Breast Implant Frequently Asked Questions.
Breast Implant FAQ’s
Will breast augmentation increase my risk of breast cancer?
There are multiple high-quality, large studies which show that the presence of
breast implants does not increase the risk of breast cancer. Having implants does
not hinder the patient or physician in finding breast tumors. Having implants
does, however, change the way mammograms need to be done. Typically,
additional views are necessary. It is important to have mammograms done at the
centre with experience with patients who have breast augmentation
Am I too old for the surgery?
The how many women in their 40s and 50s who have successfully undergone
breast augmentation however, the most common patient who undergoes breast
augmentation is in their 20s or 30s.
Should I wait until I am done having children to have augmentation?
This is a very personal decision with no right or wrong answer. Many women
have breast augmentation prior to having children. There are significant physical
and hormonal changes that happen in pregnancy and the presence of breast
implants does not change those. Breast augmentation is very unlikely to change
a woman’s ability to breast feed. If there is a decrease in nipple sensation after
surgery, this may alter some nipple reflexes needed during breast feeding.
In general, breasts, whether augmented or not, will undergo a loss of volume,
especially in the upper pole, after the hormonal and size changes associated with
pregnancy.
Will breast augmentation be effective if I have sagging breasts?
In general, augmentation is effective in addressing sagging, or ptosis, only when
the degree of ptosis is minimal and the original breast size is relatively small. In
most cases of ptosis, augmentation alone is not adequate. As the size of the
breast and degree of ptosis increase, the need to remove excess skin (breast lift)
to achieve a good result increases. This involves making an additional incision
around the areola (pigmented part around the nipple), and occasionally on the
front of the breast if the ptosis is severe. Without this breast lift, also called a
mastopexy, the relationship of the breast implant to the rest of the breast is not
correct and the lift is needed in order to make the result visually pleasing. When
a mastopexy is added to the augmentation procedure, it is called a mastopexy
augmentation.
How do I choose the size?
This is typically the hardest part of the journey. There are multiple factors that
go into making this decision. Many patients have an idea of what they are
seeking and this is the best place to start. For patients who really don’t know
how big they would like to go, there are multiple ways to use your body size and
body type to determine a good size. We also have 3D modelling software which
can show you what different sizes look like on you, both with, and without
clothing. We have a sample of breast implants you can try on as well. Dr. Chitte
and the ODC team will help you with expert suggestions, but ultimately, you will
make the decision that suits you best.
What is covered in the surgical fee?
All hospital, anesthetic and implant fees, as well as all of your follow ups, are
covered in the surgical fee. HST and prescriptions are additional.
Will my nipple sensation/feeling change after surgery?
I generally counsel patients that there will be some sensation change (either
more or less feeling) for a short time after the surgery, especially with larger
implants. Generally speaking, these changes resolve over the course of 3-6
months. The risk of sensory loss from the inframammary incision is accepted to
be less than 5-10%, which is typically the best incision for preservation of
sensation.
What is the recovery after breast augmentation? When can I exercise?
Breast augmentation is done as day surgery, meaning that you go home the day
of the surgery. You should be walking around the night of the surgery and keep
walking every day. The incisions are generally healed by 2 weeks post-surgery
and you can return to regular activities by 6 weeks. You can return to intense
exercise approximately 6 weeks post surgery. Waiting this long allows your body
to heal and decreases the risk implants will shift or that you will have
complications with the incision.
When can I go back to work?
This very much depends on the nature of your job. Reaching overhead should be
avoided for the first 1-2 weeks. Lifting more than 5-10 ( 2-5 kg) pounds should
be avoided for the first 6 weeks. These restrictions may affect when patients
return to work. If you have a job where heavy lifting is not necessary, a return
to work can happen as quickly as a few days post-surgery, but usually happens at
least 2 weeks post-operation. It can be very helpful to arrange for additional help at home for 1-2
weeks, especially if you have responsibilities, such as young children
How much does breast augmentation hurt?
Pain is certainly a consideration after any time of surgery. Pre-operatively, Dr.
Chitte at the ODC team will guide you regarding post-operative pain control. For
breast augmentation, post-operative pain would be considered mild to
moderate. If you have an implant placed below your chest muscle, it is likely to
hurt more than if you have the implant placed below your breast. In both cases,
Dr. Chitte will discuss a pain management plan with you and ensure that you
have adequate medication to get you through your recovery.
When can I drive?
The most important consideration for driving involves being off all medications
that may cause sedation. Typically, these are prescription pain medications.
Once you are no longer taking these, as soon as 2 weeks after surgery, you may
begin driving.
Can I breast feed after breast augmentation?
Breast augmentation typically does not change a woman’s ability to breastfeed
with the caveat that not all women produce adequate volumes of milk to breast
feed. The exception to this is seen in the use of a peri-areolar incision for
implant placement (not for mastopexy alone) where up to approximately 10% of
women can have difficulties breastfeeding post-surgery.
