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Breast Augmentation and Breast Implants your ultimate guide

Breast Augmentation is a common operation to enhance your breasts. This guide will help answer many of the most common questions that patients have about breast augmentation surgery. It contains extensive videos, photos and graphics. All the information is based on the latest research.

Index of information that you will find on breast augmentation

We have written this page for you to be able to see what modern breast augmentation surgery can do for you. We have also tried to cover most of the common questions that patients ask us.

We are here to help! Click here to send us an email enquiry. Throughout the page we have added resource boxes with research and videos of Dr Beldholm explaining breast augmentation surgery to you.

Press or click on the title to go directly to the section.

Dr Beldholm’s description of how he arrived at performing the 24 hour rapid recovery technique...and the benefits to you

This is a description of how Dr Beldholm trained and arrived at the current technique that he performs. From performing the standard breast augmentation technique to the rapid recovery technique, incorporating polyurethane breast implants, and how this will change your results and recovery. It describes the supporting documents and has videos of Dr Beldholm discussing his technique.

When things changed for me and my patients going from the standard technique to the rapid recovery technique

This section describes how I learnt the 24 hour recovery technique and how my surgical technique changed.

How I do the rapid recovery breast augmentation with polyurethane breast implants now

This describes how Dr Beldholm does this operation now and the benefits to you.

What happens after the operation?

This sections reviews what to expect after your surgery, recovery, back to work and gym.

Candidates for breast augmentation surgery

Are you a good candidate for breast augmentation surgery?

Breast Augmentation - what to expect from SCS or our all comprehensive tailored packages

What can you expect from Specialist cosmetic surgery? We go through what our tailored packages include and the diamond difference.

The history of breast augmentation surgery

In order to understand how far this life-changing procedure has come, you need to understand its origins. Breast augmentation surgery has actually been around a lot longer than most people realise.

Breast augmentation risks & complications

As with any operation there are always risks and complications that can occur. We go through these in detail.

Peer review journal articles that support the way that we do things

To make sure that we can provide you with the best possible care, we are constantly keeping up with the latest research conducted in breast augmentation surgery. This is the only way that you can be sure that you are getting the best possible result and care. This lists some of the research reports that we base our rapid recovery technique as well as our use of polyurethane breast implants on.

Resource boxes on breast augmentation surgery

Throughout the page we have added resource boxes for you. These contain the latest research and videos of Dr Beldholm discussing aspects of breast augmentation surgery and much more. Here is the index to go directly to these resources.

Resource box: Risk of rotation and displacement of implants

This box shows the research that demonstrates that smooth and textured implants have a rotation rate of up to 42% as compared to the polyurethane breast implants, which have a demonstrated rotation rate of 0.4%. This is one of the biggest reasons why surgeons that do not use polyurethane breast implants, prefer using round implants. Therefore polyurethane breast implants allow a more customised approach to breast augmentation, through the use of round or teardrop implants. The choice of a round or teardrop implant gives the ability to suit each individual chest, resulting in a much more refined result.

Resource box: Haematoma rates

This resource box shows the rate of bleeding is significantly reduced by using the rapid recovery technique. 2.6% for the standard technique vs 0.3% for the rapid recovery technique in the two studies used in this example.

Resource box: Benefits of using polyurethane breast implants

There are many studies in respected scientific journals that demonstrate that the polyurethane breast implants are superior to other implants as well as safe.

  • Capsular contracture rate of only 1%.
  • Large studies demonstrate that there is no health or safety issues with these implants.
  • One study recommended that all surgeons should be using these implants.
  • Another study done by a prominent plastic surgeon concluded “ “…During the span of this author’s practice, he has never been able to match the number and quality of superior results exemplified by these patients when using other devices…”

Resource box: 24 hour recovery from breast augmentation surgery. Dr Beldholm’s mini-review of these articles

This resource box goes through the scientific studies that have lead to the rapid recovery technique. It also has a video of Dr Beldholm discussing the research paper by Dr Tebbett’s.

Resource box: There are many other prominent surgeons that perform the 24 hour recovery and have shown the benefits

There are many prominent plastic and cosmetic surgeons that are using these advanced techniques. This box gives you more detail on them.

Resource box:Why have a breast augmentation as part of a breast lift?

This box has a video of Dr Beldholm discussing the benefits of adding a breast augmentation to a lift to give more fullness to the breast area.

Resource box: Common myths about breast implants - busted

Dr Beldholm discusses the top 10 myths for breast augmentation surgery.

Resource box: Benefit of Healite II LED

We include Healite in all our tailored packages, as it improves swelling and bruising post operatively.

Resource box: Can I breastfeed after breast augmentation and is it safe for my baby?

This is one of the most common questions that women have. I have created a video, as well as this resource box, to give you a detailed answer to this. In short, breast augmentation should not affect breast feeding and is also safe for the baby.

Resource box: Smooth Vs Textured Vs Polyurethane Breast Implants

What are the differences between all the different implants, and why does Dr Beldholm consider the polyurethane breast implant the best option for his patients?

Resource box: Do I need a breast lift and implants?

If your breasts are saggy, breast implants are not enough to lift the breast up and get a good result. This is when you need to consider a lift. Dr Beldholm has produced this video, as well as this extensive information resource to answer this question in detail.

Our all inclusive tailored package is $8990

How I arrived at performing the 24 hour recovery technique (by Dr Bernard Beldholm)

Breast Augmentation - The way it is usually done...

and how I did it then

When I started with breast augmentation surgery around ten years ago, I was taught to use smooth or textured silicone implants, at that stage I was also using saline implants. The technique I used was called blunt dissection technique,

and it went something like this.

