Breast Augmentation

Fat transfer breast augmentation is a type of breast augmentation that uses the patient’s own fat to increase the size and shape of the breasts. It involves harvesting fat from one or more areas of the body, such as the abdomen, thighs, flanks, or hips, and then injecting the purified fat into the breasts using a syringe or a cannula. This procedure is also known as natural breast augmentation, autologous fat transfer, or breast fat grafting.

Some of the advantages of fat transfer breast augmentation are:

• It can create a more natural and subtle result, as the fat is similar to the breast tissue and can blend well with the existing contours and texture of the breasts.
• It can avoid the potential risks and complications of breast implants, such as infection, capsular contracture, implant rupture, or leakage.
• It can also enhance the appearance of the donor sites by removing excess fat and creating a slimmer and smoother silhouette.

Some of the disadvantages of fat transfer breast augmentation are:

• It can only achieve a modest increase in breast size, usually one or two cup sizes, and may not be suitable for patients who want a significant or dramatic change.
• It can have unpredictable and variable results, as some of the transferred fat may not survive or may be reabsorbed by the body, leading to asymmetry, loss of volume, or need for touch-ups.
• It can be more expensive and time-consuming than breast implants, as it requires multiple procedures, such as liposuction, fat processing, and fat injection, and may need more than one session to achieve the desired outcome.

Fat transfer breast augmentation is a safe and effective option for breast enhancement, but it is not for everyone. It requires careful consideration and consultation with a qualified and experienced plastic surgeon, who can help determine the best type of breast augmentation for the individual goals and anatomy.

Breast augmentation is a carefully planned procedure. You will be fully anesthetized during the surgery, ensuring complete comfort and relaxation. After the procedure, some mild soreness, swelling, or a sensation of tightness in the chest area may occur, but these effects are typically brief and manageable with the prescribed pain relief.

Breast augmentation begins with an in-depth consultation with Dr. Pirani at Toronto Plastic Surgery Center, the surgery itself, and a post-operative appointment to assess your recovery.

Your results will be visible immediately after surgery, although some swelling will still occur. But as your body adjusts, the swelling will gradually subside, revealing the full contours and enhanced silhouette. For the most refined and settled results, the implants typically take a few months to settle into their final position.

Breast augmentation scars are the visible marks that remain after the incisions heal. The scars’ size, shape, color, and location depend on the implant’s type and size, the incision’s location, the patient’s skin type and quality, and the surgeon’s skill and technique. The scars usually fade and improve over time but do not disappear completely. Some treatments and products can help reduce the appearance of the scars, such as silicone gel sheets, scar creams, massage, laser therapy, and microneedling.

It’s important to allow your body time to heal after breast augmentation. Dr. Pirani typically recommends taking at least 4 to 6 weeks off from strenuous exercise. Light activities can be resumed after a few days. However, chest or upper body exercises should be avoided until Dr. Pirani clears you to resume them.

Many of our distinguished clients opt to pair breast augmentation with complementary treatments such as a tummy tuck, liposuction, or even a facelift for a seamless, head-to-toe transformation. Dr. Pirani in Toronto will take the time to understand your specific goals and curate a personalized treatment plan that enhances your natural beauty while ensuring that each procedure aligns with your desired outcomes.

Although breast augmentation is a safe and common procedure, it is not without risks, and patients should be aware of them before undergoing breast augmentation surgery. Some (but not all) important risks are listed below:

