Breast Augmentation | Breast Implants
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Enhance proportions. Restore self-image and confidence.
Breast augmentation can help women with smaller or uneven breasts enhance fullness, projection and realize balanced chest proportions.
Breast size occurs naturally with development, however women may experience additional loss of volume and shape following life events such as pregnancy and breast feeding. In this latter scenario, women with naturally smaller breasts may describe not being happy with their breast volume.
Our Surrey breast augmentation surgery enhances breast volume by placing an implant through small, hidden access incisions. The implant itself comes in a range of sizes to provide a custom solution to achieve a desired volume, firmness and projection. They are made up of a durable silicone shell filled with silicone gel or saline (i.e. sterile salt water) and are manufactured under sterile conditions. This sterility is maintained throughout your surgery. The combination of the implant, your natural breast tissue, and additional surgical techniques (where needed) help surgeons achieve your desired volume and overall breast shape.
To maintain the breast’s natural look and feel, it is ideal to have sufficient natural tissue resting on top of the implant. In women who have adequate thickness of their natural breast tissue, the implant may be placed directly below the gland. However, some women may have less breast tissue to cover the implant, making the subtle creases in the implant shell more observable through the skin (referred to as rippling). In these patients, placing the implant below the muscle affords more natural tissue to cover the implant. The trade-off in some thinner patients is that the implant may move with the pectoral muscle (referred to as animation).
All patients form scar capsule around the implant shell as part of the natural healing response. In rare cases, some patients may form a very tight scar capsule that can slowly squeeze the implant and cause distortion of the implant or discomfort. This is called capsular contracture. For these patients in whom the implant was placed below the gland, moving the implant below the muscle may reduce the risk of forming a recurrent problematic scar capsule. Regardless of location, Dr. Ratanshi employs a strict ‘no touch’ technique when handling an implant. Recent evidence has found this to be one of the most important factor to reduce the risk of developing capsular contracture.
There are a range of implants available used in breast augmentation surgery. These vary by fill material, volume, and projection. All implants are made of a highly durable outer silicone shell. The inner fill material is either a silicone gel or saline (salt water). The size and shape of the shell, and the amount of material contained within, determine the volume. Implants vary from 100 g/cc to 800 g/cc. There are three manufacturers of breast implants approved by Health Canada, including Allergan and Mentor.
The latest 5th generation of silicone gel-filled implants are filled with a form-stable, cohesive gel that maintains its shape and will not deflate. For this reason, they are referred to as ‘gummy bear’ implants. These implants have a very low rate of rupture. These implants are Dr. Ratanshi’s preferred choice for breast augmentation as they maintain their shape, confer a natural feel, and have less rippling and contour irregularities than saline implants. They are pre-filled to the size at the manufacturer level and are maintained in sterile packaging until placed during surgery.
Saline implants are also made of a durable silicone shell. This dispels the notion that they are a silicone-free alternative. However, unlike silicone filled implants, the inner material is a sterile saline (salt water) solution. This solution is instilled into the implant during your surgery to achieve your desired volume. This is the same solution (normal saline) used to administer intravenous medications and is very safe. If a saline implant ruptures, the salt water is absorbed by your body. Rupture is immediately detected as the ruptured side will immediately appear smaller and more deflated than the normal side.
Dr. Ratanshi ONLY uses smooth, round implants for Breast Augmentation. The round shape means that if the implant rotates, it does not affect the shape of the overall breast.
Textured implants are another silicone implant type available in Canada. These implants have a more defined tear drop and confer a slightly more natural shape. To help reduce the chance of the implant turning and altering breast shape, these implants are designed with a rough, textured surface to help natural tissues hold the implant in place. They are filled with silicone gel to a higher density, reducing rippling or creases as well. There is data to suggest that the texturing process may contribute to a localized inflammatory reaction, which can in turn lead to the development of very rare form of blood cancer, called breast implant associated anaplastic large cell lymphoma. The incidence of this can range from 1 in 800 to 1 in 3000 patients. For this reason, Dr. Ratanshi has never use textured devices in his practice and only uses smooth, round breast implants.
Everyone is unique. No two women will have the exact same aesthetic goals. In many patients, the breasts can vary subtly or more from left to right. Patients differ in how their tissues heal and settle with time. Weight changes and certain medical problems can also affect how our tissues behave. During your private consultation for breast augmentation Surrey plastic surgeon, Dr. Imran Ratanshi, will review your specific concerns and tailor a treatment plan that works best for you. This includes evaluating your breast history and assessing your general health.