Once you were put to sleep either with sedation or a general anaesthetic, local anaesthetic was then injected into the breast. I would use a 10 cm long needle and the local solution was injected into the breast, approximately where the incisions and internal dissection were to be performed. I would then make the incision under the breast, in the axilla or around the areola, and dissect down to the pectoralis muscle (chest muscle). If I was placing the implant under the muscle, I would then lift the muscle and cut it open to enter the plane under the muscle. If I was placing the implant above the muscle, then I would stay above the muscle. Once I had reached the muscle, I would use a big instrument (looks a bit like a hockey stick) to tear the tissue open to create the pocket. As I had injected adrenaline, which constricts the blood vessels, there was minimal to no bleeding and all looked fine during the operation. The pocket size and shape was one of the most important things, as the smooth implants would settle into the pocket that I had created (requiring special bandages/ bras and special massage techniques post operatively).

The implants were then inserted. There was no need to really place the implant in any particular way as it would move anyway. I mainly used round implants, as I had had a lot of issues with tear drop implants rotating. The rotation rate varies quite a lot between studies. However, in one recent study in 2017, the researchers found a rotation rate up to 42% (ref 3).

I then inserted drains (plastic tubes) into the breast pocket and closed the wound.

The standard care was to keep my patients in overnight. In the morning I would come and see them in the hospital. At that stage there was usually 30-200 ml of blood and fluid in the drain which was quite normal. Usually the drain was removed at that stage.

Because adrenalin wears off after the operation, bleeding and haematomas tend to occur a few hours later, and this was also my experience at the time. The research also supports this. The haematoma rate in Tebbetts article (ref 10) is 0.3% in another comparable study it is 2.6% (ref 5). To put this in perspective the haematoma rate is 8.7 times higher in the standard technique based on these numbers.

After the operation I would use special bandages that push the implants down into the pocket. If these were not used then the implants would sometimes be “high riding” i.e. be too high and look bad. After the bandages came off the patient would need to massage the breasts to push the implant down into the pocket.

I would give my patients strict instructions, not to do too much physical work and to “rest” as much as possible. Absolutely no exercise for 6-8 weeks. The reason for this was to allow enough time for the pocket to form a soft capsule around the implant, so that they would not move. Going back to work would be allowed at a minimum of 2 weeks, if it was desk type job, with minimal activity (this is also the current recommendation from Australasian society of aesthetic plastic surgeons).

Most patients would have pain for a few weeks after the operation, and it was not uncommon to have patients take strong painkillers.

All of this was quite normal and acceptable medical practice.

Risk of rotation and displacement of implants

Resource box
Peer review journal articles

Smooth breast implants rotation rate: 42% (see reference 3 below)

Polyurethane breast implants rotation rate: 1 implant out of 255. 0.4% rotation rate (see reference 4)

Haematoma rates

Resource box
Peer review journal articles

Standard technique: 2.6% (see reference 5)

Tebbett’s technique: 0.3% (see reference 10 & 11)

When things changed for me and my patients with breast augmentation surgery

breast augmentation

I feel being a surgeon is a continuous learning process. It’s a dedication to learning, and continuously striving for excellence in patient care and results. I am constantly refining my surgical techniques. This drove me to meet with Dr Daniel Fleming in Brisbane, who is a great proponent of the polyurethane breast implants. He had also recently visited Dr Tebbetts in Texas, and had learnt the 24 hour recovery technique from him. I initially spent three months training with him, after which he invited me to stay in Brisbane to continue working with him. I stayed for a further six months.

What I learnt was really a complete shift in the way to do breast augmentation surgery. It was like learning to do a new operation again and honestly it took me a good six months to become confident in this new approach.

After working in Brisbane for six months with Dr Fleming I decided to go back to Sydney to start a practice in the Eastern Suburbs. I had been maintaining my boutique practice in Lorn in the Hunter Valley throughout this time.

To me the difference was like night and day. The Tebbets technique (ref 10, 11) and polyurethane implants (ref 4, 6-9), have made a big difference to my results and the recovery that my patients get.

Tebbetts method is all about gentle manipulation of the tissue. It is radically different from the standard approach. I struggled initially for six months with this technique when I started. The standard technique is technically so much easier. I was performing breast augmentations in around 1 hour, but when I was changing over to the 24 hour recovery technique, my operating time was going up to 2-3 hours. In those initial few months I did think to myself “Why am I putting myself through this?”. However, I persisted, and I’m very glad that I did!

I now perform breast augmentation using Tebbetts technique and polyurethane breast implants in around 1 hour. I have the same outcome that Dr Tebbetts had in his article.

Benefits of using polyurethane breast implants

Resource box
Peer review journal articles

The many reasons why Dr Beldholm and many other surgeons and researchers recommend Polyurethane breast implants.

breast implants

There are many reasons to consider these implants the best implants on the market at the moment. Check out all the supporting research on this below as well. In summary:

  • Proven safe implants.
  • Minimal risk of rotation or moving.
  • Less medical complication.
  • Less capsular contracture.
  • They don’t move to the side or fall down with time – they grip the chest tissue.
  • Best possible cosmetic result of any of the breast implant types.
  • Reduce long term complications.

It is Dr. Beldholm’s firm belief that polyurethane implants are the best breast implants currently available on the market, as compared to either smooth or textured implants. This is why he uses polyurethane implants for his patients, and recommends them to other surgeons as well.

Does the research agree that polyurethane breast implants are the best choice?

As far as possible everything that Dr Beldholm does is based on the latest peer reviewed research in prestigious medical journals. This ensures that you get the best care and the latest in plastic surgery.

Quote from one article: referring to polyurethane breast implants “…During the span of this author’s practice, he has never been able to match the number and quality of superior results exemplified by these patients when using other devices…” (see reference 8)

In another article the authors recommended that all surgeons should consider using polyurethane breast implants for all breast augmentations. (see reference 9)

The main benefits of polyurethane breast implants

Capsular contracture

Capsular contracture is when scar tissue from your body forms around the implant. This can cause the breast to become hard, or tighten and feel constricted. It is essentially a hard capsule (capsular) of scar tissue around the implant that contracts (contracture) and squeezes the implant. It can happen to either one implant or both. It’s quite a common occurrence for people that have had breast implants.

