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Breast Implants and Augmentation Surgery

Breast Implants and AugmentationBreast implant and augmentation surgery is a huge decision for any woman to contemplate. In my experience, the top questions women have are divided into medical issues and practical issues. On the medical side, women need to know if breast implants are safe, if leakage is common and/or dangerous and if breast implants will have side effects such as interfering with breast feeding or cause diseases in the future. On the more practical side, women in my Toronto breast implants practice commonly ask about costs, back to work issues and need for future revisions. If you are a woman considering breast augmentation surgery, please arm yourself with the knowledge required to make an informed decision. The articles I have written on the topic are based on the information that I believe all women should know prior to undertaking this procedure. Please take some time to read them and direct questions to Dr. Backstein using our quick contact forms or calling us.

Preparation for Breast Implants Surgery

Preparing for breast implants surgery involves mental preparation, a review of your current medications and vitamins, and following standard pre-operative instructions.

Mental preparation for breast implants surgery is key to a pleasant post-operative recovery. It is important to understand that you are undertaking a very commonly performed procedure and that Dr. Backstein will have screened you pre-operatively to ensure you are a safe candidate for the procedure. Furthermore, breast augmentation by its nature is a safe procedure since the surgical work is carried out in a superficial plane of the body well away from large blood vessels or major organs. The chest cavity is never entered and bleeding is minimal and easy to control.

It is equally important to understand that immediately post-operatively your breasts will look somewhat larger and less natural than they will several weeks post-op. In particular, swelling can give the appearance that the breast implants are high on the chest whereas in reality, this look is simply a result of swelling which has a tendency to accumulate in the upper portion of the breast implant pocket. This look will resolve soon after your breast augmentation surgery. Make sure you review any medications and vitamins at least two weeks prior to your surgical date. Medications such as anti-inflammatory drugs, blood thinners/anticoagulants and vitamin E products should be discontinued completely for at least two weeks prior to breast implant surgery in order to minimize the risk of extra bleeding during or after surgery. Multi-vitamins may contain vitamin E and should be stopped if vitamin E is present. Finally, be sure not to eat or drink anything at all from midnight of the day before your breast implant surgery so as to enter the operating room with an empty stomach.

Exercise and Sex After Breast Implants

After undergoing breast implants surgery, Toronto breast implants surgeon, Dr. Robert Backstein suggests patients wait 4-6 weeks before engaging in significant exercise or sexual activity. This wait is intended to reduce the possibility of post-operative complications and to optimize the healing of the breast augmentation scar. If the chest area is stressed too early after surgery by either exercise or sexual intercourse, bleeding may start within the breast implant pocket leading to a hematoma. Furthermore, stress to the breast region can place undue forces on the breast implant incision which could ultimately lead to poor scarring or, in the worst case scenario, opening of the incision. As Toronto breast implants surgeon, Dr. Robert Backstein sees you for your post-operative visits, he will give you updates on when exercise and sex may be started.

Am I Too Young for Breast Implants?

A frequent question asked by the younger female seeking breast augmentation is: how young is too young? Dr.Backstein, Toronto breast implants specialist, suggests that patients need to have reached an age at which breast development must be complete prior to undertaking breast augmentation. Breast growth generally ceases around the age of 19 years but may continue for some time thereafter.

Dr. Backstein will ask individual patients for their own opinion as to whether they feel their breasts have stabilized in terms of growth but usually will not advise breast implant surgery prior to 19 years old. It is also important for individual patients to feel confident that their present wishes for their body will be maintained throughout their adult life. While breast implants can be removed later in life, permanent changes to the shape and form of the breast will be evident including loss of perkiness and a somewhat ptotic (sagging) look. Therefore, it is not wise for a younger woman to believe that implants put in now can simply be removed later.

Nipple Sensitivity After Breast Implants

Nipple sensitivity can be reduced by breast augmentation but this decrease in sensation of the nipple/areola should resolve with time. An exception is if the areolar incision was used.
When a breast implant is placed in the breast pocket, the sudden stretching of the breast tissue, breast skin and its associated nerves can cause the nerves to go into a temporary state of dysfunction. This results in a numbness over the entire breast, including the nipple and areola.

Over several weeks or months, as the breast tissue and nerves accommodate to the implant, the nerves will begin to function again and sensation will return to both the breast itself and the nipple/areola. Before full sensation recovers, many patients experience a feeling of pins-and-needles in the breast skin followed by complete recovery of normal feeling and sensation. In the case of breast implants done using an areoalr incision, the surgical cut itself and its associated scar tissue can impair the function of the local nerves and cause some loss of sensation to the nipple and areola that may be permanent. Toronto breast implants surgeon, Dr. Robert Backstein will explain these issues in detail during your consultation.

Breast Implants & Breast Cancer

Whether or not breast implants increase a woman’s risk for breast cancer has been studied extensively. These studies are conclusive and the answer is that breast implants do not increase cancer incidence or delay detection. There is, in fact, some evidence that the incidence of breast cancer is actually reduced in woman who have had breast augmentation surgery although the reasons for this are not clear, and certainly no woman should regard breast implants as protection against breast cancer. It remains crucial for every woman who has undertaken breast augmentation surgery to adhere to current recommendations for breast cancer screening and breast self-exam techniques after breast implants surgery. Furthermore, make sure that all medical professionals involved in your primary care and mammogram tests are fully aware of the fact that you have had breast augmentation surgery.

