Breast augmentation surgery is a common cosmetic surgery that increases the size and modifies the shape of breasts by implanting silicone, saline or fat. Breasts are larger, rounder and often firmer after this surgery. This type of surgery only increases the size of breasts. It does not lift breasts, nor will it correct breasts that are not even in size or shape (asymmetrical breasts). However, it is possible to combine breast lift or breast revision surgery with breast augmentation surgery and Dr. Chivers will discuss all options with you during your initial consultation.

At the Canadian Plastic Surgery Centre in Toronto, the most common cosmetic surgery inquiries we receive are for breast augmentation procedures. If you live in or near the Toronto area and would like to inquire about breast augmentation, you can set up a consultation at the Canadian Plastic Surgery Centre to see how we can help meet your aesthetic goals.

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Suitable Candidates

Candidates for breast augmentation are individuals in good health and have fully completed puberty. Breast implants come in different sizes, material and form which can help you achieve the contour you desires. During your consultation at the Canadian Plastic Surgery Centre, Dr. Chivers can help guide you in terms of the appropriate size and surgical option to help accentuate your body contours and achieve your aesthetic goals.

At the Canadian Plastic Surgery Centre, Dr. Chivers will assess you to provide you with the best surgical options for your goals. Good candidates are:

in good health and are non-smokers
experienced changes in weight size or shape due to weight loss
have small or asymmetrical breast
have breast that may droop after pregnancy and breastfeeding
must have realistic expectations to what a surgical procedure

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Procedural Details

Breast augmentation surgery is performed under a general anesthesia. During the procedure, an incision typically is made either either beneath the breast fold or around the nipple area and a plane is created, either above or beneath the muscular plane. The implant is placed into the plane using the touch less funnel technique and the incision is closed after proper placement.

Breast augmentation surgery is not a one-size-fits-all type of surgery. There are numerous options available for the surgery, all of which Dr. Chivers will fully explain during the initial consultation. Depending on your aesthetic needs and budget, you can choose between the following:

Saline implants - Less expensive, but not quite as natural looking
Silicone implants - More expensive, but more natural looking

Furthermore, breast implants are available in a wide range of sizes and can be implanted either above or below the muscles in your breasts. All of these decisions are made during the initial consultation with Dr. Chivers.

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Saline vs. Silicone Implants

Implants are made of a highly durable silicone shell and are filled with either saline or silicone gel. Discussion regarding saline or silicone is with respect to the filling of the silicone gel. Each type of implant has its own advantages and disadvantages.

Saline Implant

Saline Implants are made of a durable silicone shell with a saline, sterile salt water, filling. These implants can come filled or unfilled prior to surgery.

Advantages

If an unfilled saline implant is used, the silicone bad can be inserted through a smaller incision and subsequently filled, resulting in a smaller scar.
If the saline implant ruptures or leaks, the saline is simply absorbed into the body without detrimental effects.

Disadvantages

There is higher changes of rippling seen beneath the skin
The feel is less natural compared to silicone implants

Silicone Implant

Silicone implants are made of cohesive silicone gels. Unlike previous old silicone implants that disperses silicone into the body when leaked, new silicone implants have a gel-like material that is bound together.

Advantages

lower changes of ripling
more natural and breast-like look and feel
harder to rupture or leak

Disadvantages

Larger incision

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Implant Profile

Implant shapes are available in round or teardrop (anatomical shape) shapes

Round implants are uniform in shape giving breast a uniform volume.
Teardrop implants provide a more natural look and is closest to the anatomy of the body.

Implant Placement

Breast augmentation is placed in one of two positions - in the subglandular or submuscular plane.

Subglandular Plane

When the implants are placed over the pectoral muscles

Advantages

Shorter recovery
Can provide a small amount of breast lift

Disadvantages

Higher chance of capsular contracture
Less natural feel
Increased drooping
Implant more palpable

Submuscular Plane

When the implants are placed beneath the pectoral muscles

Advantages

Lower change of capsular contracture
More natural feel
More support (implant held up longer over time)

Disadvantages

Slighty longer recovery period with muscle tightness for approximately 1-2 weeks
2-3 months for implant to descend into natural position

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What is Capsular Contracture?

Capsular contracture is complication that develops from breast augmentation when the natural capsule that forms around the breast implant becomes tight or constricts the capsule around a breast implant. The capsule, composed of scar tissue, develops as a result of the body's natural response to the placement of a foreign object. Contracture of the capsule around the implant can cause pain and cause the implant to become misshapen and hard, affecting the appearance or shape of the breast.

Capsular contracture begins within months of the original breast augmentation surgery, but can occur at any time. Most cases can occur within the first two years following surgery. Symptomatic capsular contracture rates are lower with saline implants than with silicone gel implants and the range of incidence lies between 15-45%.

There are two surgical treatments methods for capsular contracture.

Capsulotomy - is a surgical procedure where the scar capsule formed around the implant is opened up or a small portion of the capsule is removed to give the implant more space
Capsulectomy - is a surgical procedure where the scar capsule formed around the implant is completely removed.

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Types of Implants

Implants come in different size and shapes. At the Canadian Plastic Surgery Centre there two types of breast implants offered to patients. Allergan Implants and Mentor Implants. You can read more about the these by clicking on the links below.

Mentor Warranty Program

MENTOR® saline-filled or MemoryGel™ Silicone Gel-filled breast implants come with a lifetime product replacement warranty in case of confirmed rupture or deflation. For surgeries after June 1, 2014, the program also covers free implant replacement in the event of a confirmed Baker grade III/IV capsular contracture within 10 years of the date of the original implant.

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Recovery

While the surgery itself is not particularly invasive, full recovery often takes a little over a month. The recovery process also requires a follow-up appointment that will be scheduled at 1, 3 and 6 weeks after the surgery for continual management and post-operative care.

Post-Operative Instructions at a Glance

Pain medication and antibiotics are prescribed for the first week following surgery. Any post-operative pain is typically mild to moderate and should be taken as prescribed.
You will find tensors on your chest after surgery which should be worn for the first week even while sleeping. It can be switched to a sports bra afterwards.
Patients are able to walk the day after surgery.
Incisions are to be kept dry for the first week. Patients can shower after that.
Patients are able to return to light duties at work typically after 2 weeks.
Ends of dissolving sutures are trimmed at 3 weeks.
Patients are able to resume full activities and to exercise after 6 weeks.
Immersion of incisions in baths, hot tubs, pools, oceans should be avoided for 6 weeks.

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Helpful Links

Consent form and Lists of Complications:

Saline Breast Implants

Silicone Breast Implants

Capsulectomy - Saline Implants

Capsulectomy - Silicone Implants

Capsulotomy - Saline Implants

Capsulotomy - Silicone Implants

Standard Pre-Operative Procedure Instructions

Post-Operative Instructions

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Complimentary and/or Alternative Procedures

Breast Lift

A breast lift, also called a Mastopexy, is an alternative procedure to breast implant augmentation. This procedure is suitable for patient's who have drooping breast as a result of weight lost, pregnancy and/or as a result of natural loss of skin elasticity. A breast lift takes your natural breast tissue and re-positions this tissue towards the upper poles of the breast. Giving you a fuller and rounder contour in the upper breasts.

Breast Augmentation Revision

Breast Augmentation revision is an alternative procedure for patients who have had a previous augmentation surgery and are dissatisfied with the results of their surgery. Revision surgery is complicated as it may require adjustments in several components and/or require complete exchange of the breast implant. If you would like to inquire about revision surgery, please bring all available information from your previous procedure with you during your initial consultation.