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Breast Augmentation Procedures In Toronto
Dr. Pirani is regarded as a top plastic surgeon in Toronto for breast augmentation with a perfect 5 star rating across all major review sites. Dr. Pirani believes that planning a breast augmentation procedure is unique to each individual which is why Dr. Pirani performs all consultations himself. Dr. Pirani spends a lot of time with his patients to ensure the best treatment outcomes possible and offers monthly financing plans that can result in affordable monthly payments.
Breast augmentation is one of the most popular procedures performed by Toronto plastic surgeons. Dr. Asif Pirani has extensive experience with breast augmentation surgery and as a board-certified plastic surgeon, he will listen to your concerns and develop a custom surgical approach to help you achieve your beauty goals.
What Is Breast Augmentation?
The breast augmentation procedure is designed to enhance breast shape and volume. It can enhance body image, symmetry, and balance but also, may be useful in rejuvenating breasts that have lost volume and shape after having children or losing a significant amount of weight. Many patients find that their clothes fit even better following a breast augmentation procedure.
What Are The Different Options For Breast Augmentation?
Breast augmentation can be performed by either inserting breast implants into your breasts or by injecting your own fat into your breasts (fat grafting or fat transfer).
Breast implants are the most common method used to enhance the size and shape of breasts.
What are the different types of Implants?
There are two types of implants: saline and silicone. Saline is essentially intravenous fluid composed of a saltwater solution. These implants require smaller incisions and are typically less expensive. However, saline implants generally feel less natural when compared to silicone implants and have a greater likelihood of rippling under the skin.
Silicone breast implants are filled with silicone gel. They feel the most natural and are less likely to create rippling under the skin. Gummy bear implants are a new type of silicone implant with improved structure cohesiveness.
Gummy Bear Implants
How Is A Breast Augmentation Performed?
There are a number of things to consider prior to undergoing a breast augmentation procedure. In addition to addressing a woman’s personal preferences and goals, Dr. Pirani must also decide upon implant type, size, incision placement, and plane of insertion.
Generally, an incision is made in the skin and then a pocket is developed either under or over the muscle. The implant is then inserted into this pocket before the pocket is adjusted to optimize the cosmetic result. The pocket is irrigated and closed in a layered fashion. A dressing is applied over the small incision and a post-operative bra is applied.
How To Choose A Breast Implant Size?
Implants sizing is not the same as bra sizing. Implants sizing is based on volume. During your consultation with Dr. Pirani, he will have you try different implants on to see what size suits your goals ad body dimensions. In addition to volume, implants also vary in terms of projection. Dr. Pirani will also have you try on implants with different projections during your consultation to ensure you are confident in your implant choice. Dr. Pirani will take the time to understand your goals and will help guide your choice of implant size whether you want a natural and subtle look or a more dramatic transformation.
It is important to remember that it is not possible to guarantee a specific post-operative size in terms of bra sizes. Bra sizing varies greatly between different bra manufacturers. A size D in one brand can be a full C in another brand for example. Dr. Pirani encourages you to bring a close friend or partner with you to your sizing appointment if you would like their opinion.
What Incision Should I Choose?
There are three main incision options for your procedure—inframammary fold (under the breast), periareolar (around the areola), and transaxillary (armpit). The two most common ones are inframammary and periareolar. The inframammary scars are generally hidden near the breast fold under the breast. Periareolar scars are placed along the lower border of the areola. Each option has its own set of benefits and risks. Dr. Pirani will review these with you during your consultation to help you make the decision that best meets your goals and expectations. Generally, Dr. Pirani recommends the inframammary incision most often as it offers the best visualization of the breast pocket, is associated with the fewest complications, and has the lowest revision rate. It is also less likely to interfere with future breastfeeding when compared to the periareolar incision.
What Are My Options for Breast Implant Shape?
In Canada, we used to offer a choice between teardrop (anatomic) or round implants for cosmetic breast augmentation. In recent years, we have discovered that the textured surface of teardrop implants may be associated with rare but serious complications. Accordingly, Dr. Pirani no longer offers teardrop implants to his patients. Your safety always has been and always will be Dr. Pirani’s foremost priority. Accordingly, Dr. Pirani currently only offers smooth round implants for cosmetic breast augmentation. Fortunately, Dr. Pirani is still able to achieve that natural teardrop appearance in most patients by placing the implants under the muscle. In doing this, the muscle pushes against the upper pole of the breast implant and helps create a teardrop appearance.
Should The Implant Be Placed Over Or Under The Muscle?
Dr. Pirani is able to place the implant either under or over the muscle. Placing the implant under the muscle is termed a subpectoral augmentation. Placing the implant on top of the muscle is known as either a subglandular or subfascial augmentation. Dr. Pirani can perform any of these three options.
