What is a boob job (breast augmentation)?
Breast augmentation (also known as a ‘boob job’, breast enlargement or augmentation mammoplasty) is a plastic surgery procedure that enhances the shape and size of your breasts.
Breast augmentation is one of the most popular cosmetic surgery procedures in Australia. With over 9,500 recorded patient surgeries in 2020, a 11% increase over the prior year. By undergoing this breast enhancement procedure, patients are able to increase their natural bust size or replace volume that has been lost from weight loss, age, pregnancy or breastfeeding
Breast Augmentation Procedures Options
- Breast Implants - Average Cost: $9,500, Down Time: 1 Week
- Breast Lift - Average Cost: $12,000, Down Time: 2 Weeks
- Breast Lift with Implants - Average Cost: $13,450, Down Time: 2 Weeks
- Breast Fat Transfer - Average Cost: $13,875, Down Time: 1 Week
There are several different procedure options for breast augmentations, however most procedures are complemented with breast implants. Filled with either silicone gel or saline (saltwater), implants come in a variety of shapes and sizes with different combinations of volume, diameter and projection (how far the breasts extend from your chest). Your doctor can guide and help you decide on implants that are the most suitable for your goals and body.
The implants are then placed over or under the pectoral (chest) muscles, the 3 incision methods surgeons use to insert the implant are:
Implant Incision Methods
- Under the breast crease (inframammary fold)
- Around the nipples (periareolar)
- Side of the armpit (transaxillary)
Enlargement can also be achieved by breast fat transfer, a procedure where your surgeon takes surplus fat from one area (e.g. thighs or belly) via liposuction and then transfers it into the breasts. Occasionally, fat transfer is paired with implants, as the fat can help the implant sit more naturally.
Implants complemented with a breast lift raises the nipple and elevates the breasts for a perkier appearance, alleviating patient concerns around sagging
What are the pros and cons of a boob job (breast augmentation)?
- Enhanced breasts can be larger, fuller and higher providing a renewed look.
- Patients satisfaction for breast augmentation is extremely high, with the vast majority of patients deeming the surgery ‘worth it’.
- The shape and size of implants are highly customizable allowing patients to tailor their choice to different body types and lifestyles.
- Results from breast augmentations can last well over 10 years.
- Bodily changes after your breast surgery including: weight loss, pregnancy or menopause can affect your results.
- Even modern implants are not guaranteed to last a lifetime, the requirement for a revision increases, the longer you have implants.
How much does a boob job (breast augmentation) cost?
Average Cost: $9,800
Range: $5,000 - $14,500
The experience of the surgeon & anaesthetist, type of augmentation surgery, and surgical venue are all contributing factors to the final surgery cost.
As breast augmentation is a cosmetic surgery the costs are not covered by Medicare. However, if there is a medical concern related to the breast reconstruction surgery e.g. mastectomy or lumpectomy, Medicare may cover a proportion of the costs.
Private health insurance may also partially cover the costs of breast augmentation depending on your policy and level of cover. Most commonly this will include hospital fees, everything else unfortunately will be out-of-pocket expenses.
What are the potential risks and side effects of getting a boob job (breast augmentation)?
There are several risks associated with breast augmentation surgery.
Some of the major risks include:
- implant rupture or leakage
- fluid build up (seroma )
- capsular contracture (a layer of hard, painful scar tissue that can form around the implant)
- implant rippling or skin wrinkling
All the above risks and how complications are handled should be addressed by your surgeon prior to the operation.
Some textured implants have been recalled, due to a causal linkage to BIA-ALCL (a type of lymphoma, immune system cancer).
An increasing number of patients are also experiencing a range of symptoms including: chronic fatigue, cognitive issues and muscle pain, now being described as breast implant illness (BII).
Current studies show no causal linkages to the aforementioned symptoms and breast implants. Additional research is being conducted to better understand these causes. However, many patients are still opting to remove breast implants to alleviate BII symptoms.
How should you prepare for a boob job (breast augmentation surgery)?
You’ll start your journey by scheduling consultations with one or more prospective plastic surgeons. During said consultation you should begin by disclosing your full medical history and body goals with your surgeon.
Selecting a surgeon who is a member of the Australian Society of Plastic Surgeons (ASPS) and a Fellow of the Royal Australasian College of Surgeons (FRACS), ensures that the surgeon is safe, qualified and experienced.
During your physical examination, the surgeon will take measurements of your breasts and chest wall. Increasingly, clinics are also offering 3D imaging, so that patients can visualise the different shapes and sizes of implants.
