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Breast Augmentation Procedures Toronto

Breast Augmentation Procedure

Breast augmentation is one of the most popular procedures performed by Toronto plastic surgeons. Although most patients are very happy with the results of their breast augmentation surgery, it is important that a board-certified plastic surgeon performs the procedure.

Dr. Asif Pirani has extensive experience with breast augmentation. As a board certified Toronto plastic surgeon, Dr. Pirani will listen to your concerns and develop a custom surgical approach to address your breast augmentation goals.

What is a breast augmentation?

The breast augmentation procedure is designed to enhance breast shape and volume. It can improve body image, symmetry, and balance. Breast augmentation is also useful in rejuvenating breasts that have lost volume and shape after having children or losing a significant amount of weight. Many patients find that their clothes fit better after breast augmentation.

What are the different options for breast augmentation?

Breast augmentation can be performed a number of ways. A new method is to use a patient’s own fat taken from the abdomen or the buttocks and use that to augment the breast (known as fat grafting or fat transfer).

The more common way to perform breast augmentation is to use implants to enhance the size and shape of breasts. There are two basic types of implants. These can be filled with either saline or silicone.

Saline is essentially intravenous fluid composed of a saltwater solution. Saline implants require smaller incisions and are generally less expensive. There are a number of downsides to using saline implants. Generally, they do not feel as natural as silicone implants and you are more likely to see ripples in these implants under the skin.

Silicone breast implants are filled with silicone gel. They feel the most natural and you are less likely to see rippling with these implants. Gummy bear implants are a new type of silicone implant which have a teardrop shape. These implants help shape an augmented breast.

How do you perform a breast augmentation?

There are a number of things to consider prior to performing a breast augmentation. In addition to addressing a woman’s personal preferences and goals, Dr. Pirani must also decide upon implant type, implant size, incision placement, and plane of insertion. Dr. Pirani considers all of these factors as well as your own breast/chest size to determine the best method to augment your breasts and improve your breast shape.

Generally in order to perform the procedure, an incision is made in the skin and then a pocket is developed either under or over the muscle. The implant is then inserted in this pocket and the pocket is adjusted in order to achieve the most optimal cosmetic result. The pocket is irrigated and closed in a layered fashion. A dressing is applied over the small incision and a postoperative bra is applied.

Should the implant be under or over the muscle?

Dr. Pirani can place the implant either above or under the muscle. Placing the implant under the muscle is termed a subpectoral augmentation. Placing the implant on top of the muscle is termed a subglandular augmentation.

In most women, the advantages of a subpectoral augmentation make it the best option, however, Dr. Pirani will make this decision with you after reviewing all of the advantages and risks associated with both subglandular and subpectoral augmentations.

Generally, subpectoral augmentation is associated with:

  • A lower incidence of capsular contracture (thick scar formation around the implant)
  • Decreased rippling
  • Maximal preservation of nipple sensation
  • Less implant visibility and palpability
  • Less tissue stretch over time
  • Better mammogram visualization
What is a Dual Plane Breast Augmentation?

The Dual Plane technique for breast augmentation combines the aesthetic advantages of both a subpectoral as well as subglandular implant insertion. With this technique, the upper two-thirds of the breast implant is covered by muscle. The lower third of the breast implant is covered by only glandular breast tissue. This allows the upper portion of implant to have more tissue coverage and the lower third of the implant to have a more rounded appearance. This results in a much more natural appearing breast contour.

Dr. Pirani regularly performs dual plane subpectoral breast augmentations in addition to offering complete subglandular and subfascial placements. Dr. Pirani will alter the technique he uses on a case-by-case basis to cater to your unique anatomy and aesthetic goals.

Who is a good candidate for breast augmentation?

A woman may be a good candidate for breast augmentation surgery if she is interested in having any of the following:

  • Larger breasts
  • Breast asymmetries resolved
  • The appearance of increased cleavage
  • Restored breast volume and shape after childbirth/breastfeeding
  • Restored breast volume and shape after significant weight loss

In addition, good surgical candidates should be relatively healthy. Smokers should quit smoking for at least 3 to 4 weeks prior to surgery. Patients who have breast-fed recently should wait at least eight weeks prior to pursuing breast augmentation.

How long does it take to recover from breast augmentation surgery?

Patients generally take 2 to 4 weeks to recover from breast augmentation. Many patients are able to return to work a week after breast augmentation. Depending on the type of augmentation performed, postoperative bras may be required for an extended amount of time. Patients should expect to continue to see changes in their breast shape and implant position for at least six months after breast augmentation.

How Much Does it Cost to have a Breast Augmentation with Implants?

In Toronto, most implant based breast augmentations cost between $8000 – $9800. The price for a breast augmentation will vary depending on incision placement, implant placement, pre-existing asymmetries, and the surgical complexity of the case.

What are My Breast Augmentation Incision Options?

