Breast Augmentation

Breast augmentation uses implants to increase the size of the breasts. It’s one of the most commonly performed cosmetic procedures in Australia, and that frequency sometimes leads people to underestimate it. The reality is that augmentation is a major operation, performed under general anaesthesia in an accredited hospital, with a defined recovery period, a long list of decisions that need to be made carefully at consultation, and a small but real set of risks that include some that are serious enough to warrant detailed discussion before any consent is signed.

The information on this page is general. The specific approach for any individual patient is worked out only after a thorough examination, a discussion of goals and lifestyle, and a careful review of the alternatives, including the option of not having surgery.

Patients consider breast augmentation for a variety of reasons, and understanding what’s bringing you to a consultation matters because it affects whether augmentation is actually the right answer. Some patients have a developmental difference in breast size between the two sides, where one breast is noticeably larger than the other. Some have lost breast volume after pregnancy and breastfeeding, or after significant weight loss, leaving the breast feeling deflated even though there may be enough skin to accommodate volume. Others simply want larger breasts than they currently have.

Augmentation isn’t necessarily appropriate for everyone in these groups. A patient with significant ptosis (droop) is unlikely to be well served by an implant alone, because the implant adds volume but doesn’t lift the breast. In that situation a breast lift, or a combined lift with implants, is more likely to produce the result the patient is hoping for. Dr Shepherd will let you know honestly if he thinks something else would suit you better, including not having surgery at all.

Dr Shepherd uses silicone gel implants, which are the standard choice in Australia. They are filled with a soft, cohesive gel that holds its shape and gives a natural feel.

Beyond the filler, implants vary in shape (round or anatomical), surface texture (smooth or textured), profile (how much the implant projects from the chest wall), base diameter, and total volume. Choosing the right combination is a joint decision made at consultation, and it draws on careful measurements of your anatomy, the quality and thickness of your tissues, your lifestyle, and what you want to achieve. The aim is to find an implant that fits the patient rather than fitting the patient to the implant.

Dr Shepherd uses one of two positions for placing an implant: subglandular or dual plane. The right choice depends on the implant selected, your anatomy and the result you’re after, and is decided together at your consultation.

Dr Shepherd’s preferred approach is the inframammary incision, which is made in the crease beneath the breast. This approach provides direct access to the implant pocket, allows precise control over the position of the implant, and produces a scar that’s generally well concealed within the natural fold once it has matured.

Other incision approaches exist, including the periareolar approach around the lower border of the areola and the transaxillary approach in the armpit. Both come with their own significant trade-offs and a higher risk profile for certain complications, which is why Dr Shepherd doesn’t routinely use either approach. If you have a preference for one of these alternatives, it’s something he can talk through with you at consultation.

Breast augmentation is performed under general anaesthesia in an accredited hospital and usually takes one to two hours. Most patients go home the same day; an overnight stay is occasionally recommended where the operation is more involved. Dr Shepherd performs breast augmentation at Bondi Junction Private and Aesthetic Day Surgery.

Most patients describe the first week as the toughest part of recovery, with moderate discomfort and a tightness across the chest that some compare to having had an intense workout. The discomfort settles steadily over the following days, and pain medication helps significantly in the first few days. A surgical bra is worn continuously for several weeks, including overnight. You’ll need to avoid heavy lifting, vigorous exercise and overhead activities while the implant pocket heals: general exercise such as swimming, bathing, running, yoga and pilates can usually resume from six to eight weeks, with upper-body training and boxing from nine to twelve weeks.

If your job is desk-based, you’ll usually be back at work within one to two weeks. Anything physical takes longer, sometimes considerably longer, and we’ll give you specific guidance based on what you do for a living. Driving generally waits until the pain is controlled without strong analgesia and you can move your arms comfortably enough to handle the steering wheel and any sudden manoeuvres safely.

The final breast shape continues to develop over several months as swelling settles and the implants find their final position. Scars take 12 to 18 months to mature, and during that time they typically go through a phase of being more pink or red before fading. How recovery feels and how quickly you bounce back is individual, and the advice we give you at discharge is specific to your operation and your circumstances.

Breast augmentation is a major operation and the risks need to be understood before any decision is made. The recognised risks include: