If you're thinking about a breast augmentation ('boob job') there are often a lot of questions you'll have on your mind. This article will hopefully help answer some of those questions.

1. What size implants should I have?

Most patients come to see me to discuss a breast augmentation with an ideal breast cup size already in mind.  However, your own individual anatomy, such as your chest circumference and height, will dictate what size breast implant is required to achieve your desired breast size.  Furthermore, to maintain a natural look to the breasts that avoids problems such as back/shoulder pain and over-stretching the breast skin, it’s important that we carefully discuss what size implants would be most suitable.  You will have the opportunity to try different implant volumes for size prior to deciding on which breast implant size you want to choose.

2. Can you guarantee me a certain cup size after breast augmentation?

The amount of breast volume needed for each different cup size varies from patient to patient and even bra manufacturer to bra manufacturer.  As a result, it’s not possible to guarantee a cup size prior to the surgery.  However, we will spend plenty of time discussing the breast implant size and how this may impact the overall cup size to try and ensure you get the result you’re looking for.

3. Can breast implants correct sagging breasts?

After pregnancy, significant fluctuations in weight and ageing, the breast tissue will naturally begin to sag with stretching of the skin and a loss of volume, especially in the upper part of the breast.  Breast implants can help to correct the loss of volume in the upper part of the breast and will tighten some of the loose skin on the breast.  However, in most cases where the breast tissue is sagging, additional cuts on the skin are required to tighten and reposition the natural breast tissue over the new breast implant.  This is called an augmentation-mastopexy.

4. Will I still be able to feel my nipples after breast augmentation?

There is about a 5-10% risk of having some reduced sensation in the nipples after a breast augmentation.  This risk is less if we choose to place the implants below the chest wall muscle and is also helped by placing the implants through a skin cut made at the crease underneath the breast (the inframammary fold).  It’s more common for patients to have some altered sensation (increased or decreased) in the initial weeks/months after surgery, especially when using larger implants, but most of this settles after 3-6 months.

5. Should I get a round or tear-drop shaped breast implants?

The theory behind this is that round breast implants have a round outer shape that is designed to give additional volume in the upper part of the breast.  On the other-hand, tear drop shaped breast implants are designed to have a more natural shape with the flatter surface sitting under the upper part of the breast and more volume in the lower part of the breast.  A downside to traditional tear-drop shaped breast implants is that they can rotate within their pocket under the skin leading to the extra volume sitting in an abnormal position in the breast.  The new range of Motiva Ergonomix implants that I use has helped correct this problem that uses a special form of silicone gel that allows the implant volume to move in a natural way and always adopt a tear drop shape when the patient is standing up.  Despite these theoretical differences, studies that have taken a panel of plastic surgeons and asked them to assess photos of patients who have undergone breast augmentation with different types of breast implants has shown they aren’t able to reliably differentiate between those patients that have a round and those with a tear drop shaped breast implant.  

6. Do breast implants increase the risk of breast cancer?

There is good evidence that breast implants don’t increase the risk of breast cancer.  It is important to let your radiographer know that you have breast implants in place when getting a mammogram, as they will need to change the technique they use to take the pictures.  There is a rare form a lymphoma that can arise in rare cases around older versions of breast implants (Breast-Implant Associated ALCL), but currently there are no reported cases amongst patients with more modern breast implants, such as Motiva Smooth Silk implants.  Have a look at my other post about BIA-ALCL for more information.

7. Can I breast feed after a breast augmentation?

Only a few scientific studies have looked into this and and a summary of these studies put together did show that individuals who had previously undergone breast augmentation were less likely to exclusively breast feed a newborn infant.  Unfortunately, this data doesn’t assess whether this is due to a reduction in the capacity for the breast to produce milk due to the surgery itself, or if other factors come into play (smaller natural breast tissue, patient preference).  Theoretically, a breast augmentation through an inframammary cut doesn’t disrupt the milk ducts passing from the breast tissue into the nipple itself and so breast feeding should be possible.  However, alterations in nipple sensation or issues with bleeding or infection after surgery could potentially disrupt the process.

8. How should I look after my breast implants?

After a few months when you’re back to normal activities there is very little you need to do to maintain your breast implants.  Any sudden changes in shape, or increasing pain should warrant a further review by your surgeon to rule out any breast implant related problems.  Most of the time, an ultrasound scan can check that the breast implants are healthy and intact.  It’s also important to get the breast implants checked after any significant injury to the chest to see if that has caused a breast implant rupture.

9. Do all breast implants need to be replaced after 10 years?

Traditional teaching was that breast implants required replacing after 10-15 years.  This figure came from an average group of patients where it appeared most patients had some reason that the implants needed replacing (ruptured, capsule contracture, patient preference).  However, if the breast implants are healthy and you are happy with the breast shape, there is no rule to say that the breast implants need changing at an arbitrary point in time.

10. What breast implants do you use?

I use Motiva breast implants.  These have an excellent safety record, are widely used across Australasia, Europe and Latin America, and have reported capsule contracture and rupture rates of <1%, which is excellent.  They also offer a broad variety of shapes and sizes that gives me the best chance of ensuring I meet my patients’ expectations.

If you’re thinking about having a breast augmentation in Tauranga, Mount Maunganui or Whakatane, I’d be delighted to meet with you to discuss your options. Give the team a call on 07 578 5350 to book in.