Breast implants have been in the headlines this week — and not for positive reasons.
A recent report found six patients of The Cosmetic Institute, one of Australia’s most popular cosmetic surgery clinics, suffered potentially life-threatening complications while having breast augmentations over the past 12 months. It’s believed the cause was anaesthetics administered in doses the clinic isn’t licensed to provide.
This is, of course, enormously concerning. To help clear up any mixed messages about what breast implants involve and what you should expect to happen, we took some burning questions to Louisa McKay, Managing Director of Costhetics.com.au and a consultant for plastic surgeons.
How do I know I’m making the right decision?
McKay says it’s essential to think long and hard about your reasons for wanting surgery, and what your expectations are. Ultimately, you need to ensure that you’re not being influenced by external factors and pressures, like what your partner thinks.
“You need to do it because you want to do it … it’s permanent surgery; while you can have implants removed, it’s still surgery so it’s better not to do that,” she says.
You might find it helpful to discuss your motivations with a psychologist, to ensure you’re in the right frame of mind and confident in your decision. Consumer advocacy group Choice also recommends speaking to a GP at this point, as they can provide “unbiased information about the pros and cons” and potentially recommend a reputable surgeon.
How do I find the right surgeon?
“It’s so hard to establish in the landscape who’s who; surgeons can market themselves so it’s very difficult to know,” McKay explains. A surgeon’s qualifications are a major consideration.
Cosmetic surgeons and plastic surgeons might sound like they have the same capabilities. As we reported earlier this year, anyone with a medical degree can perform, and call themselves, a cosmetic surgeon in Australia.
Plastic surgeons have a surgical specialty (requiring at least seven years of additional training after completing their medical degree). A plastic surgeon will have the acronym FRACS after their name, denoting that they are a Fellow of the Royal Australasian College of Surgeons.
Watch: Apparently there are seven different breast shapes. Which one are you? (Post continues after video.)
That said, not all plastic surgeons will have extensive experience in breast implants, so McKay recommends seeking out a surgeon who is known in the industry for being focused on and experienced in this type of surgery.
If you’re unsure about a practitioner’s qualifications, you can ask him or her about them directly; however, McKay says their accreditation will usually be listed on their website and visible in their office.
It’s vital to do your due diligence and research surgeons properly — McKay urges prospective patients to be skeptical of any patient reviews they read online, as these can be fabricated.
Where does the surgery happen?
This depends; it might be in a hospital, a day procedure clinic, or in a surgeon’s clinic or even their office. Choice points out there are currently no regulations around office-based surgeries, so this is something to be mindful of.
McKay, who has had a breast augmentation, says she would opt for a plastic surgeon. “They’ll be doing it in a hospital with general anaesthetic, whereas a lot of cosmetic surgeons are doing them in [clinic] rooms, maybe not with general anaesthetic,” she says.
“There are risks with any surgery, including plastic surgery … imagine if all of those happened and your life was at stake. I personally would prefer to be in a hospital where they can hit a button and your life could be saved.”
What kinds of implants are there?
The short answer? A lot. Implants are available with two different fillings — saline (sterile salt water) and silicone (a gel) — and in a variety of shapes ,like ‘teardrop’, ‘high profile teardrop’ and ’round’. McKay says silicone tends to be the most popular filling.
Although there have been reported cases of health complications from leaking silicone, she says this is rare: “These days implants are medical grade, they’re tested so much, there are hundreds and thousands of them out there in the world with very few incidences of the implant itself being faulty.”
A number of factors, including your body size and shape, will determine which implant will suit your body and look best. It’s important to get this right, because the body can reject an implant if it’s not suited.
“Have a bit of an idea of what’s available, but also be guided by what your surgeon recommends … they should have a good feel for what suits your frame and whether to place the implant above or under the muscle,” McKay says. Some surgeons might even give you some sample implants to take home and see what they look like under clothing.
An experienced surgeon will be able to recommend the best implants for you. (iStock)
How long do implants last?
Contrary to popular belief, there isn't a hard and fast answer. McKay says the longevity of breast implants has improved thanks to technology and practitioners getting better at different techniques.
"Sometimes they can last for years and years and people never need to replace them, and then some people do need to replace them. It depends on your tissue, capsular contraction, a whole lot of variables," she explains.
"It's probably a good idea to go back to your surgeon every couple of years to have them checked out to make sure they're not leaking or they haven't moved. If you feel it doesn't feel right or they feel hard, that's more reason to do so."
How long does the procedure take?
McKay says a breast augmentation will usually take 30 minutes to one hour. After marking up the area being operated on, the surgeon will make an incision and create a space for the implants to be placed, and then stitch up the incision after insertion.
This sounds simple, but a lot of preparation and planning is involved to ensure the implants are even and not too asymmetrical, the nipples remain in the right place, the placement of the implants, and other considerations.
Is there a lot of scarring?
"Most of the incisions for breast augmentations these days are just under the breast crease, so you really don't see it," McKay says, adding that the incisions aren't particularly large.
"Eventually [the scars] fade, and you could have a laser treatment or rub some cream on them to make them diminish sooner."
A breast augmentation can cost up to $13,000 in Australia. (istock)
What does a breast augmentation cost, and what do I get?
According to McKay, the ballpark cost in Australia today is anywhere between $7000-$8000 to $12000-$13000.
This is generally an all-in cost encompassing the surgeon's fee, anesthetist's fee, hospital fees and the cost of the implants, which can vary. McKay adds that practice or surgery will usually include any after-care, like follow-ups or dressings.
However, patients need to be aware that some businesses attempt to reduce the cost of surgery. This is why some surgeons perform the procedure in their clinics or offices rather than a hospital. However, this can be risky.
"I think a lot of the lower-cost, big super clinic places are opening up and trying to capture the market of people who perhaps don't have $10k to spend on breast augmentation but still want it. Unfortunately, they're often cutting corners," McKay says. "If it sounds too cheap, it probably is. There's probably a reason for that."
One area of concern is anaesthesia; McKay says there are some procedures being performed under twilight or local anaesthasia, rather than general. "There are big risks involved in doing that. You need to give the patient so much of the twilight or local that it can do things like stop their heart, which is really scary," she explains.
What would you like to know about breast augmentation?