Dr. Emad M. Guirguis
Breast Augmentation Toronto
Recovering from Your Breast Augmentation Surgery
Welcome to La Fontaine Source De Jeunesse Cosmetic Surgery Centre in Toronto near Yonge and Bloor. We take pride in providing years of excellence in performing breast augmentation and breast enlargement surgeries. We understand that there is more to breast augmentation than simply changing the size of your breasts. There are other considerations to keep in mind when doing this procedure including shape, nipple placement and of course…cleavage. We want to make your breasts as beautiful as they can be.
Are You a Good Candidate for Breast Augmentation?
Before undergoing any type of cosmetic procedure, it is vital that you understand everything involved in breast augmentation in order to maintain realistic expectations for the procedure. You must be honest with yourself about why you want this procedure done. Though breast augmentation and breast implants can enhance the appearance of your breasts, there are limitations of the surgery and its effect on your life. Never consider undergoing breast augmentation because of someone else; decisions to make cosmetic changes to your body should only be done by and for yourself.
Several common reasons for breast augmentation include:
- Reconstruct breasts after breast cancer treatment
- Improve self-esteem
- Increase breast size and change shape
- Improve breast symmetry
- Add lift to sagging breasts (usually due to pregnancy or breastfeeding)
Women who are pregnant, breastfeeding, have had previous radiation therapy or infection, or are under the age of 18 should not undergo breast augmentation.
Patients who have undergone breast augmentation range between the ages of 18-67, with average original breast sizes ranging from 225-980 cc’s. Their breast implant surface is typically 95% smooth.
What to Expect During Your Consultation
Your breast augmentation journey starts with a complimentary consultation with one of our qualified professionals. In this consultation, you will be given a full assessment of what you can expect during your stay with us. We ensure that your goals are discussed and understood and a full health background check is established. All of your questions about the facility and the procedure can be answered during this consultation. You will also be informed of the costs of your procedure and have the opportunity to discuss payment options.
Your second visit with us is where you will meet with the doctor (cosmetic surgeon). In this meeting you will discuss your personalized goals and desires and the doctor will discuss the procedure and recovery process.
Please contact us to set up your complimentary breast augmentation consultation today!
Below is a sample of breast implant and breast after photos from our patients.
Different Breast Augmentation Techniques
Different methods of breast augmentation can lead to less scarring and bleeding, as well as affect the overall appearance and feel of the transplant. The most common technique is trans-axillary breast augmentation where the incision is made through the armpit to eliminate any scarring on the breasts. This technique has many benefits, however, to increase the risk of capsular contracture after surgery it is best to decrease the risk of bleeding during and after surgery.
Bloodless Breast Augmentation
One technique that can help with the problem of capsular contracture is bloodless breast augmentation. This technique involves having the incision done either in the breast fold or the areola. During the surgery special instruments are used to cauterize or heat blood vessels to stop them from bleeding.
Several benefits of bloodless breast augmentation are:
- Significantly less bleeding
- Decreased trauma
- Less pain
- Less swelling and bruising.
Inserting Your Breast Implants: The Keller Funnel Method
Our plastic surgeons at La Fontaine Cosmetic Surgery Clinic employ the Keller Funnel method for safely inserting your breast implants, keeping them sterile and allowing for faster delivery into the breast pocket. By using the revolutionary Keller Funnel, your surgeon decreases contact with the implant, which minimizes health risks, and can perform your breast augmentation or lift with a smaller incision, allowing for better recovery.
The Keller Funnel is made of a transparent and flexible polymeric film with a lubricated hydrophilic coating inside, which facilitate ease of implant placement. There are 4 simple steps in using a Keller Funnel for breast augmentation:
Trim the funnel to make sure that the breast implant is delivered accordingly, based on its size and shape.
Hydrate the funnel with sterile solution, which allows the implant to move from the funnel to the breast pocket with ease.
Load the breast implant into the Keller Funnel.
