Breast Procedures

Breast augmentation can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with me.

There is no one ideal breast shape and very few women have perfectly symmetrical breasts. The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you’re physically healthy and realistic in your expectations, you may be a good candidate.

Since 2015 Dr Lofts has been using Motiva® implants. The Motiva Implant Matrix® – SilkSurface® and VelvetSurface® have unique nanotextured surfaces designed without the use foreign materials like salt and sugar. This provides increased compatibility with the natural breast tissue and a more natural interaction between the implant and natural breast tissues. Motiva® have developed the Ergonomix® range of implants with viscoelastic gel that adapts to the natural breast shape and has the most natural look and feel. This particular range has a round shape when lying flat but no standing up the implant assumes an anatomical or teardrop shape and there are no issues with malrotation or position change with this implant. 

Motiva® implants have very low friction coefficients and are ideal for women with an active lifestyle.

The Motiva® range of implants is available in a range of sizes, profiles and anatomical (teardrop) shaped implants or round implants, with a number of size options. They are the most technologically advanced breast implants available with many unique safety features, including an electronic serial number device in the implant approved by the Food and Drug Administration in the USA. 

During the consultation I will provide you with more information so that you can decide which implant best suits you. 

For more information on the Motiva® implant range visit www.motivaimplants.com

Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure.

The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. The incidence is approximately 8%. This squeezing of the soft implant can cause the breast to feel hard and may distort the shape. In severe cases it may also be painful. It tends to occur within 6 – 12 months following surgery. Capsular contracture can be treated in several ways, and sometimes requires either removal or “release” of the scar tissue or replacement of the implant. The chances of developing a capsular contracture depend on several factors and are not predictable.

Unsightly, thickened scars at the site of the skin incisions can occur in 2 – 5% of patients.

As with any surgical procedure, excessive bleeding following the operation may cause swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood. Postoperative bleeding occurs in approximately 1% of all breast augmentations. It tends to happen within 48 hours but occasionally it may happen up to 3 weeks after surgery.

Approximately 1% of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.

Up to 15% of women will have permanent alteration of nipple sensation. You may also notice small patches of numbness near your incisions. The loss of feeling may improve with time, but may be permanent in some patients. If nipple sensation is critical to your enjoyment of sex you should discuss this issue carefully with your partner and with me.

There is no evidence that breast implants will affect fertility, pregnancy, or your ability to breastfeed. If, however, you have nursed a baby within the year before augmentation, you may produce milk for a few days after surgery. This may cause some discomfort, but can be treated with medication prescribed by your doctor.

Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the man-made shell to leak. If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be harmlessly absorbed by the body. The PVP filling gel in the hydrogel implants will be eliminated in the urine, unmetabolised.

If a break occurs in a silicone gel-filled implant, however, one of two things may occur. If the shell breaks but the scar capsule around the implant does not, you may not detect any change. If the scar also breaks or tears, especially following extreme pressure, silicone gel may move into surrounding tissue. The gel may collect in the breast and cause a new scar to form around it, or it may migrate to another area of the body such as the lymph glands in the armpit. There may be a change in the shape or firmness of the breast. Both types of breaks may require a second operation and replacement of the leaking implant. In some cases, it may not be possible to remove all silicone gel in the breast tissue if rupture should occur. Leakage of silicone gel may cause lymph glands in the armpit area to enlarge and feel firm.

A few women with breast implants have reported symptoms similar to diseases of the immune system, such as scleroderma and other arthritis-like conditions. These symptoms may include joint pain, or swelling, fever, fatigue, or breast pain. Research has found no clear link between silicone breast implants and the symptoms of what doctors refer to as “connective – tissue disorders”.

While there is no evidence that breast implants cause breast cancer, they may change the way mammography is done to detect cancer. When you request a routine mammogram, be sure to go to a radiology centre where radiographers are experienced in the special techniques required to get a reliable x-ray of a breast with an implant. Additional views will be required. Since the breast is compressed during mammography, it is possible for an implant, or the capsule around it, to rupture. An experienced radiographer should know how to push the implant away from the breast tissue to get the best possible views of the breast. Even when this special technique is used, some breast tissue may be missed. Ultrasound examinations may be of benefit in some women with implants to detect breast lumps or to evaluate the implant.

While the majority of women do not experience these complications, you should discuss each of them with me to make sure you understand the risks and consequences of breast augmentation.