The majority of women benefit from a subpectoral augmentation; however, Dr. Pirani will make the decision with you after reviewing the advantages and risks associated with subglandular, subfascial, and subpectoral augmentations.
Generally, Subpectoral Augmentation Is Associated With:
- A lower incidence of capsular contracture (thick scar formation around the implant)
- Decreased rippling
- Maximal preservation of nipple sensation
- Less implant visibility and palpability
- Less tissue stretch over time
- Better mammogram visualization
What Is A Dual Plane Breast Augmentation?
The dual plane method combines the aesthetic advantages of both a subpectoral and a subglandular implant insertion. With this technique, the upper two-thirds of the breast implant are covered by muscle. The lower third of the breast implant is covered by only glandular breast tissue. This allows the upper portion of the implant to have more tissue coverage and the lower third of the implant to have a more rounded appearance. This results in a much more natural-appearing breast contour.
Dr. Pirani regularly performs dual plane subpectoral breast augmentations in addition to offering complete subglandular and subfascial placements, altering the technique he uses depending on your unique anatomy and aesthetic goals.
Who Is A Good Candidate For Breast Augmentation?
A woman may be a good candidate for the procedure if she is interested in having any of the following:
• Larger breasts
• Breast asymmetries resolved
• The appearance of increased cleavage
• Restored breast volume and shape following childbirth/breast feeding
• Restored breast volume and shape following significant weight loss
Additionally, good surgical candidates should be relatively healthy. Smokers should quit smoking at least four to six weeks prior to surgery. Patients who have breastfed recently should wait at least 6 months prior to undergoing the procedure.
Breast Augmentation Recovery
Immediately after your surgery, you will be taken to our recovery area where a registered nurse and anaesthesiologist will care for you as you recover. In general, most patients will remain in the recovery area for a few hours before being allowed to go home. We have a specific set of health criteria that must be met before you are allowed to go home. Dr. Pirani will usually see you prior to your discharge from our facility.
You must have an adult accompany you home from our facility and stay with you for at least 24 hours after surgery. We generally recommend that you have someone at home to help you for at least the first week after surgery.
Patients typically take two to four weeks to recover from the breast augmentation procedure. Many patients are able to return to work a week after receiving a breast augmentation. Depending on the type of augmentation performed, post-operative bras may be required for up to 6 weeks. Patients should expect to continue to see changes in their breast shape and implant position for at least six months after surgery.
For a breast augmentation consultation, Dr. Pirani will spend approximately 45 minutes going over all of your surgical and implant options, after which he will create a custom surgical plan that addresses all of your concerns and goals. He will go over risks and possible complications and give you an idea of what you should expect in terms of results and recovery. You can usually try on implants at this initial consultation to see how different implant sizes look on your body. Dr. Pirani’s goal is to educate you so that you fully understand your customized surgical plan and feel confident and informed.
To schedule a consultation with Dr. Pirani, call 416-360-8772.
Breast Augmentation FAQs
What Is Natural Breast Augmentation?
Natural breast augmentation is a term used to describe using your own fat to augment the size and shape of your breasts. It is usually only reasonable for very small increases in breast volume. In addition you need to have adequate body fat to extract the fat. This is usually not possible in lean patients. More often, fat transfer can be combined with implants to improve cleavage. This is a great option in individuals that have wide-set breasts.
Do Breast Implants Need To Be Replaced Every 10 Years?
No. In Canada, we do not currently recommend implants be replaced unless there is a problem with them.
Do Breast Implants Cause Breast Cancer?
There is no current evidence that breast implants cause breast cancer. There is, however, an association between textured implants and a rare form of lymphoma (ALCL). Dr. Pirani does not offer textured implants and has never used them since being in independent practice.
What Is Capsular Contracture?
When you place a foreign object in the body, such as a breast implant, the body reacts by creating a layer of tissue around the foreign object. We refer to this as the capsule. In most people, it resembles a layer of wet tissue paper around your implant and is not an issue. In some rare cases, however, the capsule can thicken and begin to distort the implant and even become painful. We refer to this as a capsular contracture. This usually requires surgical correction. It can be a recurring problem in very rare cases. There are off-label options to help prevent the progression of an early capsular contracture such as using Singulair for up to 3 months. If you feel that your breasts are beginning to feel firm after a breast augmentation with implants, it is important to see Dr. Pirani immediately so he can initiate such preventative care.
How Long Will I Stay In The Surgical Facility Before I Can Go Home?
