Breast augmentation is one of the most frequently performed cosmetic surgery procedures. Also referred to as breast enlargement or Augmentation Mammoplasty, breast augmentation surgery can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of breast implants. Women may elect to undergo breast augmentation surgery for many different medical and aesthetic motivations, including balancing breast size and compensating for reduced breast mass after pregnancy or surgery.
Breast enlargement surgery is performed to increase breast size and/or fix breast asymmetry. Candidates include women who want larger breasts, and those who want to restore the breast volume often lost as a result of pregnancy or significant weight loss. Breasts are typically enlarged with breast implants. Breast augmentation is not a substitute for a mastopexy, which is a procedure to “lift” breasts that sag significantly.
The Breast Augmentation Procedure
Breast implants are cohesive gel implants that are placed behind each breast, underneath the chest wall muscle. The procedure lasts one to two hours and is performed with general anesthesia. After breast augmentation surgery, the patient’s bustline may be increased by one or more cup sizes.
Incisions can be made in inconspicuous places on the breast to minimize scar visibility (in the crease on the underside of the breast, or around the areola, the dark skin around the nipple). Dr. Frank prefers the incision around the bottom part of the nipple, due to the fact the scar hides the best and gives Dr. Frank the best access to perform the surgery. The breast is then lifted, creating a pocket into which the breast implants are inserted.
Placement behind the chest wall muscle offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Most patients are quite surprised at how little pain they are in following the surgery, and often equate the pain they feel to that of an intense chest workout.
After the breast implants are placed and centered beneath the nipples, incisions are stitched and taped. Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two and many patients return to work within the week. Most post-operative pain, swelling, and sensitivity will diminish over the first few weeks. Scars will begin to fade in a few months and will continue to fade for months or years.
Candidates for Breast Augmentation Surgery
Using small incisions around the breast, a pocket is created beneath the pectoralis muscle, in which the implant is placed. The procedure usually takes between 40-60 minutes.
During a breast augmentation, Dr. Frank uses small incisions around the areola, which minimizes scar visibility. This placement of scar also limits the possibility of implant malpositioning during the recovery process.
Many women are surprised that their recovery after augmentation is relatively easy. You’ll return home a couple hours after your surgery. You’ll have bandages on your breasts and will be wearing a surgical bra for support. You’ll need pain medication for 2-4 days, but the pain isn’t overwhelming. Usually after 10 days, you will remove your dressing. You’ll return to see Dr. Frank within 2-3 weeks, to discuss how your recovery is progressing, and Dr. Frank will stress the importance of wearing the surgical bra and then transitioning to a support bra at all times for a full month.
Doing implants and a lift at the same time is risky, it’s something we don’t do here. It can often result in over-correction. The best plan is usually to do the implant first, let that settle for at least 6 months to a year, and then assess the need for a lift.
You may be surprised, but most patients can return to work approximately 3-5 days after surgery. Your sutures will be removed after one week. You’ll wear a support bra 24 hours a day for one month after your surgery so as not to place any stress on your incisions. Normal activities can resume in 1-2 weeks, but any impact exercise will need to wait for one month. Upper body exercise, such as lifting weights, will need to wait for six weeks.
Dr. Frank performs breast augmentation surgery as an outpatient procedure with the patient under general anesthesia. You will not feel any pain, and recovery (as discussed above) is not overly difficult.
Extensive research has been conducted both by the FDA and other entities into breast augmentation and breast cancer risk. All of these studies have found no increase in breast cancer risk among women with smooth, non-textured breast implants.
Breast augmentation can be confused with a breast lift. Because of the incisions made with a breast lift, patients need to be finished having children and breastfeeding before they have a lift. This is not the case with breast augmentation. Breast implants are not affected by the gain in size of the breasts during pregnancy and breastfeeding. There is a slight risk of the milk ducts being damaged during the procedure, however, which may impact future breastfeeding capability. But Dr. Frank does everything he can to keep breastfeeding capability intact.
In most cases, breastfeeding is not impacted at all. The incision location that presents the most risk to the milk ducts is the areola incision, but Dr. Frank is usually able to avoid any damage to these ducts, preserving breastfeeding potential.
Breast augmentation can be confused with a breast lift. Because of the incisions made with a breast lift, patients need to be finished having children and breastfeeding before they have a lift. This is not the case with breast augmentation. Breast implants are not affected by the gain in size of the breasts during pregnancy and breastfeeding. There is a slight risk of the milk ducts being damaged during the procedure, however, which may impact future breastfeeding capability. But Dr. Frank does everything he can to keep breastfeeding capability intact.
In addition to the risks associated with surgery and anesthesia, those related to breast augmentation and the use of breast implants include capsular contracture; implant leaks and ruptures; and implant deflation or shifting.
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"HIGHLY RECOMMENDED!! It has been exactly 6 months since I had a breast augmentation. The final results were exactly what Dr. Frank and his team had assured me and then some. Dr.Frank’s team are all true professionals and it’s easy to tell they love what they do. I was walked mentally through the procedure, the healing process and they never missed a step, therefore, I did not have any questions or anxiety about the changes I would experience. I couldn’t be more satisfied with the results. Thank you to all!!"