Propel the funnel to the right direction in order to achieve correct placement of the breast implant.
When you elect to undergo a breast augmentation at our cosmetic surgery clinic in Toronto, you can trust that our surgeons use the Keller Funnel method to ensure the safety of the procedure and top condition of your implants. The result is a faster procedure and a speedy, hassle-free recovery, thanks to small incisions made possible by this revolutionary technique.
Transferring Fat for Breast Augmentation
If patients prefer not to have breast implants, a safe option would be to transfer fat from another part of the body into the breasts. This method serves to increase and alter breast size, as well as remove undesired fat from another area of the body. However, the results of breast augmentation through fat transfer will lead to a less dramatic result than an implant. The breast size is typically increased up to one cup size. Nevertheless, one’s own fat is softer and more natural looking than an implant. Before undergoing this type of surgery, it is necessary for potential patients to be examined to see if fat transfer is appropriate. Removing fat from another area of the body may be harmful to some patients with less fat deposits. Doctors will advise patients on what the most appropriate technique of breast augmentation would be for their body type.
The benefits of transferring fat for breast augmentation are:
- Use of a natural resource so no new additives are presented to the body
- Removes unwanted fat from an area of the body
- Results look more natural
- Breasts are left softer
- Fast recovery
- Provides a slighter, natural enhancement as opposed to a dramatic, fake one
- Safer method for breast reconstruction
It is important that candidates for fat transfer breast augmentation be in good health. Further, their breasts should already be in a desired shape with elastic skin. The procedure first begins with liposuction from an area with large amounts of fat, such as the thighs or abdomen. Fat cells remain intact during liposuction for fat transfer. The fat is then prepared for injection into the breasts. Once the fat has been injected into the breasts, there may be swelling and minor soreness for a few weeks after the procedure. The results of breast augmentation by fat transfer are permanent.
Possible risks of this technique include the risks that come with liposuction and sagging. A small percentage of the fat cells either die or are absorbed by the body, which is normal. Undergoing surgery by an experienced and knowledgeable surgeon will ensure that results are satisfactory.
More on breast augmentation through fat transfer can be discussed during a consultation at our office.
Placement of Incisions
The average length of incisions is between 3- 4 cm, but the length of the scar will depend on the implant and incision technique being used. Silicone breast implants require smaller incisions than saline implants. In addition, some patients may be prone to post-operative scarring than others.
Incisions for breast augmentation can be done in four areas:
- Armpit, called trans-axillary breast augmentation
- Areola, called peri-areolar breast augmentation
- Breast fold, called infra-mammary breast augmentation
- Navel, called trans-umbilical breast augmentation
For augmentations done under the chest muscle, incisions in the armpit are best and result in no scarring on the breasts.
Those who do not have a well-defined breast fold are best suited for an areolar incision. The incision is made near the lower part of the areola where the skin is dark. This helps to conceal the scar. This technique can be used to place breast implants either over or under the chest muscle and is suitable for bloodless breast augmentation. Furthermore, the location of the areola helps doctors to have a clear view during surgery. However, there are some disadvantages to this technique. Making an incision on the areola will make the scar more visible and some sensory and milk-producing glands will be cut during the procedure.
Incisions done through the breast fold allow direct access to the chest muscle during surgery. Also, this technique is compatible with bloodless breast augmentation, no breast tissue is cut during the procedure and the scar under the fold is less visible for those who have larger breasts.
Incisions can also be made through the navel to eliminate scars on the breasts. During this procedure, an incision is made inside the navel and a tube is then inserted and maneuvered toward the breasts. Only saline breast implants can be implanted using this technique. The saline implant is folded up and inserted into the breasts through the tube. However, this technique is not preferred because it is very difficult to prevent bleeding and provide precise placement of the implants.
Engaging in vigorous physical activity after breast augmentation surgery can reopen incisions and delay healing of wounds. To ensure the best possible outcome and prevent unnecessary scarring, it is crucial that patients follow the post-operative care instructions given by doctors. Doctors can provide patients with ointments and treatments to minimize scarring.