Should complications occur that require early reoperation I will not charge an additional surgical fee but you will be required to pay for the theatre, anaesthetic and hospital costs.

During your initial consultation, I will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor may also recommend a breast lift. (For more information on this procedure, ask your surgeon for the brochure on breast lift, also known as mastopexy).

Be sure to fully discuss your expectations with me. I will be frank with you, describing your alternatives and the risks and limitations of each. You may want to see a copy of the manufacturer’s insert that comes with the implant to be used – just so you are fully informed. And, be sure to tell me if you smoke, and if you’re taking any medications, vitamins or other drugs.

I will explain the type of anaesthesia to be used, the type of facility where the surgery will be performed, and the costs involved. Because insurance companies do not consider breast augmentation to be medically necessary, they do not cover the cost of this procedure.

My staff will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.(Important information for preoperative patients)

While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for several days, if needed. One to two weeks convalescence at home may be necessary. For more details and information on pre operative instructions use this link.

Breast augmentation surgery is best performed at an accredited hospital with inpatient facilities such as St Marks Road Surgical Centre.It is recommended that you stay overnight following surgery although the procedure may be done as a daycase in selected patients.

Breast augmentation is best performed with a general anaesthesia, so you are fully asleep during the entire operation.

The operation usually takes 1.5 hours. The method of inserting and positioning your implant will depend on your anatomy and my recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible. Endoscopic techniques permit the surgeon to operate with greater accuracy through small incisions.

Working through the incision, I will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath your chest wall muscle (the pectoral muscle). The implants are then centred beneath your nipples.

Some surgeons believe that putting the implants behind your chest muscle may reduce the potential for capsular contracture. Drainage tubes may be used for several days following surgery. This placement may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue. Placement behind the muscle however, may be more painful for several days after surgery than placement directly under the breast tissue.

You’ll want to discuss the pros and cons of these alternatives before surgery to make sure you fully understand the implications of the procedure.

The surgery usually takes one to two hours to complete. Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to decrease swelling.

You’re likely to feel tired and sore for a few days following your surgery, but you’ll be up and about in 24 – 48 hours. Most of your discomfort can be controlled by painkillers prescribed by your doctor.

Within several days, the gauze dressings, if you have them, will be removed. You will wear a surgical sports bra from the time of surgery. You may experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades.

Any stitches that do not dissolve will be removed in 7 – 10 days time, but the swelling in your breasts may take three to five weeks to disappear.

For further information please read the post operative instructions and if you have further questions my staff or I are available to talk to you should you have any concerns.

You should be able to return to work within two weeks, depending on the level of activity required for your job.

You should be careful to follow post-operative advice. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually three to four weeks after surgery. Aerobics and vigorous physical exercise should be avoided for six weeks.

Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.

Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the mammographic technician should use a special technique to assure that you get a reliable examination as discussed earlier. (See Risks and complications).

For many women, the result of breast augmentation can be very satisfying, increasing self-confidence and enhancing sexual enjoyment and social interactions.

Regular examination by me and routine mammograms for those in the appropriate age groups at prescribed intervals will help assure that any complications, if they occur, can be detected early and treated.

Your decision to have breast augmentation is a highly personal one that not everyone will understand. The important thing is how you feel about it. If you’ve met your goals, then your surgery is a success.

Breast Augmentation Surgery costs between $17,000 and $19,000 depending on the type of implants used and the length of hospital stay. If you would like to talk to us about your surgery, financing options and requirements, please contact us at your convenience.

Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag.

Breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts – at least, for a time. (No surgery can permanently delay the effects of gravity). Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume – for example after pregnancy – breast implants inserted in conjunction with mastopexy can increase both their firmness and their size.

This information has been written to give you the basic facts about breast lifts. If you decide you would like to know more about this procedure please make an appointment to see me. Please write down any questions you wish to ask.

The best candidates for breast lift

A breast lift can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations.

The best candidates for mastopexy are healthy, emotionally stable women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.

Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you’re planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn’t interfere with breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure.

All surgery carries some uncertainty and risk. A breast lift is not a simple operation, but is normally safe when performed by a qualified surgeon. Nevertheless, as with any surgery, there is always a possibility of complications or a reaction to the anaesthesia. Bleeding and infection following a breast lift are uncommon, but they can cause scars to widen. You can reduce your risks by closely following your physician’s advice both before and after surgery.