• Infection: A rare but serious complication that can occur after surgery. Additional treatment, including antibiotics, hospitalization, or surgery, may be necessary if it occurs. An infection can also cause you to lose your implants.
• Bleeding: It is possible, though unusual, to experience a major bleeding episode during or after surgery. Should post-operative bleeding occur, it may require emergency treatment to drain accumulated blood. Increased activity too soon after surgery can lead to an increased chance of bleeding and additional surgery. The risk of bleeding can be reduced by avoiding aspirin, ibuprofen, or other anti-inflammatory drugs and by following your surgeon’s instructions regarding activity and medications.
• Capsular contracture is a complication that can occur if the tissue that forms around the implant tightens and squeezes it. It can cause pain, hardness, distortion, or displacement of the implant and may require surgery to release or remove the scar tissue or the implant. The risk of capsular contracture can be reduced by choosing the right implant type and placement, massaging the breasts as directed, and following your surgeon’s instructions.
• Implant rupture or leakage is a complication that can occur if the implant shell breaks or tears due to trauma, aging, or defect. It can cause deflation, change in shape or size, or migration of the implant material. Depending on the type of implant and the extent of the rupture, symptoms may or may not occur. The risk of implant rupture or leakage can be reduced by choosing a reputable implant manufacturer, following the surgeon’s instructions on implant care, and monitoring the implant regularly.
• Changes in sensation: This is a complication that can occur if the nerves that supply the breast or the nipple are damaged or stretched during the surgery. It can cause numbness, tingling, pain, or hypersensitivity in the breast or the nipple, which may be temporary or permanent. It may affect pleasure with sexual stimulation.
• Implant malposition, asymmetry, or dissatisfaction are complications that can cause aesthetic or functional problems, such as uneven or unnatural appearance, poor cleavage or projection, or difficulty fitting clothes or bras. These problems may require revision surgery to correct or improve the implant position or size. The risk of implant malposition, asymmetry, or dissatisfaction can be reduced by choosing a qualified and experienced plastic surgeon, clearly communicating your expectations and goals, and having realistic expectations.

Some of the rare but serious risks are:

• Anaplastic large cell lymphoma (ALCL) is a type of cancer that can develop in the tissue around the implant, especially in patients with textured implants. It can cause swelling, pain, lumps, or fluid accumulation in the breast and may require chemotherapy, radiation, or surgery. The risk of ALCL is low, but the patient should be aware of the symptoms and report any changes to the surgeon.
• Breast implant illness (BII) is a condition with systemic symptoms that may be related to breast implants, such as fatigue, joint pain, hair loss, headaches, or autoimmune disorders. BII’s cause and diagnosis are unclear, and the symptoms may vary from person to person. Treatment may involve implant removal. The risk of BII is not well established, but the patient should be aware of the possibility and consult with their doctor if they experience any symptoms.

Breast augmentation risks are usually rare and manageable, but they should not be ignored or underestimated. Patients should be informed and prepared for the risks and follow their surgeon’s advice and instructions to prevent or minimize them. This will help ensure a safe and successful breast augmentation experience.

Choosing the best breast augmentation surgeon in Toronto is an important decision that can affect the outcome and safety of the surgery. Some factors to consider are the surgeon’s credentials, experience, reputation, portfolio, reviews, and rapport.

The surgeon should:

• Be board-certified by the Royal College of Physicians and Surgeons of Canada, which means they have met the highest education, training, and ethics standards in plastic surgery.
• Have extensive training and expertise in breast augmentation and perform the procedure regularly and successfully.
• Have a good track record of satisfied patients and a low rate of complications or revisions.
• They will show before-and-after photos of their work and demonstrate their artistic and technical skills in creating natural and beautiful results.
• We have positive feedback from previous clients and a high rating on online platforms such as RealSelf, RateMDs, or Google Reviews.
• Make the patient feel comfortable and confident, and listen to their goals and expectations.
• Provide honest and realistic advice and explain the risks and benefits of the surgery.
• Offer a personalized and comprehensive consultation and a customized treatment plan.

Choosing the best breast augmentation surgeon in Toronto is a personal and subjective decision, but it can be made easier by doing some research and comparison. Patients should consult with several surgeons and choose the one who meets their criteria and matches their vision. By doing so, patients can help ensure that they have the best possible outcome and experience.

No, breast augmentation is usually not covered by OHIP. However, there are some exceptions. For example, breast augmentation may be covered if it is done as part of breast reconstruction after a mastectomy. Dr. Pirani does not offer OHIP procedures.

Breast implants and mammograms are compatible but may require special considerations and precautions. Breast implants can interfere with the detection and diagnosis of breast cancer, as they can obscure some of the breast tissue and create false shadows or distortions in the images. Therefore, women with breast implants should inform their mammogram technicians and request additional views or a special technique called implant displacement or the Eklund technique, which can improve the visibility and accuracy of the mammogram.

