About Breast Augmentation
Breast augmentation is a very common plastic surgery procedure that enhances your natural breast size and shape, or replace volume that’s been lost with age, weight loss, pregnancy, or breastfeeding.
Commonly asked questions about Breast Augmentation
Before undertaking any procedure, you will want to be confident in your knowledge. Find the details on Breast Augmentation here.
1. What is a breast augmentation?
A breast augmentation is a very common plastic surgery procedure that enhances your natural breast size and shape, or replace volume that’s been lost with age, weight loss, pregnancy, or breastfeeding.
2. Who is a candidate for breast augmentation?
Generally, anyone who is in reasonably good mental and physical health can be candidates for breast implants. However, you are likely not a good candidate for this surgery if:
- You’re pregnant or breastfeeding.
- You have breast cancer or an abnormal mammogram.
- You’re ill or battling an infection.
- You have unrealistic expectations for post-surgery results.
- You’re under the age of 18.
- Most surgeons prefer that you do not smoke.
3. What are the types of implants?
Saline breast implants: Saline breast implants are filled with saline water. They offer a firm feel to the breast.
Silicone breast implants: Silicone breast implants have silicone gel in them. In terms of consistency, they feel like fat. Most women feel that these implants give them a natural feel of the breast tissue.
Gummy bear breast implants: Gummy bear implants, also known as form-based implants, are a type of silicone breast implants. The consistency of the silicone gel inside the implant is thicker than traditional silicone gel implants. These implants are also firmer than traditional implants.
Round breast implants: Round breast implants are more likely to make the breasts appear fuller than form-stable implants.
After deciding to go for any of the above implants, you will also have to look for the type of outer shell you want the implant to be in:
4. Saline vs Silicone?
- Saline breast implants have been around for longer
- Often less expensive than silicone
- The incision required for saline breast implants is often smaller than that used for silicone breast implants – meaning that scarring is minimal
- They can be tailored to your body more easily, and can be altered without the need to remove them
- The solution that fills the implant can be safely absorbed by the body should a leak or rupture occur
- Saline implants may be more easily seen under the skin and are more prone to show ripples (exceptionally thin patients or those with a small amount of natural breast tissue may be better served by silicone implants)
- You may feel water sloshing
- Some people say that the saline implants feel more firm than natural breast tissue
- Silicone implants more accurately mimic the look and feel of natural breast tissue
- Less likely to result in dimples or wrinkles on the surface of the skin
- Many more options for size, profile and shape
- 70% of women choose silicone implants
- More expensive
- The FDA recommends that women with silicone implants get routine MRI scans every 2 to 3 years to monitor for possible ruptures (it is completely up to the patient to honor this recommendation) – this recommendation does not apply to saline
- Potentially larger incision and scar than saline implants
5. What type of implant is right for me?
This depends upon your age, the type of look you desire, the cost of implants, the reason for getting the implants (such as post cancer surgery, volume loss, etc.) and the maintenance required for the implants.
(example: If your primary concern is making sure that your breast augmentation looks and feels natural, silicone implants are likely the right option for you).
When making your decision with your surgeon the following should be considered:
- Body shape and size
- Existing (or natural) breast size and shape (breast anatomy)
- Desired look and feel – natural or fake, soft, medium, or hard
- Amount of sagging or drooping (ptosis) of existing breasts
- Amount and integrity of natural breast tissue
- Lifestyle and physical activity
- Likelihood of future pregnancy and breastfeeding
6. Implant placement: over or under the muscle?
The positioning of the implant in the breasts can affect how it looks and feels. So, this depends on your desired look.
Placing the implants under the muscle usually creates a softer, more natural feel with both saline and silicone implants. This is often recommended for those with little to no existing breast tissue present as the extra layer of muscle will help limit implant visibility.
Placing the implant over the muscle, however, can be a viable option for women with adequate breast tissue present, and especially if there is extra skin (implants may look more natural using this technique). Additionally, patients typically experience an easier recovery since there is often less pain and a faster healing time. Your surgeon may recommend silicone implants with over the muscle placement, since they do not show rippling like saline can.
7. Is one type of implant safer than the other?
Both saline and silicone implants are generally considered safe if your breast augmentation surgery is performed by a reputable, board-certified surgeon. Although, some believe that saline implants are safer because if the implant ruptures, most of the salt water will reabsorb into the body. Many people think that silicone implants look and feel more natural, however, they do pose more of a risk if they rupture.
While the research on this is mixed, some studies have seen a correlation between silicone implants and autoimmune diseases. Both saline and silicone implants have silicone shells, so if you have an autoimmune disorder, you may want to avoid implants entirely or opt for saline.
As well, smaller implants generally have less complications than larger ones.
8. What happens if the implant ruptures?
Saline: You’ll likely notice a saline rupture right away because the breast will look and feel deflated saline is sterile and will be reabsorbed by the body. You’ll likely need surgery to remove the silicone shell. During the removal surgery, the doctor can add a new implant.
Silicone: Silicone ruptures are more difficult to detect, as the silicone can get trapped in the fibrous capsule that forms around the implant after surgery. This is sometimes known as a silent leak, but you may notice a slight change in breast size or feel a hardness. If left alone, leaking silicone can cause breast pain or cause the breasts to change shapes. You’ll need surgery to remove ruptured implants, during which a new implant can be inserted if desired.
