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Breast Augmentation

Breast augmentation, also known as augmentation mammoplasty, is a surgical procedure designed to increase the size, or alter the shape or texture of a woman’s breasts. It is currently the most common cosmetic procedure in Canada.

Breast augmentation can be primarily reconstructive, as is the case following a mastectomy, which involves the removal of cancerous breast tissue, but many women also choose to undergo the procedure for primarily aesthetic reasons.

While the safety of breast augmentation has been controversial in past decades, it has evolved into a safe, effective, and immensely popular cosmetic surgery.

Implant Types

Most breast augmentations include the insertion of implants, filled with either a saline solution or a silicone gel, although some procedures use a fat transfer technique, which uses fat harvested from other areas of a woman’s body in place of implants.

Breast augmentation procedures can be traced back as far as the late 19th century, and various materials have historically been used for implants.

Types of Incisions

Breast augmentation usually involves one of three types of incisions:

  • The fold underneath the breast (Inframammary)
  • The border of the areola (Periareolar)
  • The armpit (Transaxillary).

The implant is placed in a “pocket” created by your surgeon, either above the chest muscles (subglandular) or underneath them (submuscular).

Implants come in a variety of shapes and sizes, and breast augmentation is highly customizable. During your initial consultation, you and your surgeon will decide on the best type of incision, implant type, and implant placement in order to achieve your desired outcome. It is important to note that breast augmentation does not lift the breast, and does not address concerns of breast “sagging,” which may be corrected with a breast lift.

Breast augmentation is most commonly combined with a breast lift for a more comprehensive result, and a breast lift usually does not require any extra incisions. A number of other cosmetic procedures may also be performed simultaneously, including liposuction or rhinoplasty (nose job).

Patients are advised that breast augmentation is not a one-time procedure: breast implants are not designed to last a lifetime, and they may shift or deflate over time. You may need to get your implants replaced if complications arise or if the size or shape of your body changes. The likelihood that your implants will need to be replaced increases with time; the average implant lifespan is 10-15 years. Women with silicone implants should be monitored for signs of silent rupture, in which case your implants will need to be replaced. Price adjustments are usually offered for implant replacements and revisions.

Why Breast Augmentation?

Women choose breast augmentation for a number of reasons. Some women are unhappy with their genetic breast size, while some women find they have lost breast volume and elasticity following pregnancy and breastfeeding, or with age. Breast augmentation aims not only to increase breast size, but also to improve symmetry, shape, texture, fullness, projection, and overall proportion.

Many women also find that breast augmentation improves their self-perceived attractiveness and contributes to a boost in self-esteem. A 2012 study by the American Society of Plastic Surgeons found that 80% of women reported “significant improvement” in areas such as satisfaction with breasts, psychosocial well-being, and sexual well-being following breast augmentation procedures.

Breast Augmentation: What to Expect

The breast augmentation procedure typically takes between 1 and 2 hours and almost always involves the use of general anaesthesia. You may be given a surgical bra to wear in order to keep everything in place following your surgery. Follow-up visits will be scheduled in order to monitor recovery. Patients can usually be discharged the same day after a period in a recovery room to monitor for any complications, and it is advised that you arrange transportation, as driving will not be possible for a few days following surgery.

Patients normally return to sedentary work within a week following surgery, and physical contact can be resumed after 3-4 weeks, or once any lingering hypersensitivity has subsided. Exercise and any other strenuous activity should be avoided for about 4-6 weeks following your breast augmentation, and patients are encouraged to rest as much as possible in the weeks following surgery, in order to promote recovery.

It is important to have realistic expectations following your breast augmentation. Some pain, tenderness, and sensitivity can be expected for a few days following surgery, and is usually treated with prescription pain medication. Submuscular implants often result in more pain and require longer healing times because of the deep tissue incisions necessary.

Scarring is usually minimal and restricted to strategic areas where they will be barely visible. Scars typically heal within about 6 weeks and fade over time. Your implants may sit high on the chest and feel tight for a few months following surgery, but should gradually descend and settle into a more natural-looking final position.

Related Links

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Subglandular vs. Submuscular Placement

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Breast Augmentation Types of Implants