In general, patients will stay with us for a few hours before going home. Patients have the option of staying overnight in one of our private overnight stay rooms, which are luxuriously furnished. 2 nurses will care for you overnight if you do choose to stay in one of these rooms. There is an additional fee if you choose to stay overnight in our facility. If you prefer to stay in a local hotel, our office has obtained special rates at a number of local hotels so please ask our staff about these.
Can I Exercise After My Procedure?
Very low impact exercise such as slow walking is highly encouraged for the first 6 weeks after your surgery. Generally, you should avoid anything high impact to avoid complications during this 6 week period.
Right after surgery: You actually should start walking around right after your surgery. You should not do anything extreme or strenuous, but taking frequent, brief walks will keep your circulation up and promote healing.
Six weeks later: You should be well enough to return to all of your normal exercise routines.
When Will My Follow-up Appointment Be?
Dr. Pirani will usually see patients five to seven days after surgery for the first post-operative visit. Based on how your healing progresses, he will then tailor the frequency of further appointments to your needs.
What Is The Recovery Time?
Patients typically take 2-4 weeks to recover from the breast augmentation procedure. Many patients are able to return to work a week after receiving a breast augmentation. Depending on the type of augmentation performed, postoperative bras may be required for an extended amount of time. Patients should expect to continue to see changes in their breast shape and implant position for at least 6 months after surgery.
How Much Does It Cost To Have A Breast Augmentation With Implants?
In Toronto, most implant based breast augmentations cost between $9000 and $10500. The price for breast augmentation will vary depending on incision placement, implant placement, pre-existing asymmetries, and the surgical complexity of the case.
How Long Do Breast Implants Last?
On average, breast implants last many years. The longevity of the implant depends on the individual. Implant manufacturers state that you should not expect your implants to last forever and they will eventually need to be replaced at some point.
The reason for replacement has to do with the natural wear and tear of the implants by your body and various activities. Sometimes you might have experienced a weight change that affects the appearance of the implants or you could have a rupture in the implant itself, making a replacement necessary.
With saline implants, it’s easier to determine when a rupture has occurred because the implant will physically decrease in size. Silicone implants, however, usually do not visibly shrink when they have ruptured.
What Are My Breast Augmentation Incision Options?
There are three principal options for inserting a breast implant:
1. A breast implant can be inserted via an incision underneath the breast in the inframammary fold (IMF incision).
2. A breast implant can be inserted via an incision placed around the areola (peri-areolar incision).
3. A breast implant can be inserted via an incision placed in the armpit (axillary incision).
Each incision option has pros and cons. In general, the inframammary fold incision offers the surgeon the greatest ability to visualize and precisely develop a pocket for your specific implant. The inframammary incision also allows the surgeon to alter your inframammary fold position in cases where there is significant pre-existing breast asymmetry.
The peri-areolar incision is also an excellent option. The incision is placed at the border of the areola and surrounding breast skin. This is an excellent option for women of dark skin colour who are worried about poor scarring and pigment issues.
The third option for incision placement is through the armpit via a transaxillary incision. This incision option offers the least direct visualization and is not ideal for patients with significant breast asymmetry.
There is a fourth described incision option through the umbilicus (belly button); however, Dr. Pirani does not offer this as the risks and complications associated with it are not warranted in Dr. Pirani’s opinion.
Can Pregnancy Affect My Breast Augmentation?
If you have already gone through a breast augmentation or are wondering how a future augmentation could be affected by pregnancy, we can help. Pregnancy can have a significant impact on the appearance of your breasts after a breast augmentation with implants.
During pregnancy, the mammary glands typically swell as they prepare for breastfeeding. As a result, the skin could possibly stretch out. Following pregnancy, the glands will shrink back down, leaving the excess skin behind. There is also a risk of dimpling, which is where the breast tissue sags around the implant, altering how the implant appears.
If you are concerned about these risks, speak with Dr. Pirani to discuss your concerns.
Can I Breastfeed Following The Procedure?
It is possible to breastfeed after having breast augmentation with implants. However, there is a possibility of reduced ability to breastfeed following surgery.
Incisions placed around the areola (peri-areolar) and subglandular (over the muscle) implant placement are more likely to interfere with breastfeeding in the future. Using an IMF (inframammary) incision and placing the implant under the muscle are less likely to influence your ability to breastfeed in the future.
Can Breast Implants Interfere With Mammograms?
A common concern with breast implants is whether they have any effect on mammograms. Since women are recommended to have routine mammograms as they age, this is a legitimate concern.
While in the past this was a bigger problem, with the advancements in technology available for screening, the ability to read accurate results has become much simpler. For patients who have their implants placed above the pectoral muscle, you can have an MRI done in order to get a better view of the breast tissue and screen for any concerns.