Preparing for Your Breast Surgery
While virtually any woman can undergo breast augmentation surgery, the best candidates for a La Fontaine breast augmentation surgery are small-breasted women with a minimal amount of sagginess. However, different problems related to the size or shape of breasts may be corrected through other techniques such as mastopexy or breast reduction.
La Fontaine Cosmetic breast augmentation surgery is usually done under general anaesthetic on an out-patient basis at our Toronto clinic. There is normally no need to stay overnight. We insert an inert, saline-filled prosthesis into a pocket created behind the breast through a small incision, about 1 inch long, usually around the bottom of the aureole (nipple).
If you require more information about breast augmentation or implants, please call La Fontaine Medical Group to arrange a private consultation at no charge.
Before and after undergoing breast augmentation, there are several phases that will take place.
Two weeks before your procedure, it is crucial that you stop taking any blood thinning medications or supplements such as painkillers and stop smoking so that your body is able to produce and transport sufficient oxygen and blood for a healthy recovery.
It is also important to make sure you have designated transportation to take you home after the surgery.
A week before your surgery it is best to not consume alcohol and to monitor your health for any infections that need to be treated. Optimal health is recommended when undergoing any cosmetic procedure.
The day before your surgery you should pack a bag with loose clothing to wear after the procedure is done. You may wear a sports bra after the procedure. You must have nothing, including water, in your stomach 8 hours prior to the surgery.
On the day of the procedure you should shower using basic soap and water. If you are undergoing a trans-axillary procedure then shave your armpits. Do not apply body lotions of antiperspirants prior to the procedure. Also, do not use hair conditioners or hair sprays.
Talk to our doctors about prescribed medications that you may need to take.
Arrive early to get comfortable and ensure a smooth procedure.
A nurse will contact you 2- 3 days before the procedure to give you detailed instructions.
What Size Should I Choose?
Breast implant sizes are measured by volume using cubic centimeters (cc’s). Larger implants mean more volume and further projection from the chest wall. When deciding what breast size to choose, bear in mind that every woman’s body type is different and this affects how the implants will look. Therefore, two women may have the same sized breast implants, but each procedure will yield a different result. Before getting the procedure done, you will need to first decide: How big do you want your breasts to be? How perky would you like them to look? What shape would you like them to have? Where on your chest would you like them to sit? How would you like your cleavage to appear and where do you desire for your scar to be?
A consultation is done to help you better answer these questions. Breast implants volume sizing charts can help you better compare sizes, as well as many before and after pictures of previous patients who have undergone breast augmentation for you to compare body type and final results of the procedure.
Bigger breast implants usually give a more false and exaggerated look, which can also be problematic for those who have a more active lifestyle. Larger implants also have higher risks of complications and bottoming out, which is when the implants move downward to an awkward placement. Moreover, you will need sufficient breast tissue to cover your breast implants and prevent implant edges from showing after surgery.
It is important to note that breast implants often look a bit smaller after surgery, so you should first find a size that suits you and then choose an implant size slightly larger to accommodate the apparent post-surgery size difference.
When trying to decide what implant size is best for you, you may also find it helpful to consult others you know who have already had breast augmentation.
What Type of Breast Implant Should I Choose?
There are several factors that need to be considered when choosing an implant type in order to yield the most satisfying results from your procedure. The following are three differences in implant types:
- round or shaped implant shape
- smooth or textured implant surface
- Silicone or saline implant filler
Breast implants can be round or shaped. Shaped breast implants are also called teardrop or anatomic implants and have more volume and projection on the lower half. This volume creates a more natural-looking teardrop shape. In comparison, round implants are symmetrical, fuller and give a more fake look.
Breast implants were originally created with a smooth surface, which allows for a more natural feel and pleasing look. On the other hand, textured implants have a rough surface and thicker shell and were made to decrease the risk of capsular contracture or hardening of the implant. However, textured implants feel harder and their rough surface creates more visible implant wrinkling.