Breast Implants FAQs
Breast implants are used to add volume. When placed behind the chest wall muscle and beneath the breast tissue the implant adds volume and increases the visible size of the breasts. Implants also add shape to the breasts, increasing volume on the upper area of the breasts, the area naturally prone to flattening and sagging.
Implants can make asymmetrical breasts more symmetrical. They can increase the projection of the breasts. They can remove the natural flattening that occurs with age. Or they can simply increase breast size by one or more cups.
There are a number of decisions to make beyond the decision to have this surgery. Patients will decide the type of breast implants, although Dr. Frank feels Allergan Cohesive Gel Implants are the best option available. They will decide on the incision location: around the areola or along the breast crease. For the implants themselves, patients will decide on the projection profile. Higher profile implants have more mass higher on the implant, with a somewhat smaller base.
Breast implants formerly were a choice between saline and silicone. The exterior shell of all implants is made of medical-grade silicone. Saline implants are filled with sterile saline solution. They have the added benefit of being filled once the implant shell is placed, requiring a smaller incision. However, the consensus is that saline implants don’t feel as natural as silicone.
Silicone implants are filled with silicone gel. The silicone gel used in today’s implants is far more cohesive than that used in the 80s. The cohesiveness of the gel means how much the gel stays together rather than dispersing. In the case of an implant rupture, this is important as modern silicone tends to stay within the shell rather than moving out into the created breast pocket. Silicone implants are considered to feel more like natural breast tissue than do saline implants.
There are two other choices here, although they are technically saline and silicone. One is the gummy bear implant. These silicone implants are made of highly cohesive silicone gel that will not move out of the shell, even if the implant is cut in half.
The Ideal implant is a brand name for a saline implant that is made with a different method. Rather than a single shell, Ideal implants are made of a series of nested shells. They have two pockets that hold silicone solution. This construction method is thought to feel more like silicone implants.
Dr. Frank believes Allergan’s two options for cohesive silicone gel implants are the best choice. These are known by the brand names of Natrelle Inspira™ Breast Implants and Natrelle® Silicone-Filled Breast Implants. The Inspira implants have a fuller appearance than the other Natrelle option.
- Natrelle® Silicone Breast Implant Styles — There are a total of eight styles of these implants, moving up from moderate profile in Style 10 to high profile in Style 45.
- Natrelle Inspira™ Breast Implant Styles — There are five styles in the Inspira line, ranging from low profile to extra full profile
Allergan has a long history of providing products for the aesthetic industry. In addition to its implant lines, Allergan also makes Botox®, Juvederm®, and Latisse®. It also provides CoolSculpting® equipment and training.
This focus on the aesthetic industry is important when weighing implant quality. Dr. Frank believes both the Natrelle® and Natrelle Inspira™ offerings of cohesive silicone breast implants are the finest available. He feels the cohesive silicone in these implants maintains its shape better than implants with lower cohesiveness. They are also less likely to ripple or pucker, especially when compared with saline implants.
As with any manufactured product, breast implants have a lifespan. At some point, the implants will rupture or begin leaking and will need to be replaced. How long will that be? Manufacturers warranty their implants for 10 years, and will generally reimburse patients for failure prior to that timeframe. But how long your implants will last can vary wildly. You should expect to need to replace your implants every 10 to 15 years. Implant durability is increasing, so this could lengthen. Regardless, if you’re in your 30s, you’ll need to replace your implants at least twice in your life, probably more than that. Replacement surgery is much easier than the original augmentation surgery, as Dr. Frank can enter through the original incisions.
Breast implants are not sized like a bra. Instead, they are sized by the amount of material filling the implant shell, as measured in cubic centimeters. For instance, an implant may be 330 ccs. Dr. Frank has an implant sizing system that allows you to accurately visualize what different sized implants will look like on your figure. This helps take much of the guesswork out of choosing implant sizes.
All implants consist of a medical-grade silicone shell. Saline implants are filled with sterile saline solution, while silicone implants are filled with cohesive silicone gel. Saline implants have an advantage in that they are filled once in place in the breast pocket. This allows some variation is size. Silicone implants are filled at the factory and are inserted fully filled. It is generally thought that silicone implants feel more like natural breast tissue than do saline implants.
Breast augmentation with Dr. Frank is major surgery, and it has the risks involved with any surgery: anesthesia reaction, bleeding, infection, and such.
For augmentation, there are some specific risks that are the same with all implant brands and manufacturers. These include the loss of nipple or breast sensation, rupture or capsular contracture.
The main enduring risk or problem with implants is capsular contracture. When a foreign object, like a breast implant or artificial knee, is placed in the body, the body responds by building scar tissue around it. If the scar tissue development becomes too aggressive, it may deform the implants and cause them to feel overly firm or hard. If this happens, they may need to be replaced and/or the excess scar tissue removed.
Schedule a Consult with Dr. Ryan C. Frank!
To learn more about breast implants and options available for a breast augmentation surgery in Calgary, Cochrane, Airdrie, Chestermere, and Okotoks, AB, CA, contact us at (403) 245-1228. You can also click here to send our office a Consultation Request Form, and we’ll get back to you at the earliest. We look forward to serving you!
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