For patients who have their implants placed below the muscle, the tech performing the mammogram can manoeuvre the breast tissue using an implant displacement technique, allowing for a comprehensive and effective reading.
You should never avoid getting a mammogram done because you have breast implants, but instead just let the office know ahead of time and they will work with you to help get the best scan possible.
Are Breast Augmentation Scars Noticeable?
A common question that we receive is whether the scars from a breast augmentation are noticeable. The answer is: It depends.
The location of your implants, the size of the implants, and your own skin all factor how noticeable your implant scars are. There are three common incision locations:
- Inframammary: This is the most common incision site used. It is an incision made in the crease that appears naturally under the breast.
- Periareolar: The incision in this type is made along the lower border of your areola.
- Transaxillary: The least common type of incision, this one is made in the armpit.
The ideal incision location for you will typically depend on how large your implants are that you are having placed as well as your body shape. You and Dr. Pirani will discuss the pros and cons of incision placement before the procedure. Keep in mind that some skin types are more likely to show scars than others, so this could be a factor in your decision.
What Kind Of Anaesthesia Is Required For Surgery?
Dr. Pirani only offers procedures with general anaesthesia provided by a board certified anaesthesiologist. Our facility is fully accredited by the Canadian Association for the Accreditation of Ambulatory Surgical Facilities (CAAASF). Our surgical facility has also passed inspection by the College of Physicians and Surgeons of Ontario (CPSO). Our anaesthesiologists are staff anaesthesiologists at the Toronto East General Hospital.
How Long Does The Operation Take?
On average, the procedure will take 1 to 1.5 hours to perform. Some more complex cases may take more time. If a mastopexy or breast lift is also performed at the same time, then the surgery can take up to 4 hours.
What Sort Of Things Are Required For Post-Operative Care?
After your surgery, Dr. Pirani will provide you with specific post-operative instructions. You will also receive a handout detailing your post-operative instructions. Generally, the following can be expected following surgery:
• Bra worn 24-7 for 1 week
• Expect some discomfort for 2-5 days
• No underwire bras for 6 weeks
• No heavy lifting or strenuous upper body exercises for 6 weeks
• Your first follow-up appointment with Dr. Pirani will be 5-7 days after your surgery.
Do Any Stitches Need To Be Removed?
Dr. Pirani usually uses absorbable sutures that do not need to be removed. In the rare case where a patient is prone to poor scarring, he will use non-absorbable sutures that are usually removed 7 days after the surgery.
How Do I Choose the Right Bra?
Following your breast enhancement, you will need to purchase new bras. As your breasts will continue to change for several months after the surgery, we advise you to wait at least six to 12 weeks before purchasing a large number of new bras.
After surgery, Dr. Pirani will provide you with a post-operative surgical bra. During your follow-up appointments, he will reassess your bra requirements and direct you about what type of bra you can wear. In most cases, Dr. Pirani will have you continue to wear a supportive bra for the first six weeks after surgery; however, in some cases he may direct you to avoid wearing a bra to help your implants descend. In some cases, Dr. Pirani may request that you wear an underwire bra.
When it is time to purchase a new set of bras, it is very important to purchase bras that fit well. There are several specialized stores in Toronto that cater to women who have had a breast augmentation. Dr. Pirani and his team are more than happy to help you find the right bra following your procedure.
What implant size should I choose?
This is always a difficult decision for some. In my opinion, the best thing to do is have a thorough sizing session. I provide my patients with a range of about 3-4 implants that are appropriate for their specific measurements. I then have them try these implants on in a special sizing bra. With this process, my patients have been able to choose their own implants. I have found this to be the best method for implant sizing. Your surgeon should be willing to spend the time with you doing this.
What are potential complications of breast augmentation with implants?
There are many potential complications of any surgical or medical procedure. During your consultation with Dr. Pirani, he will review a thorough list of complications and risks of breast augmentation surgery.
More common early complications of breast augmentation include bleeding, bruising, pain, hematoma formation and infection. Other complications include but are not limited to altered sensation, delayed wound healing, hypertrophic or keloid scarring, rippling, implant distortion, malposition, implant loss, capsular contracture and the potential need for revision surgery. Device failure may also occur.
What is a silent breast implant rupture?
This refers to an implant rupture or failure that is not evident clinically. That is, you may have an implant that has ruptured but not actually be able to tell from looking at or feeling your breasts. This is more common with gummy bear silicone breast implants as the implants are cohesive. These types of ruptures are usually found incidentally during breast ultrasounds and mammograms. Dr. Pirani generally recommends replacing implants when a silent rupture is detected.
Are There Any Increased Risks Associated With Larger Breast Implants?