Some of the benefits of breast implants and mammograms are:

• They can help detect and diagnose breast cancer early, which can increase the chances of survival and recovery.
• They can help monitor and evaluate the health and condition of the breast tissue and the implant and detect abnormalities or complications.
• They can help prevent or treat breast cancer by providing information and guidance for further tests or treatments.

Some of the drawbacks of breast implants and mammograms are:

• They can cause discomfort or pain as the breast and the implant are compressed and squeezed by the mammogram machine.
• They can cause damage or rupture, as the pressure or force of the mammogram machine can break or tear the implant shell.
• They can cause false positives or negatives, as the implant can hide or mimic the signs of breast cancer and lead to unnecessary or missed diagnosis or treatment.

Some of the tips and recommendations for breast implants and mammograms are:

• Women with breast implants should have regular mammograms, as recommended by their doctor, and follow the screening guidelines for their age and risk factors.
• Women with breast implants should inform their mammogram technicians about their implants and provide any relevant information, such as the type, size, and placement of the implant and the date and location of the surgery.

Women with breast implants should request additional views or a special technique, such as implant displacement or Eklund technique, which can move the implant away from the breast tissue and provide a clearer and more complete image of the breast.

Women with breast implants should check their breasts and implants regularly and report any changes or symptoms, such as lumps, pain, swelling, or leakage, to their doctor or surgeon.

Breast implants and mammograms are not mutually exclusive, and women can have both without any problems. However, they may also face some challenges or risks and should be prepared and informed about them. By following the above tips and recommendations, women with breast implants can ensure safe and effective breast cancer screening and prevention.

Breast augmentation scars are the visible marks that remain after the incisions heal. The size, shape, color, and location of the scars depend on the implant’s type and size, the incision’s location, the patient’s skin type and quality, and the surgeon’s skill and technique. The scars usually fade and improve over time but do not disappear completely. Some treatments and products can help reduce the appearance of the scars, such as silicone gel sheets, scar creams, massage, laser therapy, and microneedling.

Some of the factors that may influence the breast augmentation scars are:

The type and size of the implant: Larger or textured implants may require larger or longer incisions, which may result in larger or longer scars.

• The location of the incision: Inframammary incisions (under the breast fold) may result in scars that are hidden by the breast or the bra but may be visible when wearing low-cut or revealing clothes or swimsuits. Periareolar incisions (around the nipple) may result in scars that blend with the color and texture of the areola, but they may be noticeable when the nipple is erect or exposed. Transaxillary incisions (in the armpit) may result in scars that are hidden by the arm or the hair but may be visible when raising the arm or wearing sleeveless clothes. Transumbilical incisions (in the navel) may result in scars that are hidden by the navel but may be visible when wearing belly-baring clothes or swimsuits.
• The patient’s skin type and quality: The patient’s skin color, thickness, elasticity, and healing ability may affect the appearance and healing of the scars. Darker skin may be more prone to hyperpigmentation, which is the darkening of the scar. Thinner or looser skin may be more prone to hypertrophic or keloid scars, which are raised or thickened scars. Poor healing may result in infection, inflammation, or dehiscence, which are complications that can worsen the scars.
• The surgeon’s skill and technique: The surgeon’s experience, expertise, and artistry may affect the quality and outcome of the scars. The surgeon should use the appropriate type and size of implant, the optimal location and direction of the incision, and the proper closure and dressing of the wound to minimize the trauma and tension to the skin and tissue and to create a smooth and fine scar.

