Verified Plastic Surgeon
Prof. Mark Ashton

Mark Ashton

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  • Professor Mark Ashton
  • Parkville, Victoria, Australia
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Breast augmentation and pregnancy

I am 24, weigh 48kg and about 163cm in height. I am currently an A cup and I am about to book a breast augmentation for October and have been recommended 295g textured round cohesive gel implants, full projection with sub pectoral dual plane position and insertion in lower breast fold. This will apparently take me to a full C cup. I am thinking about going slightly larger with a 320g implant. My partner and I are wanting to try for children next year which will be 3 months post op approximately. A lot of girls have told me to wait and my surgeon recommended stated that if I do go ahead now as long as I am prepared that I might want them fixed in the future. I have wanted this procedure done for a loooong time and realistically if I wait until after children it could be another 10 plus years which I don't think I am prepared to do. My questions are as follows: 1. Given my small size now, is it better to go with the small implant and are the effects of pregnancy likely to be less prominent on a small implant? 2. Regarding the positioning of the implant, is a total under the muscle or the sub pectoral position likely to look good still after pregnancy? My surgeon recommended sub pectoral for a natural tear drop look however I don't mind if they look higher after breast augmentation so then after pregnancy they still look good. 3. In your experience, how have girls implant and who started with small breasts like mine looked after pregnancy. Some girls say they were ruined and some say they look fine. I know you can't accurately predict but I'm trying to get as much information as possible to make an informed decision.

Raaach 03/09/2016 SA

  • Answer
    Dear Raach, I suspect from your photos that you will have less than 2 cm of sub- cutaneous tissue in the upper pole of your breast and hence I would agree that you are best suited to a sub pectoral pocket. I wouldn't go above the muscle unless you specifically wanted a visible / prominent upper edge of the implant.  There tends to be some atrophy of the soft tissue in the upper chest as we age which will make the edge of the implant more prominent over time. Given that your nipple is in the centre of your breast I would use a dual plane one (or standard) technique. A 295 cc implant will take you to a small C.After breast feeding, most patients tend to lose volume in the upper pole and hence I would suggest a round implant over a tear drop / anatomical.  The end result after pregnancy is determined by how much stretch you put on the supporting ligaments within your breast. The more these ligaments are stretched, the more sag -or ptosis- you will have after pregnancy. The biggest factors therefore are how big your breasts become during breast feeding, if you put on a lot of weight during pregnancy and the size of the implant you choose before becoming pregnant. The difference between 295 and 320 isnt going to make a make a major difference, and hence if you want a slightly fuller look- I would go with the 320I would agree with your surgeon, there is a small risk that you might require additional sugery after you have finished your family, particularly if you have 3 or 4 children. This is unpredictable, but given that that you are slim, have minimal or no ptosis and are choosing a moderate size implant, I wouldn't let this be a reason for you delaying your surgery.
    Good luck! 
    With kind regards MarkProfessor Mark Ashton MD, FRACS, MBBS

Breast implant revision advice ...

I have had 2 breast augmentations Second was to "fix" the rippling that occured in my first implants, now 4 years down the track my second set of implants have rippled, they ache and are awful. I am 164cm tall and currently sitting on 57kg . My implants are cohesive silicone tear drops above the muscle. I've had a consult with a different but the surgeon advised to go to round high profile silicone implants and wanted to use an implant 50cc smaller, stated he couldn't guarantee until he opened me up what size he could use, wouldn't an ultra sound give some hint to what's going on? I would rather not loose size plus I'm concerned if I had a smaller implant I would be left with loose skin ? I want to go ahead with this procedure though am worried I will select the wrong surgeon again.

Butterfly 02/09/2016 WA

  • Answer
    Good Afternoon Butterfly,
    A MRI is a much more accurate method of measuring the volume of your implant.I would use this rather than an ultrasound.
    The rippling is a result of the implant, the capsule and your overlying soft tissue.
    Some implants are more prone to rippling. We know that saline implants are the worst, and that softer, less cohesive implants are more prone to rippling than firmer, more cohesive implants. The firmer the implant, or the more "cohesive" the silicone gel, the less likely the chance of rippling. You can check the cohesiveness of your implant on the company's website.
    Secondly, mild capsular contracture often first presents as rippling. You mention you also have some mild aching pain and hence if your implant is firmer on one side than the other, it would be worthwhile checking with your surgeon to ensure that the capsule on the affected side is normal.
    Finally, any mild rippling will be visible in very thin patients or in whom there is inadequate soft tissue cover. One option to camoflague this rippling, particularly in the cleavage area, is to swap the implant from above the muscle to a retromuscular pocket. In this way the muscle is used to augment and supplement the skin and soft tissue and may allow you to fix the rippling without changing the implant size.
    The other option we sometimes use is fat grafting.
    The implant shape and its profile will have very little, if any implact, on rippling. I have seen severe rippling in both round and anatomical implants.
    The most reliable method to correct your rippling is to swap the implant to a high cohesive gel implant, at the same time perform a capsulectomy, and swap the implant from it's subglandular position to a behind the muscle pocket.
    I hope this helpsCheers MarkProfessor Mark Ashton MD, MBBS, FRACS
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