Yes—larger implants generally lead to more sagging (ptosis) and this occurs earlier than with smaller implants. They may also lead to increased thinning of your natural breast tissues over time and are more likely to bottom-out over time. Dr. Pirani finds that implants over 400cc generally lead to increased complications over time but this does vary by body type and tissue quality.
Is There A Link Between Breast Implants And Lymphoma?
There does appear to be an association between textured breast implants and an uncommon type of lymphoma—anaplastic large cell lymphoma (ALCL). Fortunately, the risk is low and is not believed to be associated with smooth-surfaced implants. This is why Dr. Pirani only offers smooth implants to his patients and has never used textured implants in his Toronto practice.
How Many Follow Up Appointments Are Required After Breast Implant Surgery?
Patients generally return for routine follow up visits at 1 week, 2 weeks, 6 weeks, 3 months, 6 months, and one year post-operatively. Dr. Pirani usually attends to you himself at these appointments as he believes the post-operative period is as important as the surgery itself. It is important to catch potential problems early to avoid bigger problems later.
Can I Be Awake For My Breast Augmentation Surgery?
There are surgeons that will do awake surgery for breast augmentations, but I do not. Most surgeons in North America do not offer awake breast augmentation surgery. There may be a cost advantage to being awake; however, I believe that the safety and comfort of my patients is paramount. Accordingly, I prefer to have my patients asleep for breast augmentation surgery.
What Exactly Does The Phrase “The Pocket” Refer To In Breast Augmentation?
The pocket refers to the space that is created for the implant to be inserted into. We have to create a space in which to place the implant—that’s the pocket.
What Cup Size Will I Be After My Breast Augmentation?
There is no way to guarantee a particular bra size. Bra sizing varies greatly between bra manufacturers and a C in one bra will be a D in another. What matters more than the assigned bra size is the way the implants look on you. The best option for your body and aesthetic goals can be determined in a thorough implant sizing session.
Implant sizing depends on several factors. One of the most important factors is your breast width. Generally, your surgeon will measure your breast width, and then provide you with a range of implant sizes appropriate for your native breast size. There are more nuances to it than just what I’ve described, but this approach works for most women.
I usually have my patients bring in a large bra and a tight t-shirt to do sizing. I’ll then choose 3-4 implants that I feel are appropriate, and have my patients place them in the bra under the tight t-shirt. My patients can then look in the mirror and get a good sense of what they will look like with the provided implant sizes. My patients like this approach and get a great idea of how they will look.
By using this technique, I can outline a range of appropriate implant sizes that will be aesthetically pleasing, and you make the final decision.
Is There A Natural Way To Increase My Breast Size And Avoid Surgery?
I don’t know of any proven methods that don’t involve surgery. Be careful of any products promising natural breast enhancement.
How Much Does A Breast Augmentation Cost In Toronto?
Silicone/cohesive gel implants will run somewhere between $9000-$10500 in most cases. Saline implants are usually a few hundred dollars less. The size of your implants rarely impacts the price.
Which Incision Site Is Best?
There are several things to consider when deciding on which incision you use to perform your surgery. Cosmesis and the resulting scar are certainly an important consideration. Another consideration is the risk for capsular contracture. When a foreign body is placed in the body, the body reacts by forming a capsule of tissue around the foreign body. In the case of breast implants, this capsule can be soft or it can become hard and even painful. They can even distort the implant and result in poor cosmesis. This is termed a capsular contracture, and the rates of these can be quite high, depending on implant choices and incision type.
Recent evidence seems to indicate that there are higher rates of capsular contracture with peri-areolar (nipple) incisions. Using an incision in the fold under your breasts (IMF incision or inframammary fold incision) seems to be associated with the lowest rates of capsular contracture. The cosmesis of this incision is also ideal as it is hidden under your breasts. Armpit incisions have the potential of being seen every time you lift your arms.
The IMF incision also provides the surgeon with the best approach to perfect your implant pocket, alter the IMF if needed, and obtain hemostasis.
How Do I Sleep After My Breast Augmentation?
Sleeping on your back is your best option in the early post-operative period. Sleeping on your side is your next best option. I tell my patients that sleep will be an issue in the first few weeks after breast augmentation surgery, as you now have two weights on your chest which can make it more difficult to fall asleep.
How Long Should I Wear A Surgical Bra After My Breast Augmentation?
If I want the implants to drop (usually after a subpectoral or under the muscle augmentation), I have my patients go without a bra. I may also use a bandeau which pushes the implants down. This is because implants tend to ride high in the first few weeks after a subpectoral augmentation, and I want to get my patients to the final cosmetic result as soon as possible.
If I have inserted an implant in either the subfascial or subglandular space, I usually have patients wear a surgical bra longer, as I don’t want the implants to drop or distort the position of the IMF. The IMF is the fold under the breast (inframammary fold).