Some of the treatments and products that may help with the breast augmentation scars are:

• Silicone gel sheets: These self-adhesive sheets are applied over the scars and can help flatten, soften, and lighten them. They can also protect the scars from irritation, infection, or sun exposure. To see the best results, they should be worn for several hours a day for several months.
• Scar creams are topical products applied over scars and can help moisturize, nourish, and heal them. They may contain ingredients such as vitamin E, aloe vera, onion extract, or silicone that can help reduce inflammation, itching, or redness. Scar creams should be used regularly for several months to see the best results.
• Massage: This manual technique involves rubbing, kneading, or pressing the scars. It can help improve blood circulation, elasticity, and the appearance of the scars. It can also help relieve pain, stiffness, or numbness. To see the best results, it should be done gently for several minutes a day for several months.
• Laser therapy is a noninvasive procedure that uses a beam of light to target scars. It can help stimulate collagen production, smooth the texture, and lighten the scars’ color. It can also help treat scar complications such as infection, inflammation, or hypertrophy. Several sessions spaced several weeks apart may be required to see the best results.
• Microneedling is a minimally invasive procedure that uses a device with tiny needles to create micro-injuries in scars. It can help trigger the natural healing process, increase collagen production, and improve the texture and appearance of the scars. Several sessions spaced several weeks apart may be required to see the best results.

Breast augmentation scars are inevitable and permanent consequences of the surgery, but they can be minimized and improved with proper care and treatment. The patient should follow the surgeon’s instructions on how to care for the scars and use the appropriate treatments and products to reduce their appearance. By doing so, the patient can enjoy the results of breast augmentation without being bothered by the scars.

Yes, most breast implants come with a manufacturer’s warranty. The specifics of the warranty can vary depending on the manufacturer and the type of implant. Typically, warranties cover implant rupture or deflation for a certain period, often 10 years. Some warranties may also include coverage for capsular contracture or offer financial assistance toward revision surgery. It’s important to discuss the warranty details with your surgeon and review the terms provided by the implant manufacturer to understand what is covered and any additional costs that may be involved.

Breast implants can potentially cause pain years after the surgery, though this is not very common. Possible causes of late-onset breast pain include capsular contracture (a condition where scar tissue forms tightly around the implant), implant rupture or leakage, infections, or changes in the breast tissue due to aging or weight fluctuations. If you experience pain years after breast augmentation, it is important to consult with a board-certified plastic surgeon for an evaluation to determine the cause and appropriate treatment.

Breast implants are not designed to last a lifetime, and while some implants may last 30 years, most do not. Regular check-ups with your surgeon are recommended to monitor the condition of the implants and consider replacement or removal if there are any signs of rupture, leakage, or other complications.

Yes, this is a common procedure. Typically, this works best as an adjunct to improve cleavage or address small contour irregularities. Fat grafting alone as a reliable way to augment breast volume significantly is often not as successful or predictable as implant-based 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 will be able to cope quite well once they get used to this restriction. Due to this restriction, washing your hair is the most common issue, so we recommend getting help from a friend or family member. Dry shampoo products are also quite helpful.

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.

Getting breast implants does not directly cause weight gain. However, several factors related to the procedure might give the impression of weight changes. First, breast implants do add some weight to the body, depending on the size and type of implants chosen. For instance, silicone or saline implants can weigh a few pounds, contributing to a slight increase when you step on the scale. Additionally, after surgery, some patients experience temporary fluid retention or swelling, which can also lead to an apparent weight gain. Lifestyle changes following surgery, such as decreased physical activity during recovery, might impact weight as well. It’s important to maintain a balanced diet and exercise routine to manage overall body weight, even when considering cosmetic surgeries like breast augmentation.

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. Please check with your insurance provider for details before your consultation.

Breast augmentation is considered relatively safe when performed by a board-certified plastic surgeon. However, like any surgery, it carries some risks, including infection, bleeding, anesthesia complications, and implant-related issues such as rupture or capsular contracture. Choosing an experienced surgeon and following all pre-and post-operative instructions can help minimize these risks and improve the likelihood of a successful outcome.

Our office will provide you with instructions on how to prepare for your surgery. 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.

Breast implants are not designed to last a lifetime, but many can last decades or more without complications. The lifespan of implants can vary depending on factors such as the type of implant, surgical technique, and individual patient characteristics. Regular check-ups with your surgeon are essential to monitor the condition of your implants and determine if replacement or removal is necessary.

There are injectable treatments being used off-label to increase breast size in Canada. Dr. Pirani does not currently offer these off-label procedures as their safety and efficacy have not been established and do not yet meet his standards.