Capsular contracture is graded into four different grades:

Grade 1: Breast feels soft and looks normal.
Grade 2: Breast feels slightly firm but looks normal.
Grade 3: Breast feels firm and does not look normal.
Grade 4: Breast feels hard, does not look normal, and is painful.

Capsular contracture is generally not an issue when it is either Grade 1 or Grade 2. Implants, along with the scar tissue capsule will generally need to be removed and replaced with fresh implants if at Grade 3 or 4.

It is known that:

  • Textured implants develop less capsular contracture than smooth implants when placed over the muscle.
  • Placing breast implants under the muscle, rather than over the muscle during breast surgery, reduces the risk of capsular contracture.
  • Polyurethane implants have far less chance of capsular contracture than smooth implants or textured implants.
  • Saline implants have a higher rate of capsular contracture than silicone breast implants.
  • Smokers have a higher incidence of capsular contracture than non-smokers.
  • While breast massage is said to help prevent capsular contracture, this hasn’t been proven (hey, can’t hurt though!)

(see reference 15)

Conclusions from supporting peer review articles on capsular contracture

Conclusion of this article was that polyurethane breast implant were the best breast implants to use, with capsular contracture rate of 1%. (See reference 6)

This article concluded that capsular contracture rates were dramatically lower than any other implants. They also concluded there was no health or safety issues with these implants. Polyurethane breast implants decreased complications substantially. (See reference 7)

Rippling of breast implants

Rippling, wrinkling, or waviness in breast implants is when you can see lines on the outside of your breasts due to the surface of the implant becoming wavy. It usually occurs on the outer sides and inner sides of the breast and may only occur when you lean over and your breasts “dangle”.

This can happen because implants are under or overfilled – which can only happen with saline implants – or it can happen because there’s not enough breast tissue surrounding the implants, which can happen with small natural breasts – or it can happen because the implant is placed over instead of under the muscle.

You can also get “traction rippling” which happens when tissues connect to a textured implant and pull at it.

In terms of the prevalence of rippling between smooth, textured, and polyurethane implants, one 2006 study (See reference 16) compared the effects of each in a large group of women. The survey found that it occurred in 6.92% of all smooth implants, 6.69% of all polyurethane implants, and 14.15% of all textured implants.

Revision and reconstruction surgeries also increased the risk of wrinkling.

As you can see, if wrinkling is a concern, then polyurethane implants are the best option.

Movement & rotation

Movement and breast rotation generally occur when you are using smooth implants (i.e. ones that tissues do not adhere to). This means that your breasts can “travel” around your chest, and even rotate. If an implant has a flat base and rotates that would mean that you would have a flat breast!

While generally rotations can be coaxed back into place, this isn’t always the case.

Smooth breast implants can also move about, especially over time. If you are considering smooth breast implants, make sure that you wear your pressure garment for as long as possible to keep them in place while you are healing. Always wear a good sports bra when working out, and a good support bra daily. It would be best to consider a different type of implant if you are quite athletic.

To prevent the risk of movement and rotation, go with polyurethane implants. (See reference 3, 4)

Are polyurethane breast implants more difficult to remove?

Because polyurethane implants cause a lot less problems in the long term, they are generally changed less regularly. Each removal takes about 5-10 minutes compared to about a minute to remove smooth and textured implants.

Because there is more skill involved in performing surgery with polyurethane implants, this is why the procedure will take a little longer. Having a surgeon who has a lot of experience with polyurethane implants is very important!

Haven’t polyurethane breast implants been banned??!!

No, polyurethane implants are fully approved for use in Australia. The type that Specialist Cosmetic Surgery uses are soft, great quality, and made in Germany, by a well known brand called Polytech. Polytech have been manufacturing breast implants for approximately 25 years.

A Brazilian competitor (Silimed) has been closed since November 2015, after contamination fears. However, they are currently in the process of getting reaccredited. The contamination fears were not related to the safety of polyurethane breast implants, rather the specific manufacturing facility that Silimed used.

Until November 2016 all sales of new Silimed polyurethane implants have been suspended. There is nothing to indicate any issues with any of the implants originating from this source. The suspension of sales appears simply to be one of factory compliance with European standards.

What do I need to know about Polytech then??

Polytech is one of the leading manufacturers of silicone implants in Europe, and provide surgeons around Australia with implants too. They are committed to producing quality products and providing maximum safety for their customers. They have made more than 1500 different types of breast implants, to suit women of all shapes, sizes, and preferences.

All the implants that Polytech manufacture are “filled with highly cross-linked, cohesive medical-grade silicone gels”, which are designed to hold their shape (unlike saline). They produce both smooth and textured implants, as well as the polyurethane implants which are for use in our surgery.

Their registered form of polyurethane is called Microthane. Studies indicate that after eight years, these implants have a 15% lower incidence of capsular contracture than textured implants, and a 30% lower incidence than smooth implants. The length of years between needing a revision surgery is longer when opting for polyurethane implants.

Because the implants do not drop or rotate either, complications and further surgeries are far reduced. In fact, these Microthane implants come with a 10 year free exchange warranty for any incidence of capsular contracture, dislocation, or rotation. This is in combination with a lifetime warranty in the case of any outer shell rupture.

Still not sure about polyurethane implants? Why not come into our office and take a look at one up close? We can walk you through the benefits of the technology and you can check it all out in person. We can go through sizes, shapes, and the benefits of undergoing breast implants in Newcastle with us at Specialist Cosmetic Surgery.

How I do breast augmentation now

breast augmentation

Tebbetts technique is all about gentle handling of tissues, and minimising bruising and bleeding to the breast tissue.

I always see my patients in the anaesthetic room just before the operation. We confirm the implants together, and I draw markings on their chest to get the implants just in the right place.