Afterwards, the surgeon will discuss suitable options for the incision area, explain the risks of the procedure, provide guidance on the expected timeline, and details of the recovery process.
Be prepared to do a mammogram before your surgery, this is a common prerequisite for surgeons to request, particularly if you are over the age of 50.
Your surgeon will help you with breast implant selection, taking into account shape, size, body placement and incision area for the best desired outcome. Data from the Australian Breast Device Registry (ABDR) indicates that 99% of implants were silicon, 70% were round and 54% were textured versus 42% being smooth.
Traditionally, doctors will have you simulate breast augmentation results by placing a variety of implants in your bra. As mentioned prior, increasingly, surgeons are offering 3D imaging and virtual body scans to give patients a live preview of the results. The Vectra 3D imaging solution made by Canfield is the most commonly used.
What happens during breast implant surgery?
First, your surgeon will make an incision, in the crease under your breast, in your armpit or around your nipple.
The implants are then inserted into a pocket created by the surgeon, either above (subglandular) or below (submuscular) your chest muscles. Layers of internal stitching will close the incision, while skin adhesive, surgical tape or additional stitching is used to close up the skin.
The breast implant surgery only takes a few hours and does not require an overnight hospital stay (outpatient basis).
Silicone vs Saline breast implants: are they safe, which one is better?
In Australia, the vast majority of patients select highly cohesive silicone gel implants. The minority opt for saline implants which are filled with sterile saltwater inside a silicone case. Your surgeon will explain the positives and negatives of both options and help you decide the best implants for you.
One benefit of saline implants is the ability to fill them after they have been placed which can lead to smaller incisions and scars.
The American regulator, U.S. Food & Drug Administration (FDA) recommends silicone implant patients undergo MRI screening 3 years post operation and every 2 years thereafter, to check for ‘silent ruptures’ a silicone implant leakage without symptoms.
Published research indicates breast implants do not significantly affect mammogram results, allowing patients continued access to effective cancer screening. However, please ensure the technician is aware prior to the X Ray.
There are two types of silicone implants: smooth and textured. In Australia all reported cases of BIA-ALCL, a rare type of lymphoma (immune system cancer), were linked to textured implants. The Department of Health, Therapeutic Goods Administration (TGA) has found the risk of developing BIA-ALCL between 0.4% and 0.004%.
In August 2019, Allergan decided to recall their un-implanted Biocell® macro-textured breast implants and tissue expanders. This was due to the risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL),
What happens during breast fat transfer surgery?
Breast fat transfer surgery begins with liposuction to remove excess fat from other parts of the body, usually the thighs or stomach. The fat then goes through a purification process before injection into the breasts, shaping and volumizing.
By using this method, you can add volume to your breast with your own tissue instead of a foreign object. However, it does not provide the same level of enhancement as an implant.
Breast fat transfer augmentation can increase your breast volume by one cup size on average.
Fat transfer breast augmentation results can be unpredictable due to the fact only 50 - 70% of fat cells survive the transfer. You may even experience asymmetry as one breast can have more cells survive than the other.
What happens during a breast lift?
A breast lift begins with an incision around the nipple that may extend from the base of the areola, down to the breast crease, and across.
After the tissue is lifted and reshaped, any excess sagging skin is removed. If you want additional breast enlargement a breast lift can be complemented with breast implant surgery. The surgeon will make a pocket above or below the chest muscles to insert an implant.
Afterwards, your nipple is lifted and repositioned (never being detached). During this process you are also able to reduce the size of your areolas.
What should you expect while recovering from a boob job (breast augmentation)?
Immediately after a breast augmentation procedure the average patient recovery time is one week.
Here is what to expect during the recovery process:
- Bandages will be applied to your incision areas and you will be given instructions on how often to clean and change them to prevent infection.
- Breast augmentation patients are required to wear a sports bra or elastic bandage 24/7 the first week after surgery (except during showers) to provide support and minimise swelling. Breast lift patients may have to wear a bra for a longer period of time. However, individuals are provided with personalised instructions to maximise their recovery and results.
- If drainage tubes are used, they will be removed at a follow-up appointment two weeks after the initial procedure.
- Patients are usually able to return to work after one week. Though, patients should wait two to four weeks (depending on your surgeons recommendation) before undertaking vigorous activity e.g. sex, running, lifting weights etc.