Whether breast augmentation is “worth it” is a personal decision that depends on your goals, expectations, and willingness to accept potential risks and costs associated with the surgery. After breast augmentation, many women report increased confidence and satisfaction with their body image. A thorough consultation with a board-certified plastic surgeon can help you weigh the pros and cons to determine if the procedure aligns with your desires.

Yes, an alternative to breast implants is autologous fat transfer, which involves using a patient’s own fat to enhance breast size and shape. This method offers a more natural look and feel but may not achieve the same level of augmentation as implants. Non-surgical methods like hormone therapy or injectable products are also alternatives, but their effectiveness varies. Discussing these options with a board-certified plastic surgeon can help you determine the best approach based on your desired outcome.

Cohesive breast implants, also known as “gummy bear” implants, are a type of silicone implant made of a thicker, more cohesive silicone gel that maintains its shape better than traditional silicone implants. This makes them less likely to leak if the implant shell is damaged. Cohesive implants are known for providing a more natural appearance and feel.

Natrelle breast implants are a popular brand manufactured by Allergan. They offer a wide range of implant options, including different sizes, shapes (round and anatomical), textures, and gel consistencies (standard and highly cohesive gummy bears). Natrelle implants are known for their high quality and safety standards and come with various warranty options. Patients can choose from a broad spectrum of styles to achieve their desired breast augmentation results.

Potential complications with breast implants include capsular contracture, implant rupture or leakage, infection, changes in nipple or breast sensation, implant displacement, and aesthetic issues such as asymmetry or rippling. In rare cases, breast implants have been associated with a type of lymphoma called BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma). It is crucial to discuss potential risks with your surgeon and have regular check-ups to monitor the condition of your implants.

Breast augmentation is the surgical procedure performed to enhance the size, shape, and volume of the breasts. Breast implants are the medical devices used to achieve this enhancement during the procedure. Implants can be filled with either saline or silicone gel and come in various shapes and sizes. In summary, breast augmentation refers to the overall procedure, while breast implants are the tools used to accomplish it.

This is always a difficult decision for some. Thehing 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. This is the best method for implant sizing. Your surgeon should be willing to spend the time with you doing this.

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 tell you 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, he may direct you to avoid wearing a bra to help your implants descend. In some cases, he may request that you wear an underwire bra.

When purchasing a new set of bras, choosing ones that fit well is important. Several specialized stores in Toronto cater to women who have had breast augmentation. Dr. Pirani and his team are more than happy to help you find the right bra after your procedure.

Breast implant sizes are measured in cubic centimeters (cm3 or cc). Most patients choose breast implants in the 250-400cc range.

It is a common misconception that breast implants must be replaced every 10 years. While breast implants are not lifetime devices and may need to be replaced at some point, there is no set timeline for replacement. Replacement is generally only necessary if there are complications such as rupture, leakage, or capsular contracture or if a patient desires a change in size or shape.

There is 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.

Breast Implant-associated Squamous Cell Carcinoma is a rare type of cancer associated with breast implants. It is important to investigate any changes in your breasts after breast augmentation with implants.

Capsular contracture is a complication of breast augmentation in which tissue around the implant becomes thick and tight, causing the breast to feel hard and painful.
How Do You Know If You Have Capsular Contracture?

Capsular contracture occurs when the scar tissue around the breast implant becomes hard and contracts, squeezing the implant. Symptoms can include firmness or hardening of the breast, discomfort or pain, changes in breast shape, and visible distortion. If you suspect capsular contracture, consult your surgeon for a proper diagnosis and potential treatment options, which may include medication or corrective surgery.

In general, patients will stay with us for a few hours before going home. Patients can stay overnight in one of our private 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.

Very low-impact exercise, such as slow walking, is highly encouraged for the first six weeks after surgery. However, to avoid complications, avoid anything high-impact during this period.

Right after surgery: You should start walking around right after your surgery. Do not do anything extreme or strenuous, but taking frequent, brief walks will improve your circulation and promote healing.

Six weeks later, You should be well enough to return to all of your normal exercise routines.

