Breast Augmentation


What is Breast Augmentation Surgery?

Breast augmentation is a surgical procedure to enhance the size and shape of your breasts. Volume enhancement can be achieved with your own tissue (fat) or with implants placed behind the breast. For mild to moderate enhancements, fat grafting of the breasts can be done. Fat grafting of the breast is often combined with other procedures, such as the tummy tuck or liposuction. The fat removed during these procedures is refined and carefully transplanted into the breast tissues. This is particularly ideal for the post-partum breast that is slightly deflated and lax. If you wish a more significant enhancement and reshaping, with a firmer breast, then core volume is achieved by placing implants underneath the breasts.  Dr. vanVliet’s implant procedures are conducted with silicone gel implants of variable size, shape and dimensions.

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The best candidate for breast enhancement is looking for a fuller, more shapely breast. The ideal surgical candidate is: a nonsmoker older than 17 years of age with fully developed, stable breast size aware there will be upkeep surgery in the future (implant replacement, correction of capsular contracture, implant malposition) realistic about scars on the breast mounds in good physical and mental health, and has no existing breast disease.

Your initial consult with Dr. vanVliet is critical to ascertain what bothers you most about your breast size and shape. There are many options available for breast enhancement and Dr. vanVliet will listen closely to your wishes and your concerns. Keep in mind that your wish list needs to be balanced against tissue constraints. Dr. vanVliet will conduct a thorough breast examination and will take important measurements to help with the decision making process. Your skin quality, breast dimensions and degree of deflation are critical variables to help guide Dr. vanVliet in her recommendations for you. Dr. vanVliet has a strong respect for your inherent anatomy and tissues, and will work to give you a natural enhanced look. She utilizes a variety of implant styles and surgical techniques to provide you with the best esthetic outcome. Once a surgical plan has been settled on, an operative date can be scheduled. Dr. vanVliet will again see you for a pre-operative visit to review your operative course with you. She believes that an informed, prepared patient is a more relaxed and happier patient.If you would like to learn more, contact us by phone or email to schedule your consultation with Dr. vanVliet.

Your surgery will be conducted at Southlake Regional Health Centre. Please ensure that you follow Dr vanVliet’s pre-operative instructions regarding when to arrive for surgery and when to stop eating and drinking. Also, aspirin, anti-inflammatories and other blood thinners can significantly increase your chances of operative bleeding, so you need to avoid taking these medications at least one week prior to your scheduled operative date. A relative or friend should accompany you to the hospital. Dr vanVliet will meet you in the operative suite and she will do pre-operative breast markings and photos before you go off to sleep. You will then have your general anesthetic administered by a board certified anesthetist. After approximately 1.5-2 hours, you will wake up in the recovery room where you will be closely monitored until you are fully awake. You will have a light dressing on and be wearing a protective compression bra. Before you are discharged, Dr vanVliet will assess you and provide you with post-operative instructions and a prescription for pain medication and antibiotics. You will then be released to the care of a relative or friend for the next 24 hours.

There are many ways of performing breast augmentation. With implant surgery, there are many implant shapes and sizes to choose from. Dr vanVliet primarily uses cohesive silicone gel implants, but occasionally she will use saline implants. The majority of incision locations are in the lower breast fold, referred to as the infra-mammary fold, and occasionally the peri-areolar planes. Both incision sites are closed with an esthetic closure and are very inconspicuous in their placement on the breast. The majority of implants are placed in the sub-pectoral plane to reduce the look and feel of the implant and to reduce the potential for capsular contracture. If you are having a tummy tuck or a liposuction procedure, the fat removed can be refined and then utilized to provide mild to modest augmentation of your breasts. The ideal breast for fat grafting is the post-partum breast that has some laxity and capacity to accept fat graft. The most common sites for taking fat from are the abdomen and thighs.

You will be tender and swollen for a few days but, overall, your recovery time will be quite short. Dr vanVliet will write you a prescription for pain medications and antibiotics. You will have a light dressing on with an overlying protective compression bra during your first week. You will be in sponge bath mode during this time, not touching your dressings until we see you. We will remove your dressings at your first post-operative visit and, after that, you are good to go home and shower. Initially, your breasts will seem tight and very upright. Your incisions will be red and raised. Most of this will resolve quite quickly over the first month, with the implant settling into place and the skin relaxing around it. The scar will become softer and lighter over a full year. During the day you will wear your supportive compression bra and, at night you can sleep without it. Although it is important to convalesce during the first week, you can resume gentle activity in 2-3 weeks, and high impact activity in one month. Most people are able to return to work within 5-7 days of surgery.

Breast augmentation is a very safe procedure with minimal acute risks and complications. Nevertheless, as with any procedure, there is always the potential for complications related to surgery or to your anesthetic. Acute but uncommon complications include bleeding and infection which may necessitate further corrective surgery. In the remote chance of infection, the implant may have to be removed, the infection treated with antibiotics, and then the implant would be replaced a few months later. Long-term esthetic complications with implant surgery include: implant malposition; capsular contracture; implant show / feel; implant failure; or poor quality scarring. Capsular contracture refers to the development of a firm internal scar or capsule around an implant. Although the implant remains soft, it feels firm and may be distorted by this capsule. This often requires corrective surgery. Implants are man made and, although they are highly durable and reliable, they will eventually succumb to wear and tear. The cumulative failure rate of cohesive gel implants is much improved over that of the saline implants. Cohesive silicone gel implants, also known as “Gummy Bear” implants, are highly polymerized, stable and don’t change much in their appearance as they age. As it currently stands, the implant manufacturers guarantee the implants for the life of the patient. Dr vanVliet utilizes implants from Mentor Corporation. Visible or palpable rippling or folding of the implant, or seeing the implant contour, is a preventable esthetic complication. Saline implants are more predisposed to these esthetic issues but, even with the cohesive gel implants, choosing the right implant pocket and size are critical in reducing the incidence of these complications. Fat grafting enhancement to the breasts has its own set of complications. First and foremost, only small to moderate amounts of fat can be placed into the breast at one sitting. Of the fat that is transplanted, only 60-70% of this volume is retained. By about 2-3 months post-op, the volume retention will be stable and long-lasting. Surpassing the volume capacity of the breast will result in death of the fat that has been carefully transplanted. Fat death, referred to as fat necrosis, can cause oil cysts, inflammation, drainage and infection in the early days. In the long term, areas of fat necrosis can become firm and calcified. Clinically this may present as irregular bumps on the breast and, radiologically, as micro-calcifications. With digitial mammography, these areas of fat necrosis can most often be distinguished from breast cancer but, occasionally, a biopsy may be warranted. Patients with a strong family history of breast cancer are likely best not to consider fat grafting as a breast augmentation option.

Dr vanVliet will be able to advise you on the cost of your procedure based on your initial consultation with her. The total cost is a reflection not only of her fee but also of the hospital and anesthesia fees. The cost will be reflective of the work to be done. Fees are due three weeks prior to the surgical date and can be paid by certified cheque/ money order or credit/debit card.
If you would like to learn more, please refer to our fees & financing section or contact us by phone or email to schedule your consultation with Dr. vanVliet.