Breast FAQs


    All breast implants like all things have a lifespan and will not last forever.  Therefore, if you are thinking about having breast augmentation surgery you will need to plan for replacement surgery later in life. The life of an average breast implant is usually somewhere between 10 and 15 years. As your body changes over your lifetime with the influence of hormones, pregnancies, menopause and weight gain or loss, the size of your original implants may become inappropriate over time for your changed shape and this too might cause a desired change in implants.  Nothing lasts forever.

    Breast Augmentation: C cup 320 cc Round Smooth Saline

    Before and After Breast Augmentation: C cup 320cc Round Smooth Saline Breast Implants  by Dr Hodgkinson

    The rupture rate for saline breast implants is believed to be less than one per cent per annum. If saline implants  do rupture, the patient knows immediately as they deflate.  The benefit is twofold: 1) the patient is immediately aware that there has been a problem with the implant and 2) the saline solution which occurs naturally in our bodies anyway is merely absorbed into the tissues as opposed to with silicone where a foreign substance leaks into the tissues. Replacement surgery for saline implants is also relatively simple compared to the initial operation as the same incision line and pocket can be used . Also, the manufacturer replaces any faulty implants hence further reducing the cost of the secondary surgery.

    Before and After Breast Augmentation with Saline Breast Implants by Dr Hodgkinson

    Both the type and size of breast implant that are appropriate for you depends not only on the shape and size you wish to achieve but need to be measured against your existing breasts and your chest wall to determine what will work best to give you the result you desire. Breast implants come in many shapes and sizes, from round to tear drop, asymmetrical and anatomic and can be inserted through a variety incision sites all of which are factors in the ultimate shape and look.

    When considering which implant will give a patient the look that they want, many things must be factored in along with the patient’s desires including their physical shape e.g. current size and shape of the breast, elasticity of the breast skin, position of the nipple, and the shape and bony contour of her chest wall. For women who are very thin, generally placing silicone gel filled breast implants partly under the chest muscles is often a better choice to avoid implant show through the skin.

    Before and After Breast Augmentation: D cup 400 cc Round Smooth Gel Breast Implants by Dr Hodgkinson

    Getting natural looking breasts with breast implants is possible — it’s a matter of eliminating the “give-aways”.  Things that give the artificial look of having had breast augmentation surgery are:  seeing the margins (outlines) of the implant, an implant that is obviously too large to be real and an implant that is too “perky” or that stands to attention even when you are not. If a natural look is what is desired, then it is possible for an experienced breast surgeon working with the patient desires to choose the size, shape and position correctly and create a natural slope of your chest wall that is in balance with your body. The trend in recent years in Australia is to not have very large breasts but to lean more towards a “C” cup or average to large average look for a more natural result.

    Before and After Breast Augmentation: C cup 300 cc Round Smooth Saline Breast Implants by Dr Hodgkinson

    Breast implants can go hard due to what is called “capsular contracture”.  A capsule is caused by a build-up of scar tissue around the implant. This hardening is more common with the silicone filled breast implants, especially when they are positioned behind the breast tissue in front of the chest muscle.  Whilst some of the newer textured implants claim to have a reduced rate of capsular contracture, they too are not without their problems as texture implants have been implicated in concerns about ALCL(Anaplastic large-cell lymphoma)  This is only one of the reasons why I only use smooth walled implants

    Before and After Breast Augmentation: C+ cup 350 cc Round Smooth Gel Breast Implant by Dr Hodgkinson

    Silicone breast implants have come a long way.  The implants are no longer filled with low viscosity silicone which was more fluid but are now filled with a highly viscous grade of silicone get that is similar in texture to Turkish delight. This substance is more easily contained and removed should the implant rupture and leak.  Because no implant will last forever and because small defects in implants may be undetectable for an unspecified period of time, it is recommended that women have regular annual check-ups.  Any hardening, suspicions or irregular ultrasounds should be followed by an MRI for a definitive diagnosis.  The average life span of all implants averages approximately 10 years and this need for reaugmentation and further surgery should be factored into the decisions to have breast implants: personal, physical & financial.

    Although the newer generation of Silicone Gel breast implants have been deemed safe by Therapeutic Goods Administration, it is still good to find out if you are a candidate for saline breast implants.  Dr Hodgkinson prefers to use saline (salt water) implants, when appropriate.  In addition to their safety, they move more naturally and require a smaller incision site for insertion than gel implants, which of course means less scarring. Furthermore, if a rupture does occur, it is much easier to detect with a saline implant as it causes an almost immediate deflation of the affected side.

    Many women with large or pendulous droopy breasts suffer from back pain, neck strain, notching of the shoulders from their bra straps and blistering or rashes especially in hot weather.  It is almost impossible for them to consider jogging or any kind of jarring sport such as horseback riding due to the discomfort caused. Many women who present for breast reduction say that they have thought about surgery for years but were held by either financial concerns or not knowing what the surgery involved and were too frightened to ask.

    With regard to the incision lines, the goal with all aesthetic surgery is minimise potential scarring whilst trying to achieve a result that is aesthetically pleasing and that will stand up to normal ageing and lifestyle habits. A vertical “lollipop” incision is used for moderate reductions avoiding the full anchor incision of very large “E”+ breast reductions. For women with very large breasts it is almost impossible to avoid a “T” or anchor incision.  The sheer volume and weight of the breast tissue, combined with the compromised elasticity of the skin after years of drooping is too great to be supported by a peri-areolar incision alone. The incision lines for larger breast reduction are around the nipple and vertically downward from the nipple under the breast. They generally resolve and go from red to pink in a matter of a few months and from pink to white in a matter of a year in the average person with care taken to avoid sun exposure and adherence to post-operative instructions.