Dr. Pirani only offers general anesthesia procedures performed by a board-certified anesthesiologist. Our facility is fully accredited by the Canadian Association for the Accreditation of Ambulatory Surgical Facilities (CAAASF) and has been inspected by the College of Physicians and Surgeons of Ontario (CPSO). Our anaesthesiologists are staff at Toronto East General Hospital.

On average, the procedure takes 1 to 1.5 hours. Some more complex cases may take more time. If a mastopexy or breast lift is performed at the same time, the surgery can take up to 4 hours.

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.

Dr. Pirani usually uses absorbable sutures that do not need to be removed. In rare cases where a patient is prone to poor scarring, he will use non-absorbable sutures, which are usually removed seven days after the surgery.

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.

Yes—larger implants generally lead to more sagging (ptosis), which occurs earlier than smaller implants. They may also lead to increased thinning of your natural breast tissues and are more likely to decrease over time. Dr. Pirani finds that implants over 400 cc generally lead to increased complications over time, but this does vary according to body type and tissue quality.

Some surgeons will perform breast augmentations awake, but I do not. Most surgeons in North America do not offer awake breast augmentation surgery. While there may be a cost advantage to being awake, the safety and comfort of my patients are paramount. Accordingly, I prefer to have my patients asleep for breast augmentation surgery.

The pocket refers to the space created for the implant to be inserted. We have to create a space in which to place the implant—that’s the pocket.

Sleeping on your back is your best option in the early postoperative 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.

The literature indicates that there is a 15% chance of losing sensation to the nipple-areolar complex. However, the numbers are very high, and 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 nerve injury that provides 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.

Recovery really depends on several factors, the most important of which is adequate pain control. Individual pain tolerances differ greatly. 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, the surgeon or anaesthesiologist can do several things to decrease post-op pain.

I generally perform breast blocks prior to making any incisions with a mix of short- and long-acting local anesthetics. I have found this greatly reduces post-op pain. I also encourage patients to take the prescribed painkillers 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 sleeping in the first few weeks after augmentation due to the weight of the implants on their chest.

Slender patients with limited breast tissue can still be great candidates for breast augmentation with implants. Less soft tissue coverage increases implant visibility, rippling, and palpability risks. 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 achieve naturally appearing breast augmentation results. Discussing your aesthetic goals with Dr. Pirani is important so he can help you get the best aesthetic results.

Breast implants will eventually fail and/or rupture, as with any mechanical device. Fortunately, the newest silicone implant generation has 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.

Signs of a leaking breast implant depend on whether you have saline or silicone implants. With saline implants, a leak usually causes the implant to deflate noticeably, leading to a change in breast size or shape. Silicone implant leaks are often referred to as “silent ruptures” because the silicone gel tends to remain within the implant capsule, making it less noticeable. Symptoms of a silicone leak may include changes in breast shape, pain, swelling, or lumps. Regular MRI scans or ultrasounds may be performed to monitor silicone implants for silent ruptures.

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. Many women, however, 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 them.

The soreness of breast augmentation incisions can last from a few days to a few weeks, depending on the individual, the placement of the implants, and the surgical technique used. Most patients report that the discomfort decreases significantly after the first few days. Your surgeon will provide pain management strategies and detailed post-operative care instructions to help manage soreness during recovery. Incision itchiness is also usually a normal part of healing.

In the first few days following the surgery, the breasts may appear round and unnaturally high. The implants should drop and fluff out over the next few weeks to months to look more natural.

All of Dr. Pirani’s surgical patients receive detailed instructions on what to watch for in emergency situations that may arise after surgery. In case of an emergency, patients should call 911 or go to the nearest emergency department.

A breast lift, or mastopexy, is a procedure to lift and reshape sagging breasts, while breast augmentation is a procedure to increase the size and fullness of the breasts.

To reduce the risk of complications after breast augmentation surgery, follow your surgeon’s instructions for aftercare, avoid strenuous activity, and attend all follow-up appointments.

To care for your incisions after breast augmentation surgery, keep the area clean and dry, avoid soaking in water, and follow your surgeon’s instructions for wound care.

