Breast

Click on the procedure you are interested in or read on for further information

Any form of breast surgery is a highly individualised procedure. Naturally, breasts come in all shape and sizes, and are rarely perfectly symmetrical. Everyone has a ‘larger side’ or ‘droopier side’ and breast shapes can be affected by age, pregnancies, breast feeding, weight fluctuation, previous surgery or even the elastic quality of your skin. The challenge of breast surgery is in the ability to produce a long lasting desirable result for you, with all these unpredictable factors at play.

There is no such thing as the ‘perfect’ size or the ‘ideal’ shape, both of which are dependent on very subjective personal opinions of an individual. At our practice, we believe in finding out your particular expectations and desired result so that we are able to provide the most suitable procedure for you.

What to expect during your consultation

The success and safety of your breast procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss:

• Why you want the surgery, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries
• Family history of breast cancer, any previous breast cancer treatment and results of any mammograms or previous biopsies

Dr Vrtik may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of breast augmentation and any risks or potential complications
• Discuss the use of anaesthesia during your breast surgery

We often recommend that you bring a firm fitting shirt to your appointment, in particular if you are looking at breast implant surgery. During your consultation you may be fitted with a ‘sizing bra’. Various sizes of implants will then be inserted into the bra. With your own shirt on, this will not only allow us to determine the size of implant desired, but also give you an idea of how the breast implants would look on you.

At the conclusion of your consultation, our staff will prepare a pre-operative pack for you. This will contain:

• A quote and financial consent for your operation
• An information pamphlet specific to your procedure
• Hospital admission information
• Surgical consent forms

This introductory package will either be given to you on the day or sent to you by mail.

The consultation is completely obligation-free. You will not be pressured to proceed with anything you are not comfortable with. Often, if you are unsure, we encourage you to take your time to consider your options; you may want to sought more information and gather a list of specific questions. We may also recommend that you book another appointment to see Dr Vrtik prior to making your final decision. Please do not hesitate to ask our friendly staff for assistance.

If you decide to proceed, bookings for your surgery can be made on the day of your consultation or you could contact us via phone with your decision after you have had a chance to consider your options. Once you have booked in a date, we will help you with your preparations for surgery.

Preparing for surgery

Prior to surgery, you may be asked to:

• Get blood tests or x-rays
• Undergo a medical evaluation by a specialist
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery (minimum of 6 weeks +/- urine testing for confirmation)
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

An individualised consultation can be arranged for you to see our Practice Nurse 1-2 weeks prior to your operation. During this 30-40 minute consultation:

• You will be measured for your garment if you require one
• You will have the opportunity to ask questions in regards to your procedure or hospital stay
• You will be informed about what to expect during the immediate postoperative period
• You will be given information on your admission and hospital stay
• Clinical photos may be taken
• A deposit or the full payment for your procedure may be required

Dr Vrtik only performs breast surgery in accredited private hospitals.

Some procedures require hospital stay, and some are performed as Day-Surgery. If your procedure is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery. For those discharged from Day-Surgery after a general anaesthetic, it is essential that you arrange for someone to stay with you for at least the first night following surgery.

For some breast surgery, minimum stay in hospital is overnight, although it is recommended that you prepare to stay for two nights. The benefit of hospital-stay significantly out-weighs the risks of day-surgery in some patients:

• Allows you to adequately recover from a long anaesthesia
• Prompt effective intravenous treatment for any postoperative nausea and vomiting
• Prompt effective treatment if you have any pain
• Help and supportive nursing during the first 24 hours (especially with swelling or discomfort)
• Monitoring for any complications such as bleeding
• Allows administration of 24 hours postoperative intravenous antibiotic treatment to decrease incidence of infection (especially with breast implants)
• Allows monitoring of your drains if you have any

Risks and complications of breast surgery

The decision to have any breast surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Dr Vrtik and our staff will explain in detail the risks associated with your surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications. Risks specific to each type of procedure will be outlined below.

Most of the risks are very uncommon, and some people (with particular health problems or specific breast features), may be at higher risk for specific complications. Dr Vrtik will discuss this with you during your consultation if any of these risks are specifically pertinent to you.

Although both cosmetic and reconstructive breast surgery can be effective procedures where the benefits significantly outweigh the risks, like everything in the practice of medicine and surgery, it is not an exact science. The degree of surgical success can be altered by how each individual’s body responds to surgery and healing. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure; revision surgery may be necessary.

Be sure to ask questions: It’s very important to ask questions about your procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings and any specific concerns with Dr Vrtik or any of our staff members.