In cases where I have altered the IMF position for symmetry purposes, I will have patients wear an underwire bra to help define the new IMF.
What Is The Difference Between A Subpectoral, Submuscular, And Dual Plane Augmentation?
Submuscular = the implant is COMPLETELY under the muscle with no release of the muscle (rarely done).
Subpectoral = the implant is placed under the pectoralis major muscle, with the inferior edge of the muscle released so that the lower portion of the implant is covered by gland. This is what most people refer to as “submuscular”; however, they are technically incorrect. A classical subpectoral placement is the same as a Dual Plane I.
Dual Plane = a form of subpectoral implantation with varying degrees of muscle release/separation from the gland in order to vary the amount of muscle/gland coverage ratio. Dual Plane is a form of under the muscle or subpectoral placement.
When Do Scars Begin To Fade?
As for scars, I tell patients it will usually take a year to see the absolute final result. Practically, however, by 6 months the scar will be very close to the final result. I recommend silicone tapes/sheets for optimal scar management.
Will My Nipple Sensation Be Altered By Having A Breast Augmentation?
The literature would indicate that there is a 15% chance of losing sensation to your nipple-areolar complex. Having said that, I think the numbers in the literature are very high. I certainly haven’t had this high a rate in my patients.
Although the rates of sensation loss may be as high as 15%, a significant proportion of these cases will be temporary. It all depends on the degree of injury to the nerves that provide sensation to your nipple. If the nerves are just bruised (neuropraxia), your sensation should return within 6-12 weeks. Increased sensation or hypersensitivity is also a possibility.
How Much Time Off Of Work Will I Need After My Breast Augmentation?
My experience has been that there is a huge variation in the amount of time needed off from work. I have patients that go back to work the next day (against my advice), and I have had patients take as much as 2 weeks off from work. It really depends on what you do for work, and how you feel. I generally recommend taking 1 week off from work and/or school.
How Long Will It Take To Recover From My Breast Augmentation? How Much Pain Will I Be In Afterwards?
Recovery really depends on a few factors. Adequate pain control is likely the most important. Individual pain tolerances differ greatly. I find that women who have had children generally have less post-op pain, as they have a much higher pain tolerance. From a surgical point of view, there are several things the surgeon/anaesthesiologist can do to decrease your post-op pain.
I generally perform breast blocks prior to making any incisions with a mix of short- and long-acting local anaesthetics. I have found this greatly reduces post-op pain. I also encourage patients to take the prescribed pain killers regularly for the first 24-48 hours. If you don’t stay on top of the pain in the immediate post-operative period, it is extremely difficult to “catch-up”. Most of my patients experience very little post-op pain after their breast augmentation surgery.
Of course, the type of breast augmentation you have will also determine your post-operative discomfort. Larger implants, and subpectoral implant placement will also increase post-op discomfort. This doesn’t mean you shouldn’t get large implants, or place them under the muscle—you simply need to know what to expect. Many women also experience difficulty with sleeping in the first few weeks after augmentation due to the weight of the implants on their chest.
Should I Avoid Breast Implants If I’m An Athlete Or Involved In Contact Sports?
Being an athlete or playing contact sports is not a contraindication for breast augmentation. Generally, contact sports may be resumed once you have healed well following breast augmentation. You may generally resume exercise and routine sports after 6 weeks following breast implant surgery.
Am I Too Skinny Or Athletic For Breast Implants?
Slender patients with limited breast tissue can still be great candidates for breast augmentation with implants. Having less soft tissue coverage does increase the risks of implant visibility, rippling, and implant palpability. Nonetheless, these risks can be mitigated by placing the implants under the pectoralis major muscle and not choosing extra high projection implants. Adding fat grafting when possible to augment tissue coverage can also help with achieving natural appearing breast augmentation results. It is important to discuss your aesthetic goals with Dr. Pirani so he can help you get the best aesthetic results.
Can Breast Implants Rupture And Leak Silicone In My Body?
As with any mechanical device, breast implants will eventually fail and/or rupture. Fortunately, the newest generation of silicone implants have very low rupture rates and excellent longevity. In addition, the new cohesive gel silicone (gummy bear) implants make it much less likely that silicone will leak in the event of a rupture.
Is Autologous Fat Transfer or Fat Grafting An Alternative To Breast Implants?