Silicone breast implants have solid silicone shells and a cohesive silicone gel filling. Silicone breast implants can either be cohesive gel implants or Gummy Bear implants. Silicone implants tend to look and feel more natural, but cannot be adjusted in size during surgery, as they are made pre-set in volume. The density of the silicone fill is more similar to natural breast tissue than saline implants. Softer or cohesive silicone implants are more prone to wrinkling than harder, or Gummy Bear implants.
Saline breast implants have a silicone shell that is filled with salt water, or saline, at the time of surgery. The silicone shell can be filled with saline after being inserted into the breast, which means that breast implant sizes can be altered. This fact also allows for a smaller incision, compared to silicone implants. Since the shells can be filled with saline after insertion, each breast can be filled differently to accommodate asymmetry in breast volume. Nevertheless, saline implants feel less natural than silicone ones and have a higher risk of wrinkling, unless over-filled.
Our professional consultants and doctors will guide you through the decision-making process by allowing you to feel and assess the varying implant sizes and types.
Breast Implant Profile and Shape
The profile of a breast implant is the projection of the breast outward from the body. This is determined by the diameter and volume of the implant. Breasts are defined as having high, moderate or low profiles. Consultants will consider the width of your natural breasts to help determine what kind of profile is suitable and proportionate to your body.
High profile breast implants result in a very perky, fake look. Women with narrow chests and minimal breast tissue are limited to smaller implants to avoid complications. Oversized, or implants that are not proportioned to body size, can increase the risk of complications occurring. Such breasts tend to experience bottoming out, wrinkling due to insufficient breast tissue, the need for replacements, stretchmarks and thinning of breast tissue.
Though both silicone and saline implants are durable and FDA and Health Canada Approved, there are advantages and disadvantages of getting high profile implants with either silicone or saline.
Silicone breast implants are filled with a cohesive gel to sustain elasticity, durability and similarity to breast tissue. This gel helps to maintain the round and perky shape of high profile implants over time, regardless of your physical activity. The pre-set gel volume of silicone implants help patients better know what their implants will look like and the gel will not spill out if the implant is ruptured. Silicone implants also have less chance of wrinkling compared to saline implants.
There are also advantages to using saline for high profile breast implants. These implants are filled with a saline solution that is harmless to the body because it resembles the natural liquid that occupies most of the body. Since these breast implants are filled to their maximum after insertion of the shell into the breast, it is easier for sizing to be more precise and there is less chance of wrinkling. Saline implants also require smaller incisions and cost less than silicone implants. While there are limits to the size of silicone implants that can be inserted through trans-axillary (underarm) procedures, there are no limits for saline implants.
Breast Implant Placement
Breast implants can be placed either above the chest muscle (under the breast itself) or under the chest muscle. Above the chest muscle implants are called sub-glandular or sub-mammary. Under the chest muscle implants are called sub-muscular or sub-pectoral. Although both types of implant placements are appropriate for all patients, they each have their own advantages and disadvantages.
Sub glandular implants result in the more perky and round, fake look. They also tend to result in faster post-surgical recovery times and less discomfort during recovery. Further, the final shape and size of breasts are seen quicker after receiving sub glandular implant placements. However, there are several disadvantages to sub glandular placements:
- The implant is more visible and easier to feel
- The implant is more prone to wrinkling
- The implant is more likely to bottom out
- There is a higher risk of capsular contracture
- Mammograms become more difficult to read
Sub muscular implant placement results in a more natural look because the implant is less visible in the upper breast. As well, there is less risk for capsular contracture, bottoming out and visible wrinkling. It is also easier to read mammograms with sub muscular breast implant placements. There are minimal disadvantages with sub muscular breast implants, including slightly more post-surgical discomfort and recovery, movement of implants and breasts when chest muscles are flexed and longer time in displaying the final shape and size of breasts.