During your recovery and after hospital discharge

You will be given detailed instructions on how to care for yourself prior to leaving the hospital. You will also go home with a postoperative pack including detailed postoperative brochures specific to your procedure. These will include information on:

• How to care for the surgical site
• Medications to apply or take orally to aid healing and reduce the potential for infection
• Specific concerns to look for at the surgical site or in overall health
• How to and when to arrange follow up with our nurse and Dr Vrtik
• Contact numbers in case of concerns or after-hour emergencies

Be sure to ask Dr Vrtik and our nurse specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery? When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up a follow-up appointment?

Following your surgeon’s instructions is the key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Avoid wearing any clothing that must go over your head or require excessive movement of your arms above your head. Avoid heavy lifting and tasks that require exertion of your upper arms and shoulders.

Once you are at home, please seek medical attention if:

• You experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately.
• Notice unusual swelling, bleeding, redness, pain, or persistent discharge from your wound
• Become ill, unwell or feverish
• Break out in a persistent rash

Should any of the above occur, you may require hospitalisation and additional treatment.

Your first postoperative appointment is usually with our nurse within 5-7 days of discharge from hospital. If you are not already in a garment when discharged from the hospital, please do not forget to bring your garment (enclosed in your discharge package) with you. At this appointment, your sutures will be removed if required; your wounds will be checked and cleaned thoroughly. You may be shown how to put on your garment and advised on how long you will be required to wear it. Further instructions on wound care will be discussed with you. Nursing review may vary from twice weekly to fortnightly after your procedure depending on the type of surgery and progress of your wounds.

Depending on your procedure, your first routine review appointment with Dr Vrtik is usually at 4-6 weeks. At this appointment, your scars and swelling is assessed and more clinical photos may be taken. Further follow-up appointments may be offered as appropriate.

Your postoperative period will be fully supported by Dr Vrtik and our staff. If you have any concerns or queries during this period, please do not hesitate to ring our office. If necessary, our Practice Nurse may ask you to come into the office for an assessment earlier than your planned review appointment.

For more information on postoperative instructions, please click here. (here is linked to Patient Resources – postoperative care page)

How much does breast surgery cost?

Cost is always a consideration in elective surgery. Prices can vary widely. A surgeon’s cost for breast surgery may vary based on his or her experience, geographic office location and inclusive services.

We have simplified your costs into three components, these are:

• Surgeon’s fee (which is inclusive of surgical assistant fee, your garment if you require one, breast implants or any prosthesis required, routine follow-up appointments, postoperative dressings and GST if applicable)
• Hospital fees or Outpatient Surgery Facility Fee
• Anaesthesia fees if you are having a general anaesthetic or intravenous sedation

Your Quote from our practice will only specify the Surgeon’s fee (with above-specified inclusions). We provide you with contact numbers of the hospital and anaesthetist for your procedure – it is your responsibility to check and confirm an agreement on these costs with the relevant parties prior to your booking.

Other costs which are not included in the above may be:

• Prescriptions for medications
• Blood Tests and X-rays as required before or after the operation
• Any revision or emergent surgery required secondary to an unexpected complication

Private health insurance does not cover any component of cosmetic breast surgery. However, if your breast surgery was recommended to you by Dr Vrtik for a medicare-approved indication (e.g. breast reconstruction, breast reduction, breast asymmetry, implant rupture, gynaecomastia etc), you will be provided with a medicare item number on your quote, which should also specify the possible rebate you may receive from your private health fund. You should then contact both the hospital and anaesthetist to find out their overall cost and possible rebates you may be eligible for.

Don’t forget: Your satisfaction involves more than a fee. When choosing a surgeon for breast surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

Questions to ask your Plastic Surgeon:

Use this checklist as a guide during your consultation

• Are you a member of the Australian Society of Plastic Surgeons?
• Were you specifically trained in the field of plastic surgery?
• Do you have hospital privileges to perform this procedure? If so, at which hospitals?
• Am I a good candidate for this procedure?
• What will be expected of me to get the best results?
• Would I need to stop any medications or herbal supplements prior to my operation, if so, for how long?
• What surgical technique is recommended for me?
• Where and how will you perform my procedure?
• What should I expect during my recovery and how long would my recovery take?
• What kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• How are complications handled and what additional costs should I expect?
• What shape, size, surface texturing, incision site and placement site are recommended for me?
• How will my ability to breastfeed be affected?
• How will my breasts look if I choose to have the implants removed in the future without replacement?
• Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?
• What are the results I can expect and how would it look over time?
• How can I expect my breasts to look after pregnancy? After breastfeeding?
• Am I likely to need further revision surgery in the future?
• What are my options if I am dissatisfied with the cosmetic outcome of my surgery?