Yes, breast augmentation can be used to correct asymmetrical breasts, but it may require different-sized implants and/or a breast lift to achieve greater symmetry.

Breast augmentation can help correct asymmetry by using implants of different sizes or shapes to create a more balanced appearance. This is a common reason why patients seek breast augmentation.

Breast augmentation surgery can be performed on women who have stretch marks on their breasts, but it is possible that the stretch marks may increase after breast augmentation.

If you have a history of keloid scarring, you may still be a candidate for breast augmentation surgery, but you should discuss your options with your plastic surgeon.

Smoking can increase the risk of complications after surgery, so it is recommended that you quit smoking for several weeks before and after breast augmentation surgery.

It’s recommended to wait at least 5 to 6 months after finishing breastfeeding before undergoing breast augmentation. This allows time for your breasts to stabilize in size and shape, giving you and your surgeon a better idea of the final result. It also helps avoid a rare complication called a galactocele.

There is no specific waiting period required before getting pregnant after breast augmentation. However, waiting at least a few months is generally recommended to allow your body to heal. Pregnancy and breastfeeding can potentially affect the appearance of your augmented breasts, so it’s best to discuss your plans with your surgeon.

Breast augmentation and pregnancy are generally compatible as long as the surgery does not interfere with the normal development and function of the breasts. Some women may experience changes in their breast shape, size, or sensation during or after pregnancy with implants.

Some of the factors that may influence pregnancy with implants are:

• The size of the implant: Large implants may compress the breast tissue and affect the breast changes during pregnancy. They may also cause more stretching and sagging of the skin and tissue, which may affect the nipple position and function.
• The placement of the implant: Subglandular implants (over the muscle) may be more likely to affect the breast changes during pregnancy as they are closer to the breast tissue. Submuscular implants (under the muscle) may be less likely to affect the breast changes during pregnancy as they are farther from the breast tissue.
• The location of the incision: Periareolar incisions (around the nipple) may be more likely to damage the milk ducts and nerves as they involve cutting through the breast tissue. Inframammary incisions (under the breast fold) may be less likely to damage the milk ducts and nerves as they avoid the breast tissue.

Some of the changes that may occur in the breasts during or after pregnancy with implants are:

• Increase or decrease in size: The breasts may enlarge or shrink due to hormonal changes and milk production during pregnancy and breastfeeding. This may make the implants more visible or palpable or create a gap or overlap between them and the breast tissue.
• Sagging or drooping: The breasts may sag or droop due to the weight and volume changes of the breasts and the implants, as well as the loss of skin elasticity and tissue support. This may make the breasts look deflated or uneven or lower the nipple position.
• Changes in sensation: The breasts may become more or less sensitive due to the nerve stretching or compression caused by the implants and the breast changes.

Some of the treatments or solutions that may help with the changes in the breasts during or after pregnancy with implants are:

• Revision surgery: This is a procedure that can correct or improve the appearance or function of the breasts during or after pregnancy with implants. It may involve replacing or removing the implants, adjusting the implant position or size, or performing a breast lift or reduction.
• Non-surgical treatments: These are methods that can enhance or restore the shape or size of the breasts without surgery. They may include exercises, massages, creams, or supplements. However, they may not be very effective or reliable and may have side effects or interactions.
• Acceptance and support: This is the attitude that can help the patient cope with the changes in their breasts during or after pregnancy with implants. The patient should remember that the changes are normal and natural and that they do not affect their beauty or worth. The patient should also seek support from their partner, family, friends, or professional and celebrate their achievements and experiences.

Breast augmentation and pregnancy are not mutually exclusive, and many women can have both without any problems. However, they may also face some challenges or changes and should be prepared and informed about them. By consulting with a qualified and experienced plastic surgeon and following their advice and instructions, the patient can help ensure a safe and satisfying breast augmentation and pregnancy.

If you have already gone through a breast augmentation or are wondering how a future augmentation could be affected by pregnancy, we can help.

Breast implants and breastfeeding are generally compatible as long as the surgery does not damage the milk ducts, nerves, or glands. However, the type, size, and placement of the implant and the location of the incision may affect the ability and amount of breastfeeding. Some women may experience changes in their breast shape, size, or sensation after breastfeeding with implants.