There are 3 types of incisions that can be done for breast augmentation:
- Trans axillary breast augmentation through the arm pit
- Infra-mammary breast augmentation through the breast fold
Recovering from Your Breast Augmentation Surgery
Simple Tips after Your Cosmetic Breast Surgery
Breast augmentation is an out-patient surgery, which means you will be able to go home on the same day of the procedure. It is advised that a companion monitor you for 24 hours after the surgery. You may feel weakness or pain and need assistance with common tasks. Numbness and altered sensitivity have also been known to occur after breast augmentation surgery, but these usually disappear with time.
The most common complication to occur after breast augmentation is called capsular contracture. This is the formation of a film of scar tissue around the breast implant that constricts the implant, causing the breast to feel hard. This can take place either weeks or up to a year after surgery. When something is implanted into the body its natural response is to form a capsule of protective collagen fibres around the implant.
In capsular contraction, this protective layer abnormally hardens, causing the breast implant to deform or compress. As a result, the breast itself tightens and rises higher on the chest. This can be followed with hardness and pain in the breast. In most cases, this can be alleviated by applying external pressure. This is done by your cosmetic surgeon at the La Fontaine clinic with or without sedation. They will correct the problem, making your breast feel soft again. In very rare cases, the surgeon may need to open the incision to achieve the same result. Today’s safe and technological-improved breast implants have reduced the incidence of capsular contraction to less than 5%.
There are several criteria needed to properly diagnose capsular contraction, which are determined by the Baker Classification for capsular contraction.
- Grade I- The breast appears normal, having desired size, shape and softness
- Grade II- The breast becomes slightly firmer
- Grade III- The breast becomes hard and appears abnormal
- Grade IV- The breast is hard, painful and looks abnormal
For the first while, avoid spending too much time examining your breasts. Devote this time to mental and physical relaxation for your state of mind. A positive attitude plays an important role in your overall results.
After the surgery you will be taught how to properly massage your new breasts to prevent improper positioning of the implants and help keep them soft. Special instructions will be given to those who undergo breast lifts with their breast augmentation.
Massaging is usually done regularly for the first 3 months after your breast augmentation procedure is completed. The massaging then continues less frequently for up to a year after the procedure. There are several massaging techniques that you will be taught to help keep your breast implants in the correct placement. There are upward and downward massages. Upward massages push the implant upward to help the implant capsule to stretch. Downward massages are usually more beneficial for sup-muscular implants because these implants sit higher on the chest. Downward massages help the implant to settle downward. Further, massaging your breast implants toward each other helps to better outline cleavage.
You might find that a breast on either side may take longer to settle than the other, which is normal.
In the case of capsular contraction, you will be given special instructions by your doctor or a nurse on what massage techniques to use to heal and prevent a repeat of this complication.
Wearing the right bra after having a breast augmentation is very important. Your bra can significantly affect the appearance of your new breasts and even contribute to complications. It is best that you avoid wearing an underwire bra for at least the first 2 months after surgery. The underwire can irritate or cut into the incision under the breast fold. As well, the breast implants need time to settle into their shape and an underwire or push up bra can interfere with this process.
You will most likely need to buy new bras after undergoing breast augmentation. You want to make sure that your new bras fit correctly in order to support your new breasts and avoid drooping or bottoming out.
The following criteria provide a guide on how a proper bra should fit:
- Bra straps should sit comfortably along shoulders without falling off or digging into skin. Adjust straps to a comfortable fit and for adequate support.
- The centre panel of the bra should sit comfortably on the area between your breasts. If the panel does not rest on your skin, this could mean that the bra size is too small.
- The band of the bra at the back should be parallel to or slightly lower than the front. If the band rides up or causes rolls in your backs, the bra could be too small.
- Cups should fit comfortably against your breasts. Spaces between cups and breasts indicate that the bra is too big
In rare cases, there can be complications that can occur after any surgery such as infection and bleeding.