    Before and After Breast Reduction Surgery by Dr Hodgkinson

    There are basically two options for patients who want a reconstruction: to use your own tissues to make a new breast or to try to get more skin and then place an implant under the skin (the expansion technique).

    Post-operative treatment following a mastectomy, such as radiation or chemotherapy, might impact on the available options. If the patient has not had radiation, then the expansion method can be used. This involves placing a silastic balloon underneath the residual skin on the chest wall. Every two weeks, more saline solution is added to the balloon in order to stretch the skin. Once the required amount of skin has grown, a gel implant is positioned.

    In the method that uses your own tissue (autogenous), the tissue can be brought from the back or the abdomen to make the new breast. We use both these techniques for breast reconstruction.

    Before and After Breast Reconstruction (Latissimus) by Dr Hodgkinson

    Breast implants can be inserted through many different incision sites, including endoscopically through the navel (saline only). The most common incision sites are under the breast, around the nipple or in the armpit. Interestingly, saline implants can be inserted through smaller incision sites than silicone implants.

    The choice of incision site needs to be discussed with your surgeon as just with the type of implant, the location of the incision site can affect the look that you will achieve.  For example, while the armpit avoids any potential scarring on or around the breast, it makes if very difficult to achieve cleavage.  It is important to choose a highly experienced breast surgeon and to discuss your expectations with him or her to ensure that they have the ability to use multiple types, sizes and shapes of implants through a variety of incision sites to customise each patient’s result to their body shape and desires.  Remember, one size does not fit all.

    Before and After Breast Augmentation: C cup 240 cc Round Smooth Saline Breast Implants by Dr Hodgkinson

    The extent to which this will happen is in your hands and the hands of the Gods.  The patient needs to control weight gain or loss, lifestyle habits that erode skin elasticity (smoking, drinking, sunbathing) and general wellness.  The Gods have given you your genetic make-up and that in turn determines how we age and we all age differently.  One thing is for sure, with time and ageing gravity will take its hold whether you have had surgery or not.  Patients who require breast lifts also usually have compromised elasticity of their skin and women who have had children especially, due to previous enlargement and shrinkage of the breasts following pregnancy and lactation. Breast implants in conjunction with a lift can help prop up the sagging breast tissue and give volume especially in the upper pole. Sometimes the patient’s own fat is injected to fill the upper pole of the breasts. If necessary, a mastoplexy (breast lift) can be repeated at a later date.

    Before and after Breast Lift (Mastopexy)

    Drooping breasts can be a source of embarrassment as well as a sign of their loss of youth and femininity. This sagging can occur naturally with age or follow after pregnancy when the breast tissue shrinks. Breast droop can be corrected with an operation called mastopexy which involves removing some skin and excess tissue from the lower breast with a vertical incision combined with a peri-areolar incision (incision around the nipple) or with just the peri-areolar incision itself (the Bennelli technique). The skin is drawn together and stitched creating a higher, tighter breast. Sometimes I insert an implant to give the breast added support and fullness if the patient has inadequate breast tissue.

    Before and After Breast Lift with Breast Implants (Bennelli: Minimal Incision) by Dr Hodgkinson

    Breast implants should not shift in position once they are inserted if the implants are responsibly chosen to fit the patient’s build and the surgery is performed properly. The surgeon’s challenge is to make the pocket the exact size of the implant if not a little firm to avoid movement or rotation.  The problem with the tear drop shaped implants is that in the hands of the less experience surgeon is if the pocket is not perfect and they rotate, resulting in an unnatural shape to the chest… In placing any implant—whether it is a breastcheekchin or calf implant—the aim of the procedure is to make the pocket the correct size and shape for the proposed implant. A pocket which is proportional to the chest wall diameter will allow the implant to sit nicely and protects the implant from displacement.

    Before and After Breast Augmentation: D cup 400 cc Round Smooth Saline Breast Implants by Dr Hodgkinson

    Breast size, bra size and implant size cannot be directly compared. Correct sizing of patients is important because no two women are the same. No woman has the same exact same sized breasts on both sides and no two bras are the same, but two implants by the same manufacturer will be the same size. At the Cosmetic & Restorative Surgery Clinic, we pride ourselves on our ability to size a patient accurately based on the size she wants for breast implants, not only by measurements but also by using industry specific tools and  trialling different sizes and shapes of implants with the patient. To learn more about breast implants, to make a time for sizing and or learn about other procedures, contact us at the Clinic or just check our website.

    Furry Brazilian Implants is a sexy name for an implant manufactured by a Brazilian Company called a Polyurethane implant.  Polyurethane implants have been in the market for over 30 years but they were taken off the market in 1992 in the Moratorium against implants in the United States and have never returned there. The arguments made for these textured implants is that they form less capsular contracture.  Recent scientific studies, however, have linked textured implants to a rare form of cancer called ALCL, anaplastic large cell lymphoma.   All cases of this in Australia have been linked to textured or polyurethane implants See the TGA reference which is updated regularly for consumers.

    Note: these implants are being widely promoted and used still in Australia despite concerns:

    I’m often asked this question. In contrast to many surgeons who prefer to use one particular type, I use every sort of implant *as well as a wide range of incisions to insert them. This flexibility is important to meet the patient’s desires and obtain the optimal result. The choice is contingent upon the patient’s shape, the condition of the breast tissue, whether there is droop (ptosis) of the breasts and the overall figure shape. In over 90% of cases, I use a saline implant. The smooth-walled saline is ideal for the younger patient who has never had an implant, has very little ptosis of the breasts and wants to have a C or C+ brassiere size. A gel implant is used if patients want a more generous size or they are quite thin and have little breast tissue to cover the implant.

    * (except for textured polyurethane breast implants which are under suspicion due to links to ALCL anaplastic large cell lymphoma)

    Before & After Breast Implants by Dr Hodgkinson