There are three principal options for inserting a breast implant:

  1. A breast implant can be inserted via an incision underneath the breast in the inframammary fold (IMF incision).
  2. A breast implant can be inserted via an incision placed around the areola (peri-areolar incision).
  3. A breast implant can be inserted via an incision placed in the armpit (axillary incision).

Each incision option has pros and cons. In general, the inframammary fold incision offers the surgeon the greatest ability to visualize and precisely developed a pocket for your specific implant. The inframammary incision also allows the surgeon to alter your inframammary fold position in cases where there is significant pre-existing breast asymmetry.

The peri-areolar incision is also an excellent option. The incision is placed at the border of the areola and surrounding breast skin. This is an excellent option for women of dark skin colour who are worried about poor scarring and pigment issues.

The third option for incision placement is through the armpit via a transaxillary incision. This incision option offers the least direct visualization and is not ideal for patients with significant breast asymmetry.

There is a fourth described incision option through the umbilicus (belly button), however, Dr. Pirani does not offer this as the risks and complications associated with it are not warranted in Dr. Pirani’s opinion.

Can I Breastfeed after a Breast Augmentation?

It is possible to breastfeed after having breast augmentation with implants. There is the possibility of a reduced ability to breast feed after a breast augmentation, however.

Incisions placed around the areola (peri-areolar) and subglandular (over the muscle) implant placement are more likely to interfere with breastfeeding in the future. Using an IMF (inframammary) incision and placing the implant under the muscle are less likely to influence your ability to breastfeed in the future.

What Kind of Anaesthesia will I require for my surgery?

Dr. Pirani only offers breast augmentation with general anaesthesia provided by a board certified anaesthesiologist. Our facility is fully accredited by the Canadian Association for the Accreditation of Ambulatory Surgical Facilities (CAAASF). Our surgical facility has also passed inspection by the College of Physicians and Surgeons of Ontario (CPSO). Our anaesthesiologists are staff anaesthesiologists at the Toronto East General Hospital.

How Long is the Operation?

On average, a breast augmentation will take less than 2 hours to perform. Some more complex cases may take more time. If a mastopexy or breast lift is also performed at the same time, then the surgery can take up to 4 hours.

What should I Expect in Terms of Post-Operative Care Instructions?

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 after a breast augmentation:

  • Bra worn 24-7 for 1 week
  • Expect some discomfort for 2-5 days
  • No underwire bras for 6-8 weeks
  • No heavy lifting or strenuous upper body exercises for 4-6 weeks
  • Your first follow-up appointment with Dr. Pirani will be 5-7 days after your surgery.
Will I have to get my Stitches Removed? When Will this Happen?

Dr. Pirani usually uses absorbable sutures that do not need to be removed. In the rare case where a patient is prone to poor scarring, he will use non-absorbable sutures that are usually removed 7 days after the surgery.

What Happens to Me After My Surgery?

Immediately after your surgery, you will be taken to our recovery area where a registered nurse and anaesthesiologist care for you as you recover. In general, most patients will remain in the recovery area for a few hours before being allowed to go home. We have a specific set of health criteria that must be met before you are allowed to go home. Dr. Pirani will see you prior to you going home.

How Long Will I Stay in the Surgical Facility before I can go Home?

In general, patients will stay with us for a few hours before going home. Patients have the option of staying overnight in one of our private overnight stay rooms which are luxuriously furnished. 2 nurses will care for you overnight if you do choose to stay in one of these rooms.

When Will My Follow-up Appointment be?

Dr. Pirani will usually see patients 5-7 days after surgery for the first post-operative visit. Based on how your healing progresses, he will then cater the frequency of further appointments to your needs.

What if I have a Problem after Surgery?

All of Dr. Pirani’s surgical patients receive his cell phone number to call if they have any issues or concerns. In case of an emergency, patients should call 911.

How Do I Decide What Size Bra I will Need After My Breast Augmentation?

After your breast augmentation, you will need to purchase new bras. It is important that you keep in mind that your breasts will continue to change for several months after your breast augmentation. It is advisable that you wait at least 6-12 weeks before purchasing a large number of new bras to account for this.

Initially after surgery, Dr. Pirani will provide you with a postoperative surgical bra. Dr. Pirani will reassess your bra requirements at your follow-up appointments and will direct you in terms of what type of bra you can wear. In most cases Dr. Pirani will have you continue to wear a supportive bra for the first 6 to 8 weeks after surgery; however, in some cases he may direct you to avoid wearing a bra to help your implants descend. In some cases, Dr. Pirani may request that you wear an underwire bra.

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

The Breast Augmentation Consult

There is a large amount of information to review during a breast augmentation consult. Dr. Pirani will usually spend over an hour with you during this consultation to go over all of the surgical and implant options prior to creating a custom surgical plan for you. He will go over risks and complications and give you an idea of what you should expect in terms of results and recovery.

Dr. Pirani’s goal is to educate you so that you fully understand your customized surgical plan.

To schedule a consultation with Toronto Breast Augmentation surgeon, Dr. Pirani, call 416-360-8772.

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