Fri Jul 31

Dr Eddy Dona: Thinking about breast enlargement surgery – what are your options?

Written by Tess Sanders Lazarus

According to Dr Eddy Dona, while breast augmentations are the most common plastic surgery in Australia, people still do not know about all of their options.

Dr Dona is one of Sydney’s leading plastic surgeons specialising in reconstructive and cosmetic surgeries. He has decades of experience in the surgical profession and has built up a highly respected practice in Bella Vista Sydney which he founded in 2009.

As a society, cosmetic procedures and plastic surgery have become less taboo to talk about. However, many people still don’t understand the options available to them and the importance of doing their research,” Dr Dona said.

A breast augmentation is a procedure that involves inserting implants into your breasts to create an enlarged appearance. But it is not that simple – the look and feel of your post-surgery breasts depends significantly on the decisions you make before you go under the knife.”

According to Dr Dona, these are the important decisions that need to be made when electing to have a breast augmentation.

Your Budget

As per everything in life, you often get what you pay for. This is also true with breast enhancement surgery. Cheap surgery is available overseas, however this comes with many potential problems. Many Australian junior or inexperienced plastic surgeons offer budget breast enhancement surgery. Also, many non-plastic surgeons, or doctors with no formal surgical qualifications offer inexpensive breast enhancement surgery. Of course, the most expensive breast enhancement surgeons do take it to an extreme, and charge a lot more than ‘average’, whilst providing no more in results. So basically, do your research on your surgeons beforehand,” Dr Dona said.

Implant Style – Round vs Teardrop

The shape of the implant can affect the final results. Some surgeons will exclusively only use a round implant style because it is an ‘easier to use’ implant with predictable results and less potential problems. Other surgeons may choose to only use teardrop implants because they believe they can achieve the aesthetic results they want with these and are prepared to accept the greater potential problems associated with these implants. Of course, some surgeons will use both types depending on the patient. Having said that, in the last few years many surgeons who have previously used teardrop implants have moved to round style. In the end, if you have a particular look you’re after, and your surgeon is not offering you that, get a second opinion,” Dr Dona added.

Implant Surface – Textured vs Smooth

“The implant surface can be either textured (sandpaper rough) or smooth,” Dr Dona said.

Most surgeons have used a textured implant as they do provide some benefits, including providing grip and stability of the implant, and also reducing the risk of capsular contracture (implant hardening). However, in recent times, textured implants have been associated with a rare cancer (ALCL) with the risk varying from anywhere between 1:2,800 to 1:86,000. Due to this, many of the textured implants are no longer available. The benefit of the implant stability that textured implants provide means that teardrop implants are all textured. Therefore, many surgeons who have previously used teardrop implants no longer offer these to avoid using textured implants, despite the relatively low risk of 1:86,000 that current textured teardrop implants readily available on the Australian market provide.”

Implant Profile

How far forward the implant projects is what the implant profile refers to. However, different brands have different naming systems so it can get very confusing when looking at before and after pictures. The varying profiles used by different brands to describe the implant projection include: low, mini, moderate, moderate plus, demi, high, full, extra high, extra full, corse. The simplistic way of viewing it is that the greater profile, regardless of the naming system, will create a bigger breast. Not to confuse things further, but what one brand may refer to as a ‘moderate plus’, may have the same projection as a ‘full profile’ in another brand. So, make sure you speak to your surgeon and have them clearly explain the profile that’s been chosen for you, why, and is it going to achieve the look you’re after,” Dr Dona said.

Saline or Silicone

There are two types of implants available, saline and silicone. I prefer to use silicone because they look and feel more natural. Most surgeons in Australia would use silicone implants because of the better aesthetic outcomes achievable. Saline breast implants are a silicone envelope filled with saline, which is sterile salty water. The benefit of this implant is that if it leaks, the body will simply absorb the saline and you will immediately know because your breast will deflate. Some patients may request saline implants because they believe they are safer,” Dr Dona said.

Silicone breast implants are a silicone envelope filled with an elastic gel. The benefit of this implant is that they typically look and feel more natural. Whilst silicone implants can rupture, because the silicone does not go anywhere, most patients would not know the implant has ruptured and it does not cause any medical issues. Despite extensive discussion on the topic, no evidence exists to suggest silicone implants (intact or ruptured) are associated with any medical problems.”

Implant Pocket

The pocket essentially refers to where the implant is placed with respect to your chest wall muscle (pectoralis major). The implant can be over the muscle, or under the muscle. The different terms used for over the muscle include – overs, prepectoral, subglandular, subfascial. The different terms used for under the muscle include – unders, subpectoral, dual plane, dual plane 2, or other variations of ‘dual plane’. Whilst under the muscle pockets (whichever variety) are technically more demanding, with very few exceptions they are the better option and most experienced surgeons use these almost exclusively. You will need your surgeon to explain what pocket they are using and why,” Dr Dona said.

Incision and Scar Location

The incision required to insert your implant is another consideration. The three recognised incisions are in the lower breast fold (IMF), around the areolar border, or via the armpit,” Dr Dona said.

The vast majority of surgeons would choose the IMF incision as it is the most reliable, safest, and more predictable incision to perform the surgery. This is the approach that I would use exclusively.”

How Many CC’s?

How many cc’s (cc’s are essentially equivalent to mls) is an extremely important consideration but it is the least relevant! Almost every breast enhancement before and after picture you see will mention the implants cc’s. However, the correct implant for any given individual is determined by taking the appropriate measurements of that patient, and finding an implant that is precisely going to fit their frame and breast footprint, complement the existing breast tissue, and of course give them the desired look. This determines the cc’s,” Dr Dona said.

So, if a person has a small frame size with a small breast base diameter (breast footprint diameter), then they are going to have an implant with ‘small’ cc’s. A large framed girl will require larger cc’s to fit their frame. Basically, your surgeon needs to discuss and determine the precise cc’s for you during your consultation. You should never go to sleep for surgery without knowing exactly what implant cc’s you are waking up with. Some surgeons don’t bother assessing patients properly and use a ‘sizer’ during the surgery. This is basically a deflated balloon that they insert into your breast implant pocket, inflate it to whatever cc’s they can, and then pick an implant based on the cc’s they’ve used in the sizer. Only an unskilled or lazy surgeon would use a ‘sizer’ during the surgery as it does not take into consideration your specific chest wall dimensions and requirements. Furthermore, numerous implants exist, including implants with identical cc’s but different dimensions, so a ‘sizer’ does not help with this.”

Second Opinion

If you’re not sure about your first surgeon during your consultation, then get a second (or third) opinion. The cost of a consultation is relatively inexpensive compared to the cost of surgery,” Dr Dona added.

Specialist plastic surgeon Dr Eddy Dona has become one of the most in demand breast enlargement plastic surgeons in Australia. Over the years, he has continued to refine his technique and apply the latest advancements to ensure he is able to consistently achieve exceptional results for his patients. Dr Dona has become a pioneer in providing detailed and easy to understand patient education videos and brochures. Thousands of patients and many doctors that have been personally trained by Dr Eddy Dona believe he is more than just a master surgical technician, Dr Dona is considered a surgical ‘artist’.