breast augmentation

Breast augmentation is an invasive surgical procedure that aims to achieve the appearance of natural looking breasts by enhancing breast volume through the use of implants.  Breast augmentation allows you, the patient, to choose the size of your breasts and the type of implants used to enhance your natural bust line.

Incisions:

One of the most frequent questions surgeons hear from patients when discussing augmentations is where the incisions will be made. Dr. Andrade, MD, FRCSC, and the owner of the Breast and Body Clinic in Newmarket, Ont says there are three common incisions used for the procedure:

1. Axillary: An incision made in the armpit; only saline implants can be inserted using this incision.

2. Periareolar: Cuts along the border of the areola; the scar is barely noticeable, but there is a higher risk of nipple sensitivity changes.

3. Inframammary: Incision is made just above the crease under the breast.

Ideal Candidate: “The surgery is for someone who’s healthy, has a good understanding of the procedure, its risks, benefits and healing time, and someone who has realistic expectations of the results,” says Dr. Andrade,. Basically, the surgery entails enhancing breast volume, which reshapes and recontours the chest. “The surgery is most often done on women who have finished having children and have lost breast volume; it is called postpartum atrophy. Women miss that voluptuous look they had during pregnancy and breastfeeding,” adds Dr. Nancy Van Laeken, MD, FRCSC, a plastic and reconstructive surgeon in Vancouver. “Most patients are not striving for a fake, artificial look. Many women don’t even want it to appear that they’ve had surgery,” she says. Augmentation is also useful for slender women who are naturally underdeveloped. “Women who have little to no breasts, who wear padded bras and who’d like a more feminine figure are also good candidates,” she says.

WHAT TO CONSIDER:

1. Placement of the Implants

Submuscular (under the muscle): The implant is inserted beneath the pectoral muscle. This option can give a more natural look, since the implant is less visible on top. The recovery process will typically be longer, since more tissue is being cut, and the breasts will have a longer settling period as it is a more invasive technique.

Subglandular (over the muscle): This option has a quicker recovery, and final results can be seen sooner. There is a higher risk of capsular contracture (the body’s immune system attacking the foreign material), and the breasts will have a more rounded, bubbly look since the implant is so close the skin’s surface. There is more chance of rippling to occur on top.

2. Shape and Sizing of Breast Implants

Dr Rice, BA, MD, M.SC, FRCSC, of Rice Cosmetic Surgery in Toronto, also advises that if a patient wants their implants to look more natural "The implant should not go above the armpit or too wide on their chest."

Women also need to consider how they will look in clothes, not just how their breasts will look when they're naked. He also reminds his patients that a good push-up bra creates cleavage. "Very few people have cleavage naturally," he says. "If a patient gets implants that are just too big for her body frame it can cause the skin to stretch over time and she may notice rippling of the implants."

If your nipples are near the centre of your breast, a round implant will work well says Dr Rice. If there is some droopiness, an anatomical (tear-shaped) implant will be needed. If the drooping is more severe you may need a lift before getting a rounder implant.

Dr. Rice also reminds patients to wait about six months after surgery before judging their final shapes since implants need time to "settle" and for healing to occur.

3. Saline or Silicone Implants

Saline implants are filled with salt water instead of silicone. When touched they feel like a water balloon. They move with the body and can work with gravity to fill out the lower part of the breast over time, so they look more natural. As with all implants, there is a risk of capsular contracture. Rippling of the skin is more likely with saline implants, and if they puncture or rupture, they lose their shape more rapidly. Cohesive silicone implants, more commonly used now, are more solid than regular silicone implants. This means they are less likely to ripple, change shape over time, or cause capsular contracture. The latest ones also come in a round shape rather than teardrop, and have a smooth surface for natural movement and mobility. Because they are firmer and not deformable, a much larger incision needs to be made, usually under the breast, in order for them to be inserted. Since the shape of these implants is much more defined, if they rotate it will cause distortion. The only way to fix it is to have them taken out and reinserted. It’s also possible for the implant to crack (though it won’t rupture), but this is extremely rare.

Complications: Capsular contracture is a risk with any augmentation procedure. The immune system, recognizing that there is a foreign material in the body, creates a sac of tissue around the implant to isolate it. This can be harmless, unless the tissue contracts or hardens, essentially squeezing the implant until it ruptures, which can cause pain and discomfort. Since everyone’s immune systems act differently, it’s impossible to tell if this will be an issue until after the surgery. Aside from this, major complications are unusual, though infection and slow healing can occur. Scarring can form around the implant, causing it to feel tight and hard. Occasionally, the implant can rupture or leak.

Down time: Five to seven days; exercise after three to four weeks. Your breasts may be sore and swollen for several weeks. For three to four weeks you will need to wear a bra at all times.

Cost: From $6,000 to $9,000 depending on the surgeon, as well as the type of implant and incision you choose to have done.

Considering this procedure? Browse a list of Plastic Surgeons in Canada.