Once you are asleep on the operating table and we have prepared you, and put the sterile drapes on, I make an incision in the lower breast fold. Note that I do not inject local like in the old days all around the breast. I then gently dissect the tissue down to the pectoralis muscle. Any blood vessels are sealed prior to being cut. The most common implant placement is under the muscle, so I will describe this approach. Once I get to the muscle, I gently lift up the muscle fibres and cut through them with a diathermy. This provides me access to so called subpectoral plane. Once here, it is all about making sure the pocket is created with minimal trauma to the ribs and other tissues. I gently lift the tissues up with the breast retractor and use the diathermy (this is an electronic device that seals tissues). Being aware of the anatomy of this area is critical to be able to anticipate blood vessels, such as the intercostal, perforating blood vessels and other blood vessels. The pocket is created that is slightly bigger than what the implant requires.

Once the pocket is made, the polyurethane breast implant is opened. A plastic sleeve is used to insert the implant into the breast (the plastic sleeve makes it easier to put in the implant and also the implant is protected from the skin to minimise the risk of infection).

The next step is probably the most critical step in the whole operation. Polyurethane breast implants are not like textured or smooth. They stay where you put them, which has many benefits from minimal rotation rate to not having to do massage or have strapping after the operation. However, it also means you need to get the placement absolutely perfect at the operation, or it is not going to be right. I therefore spend a good 10 minutes adjusting the implant to place it just right. The operating table is elevated to around 60 degree, and I have a look at the symmetry to make sure that it is perfect.

After this it is a matter of closing the incision. which I do with absorbable sutures, that do not need to be removed. I place a simple dressing on the wound and you are done!

24 hour recovery from breast augmentation surgery

Resource box
Peer review journal articles

There are actually 2 articles that Dr Tebbetts wrote about this technique

Tebbetts JB. “Achieving a predictable 24-hour return to normal activities after breast augmentation: part I. Refining practices by using motion and time study principles.”. Plastic & Reconstructive Surgery. 109(1):273-90; discussion 291-2, 2002 Jan.

Tebbetts JB.”Achieving a predictable 24-hour return to normal activities after breast augmentation: part II. Patient preparation, refined surgical techniques, and instrumentation.” Plast Reconstr Surg. 2002 Jan;109(1):293-305; discussion 306-7

Summary of findings in these studies

  • Study done over 5 year.
  • 627 patients had the “24 hour recovery technique” done
  • 96 percent of these patients were able to return to normal activities within 24 hours
  • Time to return to normal activities were defined as:
    • Lifting the arms above the head three times in sequence four times a
      day
    • Lifting all normal-weight objects (up to
      20 pounds) or young children
    • Driving personal car
    • Going out of house for shopping or entertainment
    • Returning to work or full normal activities
    • Being able to lie prone on breasts for at least 15 minutes
    • Being totally free of all postoperative adjunctive devices or narcotic medications
  • Within 24 hours of the operation there was no need for:
    • Drains
    • Bandages
    • Special bras
    • other adjunctive treatments within 24 hours after their partial retropectoral
      breast augmentation.
  • What about complication?
    • Fold revision 0.6%
    • Infections 0.3%
    • Haematoma 0.3%
    • Implant Size Change 0.3%
    • Malposition 0.3%

Quote from these studies:

“…Dramatic improvements in patient outcome are possible by detailed reassessment of practices and techniques, even by surgeons with 15 years of experience…”

What happens after breast implant operation?

skin cancer recovery

This is when the magic happens. The rapid recovery technique (ref 10,11) has made an amazing difference to the recovery process.

This is what you can expect.

  • Some discomfort for the first few days that varies from patient to patient.
  • You should be able to lift your arms up above your head within a few days.
  • Go home the same day of the operation with minimal discomfort.
  • Most patients only need simple pain medications such as panadol.
  • No drains.
  • You can have a shower the next day.
  • You wear a soft surgical bra that you can take off for showers.
  • No need for breast massage.
  • No need for any sort of strapping.
  • If you have desk type job, then you should be able to go back to work in 3-5 days.
  • Full exercise with no restrictions after 4 weeks.
  • Your breasts will swell after the operation. This swelling is usually worse at 2 weeks and then settles towards the 4 week mark.

Give us a call and book a consultation today. Call (02) 4934-5700

There are many other prominent surgeons that perform the 24 hour recovery and have shown the benefits

Resource box

The medical board in Australia forbids testimonials on doctors websites. So unfortunately I’m not allowed to film my own patients to be able to demonstrate the great advantages of these techniques, or provide any sort of testimonials from them. However, check out the videos on Dr Epstein’s website. Also once you have had a consultation with me, we are very happy to put you into contact with one of our patients, to talk about their experiences with the surgery.

Quote from medical board guidelines:

“To comply with s. 133 of the National Law and these guidelines, advertising of services must not: …

(d)  use testimonials or purported testimonials”

Check out

Centre for aesthetic surgery

Dr Epstein’s experience with this technique. He has had a much longer career than I, but he has had a similar experience with the transition from performing the standard blunt dissection technique, to now using the 24 hour rapid recovery technique, pioneered by Dr Tebbetts.

http://www.epsteinplasticsurgery.com/procedures/breast-procedures/breast-augmentation/

Off course check out Dr Tebbetts website

“The best breast”

http://www.thebestbreast.com/an-introduction-to-john-b-tebbetts-md/

Why have a breast augmentation as part of a breast lift?

