BREAST AUGMENTATION

Breast enlargement is one of the most popular procedures in cosmetic surgery. The procedure is typically performed to enlarge small or underdeveloped breasts, or breasts that have decreased in size due to having children. It is a safe and effective surgical procedure designed to improve and enlarge a breast by inserting an implant behind each breast. An implant can be placed behind the breast tissue or behind the chest muscle (pectoralis major muscle). The incision can be made around the nipple (periareola), under the breast fold (inframammary), underarm (axillary), and through the belly button (umbilical). If your breast skin sags as well, then we might suggest having a breast lift in conjunction with the enlargement surgery; please refer to the section on breast lifts (mastopexy).

TYPES OF IMPLANTS

A variety of implants are available and can be categorized by surface feel (smooth or textured), shape (round vs anatomical tear drop), and content (saltwater saline solution vs cohesive silicone gel). High profile saline implants have gained recent popularity because they provide more outward projection for a saggy breast, giving upper breast fullness and a more “perky” look. The most commonly used implant is a smooth, round saline implant. The breast implant has a silicone elastomer (rubber) outer shell and is filled with saline or a sterile saltwater solution. The cohesive gel implants are filled with a semi-solid silicone gel that does not leak if the shell is damaged. It is important to note that silicone cohesive gel implants are still under investigation by Health Canada and the FDA (as of May 2003). At your consultation, we will help you decide what is the best type of implant for you.

WHO IS A GOOD CANDIDATE FOR BREAST SURGERY?

Any healthy female 18 years of age or older with realistic expectations is a good candidate. She should have no history of malignant cancer or have an active infection of the breast. Women who are pregnant or nursing are not eligible for breast augmentation.

BEFORE SURGERY

During your initial consultation, the doctor will cover all areas of concern, including pre and post-operative care, risks, and answer any other questions you may have. He will also show you different implant sizes and will let you try on the implants with a sports bra to see what size you think suits you best. After your initial consultation, the doctor will do a complete physical examination at a second consultation. He will also do some blood work and take photos, which will allow you to better see the physical changes once the operation is complete. He will again review with you all the important issues regarding the surgery including pre and post-operative care, expectations and fees. The doctor will also tell you what medications to avoid, such as aspirin, as it increases bleeding. If you are a smoker, you will be asked to avoid smoking two weeks before and after the procedure, as it can seriously affect the healing process.

THE SURGERY

The surgery is performed in our fully equipped surgery center under intravenous sedation and local anesthetic. Patients sleep comfortably throughout the procedure and wake up in the recovery room with no ill effects of general anesthetic. After making an incision, a pocket is created under the breast tissue or under the pectoralis major muscle. The implant is then inserted and filled to the appropriate size in each breast. After making the final adjustments, the incision sites are closed. Dressings are placed over the incision sites and a tensor bandage and a sports bra are put into place.

AFTER SURGERY

The procedure is performed as a day surgery. After approximately one to two hours after surgery, patients are ready to be picked up by a responsible adult. In the first four days, patients will experience some degree of pain, swelling, and bruising. The pain will subside dramatically in 4-6 days, and the bruising and swelling will subside within a few weeks. You will be provided with a prescription for pain medication and antibiotics, which you will take for one week after surgery. Patients are able to bathe two days after surgery and must wear their sports bra for one month. Patients can return to work one week after surgery. At the 10-day follow-up appointment, the sutures will be removed (if they are non-absorbable) and the tensor bandage will be removed. Breast massage exercise will then commence. Patients are advised to avoid strenuous activity for 4 weeks following the surgery. The small scars that you will see at this time will fade significantly over time.

Follow up appointments are booked for 10 days, 6 weeks, 3 months, 6 months, and 1 year after the surgery.

RISKS

The complications associated with breast augmentation are uncommon, but do include reaction to anesthesia, infection, bleeding, implant leakage, scar tissue buildup around the implant (capsular contracture), delayed or altered healing of scars, altered nipple/breast sensation, hematoma (blood collection), seroma (fluid collection), interference with mammograms, and implant asymmetry. Studies have shown that breast implants significantly decrease your chances of breast-feeding in the future. Current scientific research has proved that breast implants do not increase the risk of cancer or connective tissue disease.

THE RESULTS

With new and improved breast size and contour, women who undergo this procedure tend to be among the happiest patients in cosmetic surgery. Most patients experience a significant boost in confidence and a more positive body image.

Click here for a breast augmentation diagram