Where are Breast Implant Incisions Made?

Breast Implants have traditionally been inserted into the implant pocket via three incisions: axillary, peri-areolar, and inframammry fold. The axillary (armpit) incision is considered by many surgeons to be more technically difficult than the other two incisions since the incision site is located farther from where the implant pocket is to be created and the surgical dissection may require the use of an endoscope. This had led to a higher incidence amongst many breast augmentation surgeons of some degree of asymmetry between the two breasts in the final result. Quite a few breast augmentation surgeons have abandoned this technique for this reason. Furthermore, the proposed advantage of the axillary incision which is that no incisions and therefore no scars are left on the breast can sometimes be negated by the discomfort that some women feel about having potentially visible scars on both armpits which can be seen by the public when wearing sleeveless dress and shirts. There is also an increased theoretical risk of infection of the breast augmentation procedure when using the axillary incision since the breast implant makes contact with the axillary skin which may harbor invisible germs even after a full surgical antiseptic cleaning of the area.

The peri-areolar incision is made at the border of the areola and breast skin from around the 3 o’clock to the 9 o’clock positions along the areola. When using pre-filled gel implants, many women have areolas that are simply too small in circumference to allow for use of this incision. The breast implants cannot be inserted through this incision without putting undue stress on the areolar skin which can traumatize the area and lead to sub-optimal scarring. This incision also carries the highest risk of permanent loss of nipple sensitivity and breast feeding issues. The inframammry fold incision is made at the base of the breast and is by far the most popular incision since it makes the breast implants surgery technically more easy to perform perfectly, and carries negligible risk of nipple desensitization or breast feeding issues. In general, pre-filled breast implants (gel) will require an incision that is slightly longer than the incision used for saline breast implants which are filled once the implant has already been inserted into the breast implant pocket.

Breast Augmentation Post-Op Care

  • 1

    Leave your dressings on and dry until your first follow up appointment

  • 2

    Expect swelling - especially at the upper part of your breasts

  • 3

    If you feel that one breast has suddenly become significantly more swollen, painful, hard and tender compared with the other, contact Dr. Backstein

  • 4

    Bring a bra to your first check up (one without an underwire such as a sports bra)

  • 5

    Contact Dr. Backstein at if you have significant concerns

  • Is it comment for breast implants to rupture and leak?
  • Breast implant rupture and leaking is very uncommon and has essentially been eliminated with the advent of cohesive gel breast implants. Saline (salt water) implants will leak if the implant shell is damaged or if the fill-valve at the back of the implant fails. This will result in a deflation of the affected implant and a dramatic asymmetry requiring implant replacement. Silicone cohesive gel implants are prefilled with material of the same consistency as jello or a gummy-bear and have no fill-valve. As such leaking or deflation of these breast implants is essentially unheard of.

  • How long after my breast augmentation surgery should I wait before I wear a bra?
  • Dr. Backstein, Toronto breast augmentation specialist recommends the use of a sports bra for the first 6 weeks post-operative. A sports bra is will give excellent support, help decrease swelling and is easy to put on and take off. A bra with an underwire should not be used for the first 6 weeks post-op after breast implants surgery. An underwire can irritate the surgical incision in the case of a breast fold incision and can also cause an unsightly indentation at the bottom of the breast that can be persistent. Six weeks post-operative, any type of bra can be worn according to patient preference.

  • What happens if breast implants are removed?
  • The consequences of removing breast implants depends on several factors including the age of the patient, the size of the implants removed and the length of time the implants were in. Typically with removal of implants, the breast will take on a looser, more pendulous and ptotic (sagging) appearance. This is due to the stretching of the elastic fibers within the breast tissue that occurs after breast implant insertion that cannot be restored after removal of the implants. The look of breasts after implant removal is similar to that of a woman who has gone through pregnancy and/or breast feeding. In general, this effect will be more extensive and problematic in older patients, patients who have had larger size implants, and patients who have had the implants for longer periods of time.

  • Can I fly after breast augmentation surgery?
  • Patients can fly after breast augmentation surgery. Pressure effects on the implant are theoretical only and in reality have no effect on the breast implant itself or the outcome and results of the breast augmentation surgery.

  • Is Breast Augmentation Covered by OHIP?
  • Breast augmentation is not covered by OHIP when done for aesthetic purposes. Dr. Backstein, a Toronto breast augmentation specialist also performs breast implant surgery for breast reconstruction following mastectomy for breast cancer and for cases of extreme congenital disorders of breast development. In these cases the breast implant surgery will be covered by OHIP.

  • Do breast implants cause stretch marks?
  • Breast implants do not frequently cause stretch marks but the possibility exists that this will happen. It is far more likely that breast implants will cause stretch marks if a larger size implant is used in a patient with minimal breast tissue to start with since it is more difficult in these cases for the skin to accommodate the new implants. Toronto breast implants surgeon, Dr. Robert Backstein will assist patients in choosing a size of implants that will minimize the risk of stretch marks forming.

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