Resource box

Good candidate for breast augmentation surgery

If you have realistic expectations, breast augmentation surgery can give you a great boost in confidence. Most women that I see are very happy with their choice to have breast augmentation surgery. It is however important to keep in mind that this is a surgical procedure and to make sure it is the right choice for you. You should make sure you’re doing this for you–rather than doing it to please someone else. You may be a candidate for breast augmentation surgery if:

You have realistic expectations

Our physical appearance is very important and if you are not happy with the shape or size of your breasts then having breast augmentation surgery can make a big difference to your look and how you feel about yourself. Dr Beldholm will discuss your expectations at your consultation and make sure that these are realistic. We use 3D imaging to give you an idea as to what you can expect after the surgery as well

Your breasts have fully developed

Ideally you should wait to have your surgery until after your breasts are fully developed. Every women is different. However, the usual age is from 18 years to around 22 years. If you are younger than 18 years old the then the medical board requires additional assessment by a psychiatrist or other independent medical practitioner before you can have the surgery. Your parents will also need to consent. Dr Beldholm therefore does not do any breast augmentations for patients that are under 18 years old. s well

You are bothered by the feeling that your breasts are too small, asymmetrical or appear “empty”

If your current breast size prevents you from wearing the type of tops you’d love to wear, makes you insecure to be in a swimsuit or be intimate with your significant other, you may benefit from breast augmentation surgery. Studies have shown that this procedure can greatly boost a patient’s confidence and self-esteem.

You are dissatisfied with your breasts losing shape & volume

Unfortunately, pregnancy, massive weight loss and ageing can all impact the look and feel of your breast. No miracle cream, exercise or fancy gimmick will repair them to their natural state–only cosmetic surgery will.

One or both breasts failed to develop normally or have an elongated shape

This would fall under reconstructive surgery which restores a patient’s breast to near normal shape, appearance and size following a mastectomy, lumpectomy or other trauma.

Common myths about breast implants - busted

Resource box

Myth 1: All implants look fake

Patients who choose an unnatural implant size that isn’t proportionate to their body increase their chance for looking fake. However, any good cosmetic surgeon aims to avoid this–and generally discourages this look. There are also many implant options, including teardrop shaped implants, that strive to give you a more natural look. In fact, if you talk to many surgeons, their goal is always to give patients a natural (yet improved) look–this includes Dr. Beldholm.

Myth 2: Breast implants are for women who want big breasts

Not everyone wants big D cup breasts or larger. In fact the trend over the last five years has been for more in proportion natural looking breast, around the C cup. Most women that see Dr Beldholm want great cleavage, natural looking breasts from C-D cup in size, that make them look in proportion, and allows them to wear good looking clothes and look great in swimmers.

Myth 3: Silicone implants aren't safe

  • Any woman who is now considering breast augmentation needs to understand that the latest generation of silicone gel implants have a solid track record of safety.
  • They are likely some of the most studied medical devices in the history of medicine.
  • The FDA has approved the use of silicone gel breast implants for primary breast augmentation in women age 22 and older.
  • Ongoing studies of modern silicone gel implants have found a safety profile similar to that of saline breast implants, which have been in use for over four decades.

MYTH 4: Implants can cause breast cancer and other diseases

There is no medical evidence to show that women with breast implants have a higher chance of developing breast cancer or autoimmune diseases. There are however some studies that associate textured breast implants with Anaplastic Large Cell Lymphoma (click here to read more about this).

Myth 5: I will not be able to breastfeed with implants

Check out our dedicated resource box on this (click here)

  • There is no medical evidence to show that breast implants interfere with breastfeeding, and women with breast implants do not risk exposing their breastfed children to excessive amounts of silicone.
  • The ability to breastfeed successfully varies in all women with or without breast implants.

Myth 6: Implants make it difficult to detect breast cancer

  • It is recommended that all women regularly self-examine their breasts for lumps and changes, and have an annual examination by a doctor.
  • Mammography is more difficult for women with breast implants, but is well practiced by radiologists. Patients should inform radiologists of breast implants prior to examination.

Myth 7: Breast augmentation is painful surgery that requires a lot of time off work and physical activity

  • This was definitely true of the older surgical techniques.
  • But since the rapid recovery technique and polyurethane breast implants this has all changed.
  • You will have discomfort for around 3-5 days in most cases.
  • In most cases you will also be able to get back to work within a few days and full exercise in around 4 weeks.

Myth 8: Implants make the breasts sag earlier

This again is actually true for smooth and textured implants. These implants are held up by the breasts and gravity over time pulls the breast and the implants down. The name “ball in a sock” appearance is coined to tell you how the implants will look after a few years.

However

The polyurethane breast implants are different. These implants stay in place and are held up by the muscle and the surrounding tissues, so that they do not put strain on the actual breasts. This prevents the breasts from sagging over time.

Myth 9: Breast implants need to be replaced regularly

  • “If it is not broke don’t fix it!!”
  • Again this relates to the older style implants, with a high rotation rate and capsular contracture rate, which is the most common reason for having to have them replaced. The smooth implants also tend to move over time and drop. This meant that over time a very high proportion of breast implants had to be revised.
  • Polyurethane implants are not without problems. However, they do have a much lower rate of complications than other implants, and you should expect to have a lot lower rate of problems with them

Myth 10: Breast augmentation scars are obvious

Breast implants are inserted through a small incision. These incisions can be made either in the crease under the breast, under the arm, or around the nipple. These incisions usually heal very well and are not usually very obvious.

Benefit of Healite II LED

Resource box

Peer review journal articles

Proven benefits of LED light treatment

  • LED light is effective for speeding up healing. (see reference 1).
  • Shorter healing periods and improved scarring with 830 mn LED light. (Reference 2).

Check out this article on Heelite from Aesthetic Medical Practitioner magazine.

This picture shows one of our patients, post inner thigh lift, one week post operatively. She had compression tape covering the left side (without LED treatment). The lower (right side of the photo) had been exposed, so had a full three treatments of LED light. This demonstrates the effectiveness of the 830nm LED light that we use post surgery. Note that individual results vary*

Breast Augmentation - what to expect from SCS and our all comprehensive tailored packages

Our all inclusive price: $8990

What is included in this price?