- It is also recommended to sleep on your back for roughly six weeks post surgery to prevent implant deformation. If you sleep on the side of your body and struggle on your back, consult your doctor for alternatives e.g. using pillows for support.
When will I see results from my boob job (breast augmentation)?
After breast augmentation with implants, your skin will begin to stretch and the muscles will relax, moving the implants from their initial higher position to a more natural sitting, a process known as ‘drop and fluff’. Your breast implants will begin settling down after 6 weeks and you should achieve 80% of the results at 12 weeks.
After a breast fat transfer, you will experience an immediate increase in breast volume. However, within a 3 month period your body will have absorbed some of the injected fat. After six months, swelling will have subsided and your results will be fully displayed. In a year's time, the injected fat will behave like natural breast tissue.
After a breast lift, you will observe an immediate change, though your tissue will begin to move and settle during the next several months. Significant results of the procedure will be visible after a three to four month period, with the final outcome being apparent within a year.
How long does a boob job (breast augmentation) last?
The results from breast implant surgery normally, at a minimum, last a decade. Breast implants requiring replacement every 10 years is a misconception, but it is true they are not intended to last a lifetime. The TGA states that implant devices are typically removed after 10-15 years. Additionally, the longer you have implants the increased likelihood of complications occurring (capsular contracture, leaks etc.) eventually requiring removal. Without complications modern implants are able to last up to 20 years or more.
The results of a breast lift or breast fat transfer typically also lasts 10 years, but with weight fluctuations, your breast will age, shrink and expand. Also, your breasts may begin to sag, as your skin becomes more elastic during late middle age. Frequently, leading patients to seek out revision surgery after a decade or so.
Can you still breastfeed after a boob job (breast augmentation)?
After getting breast implants you should still be able to safely breastfeed. Though published research in the International Breastfeeding Journal indicates that any type of breast surgery (specifically incisions around the nipple) can potentially damage the milk ducts, leading to insufficient milk production.
Given that you are not also undergoing any kind of nipple surgery, fat transfer breast augmentation has less risk in impacting your breastfeeding ability,
Sources & Studies
Australian Breast Device Registry (ABDR) 2020, AUSTRALIAN BREAST DEVICE REGISTRY 2020 REPORT, viewed 22 November 2022, <https://www.abdr.org.au/content/uploads/2021/12/2020-ABDR-Annual-Report-FINALweb.pdf>.
Australian Society of Plastic Surgeons n.d., Is Your Surgeon an ASPS Member?, Australian Society of Plastic Surgeons, viewed 22 November 2022, <https://plasticsurgery.org.au/information-for-patients/is-your-surgeon-an-asps-member/>.
Center for Devices and Radiological Health U.S. Food and Drug Administration 2011, FDA Update on the Safety of Silicone Gel-Filled Breast Implants, June, viewed 22 November 2022, <https://www.fda.gov/media/80685/download>.
Kam, K, Lee, E, Pairawan, S, Anderson, K, Cora, C, Bae, W, Senthil, M, Solomon, N & Lum, S 2015, ‘The Effect of Breast Implants on Mammogram Outcomes’, The American Surgeon, vol. 81, no. 10, pp. 1053–1056.
Loch-Wilkinson, A, Beath, KJ, Knight, RJW, Wessels, WLF, Magnusson, M, Papadopoulos, T, Connell, T, Lofts, J, Locke, M, Hopper, I, Cooter, R, Vickery, K, Joshi, PA, Prince, HM & Deva, AK 2017, ‘Breast Implant–Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand’, Plastic and Reconstructive Surgery, vol. 140, no. 4, pp. 645–654.
Schiff, M, Algert, CS, Ampt, A, Sywak, MS & Roberts, CL 2014, ‘The impact of cosmetic breast implants on breastfeeding: a systematic review and meta-analysis’, International Breastfeeding Journal, vol. 9, no. 1, p. 17, viewed 22 November 2022, <https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-9-17>.
Therapeutic Goods Administration (TGA) 2019, Consumer fact sheet: recall of Allergan Biocell breast implants, Therapeutic Goods Administration, viewed 22 November 2022, <https://www.tga.gov.au/resources/publication/publications/consumer-fact-sheet-recall-allergan-biocell-breast-implants>.
― 2021, Breast implant associated cancer (BIA-ALCL): Information for consumers, Therapeutic Goods Administration, viewed 22 November 2022, <https://www.tga.gov.au/breast-implant-associated-cancer-bia-alcl-information-consumers>.