Breast augmentation is one of the most common procedures in aesthetic plastic surgery.
- She may perceive that her breasts are underdeveloped and want a more proportional shape
- To correct differences in the sizes of the breasts
- Because of changes in the size or shape after a weigh loss, pregnancy or breast feeding
- As a technique of breast reconstruction
Breast augmentation surgery is a procedure to enhance the size and shape of a woman's breasts by placing an implant behind each breast to increase its volume and enhance its shape.
If you are considering breast augmentation, the information provided will give you a basic understanding of the procedure. You must realize that it can't answer all of your questions because plastic surgery must be individualized. A consultation with Dr Larocque will help you to take the best possible decision based on complete information.
The frequently asked questions are:
1. Am I a good candidate for the surgery?
2. What should I expect from my consultation?
3. Can I choose the shape of my breasts?
4. Breast implants fill - saline or silicone?
5. How is the surgery performed?
6. What is the recovery like?
7. When can I see the final result?
1. Am I a good candidate for the surgery?
Breast augmentation can enhance your appearance and your self-esteem, but it won't necessarily change your looks to match your ideal, represent a guarantee of happiness or better relationship with others.
The best candidates for breast augmentation are looking for improvement, not perfection, in the way they look. If you are healthy and realistic in your expectations and have a reasonable desire to have your breasts enlarged, you may be an appropriate candidate.
2. What should I expect from my consultation?
During the consultation, you will be asked about your desired breast size and anything else related to the appearance of your breasts that you feel important. Dr Larocque will consider your desires and your physical characteristics and will determine what can realistically be accomplished. Measurements will be made to choose the right implant for the best result. Photographs will be taken to complete your medical record.
We will discuss your medical history to evaluate any conditions that can influence the result or risk for the surgery. You will meet the patient coordinator to discuss the surgery fees and scheduling dates.
3. Can I choose the shape of my breasts?
Many factors may influence the result of the surgery. The size and the distribution of the mammary glandular tissue, the position of the areola in relation with the chest, mammary or chest asymmetry, the width of the sternum ( the bone between your breasts ), the distance between the nipple and the infra-mammary fold, the definition of the fold, the width of the breasts and the shape of the chest are some of the factors that can play a role in the final result and the shape of your breasts.
Many studies have demonstrated that a proportional breast augmentation has a lower risk of complications in the long term. Obtaining good tissue coverage over the implant is the major factor in obtaining the best possible natural result with any type of implant. If the implant is too large for you, it may look nice in the short-term but is rarely aesthetic in the long-term. The tissue will stretch over time, the contour of the implants will become more visible, the implants can be palpable under the skin and the breast may sag. The goal of aesthetic surgery is to obtain the best possible result with the less possible risks. This is the philosophy of Dr Larocque and this is why he has the privilege to refuse to operate if he judge that your expectations are not realistic or the risk of complications is too high.
4. Breast implants fill - saline or silicone?
A saline breast implant is a silicone elastomer shell filled with a salt-water solution known as saline. This solution is regularly used as intravenous fluid replacement so if the implant leaks the saline released can be safely absorbed. Plastic surgeons are using saline implants since a long time and they were the only implants available in Canada and the United States between 1992 and 2000. It is interesting to note that we had a 400 percent increase in the number of breast augmentation during that period. The saline implants have a lower risk of capsular contracture (hardening of the breast because of a scar contracture around the implant) compare to silicone implants. Because the saline implant is inserted empty and filled with sterile saline fluid once placed in position, the incision is smaller than the one used to insert a silicone filled implant that come pre-filled. The saline implant gives a better result under thicker tissue. This is why Dr Larocque always inserts the saline implant under the muscle.
He also use smooth round saline implants because the smooth shell has low palpability (capable of being felt) and allows the implant to freely move within the breast pocket therefore behaving more like natural tissue. The saline implants have different width and projection to adapt to the different breast shapes. They allow the surgeon to compensate for breast asymmetry with more precision. The disadvantages are that they are more likely than silicone to cause visible rippling under thin tissues and are generally firmer to the touch than silicone gel breast implants.
A silicone implant is a silicone elastomer shell filled with silicone gel. In 1992, the Food and Drug Administration (FDA) greatly restricted the use of breast implants filled with silicone gel and Health Canada soon followed. Silicone implants were removed as there was no evidence to confirm their safety, not that there was proof that the implants were a risk to a patient. Since the year 2000 silicone implants have been available in Canada through special approval by Health Canada and since October 2006 they can be used without restriction. The consistency of the newer silicone gel is thicker and more cohesive than previous generations of silicone implants. If you had cut into an old silicone gel implant, the silicone gel escaped from the implant shell. Now when you cut into a silicone gel implant, the implant fill maintains its shape.
Breast implants are not lifetime devices and cannot be expected to last forever. The rate of rupture of a saline implant is estimated to be 1% per year. If a saline-filled implant breaks, its contents are harmlessly absorbed by the body within hours and a definite change in the size of the breast is clearly noticed. Changing the implant is a minor procedure under local anaesthesia. We don't have to change a saline implant after a definite period of time if there is no rupture. Rupture of a silicone-filled breast implant is more difficult to detect and usually require a magnetic resonance imaging (MRI). We don't really know how long the new silicone implants will last but we estimate a life about 10-15 years.
5. How is the surgery performed?
The surgery can be performed under general anesthesia or local anesthesia with sedation under the care of an experienced anaesthesiologist. The procedure may take between 60 to 90 minutes. The most frequent incision is inframammary (underneath the breast), periareolar (around the lower edge of the areola) and axillary (in the armpit region). They are done in a natural crease and are barely visible when healed. The location of the incision is chosen according to your breast characteristics and to minimize the risk of complications. The surgery is performed in our surgery center under continuous medical supervision and the care of a professional team. After the surgery, you can directly contact Dr Larocque.
You will feel tired and sore for a few days following your surgery, but you will be up moving around. Most of your discomfort and/or pain can be controlled by the prescribed medication.
It is often possible to return to work after a week depending on what physical activity your job may require of you. Vigorous activities should be restricted for 4 weeks. There is no physical restriction after the healing period.
7. When can I see the final result?
For a few days after the surgery, the pectoral muscle is stretched and applies pressure on the implant which is pushed in the upper part of the breast. The shape of the breast is not ideal for a few weeks and the breast is firmer than normal. There will be improvement week after week but it may take a few months before observing the final result.