Mastopexy does leave noticeable, permanent scars, although they’ll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers). The procedure can also leave you with unevenly positioned nipples, or a permanent loss of feeling in your nipples or breasts.

During your initial consultation, it’s important to discuss your expectations with me.

I will examine your breasts and measure them while you’re sitting or standing. We can discuss the variables that may affect the procedure – such as your age, the size and shape of your breasts, and the condition of your skin – and whether an implant is advisable. You should also discuss where the nipple and areola will be positioned; they’ll be moved higher during the procedure, and should be approximately even with the crease beneath the breast.

If you become pregnant after the operation, your ability to breast-feed should not be affected, since your milk ducts and nipples will be left intact.

I will describe the procedure in detail, explaining its risks and limitations and make sure you understand the scarring that will result.

Don’t hesitate to ask me any questions you may have, especially those regarding your expectations and concerns about the results.

Depending on your age and family history, your surgeon may require you to have a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.

While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

For more details and information on pre-operative instructions use this link.

 This surgery is best performed at an accredited hospital with inpatient facilities such as St Marks Road Surgical Centre. It is recommended that you stay overnight following surgery although the procedure may be done as a daycase in selected patients.

 Breast lifts are usually performed under general anaesthesia, which means you’ll sleep through the operation.

In selected patients – particularly when a smaller incision is being made – the surgeon may use local anaesthesia, combined with a sedative to make you drowsy. You’ll be awake but relaxed, and will feel minimal discomfort.

Mastopexy usually takes about two hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast.

The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.

Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the “doughnut (or concentric) mastopexy”, in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed.

If you’re having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall.

After surgery, you’ll wear an elastic bandage or a surgical sports bra over gauze dressings. Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn’t be severe. Any discomfort you do feel can be relieved with prescribed medication.

Within a few days, any bandages will be removed. You’ll need to wear the bra around the clock for three to four weeks, over a layer of gauze. The stitches will be removed after a week or two.

You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

You will be given very comprehensive pre and post operative instructions and my staff or I are available to talk to you should you have any concerns.

For further information please read the post operative instructions and if you have further questions my staff or I are available to talk to you should you have any concerns.

Healing is a gradual process. Although you may be up and about in a day or two, don’t plan on returning to work for a week or two, depending on how you feel, and avoid lifting anything over your head for three to four weeks. If you have any unusual symptoms, don’t hesitate to call me or my staff.

You will be given very comprehensive pre and post operative instructions and my staff or I are available to talk to you should you have any concerns.

I will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that mastopexy scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear low-cut tops.

You should also keep in mind that a breast lift won’t keep you firm forever – the effects of gravity, pregnancy, ageing, and weight fluctuations will eventually take their toll again. Women who have implants along with their breast lift may find the results last longer.

Your satisfaction with a breast lift is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic.

Uneven breast shape, asymmetry in shape and volume and visible implant ripples are a few of the unfavourable outcomes associated with augmented breasts that can be improved with fat grafting. Ideally, the implant can be left in place and fat added to specific areas to improve the appearance of the breast. This procedure can be carried out at the practice under local anaesthetic with or without sedation. It is minimally invasive and requires little if any time off from normal activities.

Breast defects after lumpectomy following breast cancer can be addressed with fat grafting. With mastectomy patients, depending on the type of reconstruction (flaps or implants), the inclusion of fat grafting to address contour defects improves the cosmetic result for the patient. For smaller areas the procedure is carried out at the practice, under local anaesthetic, requiring limited downtime. For more substantial areas there may be a need to have sedation at the hospital as a daycase procedure.

To achieve optimal results from breast fat grafting following reconstructive surgery Mr Lofts selectively recommends the use of the BRAVA system. This system optimises the survival of the grafted fat when use before and after surgery through increased blood flow and oxygen to the breast tissue.

BRAVA is an external tissue expander that thickens the breast tissues and stretches the skin. With thicker breast tissues and more space this allows the surgeon to transfer bigger volumes of fat, which often means that only a single fat grafting procedure is required.

The technique was pioneered by Dr Khouri at the Miami Breast Center and for more information on the BRAVA system used by Julian Lofts check the following website:

https://www.miamibreastcenter.com/