Will I need additional surgeries?
Additional surgeries may be required. Over time, you may wish to undergo a
breast lift to address changes see with gravity and aging. You may have
complications such as implant rupture or capsular contracture which may
require additional surgeries.
What is BIA-ALCL (Breast Implant Associated Anaplastic Large Cell Lymphoma)?
Approximately 10 years ago, as association was found between textured breast
implants and a rare form of a blood cancer called lymphoma. This is a cancer of
the immune system and not a breast cancer. BIA-ALCL is typically diagnosed
years after augmentation and treated with removal of the breast implant and
capsule. Occasionally, adjuvant treatments such as chemotherapy are
necessary. Dr. Chitte uses only smooth breast implants and as per the American
Society of Plastic Surgeons, there have been no cases of BIA-ALCL associated
with smooth implants.
Will implants be placed under my breast, or under my chest muscle?
This depends on your body type and your goals. For example, there are benefits
of placing implants under the muscle, especially in very thin women. As well,
there are benefits in placing the implants under the breast in women who have
had children. With all patients, Dr. Chitte and the ODC team will talk with you at
your consultation and help guide you to the best decision for you.
What is capsular contracture?
Capsular contracture is a condition where the scar tissue envelope which forms
around all breast implants tightens up. This may become painful and hard.
Occasionally, an additional surgery is required to address this complication. Dr.
Chitte will discuss with you at your consultation. The most common factors implicated in capsular
contracture include infection and bleeding. Before, during and after your procedure, antibiotics are
used to try to decrease the risk of infection. Dr. Chitte also uses a Keller Funnel and a
no-touch technique to minimize the risk of infection. This has resulted in
a very low risk of capular contracture. During the surgery, Dr. Chitte meticulously
ensure the surgical field is irrigated, washed out and free of any blood before the
implant in placed in to decrease the risk of hematoma and capsular contracture.
Who is a good candidate for breast augmentation?
A good candidate for breast augmentation is a relatively healthy women who has
given some thought to having the surgery done and has a good idea of how the
implants will enhance her body. The best candidates have thought about
increasing the size of the breast for years to better fit into clothes and improve
body proportions. Women who have had children and wish to return their
breasts to a more youthful appearance also makes excellent candidates.
Who is not a good candidate for breast augmentation?
Patients who are not generally in good health are not good candidates for breast
augmentation surgery. Smoking at the time of surgery significantly increases
risks of wound healing complications and therefore, smoking needs to be
stopped before considering surgery.
What kind of anesthetic will be used?
General anesthesia (going to sleep) is used.
What are the risks of the procedure?
The major risks of the procedure include: bleeding, infection, asymmetry,
implant malposition, capsular contracture and rippling. Dr. Chitte and the ODC
team will discuss these and other risks with you at your consultation.
What is the risk of implant rupture?
Dr. Chitte uses the newest generation cohesive gel “gummy bear” silicone
implant. The extensive cross-linking of the silicone molecules makes this implant
very strong and stable. While nothing is 100% failsafe, the risks of implant
rupture are exceedingly rare (less than 1% per year) so you should be able to
enjoy your implants for years to come
What kind of implants are used?
o Dr. Chitte uses the newest generation cohesive gel “gummy bear” silicone
implant. The extensive cross-linking of the silicone molecules makes this implant
very strong and stable.
What is the location of the incisions?
Dr. Chitte typically uses an incision hidden in the fold below the breast. In other
cases, an incision around the areola (pigmented area around the nipple) is used.
What is rippling and how can it be prevented?
Rippling occurs when the skin overlying the implant is too thin. An outline of the
implant can be seen through the skin. In patients who have thin skin, placing the
implant below the muscle places a thick, healthy layer of tissue over the implant.
This significantly decreases the risk of rippling.
What happens if I get pregnant after breast augmentation?
Many women have breast augmentation prior to having children. There are
significant physical and hormonal changes that happen in pregnancy and the
presence of breast implants does not change those. Breast augmentation is very
unlikely to change a woman’s ability to breast feed. If there is a decrease in
nipple sensation after surgery, this may alter some nipple reflexes needed during
breast feeding. In general, breasts, whether augmented or not, will undergo a loss of
volume, especially in the upper pole, after the hormonal and size changes associated
with pregnancy.
Do my implants have to be replaced every 10 years?
This recommendation is a holdover from a previous generation of breast
implants which were filled with a liquid silicone. Dr. Chitte uses the newest
generation of breast implants that are filled with heavily cross-linked silicone
which is like a “gummy bear” and does not flow. Most experts agree that as long
as your breast implants are monitored regularly and are not giving you problems,
they do not have be replaced.
Can I get a breast augmentation if I smoke?
Smoking at the time of surgery significantly increases risks of wound healing
complications and therefore, smoking needs to be stopped before considering