Some of the factors that may influence breastfeeding with implants are:

• The size of the implant: Large implants may also compress the breast tissue and reduce the milk supply or output. They may also cause more stretching and sagging of the skin and tissue, which may affect the nipple position and function.
• The placement of the implant: Subglandular implants (over the muscle) may be more likely to affect the milk ducts and glands as they are closer to the breast tissue. Submuscular implants (under the muscle) may be less likely to affect them as they are farther from the breast tissue.
• The location of the incision: Periareolar incisions (around the nipple) may be more likely to damage the milk ducts and nerves as they involve cutting through the breast tissue. Inframammary incisions (under the breast fold) may be less likely to damage the milk ducts and nerves as they avoid the breast tissue.

Some of the changes that may occur in the breasts after breastfeeding with implants are:

• Loss of volume or fullness: The breast tissue may shrink or deflate after breastfeeding, making the implants more visible or palpable.
• Sagging or drooping: The skin and tissue may stretch or loosen after breastfeeding, which may make the breasts sag or droop.
• Changes in sensation: Surgery or breastfeeding may affect the nerves that supply the breast or the nipple, causing numbness, tingling, pain, or hypersensitivity.

Some of the treatments or solutions that may help with the changes in the breasts after breastfeeding with implants are:

• Revision surgery: This is a procedure that can correct or improve the appearance or function of the breasts after breastfeeding with implants. It may involve replacing or removing the implants, adjusting the implant position or size, or performing a breast lift or reduction.
• Non-surgical treatments: These are methods that can enhance or restore the shape or size of the breasts without surgery. They may include exercises, massages, creams, or supplements. However, they may not be very effective or reliable and may have side effects or interactions.

Breast implants and breastfeeding are not mutually exclusive, and many women can successfully breastfeed with implants. However, they may also face some challenges or changes and should be prepared and informed about them. By consulting with a qualified and experienced plastic surgeon and following their advice and instructions, patients can help ensure a positive and satisfying experience.

Yes, it is possible to remove or replace breast implants. Some women may choose to have their implants removed or replaced due to personal preferences, changes in their lifestyle, or to address complications. Your surgeon can discuss the options available and help you make an informed decision based on your individual circumstances.

Breast implants can last decades. However, they are not permanent and will eventually need to be replaced.

The “safest” breast implant can vary depending on individual factors such as body type, lifestyle, and personal preferences. Generally, silicone implants are considered safe and are preferred for their natural feel and appearance. Saline implants are also safe and are preferred by some patients because they contain a sterile saltwater solution that the body can absorb safely in case of a rupture. Cohesive silicone gel implants, or “gummy bear” implants, are considered safe because they tend to maintain their shape even if the outer shell is damaged. Discussing your options with a board-certified plastic surgeon is essential to determine the safest choice for you.

Gummy bear implants are a type of cohesive silicone gel breast implant that is thicker and more form-stable than traditional silicone implants. They are named for their consistency, which is similar to gummy bear candy. Gummy bear implants are designed to mimic the breast’s natural shape, particularly in anatomical or teardrop forms. They are less likely to fold or ripple, providing a natural look and feel.

Mentor manufactures Mentor MemoryGel breast implants, including 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.

Profile refers to the projection forward from the chest. Generally, high-profile implants have more projection, creating more roundness. These tend to create more of a “done” look and can look less natural. Low-profile implants have less projection, creating a more subtle appearance. There are also moderate, full, and moderate-plus profiles that create varying amounts of projection or fullness. The choice depends on your anatomy and the desired outcome. Dr. Pirani and his team will help you wchoose the right implantfor you.

The main difference between smooth and textured breast implants is the surface of the implant. Smooth implants have a smooth surface, while textured implants have a rough surface.

Textured implants are thought to be less likely to develop capsular contracture, a hardening of the scar tissue around the implant. However, they are also more likely to cause BIA-ALCL, a rare type of lymphoma.

The best type of implant for you will depend on your individual circumstances.