A/Prof Damian Marucci, a Sydney breast augmentation surgeon serving Kogarah, Miranda and the surrounding locations, encourages prospective candidates to research all aspects of the surgery, including breast augmentation recovery, to get an idea of what to expect. Here, he answers some of the most frequently asked questions about breast augmentation.

 Do I need a breast augmentation, a breast lift or both?

A breast lift is a procedure to improve the shape of the breasts, by elevating the position of the nipple and securing the breast tissue back up onto the chest wall where it belongs. Although the breast shape will improve, the volume will pretty much remain the same, maybe even decrease a little.

A breast augmentation is a procedure to increase the volume of the breasts by placing an implant behind the native tissue. The procedure may slightly lift the position of the nipple.

A breast lift with breast implants (an “augmentation mastopexy”) combines these two procedures. The breast shape and nipple position are improved through lifting the breast tissue AND the breast volume is augmented with an implant.

There are more scars associated with a breast lift. There is a foreign body associated with breast augmentation, which may cause problems like capsular contracture, infection or malposition. A breast lift with implants combines the best and worst of both procedures.

In summary:

• ​If you are happy with the volume of your breasts, but not the shape, you need a breast lift.
• If you are happy with the shape of your breasts, but not the volume, you need breast implants.
• If you are happy with neither the shape nor the volume, you need a breast lift with implants.

Will be surgery be cancelled if I am sick that day?

As a plastic surgeon, Dr. Marucci wants you to get a fantastic result from your surgery, but his first priority is your health and safety. He performs breast augmentation surgery under general anaesthesia. The anaesthetist will monitor your heart and lungs carefully during the procedure.

If you are unwell with some sort of bacterial infection, it would be unwise to place a foreign material, such as a breast implant, into your body, as germs may travel in your bloodstream and infect the implant. If you are recovering from a cold or have a cough, Dr. Marucci will be guided by his anaesthetist as to your fitness for surgery. If there are doubts, the safe thing to do is to wait until you are completely well.

Your safety and welfare always come first. The surgery can come a little later if need be.

What is the breast augmentation recovery like?

Dr. Marucci performs breast augmentation as day surgery. The surgery is performed under general anaesthesia and he uses lots of local anaesthetic at the time of surgery so that everything is nice and numb when you wake up. He uses an incision that is hidden in the fold underneath the breast. All the sutures to close the wound are dissolving. The dressings are waterproof. Dr. Marucci doesn’t use a drain. You go home wearing a bra with no underwire and you can shower from the day after surgery. He generally sees patients after surgery at the 2 day, 2 week and 2 month marks.

Dr. Marucci advises patients to take it easy for a few weeks after breast augmentation. He recommends no exercise and no heavy lifting for 2 to 3 weeks. He also recommends trying to have at least 2 weeks off work, although many patients have returned to work after one week. Similarly, plan for 2 weeks of no driving (although most patients are fine to drive sooner than that).

As Dr. Marucci uses a lot of local anaesthetic around the implant at the time of surgery, most of his patients have little pain the night of the surgery. Most patients do take oral painkillers the following day, when the local anaesthetic has worn off.

The scars underneath the breast heal particularly well. Most of his Sydney breast augmentation patients’ scars have faded to fine white lines within 3 months of surgery. He adjusts the level of the fold underneath the breast so that the scar will lie in that fold, making it harder to see.

How long does it take for swelling to settle after breast augmentation?

Swelling has usually resolved 2 to 3 months after breast augmentation surgery. The position of the implants may also change during this time (the implants may “drop” into position). It is important to take it easy for the first week or two and avoid exercise for the first few weeks to allow the swelling to subside.

Should I massage the breast implants after surgery?

Dr. Marucci uses textured breast implants and there is no need to massage the breasts following surgery. He advises all his patients to massage their scars commencing three weeks after surgery using either silicone gel, Bio Oil or Vitamin E cream — no matter which part of the body the surgery was performed on. However, modern breast implants do not need to be massaged. They are deliberately placed in a tight, accurate pocket at the time of surgery, so massaging them is not only unnecessary but could also potentially move them into a bad position.

What is capsular contracture?

Your body forms a wall of scar tissue around any foreign material. The scar tissue formed around a breast implant is called a “capsule.” Breast implant capsules may harden over time and potentially distort the shape of the breast. In some cases, the capsules can even cause pain.

Signs of capsular contracture include firmness of the breasts, change in breast shape and pain within the breast. These symptoms should be investigated by your breast augmentation surgeon. Typical tests that may be ordered include an ultrasound or maybe an MRI. The treatment of severe capsular contractures may involve removing the implant together with the capsule and placing a new implant into a new pocket (preferably under the muscle).

It is increasingly clear that most cases of capsular contracture are related to infection within the capsule. Studies have shown that minimising the risk of infection of the implant at the time of breast augmentation will decrease the incidence of capsular contracture. This is why plastic surgeons are meticulous about maintaining a sterile field during surgery, giving antibiotics, minimising handling of the implant and washing the implant and breast pocket with antibiotic and antiseptic solutions.

When can I exercise after breast augmentation?

Dr. Marucci advises patients that have breast augmentation in Sydney not to exercise for at least 2 and preferably 3 weeks after surgery. Upper body exercise could potentially move the implant into an incorrect position. The elevated blood pressure associated with exercise may cause bleeding in the area. He also doesn’t want patients perspiring, as the sweat may have a negative effect on the wound. Finally, especially for implants that are under the muscle, too much moving around early on will cause more pain than if you were to take it easy — so take it easy!

Studies have indicated that even highly trained athletes do NOT lose significant conditioning in a 2 week period of rest. You need to let your body recover from breast augmentation surgery. Dr. Marucci advises all patients that if they don’t have time for a proper recovery, they shouldn’t go ahead with the surgery.

 Do I need to wear a special bra after breast augmentation?

Dr. Marucci as all his patients wear a sport bra with no underwire and with the clasps in front day and night for the first 2 weeks after surgery. His patients bring the bra into the operating theatre with them, and when they wake up they are wearing the bra. They can instantly see the augmentation provided by the surgery, and Dr. Marucci thinks it’s a nicer look than having surgical tapes and bandages everywhere. He thinks the bra supports the weight of the implants as well as being comfortable for the patient.

Contact Our Breast Augmentation Surgeon in Sydney

For more information about what to expect during and after breast augmentation, A/Prof Damian Marucci invites you to call or email our Kogarah or Miranda practice.