  • Pre and post of care by our nurses and Dr Beldholm. Once you have had your initial consultation with Dr Beldholm, then all subsequent visits are free of charge.
  • 3D imaging, and you are able to see the 3D images on your own computer, ipad or iphone at home.
  • Two surgical bras to use after your surgery.
  • The operation takes around 1.5 hours, if it takes longer you do not pay more.
  • State of the art polyurethane breast implants. Teardrop or Round, and there is no additional charges for bigger implants.
  • Hospital charges.
  • Anaesthetist charges.
  • Surgeons fees.
  • Six LED light treatments with (Healite II LED) this helps any bruising or swelling after your procedure, to get you back to your normal activities sooner.
  • Access to 24/7 emergency number after your procedure if you have any concerns.
  • Our diamond service commitment.

Can I breastfeed after breast augmentation and is it safe?

Breastfeeding after breast augmentation is absolutely safe and possible. The implants are normally placed under the breast tissue which means they should not damage any breast ducts. Silicone is biologically safe and has not been shown to be harmful for your baby. We will discuss the research that support this view further down on this page.

breast lift

Latest research into breastfeeding and breast augmentation

When women ask about breastfeeding and breast augmentation there is really two implied questions in this:

  • Are breast implants safe for my baby?
  • Am I going to be able to breastfeed with implants?

To be able to answer these questions I have reviewed the current medical literature. There is a lot of misinformation on this topic on the internet, and it is important that potential mothers get the right information.

Are Breast implants safe for my baby?

Breast implants have been around for a long time and there has been a few scandals associated with them. From getting banned in the 1980’s in the USA to the recent PIP scandal. All this makes mothers anxious about potential harm that could happen to their babies.

There has been much research on the safety of the implants. “Institute of Medicine (US) Committee on the Safety of Silicone Breast Implants” did an extensive review of the research available on this issue in 1999.

The main conclusion that they came to is that it is safe for the baby and that there is no “plausible” way that the silicon or implants could harm the baby.

Since the 1990’s breast implants have gone through a lot of changes, making them even safer than they were at that stage.

Gel bleed is a particular problem with liquid breast implants. The silicon leaks through the shell of the implant. Modern implants contain cohesive silicone gel often referred to as “gummy bear” implants. The cohesive gel sticks together and avoids a lot of the issues that liquid silicon had. So modern implants are much safer than the older generation implants.

Summary of the review done by Institute of Medicine (US) Committee on the Safety of Silicone Breast Implants

Effects of silicone breast implants during pregnancy and lactation

Two main issues need to be answered:

  • Is silicone harmful to the baby?
  • Do women with implants have silicon in their body and does this silicone reach the baby?
Is silicon harmful to the baby?

There has been no studies to date that show that silicon in any way is harmful to the baby. For obvious reasons there has not been any direct studies with babies. All the human studies have been observational and in all of these there is no sign that there is any potential harm to the baby. There has been animal studies to see if silicon is safe for a growing fetus. These studies have not shown any harmful effect.

As far as the latest research suggests, there is no sign that silicon in any way can harm the baby.

Do women with implants have silicon in their body and does this silicone reach the baby?

The other piece of this puzzle is; if silicon was harmful to the baby, does it actually reach the baby in the womb or during breastfeeding.

For the silicone to reach the baby it has to get in the blood first. There is studies to show that this does not happen.

So in conclusion there is no risk to your baby from silicone.

Am I going to be able to breastfeed with breast implants?

For women who are considering breast augmentation surgery and want to have children in the future, the ability to breastfeed is often a concern. The location, orientation, and extent of the incision during the procedure, ultimately determines how much milk production will be affected.

Your chances of breastfeeding improve if your milk duct system is intact. Implants are typically placed behind the milk glands or positioned underneath the chest muscle. Incisions made under the fold of the breast or through the armpit are less likely to cause difficulty. Incisions made around the areola can.

Nerves are vital to breastfeeding, since they trigger the brain to release prolactin and oxytocin, two hormones that affect milk production. If the nerves around the areola were cut or damaged during surgery, you have an increased risk for low milk production. You won’t know the full extent of nerve damage, if any, until you try to breastfeed.

Breastfeeding is important for a number of reasons. From bonding with your new baby to providing important nutrition and disease fighting substances. It has been shown that women that have implants have a reduced rate of breastfeeding.

There might be many factors why this is the case:

  • Anxiety about breast implants and safety for the baby.
  • Having small breasts before breast feeding may mean less ability to breastfeed.
  • Pressure on the breast tissue.
  • Potential nerve damage.
  • Potential damage to the ducts.

To be sure that you have the optimum chance of breast feeding you should see a surgeon that specialises in breast augmentation. You also want to see a surgeon that uses the rapid recovery technique, which minimises damage to the breast tissues.

If you become pregnant then you should make sure that you have a breastfeeding nurse helping you to get the optimum chance to breast feed.

(see reference 12 to 14 below)

The history of breast augmentation surgery

In order to understand how far this life-changing procedure has come, you need to understand its origins. Breast augmentation surgery has actually been around a lot longer than most people realise.

In fact, the very first implant surgery was performed in 1895 at the University of Heidelberg in Germany! The surgeon, Vincent Czerny, took fat from a female patient’s hip and implanted it into her breast, which needed reconstruction after the removal of a massive benign tumor.

After World War II in Japan, prostitutes catering to the tastes of the U.S. military, began injecting industrial silicone directly into their breasts–which is definitely risky to say the least. They previously tried goats’ milk and paraffin. Looking back, it’s pretty shocking the lengths some women would go to in order to achieve the “perfect chest.”

By the 1950s, doctors started inserting sponge implants into women’s breasts. One was the Ivalon sponge, made of polyvinyl; another was polyethylene tape wound into a ball and encased in fabric or more polyethylene.

In 1962, Timmie Jean Lindsey, who hails from the state of Texas in the United States, became the very first woman to receive silicone breast implants. She went from a B to a C cup, in an operation that made history.

“I thought they came out just perfect. They felt soft and just like real breasts,” she told the BBC in 2012. “I don’t think I got the full results of them until I went out in public and men on the street would whistle at me.”