9. How long do the results last?
The FDA recommends replacing breast implants every 10 years, however studies have shown that only
one out of five patients needed a replacement or revision after 10 years. Patients who do not experience issues with their implants can safely go beyond 10 years, and surgeons may advise that it is not necessary to change them at all.
Most patients only have 1-2 replacements in their lifetime, and this can be for various reasons, for example you may elect to replace your implants due to weight gain or loss, pregnancy, breast-feeding, change in desired look or size, or more specific medical reasons such as rupture.
Breast implant ruptures are rare in the first few years, but the risk does increase over time (rupture risk usually increases after 6-10 years). It’s reported that in the modern type of silicone gel implant, less than 3% of implants will “fail,” as in rupture or deflation. On average, breast implants last about 15 years before potential rupture.
10. What happens during consultation?
Usually, your surgeon will measure your chest and breast size, as well as your height and weight. These measurements will be used to recommend the right implant to fit your existing proportions, a method known as Dimensional Breast Augmentation. You will also be given an opportunity to look at, feel and try on samples of the various implants available to you (known as breast implant sizers). Many surgeons also offer 3D imaging, so you can virtually see the results of different implant sizes and projections. Then they’ll make their recommendations for the surgery (including incision locations), make sure you understand the risks, and give you a run-down of the recovery process and timeline. Most surgeons also require a pre-surgery mammogram.
11. How is a breast augmentation performed?
There are a few different options, but the procedure is most commonly performed with breast implants. Your surgeon will help you determine the best size, type, incision location, and placement for your body and desired outcome. After being placed under anesthesia, your surgeon will start by making an incision around the nipple, in the fold under your breast, or in the armpit. Then your implants with be placed in a pocket, either above or below your chest muscles. The incision is closed with internal stitches, and the skin is closed with stitches, skin adhesive, or surgical tape.
Another type of breast augmentation enhances your breast size using your own fat. This is performed via breast fat transfer, where your surgeon removes excess fat from one area (like stomach or thighs) via liposuction and then injects the fat after it’s purified into the breasts. You cannot get as much enhancement as you can with an implant – in general, you will only be able to achieve a volume increase of 1-2 cup sizes and results are less predictable (asymmetry is possible if more fat survives on one side – only about 50-70% of cells survive the transfer). Because of the additional cost of liposuction, breast fat transfer is usually more expensive than breast augmentation with implants. Fat transfer breast augmentation carries a lower risk of impacting your ability to breastfeed, provided you’re not also having some kind of nipple surgery.
12. How long does breast augmentation surgery take?
The whole surgery takes about 1-2hrs and does not require an overnight stay in the hospital, although you can elect for one.
13. Do you have to go under anesthesia for breast augmentation?
Yes, the surgery can be done under local anesthesia, where the patient remains awake and only the breast area is numbed to block the pain, or under general anesthesia, where the patient is put to sleep and is unable to feel pain. Most women receive general anesthesia for this surgery.
14. What is the recovery like after surgery?
Your breasts will be covered with gauze after the surgery. You may have drainage tubes for up to two weeks and removed at a follow-up appointment. You will need to wear a surgical bra as you heal to provide support, minimize swelling, speed up recovery time, and help make you more comfortable as you heal.
The more you rest in the first 2 weeks, the quicker you will tend to recover and heal (most people require about a week of recovery time). You’ll need to hold off on sex for about two weeks, vigorous activity like running for about four weeks, heavy lifting for up to six weeks, and you may also need to sleep on your back for about six weeks to prevent implant deformation – depending on your surgeon’s recommendations.
Over-the-counter pain relievers such as acetaminophen may help relieve discomfort. Your doctor may also prescribe pain medication for you.
You will probably have some swelling in the area where the surgery was done. Over time, the swelling should ease, and the scars will fade.
15. How long does it take for breast implants to “settle” and reach their “final” appearance after surgery?
Immediately after getting breast augmentation, patients experience an inflammatory process that causes swelling of the tissues combined with tightening of the chest muscles. This can give the breasts a tight appearance that may include breasts looking higher, smaller, and wider apart than they actually are. In general breast implants should “settle” within 6 weeks-3 months – one breast may settle before the other. This is normal and is nothing to be concerned about. Plastic surgeons sometimes call this “dropping and fluffing”. The breast implants drop into a lower position on the chest and expand in size as the pectoral muscle and breast tissues place less pressure on your implant.
16. How much do breast augmentation surgeries cost in Canada?
The cost of breast augmentation depends on things like geographic location, surgeon/surgeon experience, and type of implant used. Typically, breast augmentation surgery cost ranges from $5,000 to $10,000 and on average silicone gel implants are roughly $1,000 more than a comparable saline implant.
17. What are the risks of a breast augmentation?
While the majority of breast implant operations go smoothly, there are risks associated with the procedure such as:
- Scar tissue that distorts the shape of the breast implant (capsular contracture)
- Breast pain
- Changes in nipple and breast sensation
- Implant position changes
- Implant leakage or rupture
- Future breastfeeding complications – you should still be able to safely breastfeed with implants, but any breast surgery (and specifically the incision around the nipple) can potentially damage milk ducts, so there is a risk of insufficient milk production
18. Is a breast augmentation worth it?
4,438/4,587 people who have undergone a breast augmentation with implants have rated the procedure “worth it” (97%).