Montreal breast augmentation & breast implants – Objectives

Breasts can lose volume and shape after weight loss, childbirth or as a result of aging. Breast augmentation canbreast augmentation & breast implants enhance the size of the breast as well as give a better proportioned figure. During consultation for breast augmentation, Dr. Nicolaidis will examine the patient taking into consideration factors such as the size and shape of the breasts, skin quality and the placement of the nipples. If the breasts are sagging, a breast lift may also be recommended together with or instead of breast augmentation.

Breast implants can make it more difficult to read standard mammograms, but modified mammography techniques have been developed given the huge number of women with breast implants. Women at risk of breast cancer will need to consider this prior to making a decision about whether to have breast implants. Implants can be placed under the chest muscle so that they may interfere less with mammograms, but other factors also need to be considered. Dr. Nicolaidis will discuss this with the patient fully.

Over the last several years, an association has been found between TEXTURED breast implants and a very rare, slow-growing lymphoma in 1 out of every 300,000 to 1 million patients. For this reason, Dr. Nicolaidis no longer uses textured implants for breast augmentation in Montreal. He can discuss this matter further with you at the time of consultation.

Fat grafting has become increasingly popular over the last number of years. Dr. Nicolaidis will perform small amounts of fat grafting to the breast, even as an office procedure. But he hesitates to do large-volume fat transfer to the breast for 2 reasons. Firstly, large-volume fat transfer has a higher incidence of resorption, thereby leading to more cyst formation or microcalcifications. The latter can be confused on mammogram for possible breast cancers, leading to stress, investigations, possible skin incisions, etc. Secondly, breast implants have a longstanding history of reliability with minimal complications.

Montreal breast augmentation – Anesthesia

Dr. Nicolaidis always performs breast augmentations under general anesthesia. However, should you desire a breast augmentation surgery without implants and general anesthesia, we invite you to consult our section about breast augmentation by fat injections.

Montreal breast augmentation & breast implants – Surgical Techniques

A number of decisions regarding a breast augmentation must be considered with your plastic surgeon. First of all, there are 4 possible incision locations through which to place the implant : the breast fold, under the nipple, the armpit and the belly button. Dr. Nicolaidis will discuss incision location with you in preparation for your breast augmentation.

Vreast augmentation & breast implants 1 breast augmentation & breast implantsSecondly, implant placement can be either under the chest muscle or over the muscle (between the chest muscle and the breast tissue). There are advantages and disadvantages with each choice.

Thirdly, individual factors and personal preferences will help determine the appropriate implant size for your breast augmentation. Keep in mind that, in general, the larger the implant, the greater the risk of complications.

The final decision to consider is the implant type : saline-filled or gel, round or anatomic. Cohesive silicone gel implants are now available in Canada. Health Canada has determined that cohesive silicone gel implants are safe for use. The cohesive gel does not seep, run or shift. Silicone gel implants tend to give a more natural appearance than saline implants, feel more like real breast tissue and do not normally ripple or fold as saline implants sometimes do. Silicone gel implants have been available in Europe for several years and have an excellent safety record.

Montreal Breast augmentation – Recovery after breast implants surgery

Following breast augmentation, dressings are left in place for one to two weeks. Breast augmentation is usually performed on an outpatient basis so it is important to arrange for someone to drive the patient home after surgery and to stay with her the first night following surgery preferably in the Greater Montreal area. After breast augmentation, some bruising and swelling may occur initially, but this will disappear quickly. Most residual swelling will resolve within a month of the breast surgery. Wounds are well-healed after two to three weeks. However after a breast augmentation, patients are asked to sleep only on their backs for a period of approximately one month.

Montreal Breast augmentation : Return to work after breast implants surgery

After breast augmentation surgery, it is often possible to return to work within just a few days or a week.

Montreal Breast augmentation : Possible complications after breast implants surgery

Although uncommon, some potential complications of breast augmentation include reactions to anesthesia, capsular contracture, blood accumulation and infection. Although rare, implant exposure or infection that does not subside with appropriate treatment may require removal of the implant. Changes in nipple or breast sensation may result from breast augmentation surgery, though they usually are temporary.

It is normal for the human body to form a capsule around any foreign body, including a breast implant. However, in about 10% of patients with breast implants after 10 years, this capsule can become hard, painful and even move the implants. Treatment of capsular contracture varies from applied external pressure to complete removal of the implant, depending on the degree of contracture.

Breast implants are not guaranteed to last forever. If they deflate or rupture, surgery will be required to replace them. Otherwise, the results of the breast augmentation surgery may be long-lasting.

Textured implants (with a certain roughness on the outside in order to decrease the contracture rate) have now been shown to have a one in 3000 risk of causing a rare type of Iymphoma called BIA–ALCL. For this reason, Dr. Nicolaidis stopped using textured implants as soon as this association became clear.

On the other hand, smooth implants have never been shown to increase the risk of this lymphoma. However, it is becoming increasingly clear that silicone (which is in the envelope of both gel and saline implants) is not inert as we once thought. Some patients seem to develop a reaction to the silicone (or some other chemical in the implant), which over time may lead to chronic  inflammatory conditions and perhaps even immune disorders. The term Breast Implant Illness has been coined to describe the symptoms that may be caused by breast implants.

Montreal Breast augmentation : Post operative instructions after breast implants surgery

Our post operative surgery service is important to us. Immediately after your breast augmentation surgery, you can reach us at any time to address all your concerns ; that type of service differentiates us from other clinics in Montreal, performing breast augmentation surgeries.

In the first week after breast augmentation, be sure to :

  • Keep your dressing dry and clean ;
  •  Do not force with your arms ;
  •  Wash with a sponge unless Dr. Nicolaidis says otherwise ;
  •  Sleep ONLY on your back ;
  •  Wear your compressive band above the breasts at all times ;
  •  Walk at least 5 minutes every hour during the day (do NOT simply stay in bed constantly).
  • After your breast augmentation, your first post-operative appointment with Dr. Nicolaidis is very important, even if you feel very well.
  • After the first week of your breast augmentation surgery :
  • Continue wearing the compressive band until Dr. Nicolaidis says otherwise ;
  • You may shower with your back to the shower ;
  • Avoid bathing until Dr. Nicolaidis gives permission ;
  • Protect your new scars from sun exposure for a total of 6 months ;
  • Avoid lifting heavy objects after your breast augmentation surgery, until Dr. Nicolaidis gives permission ;
  • In order to avoid blood clot complications, keep moving (walk regularly during the day).
  • Please note :
  • It is normal to have swelling and bruising around the breasts in the first weeks after surgery involving breast implants. However, it is not normal if one breast becomes much larger than the other, in which case you should call us.
  • For your comfort, after your breast augmentation surgery, be sure to take your pain medication as prescribed.

If you have questions or concerns regarding your breast augmentation surgery, do not hesitate to call us. We are there for you.

For further information about breast implants, please click here : American Society of Plastic Surgeon