Fast forward to today and breast implants have fortunately come a long way—and that’s definitely a good thing. Today, the material implants are made from has greatly improved. The technique has improved, and now more than ever woman have lots of options. Interested in learning what those options are? Send us an email..

Smooth Vs Textured Vs Polyurethane Breast Implants

Resource box

Peer review journal articles

There is just so much information to wade through when you’re researching what to get, when you’re considering undergoing a breast augmentation! We have created a more extensive page on sizing and implant choices. Click here.

From saline to silicone. How many cc’s you need for your ideal cup size. Researching which Newcastle cosmetic surgeon to use. How long you’ll need off work, what the risks are… It’s a wonder that you’ve got time to think about anything else, really!

You might just have gotten to the point now where you have found out about polyurethane breast implants – as if there weren’t enough choices already. While most people are familiar with both smooth and textured breast implants, polyurethane implants are a lesser known type – although they really shouldn’t be!
This resource box is an unbiased look at the differences between all three different types of breast implants.

At Specialist Cosmetic Surgery we’ve chosen to use polyurethane implants because we believe that they are the best available on the market for customers.

But don’t just trust our opinion – read on to find out why we’ve made the decision to go polyurethane.

plastic surgery nsw

What are smooth breast implants?

The “smooth” in smooth implants refers to the surface of the actual implant – it’s completely smooth. This coating is made of silicone elastomer. This smooth surface means that the implant doesn’t stick to the surrounding tissues within the breast, and the implant can move around a bit in the cavity created.

While this is more similar to how a natural breast behaves, some smooth implants can either move too much, or permanently, or rotate around in their pocket – which can lead to the breasts looking unnatural. Over time especially, people with smooth implants can notice implant drift – either to the sides of the body or further down the chest.

Smooth breast implants can have an inner core of either saline or silicone gel. They are the traditional type of breast implants – they were the first type available for consumers on a large scale.

What are textured breast implants?

breastimplantsnewcastle

Textured implants have – you guessed it – a textured surface rather than a smooth one. The textured surface (made of silicone elastomer) adheres to the surrounding tissue in the breast which means that your breasts are less likely to travel, and won’t rotate about unlike the smooth implants. They were designed to eliminate the rotation and movement associated with smooth implants. The difference in textures varies a lot from manufacturer to manufacturer.

Textured breast implants can have either a silicone gel or saline inner. They are probably the most popular form of breast implants globally at the moment.

Polyurethane breast implants

breast implants

Polyurethane implants are silicone gel implants coated with a type of polyurethane foam. They were developed to decrease the likelihood of capsular contracture occurring. These type of implants are similar to textured implants as they adhere to the surrounding tissue in the breast, and so will not travel over time, and don’t rotate within the cavity. Different manufacturers each have different widths of the coating on the implant.

These type of breast implants have been called “Furry Brazilians”. This is due to the “furry” coating of the implant, and the fact that a Brazilian manufacturer is one of the first large scale producers of these types of implants. Although the implants are not available in the US under the FDA guidelines. They are approved for use in Australia, and are popular in Europe, too.

Check out the detailed resource box on polyurethane breast implants for more detail. Click here.

Breast augmentation risks & complications

Risks and complications of breast implants include all those seen in most surgeries: infection, bleeding, poor scars, unsatisfactory size and/or shape of the breasts, loss of feeling in the nipple/areola area, and asymmetry. With this said, choosing a skilled and experienced cosmetic surgeon like Dr. Beldholm (that has a FRACS – Fellow of the Royal Australasian college of surgeons, meaning that they are a specialist surgeon) will significantly reduce the chance for complications.

Implants & breast cancer

For some women who are considering breast augmentation surgery, they may hesitate to go through with the procedure out of fear of an increased risk for breast cancer. However, there is some good news. According to recent studies, neither saline nor silicone implants appear to increase a woman’s risk for breast cancer risk.

You may have seen media reports suggesting that breast implants used in breast reconstruction may be linked to a very rare type of lymphoma called anaplastic large cell lymphoma. According to Breast Cancer Network Australia, this is an exceptionally rare cancer, affecting only 170 women worldwide to date. This is a potential risk for approximately one in one million women with breast implants.

Most health experts and organizations do not recommend special care for women with breast implants. However, if you have breast implants and feel any pain around the implants or have other problems, see your healthcare provider.

Anaplastic Large Cell Lymphoma Risks

As mentioned above, the risk for developing cancer following breast augmentation surgery is extremely rare. However, 46 known cases of Anaplastic Large Cell Lymphoma (ALCL) have been diagnosed in Australia patients since 2015.

Globally, recent research has shown that the cancer diagnosis was more common with patients who received textured surface implants, compared to those who received polyurethane foam covered implants.

According to the Australasian College of Cosmetic Surgery, most patients with breast implants diagnosed ALCL do not develop any invasive form, and can be cured by the removal of the implants and the capsule or membrane surrounding the implants. While some patients may develop invasive cancer, most of these are cured by additional chemotherapy and or radiotherapy. Deaths are very rare but have occurred, according to the organisation.

Dr. Beldholm advises patients considering breast augmentation surgery to be aware of the new cancer findings. At the same time, he wants to reassure them that more than 99.9% of women with breast implants will not get ALCL. According to the ACCS, the risk is STILL more than 100 times less likely, than the risk of any Australian woman of developing breast cancer in her lifetime, which is about 1 in 8.

Do I need a breast lift & implants?

Resource box

Peer review journal articles

There is not a one answer that fits all. Honestly, it really and truly depends on the patient. After all, each woman’s body is different, and at Specialist Cosmetic Surgery, we make sure each procedure we perform is unique to that person.

With this said, Dr. Bernard Beldholm regularly sees lots of patients who suffer from droopy breasts and/or volume loss. More often than not, they all have the same question:

“Can my sagging breasts be corrected with just implants or do I need a lift?”

There are a number of factors that will determine if a patient needs just a breast lift, breast augmentation, or both. During your consultation with Dr. Beldholm, he will advise you what procedure(s) will help you achieve your desired look.