Fat grafting is an option for breast augmentation, however it generally cannot achieve the same results as breast implants and is generally less consistent in terms of results. The procedure involves harvesting fat via liposuction from areas such as the flanks, abdomen, or love handles and then injecting this fat into the breasts to increase breast volume. This fat has to reestablish a new blood supply to survive. The fat that does survive can feel very natural; however, this procedure is unlikely to match the volume and shape that can be achieved with breast implants. Accordingly, it is usually reserved for people with small goals for increased breast volume or people that do not want implants. Concerns have been raised regarding the potential for grafted fat to cause micro-calcifications that could interfere with mammogram interpretation. Similarly, some have questioned whether the stem cells in injected fat could induce breast cancer; however, these concerns have not been substantiated in the medical literature. In most cases, fat grafting to the breast is most useful as an adjunct to improve cleavage, mask rippling, and improve minor contour irregularities.
Can I Move My Arms After Breast Augmentation?
Dr. Pirani generally prefers that you keep your elbows at the sides of your body for most activities during the first 6 weeks after your surgery. You will have to alter how you perform regular activities during this period but most patients are able to cope quite well once they get used to this restriction. Washing your hair is the most common issue due to this restriction so we recommend getting help from a friend or family member. Dry shampoo products are also quite helpful.
Are Breast Implants Under Warranty?
Breast implants are generally covered by a manufacturers warranty for their lifetime. Following breast augmentation surgery, you will receive an implant registration card that lists your implant size, model, type, and serial number. It is important that you save this in a secure location for future claims. Patients are encouraged to take the time to review the details of their specific implant warranties.
Do Breasts Sag After Breast Augmentation?
Breasts certainly may sag after breast augmentation and this may be related to the increased weight added to the breasts by the implants and/or normal tissue aging, pregnancy, breastfeeding, weight changes, UV exposure, and nicotine use. Larger and heavier implants are more likely to develop sagging or ptosis with time. There is no way to predict when this will happen.
After breast augmentation surgery with implants, it is recommended that you wear a supportive bra as much as possible to limit ptosis. This is especially important when performing high-impact activities.
How Do I Know If My Breast Implant Is Leaking or Has Ruptured?
This will depend on the type of breast implant you have. Saline implant ruptures are usually associated with a sudden loss of volume although it is possible that a small saline leak could result in a gradual decrease in size over a few days. Cohesive gel silicone implants are more likely to have silent ruptures if a small defect is present. Silicone implant ruptures are best detected through imaging modalities such as ultrasound or MRI scans.
What Is A Normal Breast Shape?
Although breasts come in many different shapes and sizes, a “natural” breast classically has a teardrop shape with a sloped upper breast and a rounded or fuller lower breast. Having said this, many women actually prefer a more rounded upper breast and/or a round appearance throughout the breast. Dr. Pirani will take the time to understand your aesthetic goals and help you achieve these goals.
Can Breast Implants Last 30 Years?
Breast implants can potentially last decades. Having said that, we do not know how may decades the new generation of implants will last as they haven’t been around for 30 years.
Can Breast Implants Cause Pain Years Later?
Capsular contractures, implant ruptures, and breast implant illness are but a few potential causes for breast pain years after breast augmentation with implants. If you have late-onset breast pain you should always first see your primary care physician to investigate and determine the cause. If indicated, they can refer you to your surgeon if the implants are the source of your pain.
Does Getting Breast Implants Make You Gain Weight?
Most weight gain from breast implants is usually limited to the weight of the implants themselves. This is usually minimal unless very large implants are chosen. It is important to maintain healthy lifestyle choices after surgery as you will be not be allowed to perform high-impact exercises for 6 weeks after surgery.
Does Insurance Cover Breast Implants?
Breast implant surgery is usually considered cosmetic surgery and therefore not usually covered by most insurance providers. Dr. Pirani does not perform OHIP procedures and does not accept payment directly from any insurance providers for cosmetic procedures. We encourage you to check with your insurance provider prior to your consultation for details.
How Dangerous Is Breast Augmentation Surgery?
Breast augmentation comes with risks like any other surgery. The best way to mitigate risks is by selecting an experienced, board-certified plastic surgeon.
How Long Do Breast Implants Last?
Breast implants can theoretically last decades. It is rare for implants to rupture or leak within 10 years of implantation.
How Painful Is Breast Augmentation Recovery?
For most patients, breast augmentation is a very well tolerated procedure. Dr. Pirani usually injects a long-acting local anaesthetic into each breast to significantly reduce post-operative pain. Most of our patients will use prescription pain medications for only 2-3 days after surgery and then often switch to acetaminophen (Tylenol) for a few days longer.
Is Breast Enlargement Possible Without Surgery?
There are injectable treatments being used off-label to increase breast size in Canada. Dr. Pirani does not offer these off-label procedures currently as their safety and efficacy have not been established and do not yet meet his standards.
What Are Natrelle Breast Implants?