Breast Augmentation Risks & Complications

Breast Augmentation Recovery

Breast Implant Removal

Breast Reduction & Lift

Combined Breast Augmentation & Breast Lift

Breast Lift

Breast Revision

Inverted Nipple Correction

Asymmetrical Breast Augmentation

Fat Transfer Breast Augmentation

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Anaesthesia & Sedation

Choosing the Right Surgeon

Breast Augmentation FAQ

What is a breast augmentation?
A breast augmentation, or augmentation mammoplasty, is a cosmetic surgical procedure designed to increase the volume and alter the size, shape, and texture of the female breasts, often by means of saline or silicone implants.
Why do women undergo breast augmentation procedures?
Many women choose to undergo breast augmentation procedures because they have experienced a loss of volume with aging, weight loss, following pregnancy or breastfeeding, or with hormonal changes such as menopause. Some women require breast reconstruction following a mastectomy. Some women simply desire to alter the look and feel of their breasts.
What are some of the risks of breast augmentation?
Breast augmentation carries all the risks of any surgical procedure, including those associated with bleeding, infection, scarring, and anaesthesia. In addition, following your procedure, some of the most serious complications you may experience include implant rupture, leakage, deflation, and capsular contracture. Other risks include altered sensation, persistent pain, hematoma, implant rippling or wrinkling, impeded breastfeeding function, asymmetry, thinning of breast tissue, and symmastia (the “fusing” of the breasts at the sternum). Many of these risks can be avoided in the hands of an experienced surgeon.
What is the cost of a breast augmentation?
The cost of a breast augmentation can vary widely depending on a number of factors, including the experience of the surgeon performing the procedure, the type and placement of implants, the number of combination procedures desired (e.g. breast lift), the type of anaesthesia used, and the type and extent of work to be performed.
How long does a breast augmentation take?
A typical breast augmentation procedure takes between 1 and 2 hours to perform depending on the type and extent of correction desired.
What types of incisions are used for a breast augmentation?
Your surgeon will typically use one of three types of incisions depending on your particular situation. A periareolar incision is located around the areola and is most commonly used in combination with a breast lift. An inframammary incision is made along the length of the breast fold and is usually used for pre-filled silicone implants as it is long enough to accommodate their larger size. A transaxillary incision is made in the armpit and is usually used for saline implants that can be filled after insertion. Less commonly, a transumbilical incision may be made at the navel, especially in combination with an abdominoplasty, or tummy tuck.
What type of anaesthesia is used for a breast augmentation?
A breast augmentation is typically performed under general anaesthesia.
Will I have any scarring following a breast augmentation?
As with any surgery, breast augmentation poses a risk of scarring. However, as is the case with most cosmetic surgeries, scars will be hidden in inconspicuous places, such as in the breast fold, around the areolar border, or in the armpit, depending on the type of incision used.
How do I know what size implants to get?
While implant size is ultimately a personal choice, your surgeon is the best resource in helping you decide on the right size implants to achieve your desired results. Implants can appear bigger or smaller once implanted, and your surgeon will be able to provide photos to help illustrate the final appearance of implants of various sizes. Your surgeon should also be able to make recommendations based on your skin tone and whether your existing breast tissue will provide adequate coverage for your implants.
What are my options for implant placement?
Your implants may be placed in a subglandular or submuscular position. Subglandular implants are placed beneath the glandular breast tissue but above the pectoral muscle. Submuscular implants are placed beneath the pectoral muscle and generally result in a lowered incidence of capsular contracture and less implant “rippling.” Each placement location has its risks and advantages, which your surgeon will discuss with you in detail at your initial consultation.
What types of implants are available for breast augmentation?
A wide range of implants are available for breast augmentation, but all are filled with either a silicone gel or a saline (salt water) solution. Silicone gel implants are available as a viscous fluid or a semi-solid gel (“gummy bear” implants), which hold their shape if the membrane is punctured, reducing the complication associated with silicone implant rupture. Implants are also available in a variety of sizes, shapes (round, elliptical, or teardrop), and textures (smooth or textured), each of which have their own advantages and are suited to particular situations. Your surgeon will be able to recommend the implants best suited to your situation.
Are there any alternatives to implants when undergoing breast augmentation?
Yes. Fat transfer, or fat grafting, is often touted as the “natural boob job,” as it uses fat harvested from another area of the patient’s body (usually the thighs or abdomen) and implants it into the breasts for a more subtle augmentation.
How long is the recovery following a breast augmentation?
Every patient recovers differently, but most patients can return to sedentary work within a week following surgery. Heavy lifting and other strenuous activities should be avoided for at least 4-6 weeks following surgery, and can be resumed under the advice of a physician. Submuscular implants typically result in longer and slightly more difficult recovery, but they ultimately result in fewer complications.
Will I need to stay in the hospital overnight?
Most patients can be discharged the same day following a breast augmentation procedure.
Is breast augmentation painful?
Because of the anaesthesia used, the procedure itself will be totally painless. Some swelling, bruising, tenderness, and soreness can be expected in the days following surgery, and may be managed with prescribed pain medication. You may also experience some numbness and loss of sensation which should subside within a few days.Your surgeon may recommend a sports bra or similar compression garment in order to manage swelling in the surgical area. Submuscular implants generally result in more postoperative pain and slightly longer recovery times.
Can I breastfeed following a breast augmentation?
Yes. Breast augmentation procedures generally do not interfere with the normal functioning of nipples and milk ducts. However, because every woman heals differently, some women may find their breast feeding function to be impeded.
What results can I expect following breast augmentation?
Patients report high rates of satisfaction following breast augmentation procedures, whether or not they experienced complications. While it is important to maintain realistic expectations, you can generally expect larger breast volume, better symmetry, and a more uniform breast shape. Your surgeon will arrange follow-up visits as necessary to ensure your recovery is proceeding well. Every woman heals differently, and while you will see some results immediately, you may not see your final results for several months following surgery. Your implants may sit high on the chest initially, but should gradually descend and settle into a more natural-looking final position. Many women even report improved confidence and increased self-esteem following breast augmentation.
How long do breast implants last?
Women considering breast augmentation are advised that breast implants are not permanent, and most women will need them replaced at some point in their lives. The incidence of complications such as rupture, leakage, and capsular contracture increases with time as implant materials chemically degrade. Most breast implants have a lifespan of about 10-15 years. Implant replacement surgeries are generally less expensive than an initial breast augmentation.
How do I know if breast augmentation is right for me?
If you have experienced a loss of breast volume with age, menopause, or following pregnancy and breastfeeding, and are generally in good health with good skin tone, breast augmentation could be right for you. The best way to determine your suitability for this procedure is to book an initial consultation with one of our experienced surgeons.
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