Breast Lift + Implants: Who benefits

As a general guide, if a woman’s breasts sag and are also too small, both a breast lift and augmentation are usually needed. Often a lift, without adding implants, leaves the upper part of the breast too flat after the swelling has subsided. Frequently an uplift is accompanied with a small implant to solve this problem.

Implants alone: Who benefits

Breast implants alone can correct a woman’s sagging breasts if the drooping is mild, and the nipple still sits near the center of the breast and doesn’t point downward. As long as the patient is okay with increasing their breast size by at least two cup sizes, a lift is usually not needed.

Breast lift alone: Who benefits

If the patient is already a C or D with good tissue volume still intact, a patient may benefit from a lift alone. This procedure by itself works well for women who experience moderate to severe drooping, and the nipple is at the bottom of the breasts, pointing down.

Other Resources you may find useful

Breast Augmentation before and after photos and videos

This page shows a range of before and after breast implant photos and videos for my breast augmentation surgeries.
Click here.

Check out our comprehensive breast implant guide

This guide will give you extensive information on how to choose a breast implant that will give you the perfect result. What determines your final result? There are several factors to take into consideration which includes:

  • What does your breast look like
  • What plane are we using (under muscle, above the muscle or dual plane)
  • What shape of implants are we using (teardrop, round or special teardrop)
  • Size of the implants

Click here.

Peer review journal articles that support the way that we do things

  1. R Glen Calderhead, Won-Serk Kim and David B Vasily “Adjunctive 830 nm light-emitting diode therapy can improve the results following aesthetic procedures” Laser Ther. 2015 Dec 30; 24(4): 277–289.
  2. Kim, W. S. & Calderhead, G. R. (2011). “Is light-emitting diode phototherapy (LED-LLLT) really effective?” Journal for laser surgery, phototherapy and photobioactivation, 20(3): 205-215
  3. David A. Sieber, MD  Ran Y. Stark, MD  Serena Chase, MBA  Mark Schafer, PhD William P. Adams, Jr., MD “Clinical Evaluation of Shaped Gel Breast Implant Rotation Using High-Resolution Ultrasound”, Aesthet Surg J (2017) 37 (3): 290-296.
  4. Pompei S; Evangelidou D; Arelli F; Ferrante G. “The Modern Polyurethane-Coated Implant in Breast Augmentation: Long-Term Clinical Experience.”. Aesthetic Surgery Journal. 36(10):1124-1129, 2016 Nov.
  5. Cunningham B1. “The Mentor Core Study on Silicone MemoryGel Breast Implants”, Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):19S-29S; discussion 30S-32S.
  6. Vazquez, G. “Polyurethane-Coated Silicone Gel Breast Implants Used for 18 years”. Aesthetic Plastic Surgery, 2007.
  7. Handel, N. “Long–term safety and efficacy of Polyurethane Foam-Covered Breast Implants.“ Aesthetic Surgery Journal Vol.26 2006
  8. Hester T.R., Tebbbets, J. Maxwell, G.P. “The polyurethane-covered mammary prosthesis: Facts and fiction (II).“ Clinics in Plastic Surgery Vol.28 2001
  9. Pompei S; Evangelidou D; Arelli F; Ferrante G. “The Modern Polyurethane-Coated Implant in Breast Augmentation: Long-Term Clinical Experience.”. Aesthetic Surgery Journal. 36(10):1124-1129, 2016 Nov
  10. Tebbetts JB. “Achieving a predictable 24-hour return to normal activities after breast augmentation: part I. Refining practices by using motion and time study principles.”. Plastic & Reconstructive Surgery. 109(1):273-90; discussion 291-2, 2002 Jan.
  11. Tebbetts JB.”Achieving a predictable 24-hour return to normal activities after breast augmentation: part II. Patient preparation, refined surgical techniques, and instrumentation.” Plast Reconstr Surg. 2002 Jan;109(1):293-305; discussion 306-7
  12. Institute of Medicine (US) Committee on the Safety of Silicone Breast Implants. https://www.ncbi.nlm.nih.gov/books/NBK44780/; Bondurant S, Ernster V, Herdman R, editors. Washington (DC): National Academies Press (US); 1999.
  13. Schiff M, Algert CS, Ampt A, et al. The impact of cosmetic breast implants on breastfeeding: a systematic review and meta-analysis. Int Breastfeed J 2014; 9: 17. http://www.internationalbreastfeedingjournal.com/content/9/1/17 (accessed Dec 2014).
  14. Reduced breast milk feeding subsequent to cosmetic breast augmentation surgery. Roberts CL; Ampt AJ; Algert CS; Sywak MS; Chen JS. Medical Journal of Australia. 202(6):324-8, 2015 Apr 6. [Comparative Study. Journal Article. Research Support, Non-U.S. Gov’t] UI: 25832160
  15. Stevens, W. Grant M.D.; Nahabedian, Maurice Y. M.D. et Al ”Risk Factor Analysis for Capsular Contracture: A 5-Year Sientra Study Analysis Using Round, Smooth, and Textured Implants for Breast Augmentation”, Plastic & Reconstructive Surgery: November 2013 – Volume 132 – Issue 5 – p 1115–1123
  16. Handel, Neal M.D.; Cordray, Tracy M.D.; Gutierrez, Jaime M.D.; Jensen, J Arthur M.D. “A Long-Term Study of Outcomes, Complications, and Patient Satisfaction with Breast Implants.” Plastic & Reconstructive Surgery. 117(3):757-767, March 2006.
 

*Disclaimers

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There is no guarantee of specific results and the results can vary from patient to patient. The photos shown have not been altered, other than removing identifiable marks such as tattoos and birthmarks at the request of the patient. If any such alteration has been done then it has been done equally on both before and after photos and there is a notation under the photo stating what alteration has been done.

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AHPRA (Australian Health Practitioner Regulation Agency) disclaimer, required by Australian Law

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