Natrelle breast implants are manufactured by Allergan and include a wide range of implant types and sizes. Dr. Pirani offers the full range of Natrelle implants including the very popular INSPIRA silicone implants.
What Are Mentor MemoryGel Implants?
Mentor MemoryGel breast implants are manufactured by Mentor and include a wide range of cohesive gel silicone implant types and sizes. Dr. Pirani offers the full range of MemoryGel breast implants including the very popular MemoryGel Xtra silicone implants.
What Can Go Wrong With Breast Implants?
There are risks associated with any surgical procedure such as breast implant surgery. Dr. Pirani will review these risks with you during your consultation.
What Is The Difference Between A Breast Augmentation And Breast Implants?
Breast augmentation refers to any procedure that adds volume to the breasts. Breast implants are one way to augment the breasts. Other methods include fat transfer or fat grafting.
How Do I Prepare For Breast Implants?
Our office will provide you with instructions on how to prepare for your surgery. Ideally, you should avoid all nicotine use/exposure for 6 weeks prior to surgery. You should also avoid any medication or supplement that increases bleeding such as ibuprofen, Advil, Motrin, ASA, Aspirin, blood thinners (warfarin, etc.), vitamin E, omegas, fish oils, turmeric, Gingko biloba, garlic, ginseng, ginger, dong quai, feverfew, St. John’s wort, valerian root, and echinacea. You should also avoid drinking alcohol a few weeks before and after your surgery.
How Do You Know If You Have Capsular Contracture?
The most common early sign of a capsular contracture is increasing firmness. At the earliest sign of breast firmness, be sure to contact your surgeon. There are off-label treatments that can be started in the case of an early capsular contracture to potentially prevent progression to breast distortion or pain.
How Long Are Breast Augmentation Incisions Sore and itchy?
It is expected for breast augmentation incisions to feel tender and sensitive for about two weeks after surgery. Incision itchiness is also usually a normal part of healing.
Is Getting A Breast Augmentation Worth It?
Breast augmentation with implants is associated with one of the highest rates of patient satisfaction of any cosmetic plastic surgery procedure.
Is There An Alternative To Breast Implants?
Breast fat grafting (fat transfer) or off-label injectables are possible. Dr. Pirani can discuss these with you but he usually recommends breast implants for more significant changes in breast volume and for consistency of results.
What Are Cohesive Breast Implants?
Cohesive gel implants refer to the newest generation of silicone implants. These implants are filled with a silicone gel with increased cross-links between gel molecules. This results in the silicone maintaining its shape more effectively than previous generations of silicone implants which were much more liquid in terms of consistency.
What Is The Most Common Breast Implant Size?
Breast implant sizes are measured in cubic centimetres (cm3 or cc). Most patients choose breast implants in the 250-400cc range.
What’s The Safest Breast Implant?
There are benefits and risks of all implants. Generally, saline implants are safer than silicone implants as the saline should simply be absorbed by the body in the event of a rupture.
How to choose implant shape?
Choosing breast implant shape can be complicated since manufacturers have so many styles in their line-ups. However, it is really only a matter of making a couple of choices. The first choice is the shape and the second choice is the profile. Shape refers to the actual breast implant shape (round or anatomical). Implant profile refers to the distance the implant projects off the chest wall. Breast implant shapes may either be round or anatomical (teardrop/contoured/shaped). Breast implant profiles include: low, moderate, and high. Dr. Pirani will review the shape and profile options with you and help you choose the best breast implants to suit your body. Generally, we no longer offer teardrop implants in Canada.
Can I still have a Mammogram after Breast Augmentation with Breast Implants?
In general, you can still have a mammogram after having an augmentation using breast implants. It is easier to see the breast tissue if the implant is placed under the muscle. If the entire breast cannot be adequately visualized, an MRI may be required.
Will the breast implants drop?
In the first few days following the surgery, the breasts may appear round and unnaturally high. Over the next few weeks to months, the implants should drop and fluff out to look more natural.
Do implants need to be replaced regularly?
Breast implants can last decades. They are not permanent, however, and will eventually need to be replaced.
How do I know if my breast implants have ruptured
Ruptured implants can either be detected when a patient notices a marked change in shape or volume. They can also be detected on imaging such as an MRI or ultrasound. Regular breast check-ups are encouraged.
Will the feeling in my breasts or nipples change?
You may experience altered sensation around the nipples or breasts following breast augmentation surgery. This is usually temporary and normal sensation returns in most people within a few weeks or months. Permanent altered sensation is possible, but is quite rare.
What If I Have A Problem After Surgery?
All of Dr. Pirani’s surgical patients receive detailed instructions regarding what to watch for in terms of emergency situations that may arise after surgery. In case of an emergency, patients should call 911 or proceed to the nearest emergency department.