Antibiotics can be used before and after surgery to prevent infections. If an infection arises in another part of your body it is crucial that it be treated immediately so that it does not spread to the vulnerable section of your breast augmentation. If an infection does occur in the breasts, the implant must be removed and a replacement implant can be inserted after 9 months of the infection being treated.
In very rare cases, breast implants can rupture or deflate due to tearing of the shell by capsular contraction or physical trauma. If a rupture or tear does occur, the actions for treatment depend on the type of implant. Silicone implants will not leak into the body nor does the body absorb it. However, surrounding tissue around the ruptured implant will thicken which can deform the shape of the breast or make it hard.
Saline implants will leak if ruptured. Fortunately, the saline solution is not dangerous to the body. In this case, the implant will deflate and the appearance of the breast will change.
Once tests are done to check if the implant is intact or not, the implant will need to be removed and replaced. Usually this process is simple and precautions taken when the original implant was inserted will need to be adhered to again.
Other potential but extremely rare problems that may occur after breast augmentation surgery include:
- Rash on or around breasts
- Hypertrophic scarring, which is a deep, red scarring that occurs after surgery
- Inflammation of blood vessels under the breasts
- Fluid build-up around the implant which causes swelling and pain
- Separation of the edges of the wound, causing opening of the incision as oppose to healing
- Changes in nipple sensitivity
All breast implants will have some degree of wrinkling. Folds on the shell of the implant occur because the implants are soft. Usually this wrinkling is felt when certain movements are made, such as leaning forward. However, it may become a problem if the wrinkles become visible. Saline implants are more likely to wrinkle than silicone ones.
There are several signs to be aware of and monitor to ensure the success and proper healing of your breast augmentation:
- You will experience some pain and discomfort in and around your breasts
- You may see bruising around your breast area
- Your breasts may swell
- You may experience slight bleeding near the incision
- You may feel nauseous or have constipation due to use of pain killers
Certain signs may indicate the need for emergency. In the case of the following, contact La Fontaine Source De Jeunesse Cosmetic Surgery Centre immediately:
- If you experience unbearable headaches
- If you are experiencing chest pain or shortness of breath
- If your wounds are bleeding excessively and do not show signs of stopping
- If your breasts appear abnormally swollen
If we are closed during the time that you call, go to your nearest hospital to be examined right away.
Though pain levels are largely based on a person’s pain tolerance, different procedures will result in experiencing slightly more pain than other procedures. For example, sub muscular, or under the chest muscle procedures usually are a bit more uncomfortable than sub-glandular procedures. Nevertheless, most patients who have undergone breast augmentation are able to resume to their normal activities a day or two after the procedure.
To avoid causing any complications or unnecessary pain, it is important to adhere to a few guidelines after having your surgery. These are:
- Refrain from wearing an underwire bra for up to 6 months after surgery. After this time, avoid wearing underwired bras for long periods of time.
- Sleep on your back only. Sleeping on your stomach or sides could alter the results of the augmentation or open wounds.
- Refrain from engaging in robust physical activity that would cause your breasts to bounce up and down. This may alter the placement of your implants or re-open the incision area.
- Avoid pulling your skin near the armpit and breast area in an attempt to look at your scars. This can open or tear your wounds.
- Avoid lifting your arms too high, as this will cause the skin around your breasts and underarm to stretch.
- Do not allow your wounds to get wet for the first week after surgery. It is best that you shower, as oppose to taking tub baths, to avoid soaking your wounds.
- Do not remove your bandage until instructed to do so. You need to provide your wounds with sufficient time to heal.
Upon your follow-up visit, your surgeon will tell you when you may return to normal activities.
If you require more information, please call La Fontaine Medical Group to arrange a private consultation at no charge.
There is hardly any other procedure in cosmetic surgery that can surpass the enhanced self-esteem and instant gratification felt by a woman who has undergone breast augmentation from La Fontaine Source De Jeunesse Cosmetic Surgery Centre.