188).

Alternatively, you can email us at info@cosmetic-surgery.com.au

Where can I get more information?

If you have specific questions or wish more information on specific procedures, please contact my office for a complimentary appointment with my nurse / patient liaison officer.

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