Dr. Ratanshi will examine your existing proportions (breast width, thickness, degree of deflation) and take chest wall measurements. This will help to determine your candidacy for breast augmentation, as well as help you choose an implant that is appropriate for your chest frame. Dr. Ratanshi will then guide you through the sizing process and review your surgical plan. There is always ample time for questions. Dr. Ratanshi may also order relevant investigations, such as a mammogram, where indicated.
On the day of your first consultation, it is helpful to wear an elastic/stretchy sports bra with some elasticity and a loose-fitting shirt. Dr. Ratanshi’s office has a range of implant sizers that can be inserted into your sports bra in serial increments to focus on a size that fits your frame. These sizers help represent what the additional volume will look like in clothing. This enables you, the patient, to choose a size that you are most happy with. A follow-up visit gives you the time to consider your choice and ensure you are happy with your decision.
Breast Augmentation Surgery takes approximately 1 hour. If additional procedures are needed, such as a Breast Lift, this may extend to 1.5 to 2.5 hours. Your surgery will be performed in a private surgical facility under general anesthesia. A board-certified Anesthesiologist will provide your anesthesia and will discuss your anesthesia plan with you the day of surgery. Additional local freezing is placed in all incisions and around the breast to maximize comfort after surgery.
Most patients can expect to be back to work in 5-7 days. This may be longer for patients who have more physical responsibilities. While most patients recover quickly, everyone is different and may need to adjust for their own situation. A discrete note for work can be provided that will not describe the details of your surgery.
You can move your arms right away. A support bra should be worn for 6 weeks. You should avoid strenuous activity that will move your breasts for 4 weeks. Chest exercises should be avoided for 6-8 weeks. Remember, your arm is also stabilized by your chest muscles. If your implants are placed below the chest pectoral muscle, the muscle will want to impart a downward force.
Frequently Combined with Breast Augmentation
Your breast implant is placed through a small access incision in one of two locations: (1) along the natural crease below the breast or (2) at the lower border of your areola. The incision is closed in layers to help you achieve a fine line scar.
Breast augmentation surgery requires a general anesthetic. Possible complications you should be aware of include, but are not limited to:
Starting at $9500 + GST
Breast Augmentation to address a cosmetic concern is NOT a benefit of the British Columbia Medical Services Plan.
In patients who have undergone a mastectomy for breast cancer, Dr. Ratanshi does perform staged reconstruction using breast implants. This unique scenario is a benefit of the Medical Services Plan.
The goal of cancer reconstruction is to help restore pre-mastectomy volume and appearance. Therefore, breast reconstruction is not an avenue for cosmetic breast augmentation. In patients undergoing unilateral reconstruction who wish to be larger than their pre-mastectomy volume, enlarging the normal, non-cancerous breast is not a benefit of MSP and will incur a private fee.
No. Dr. Ratanshi does not routinely place drains with Breast Augmentation.
While Plastic Surgeons strive for perfect symmetry, it is impossible to make both breasts exactly the same. This is because the natural breast footprint and the chest wall in most women can vary slightly from right to left. Pre-operative measurements and markings help surgeons get as close as possible. For this reason, you may hear your surgeon say that a reasonable goal is to create ‘sisters, but not twins’.
Even the latest generation of breast implant is not designed to be kept in the body forever. Left indefinitely, all implants will eventually experience disruption of the internal silicone, breakdown of the outer shell, and possible rupture. While many women have had implants in place for 15 to 20 years without issue, manufacturers recommend replacing your implant by the 10 year mark. This also affords you the opportunity to manage any associated capsule, adjust your size if your goals have changed, or update your implant to a newer generation if available.
The rupture rate for older generation silicone implants within 10 years is approximately 10%. Dr. Ratanshi uses the newest 5th generation implants. Although designed to be more robust yet supple, long-term data is not yet available to characterize their new durability compared to older implants.
Most ruptures occur within the substance of the inner silicone gel with the capsule intact. This is called an intracapsular rupture. If a rupture extends to include the outer shell, this is called an extracapsular rupture. Unlike earlier generation implants that used a more liquid form of silicone often prone to leaking outside the shell, newer generation implants are cohesive like a gummy bear. Your body may react to any exposed inner silicone layer by forming a tighter capsule or fluid collection. This may cause distortion of the breast.
Despite their soft, supple nature and low potential for rupture, breast implants are quite robust and strong. Check out this article about a breast implant deflecting a bullet!
https://www.cnn.com/2020/04/21/americas/breast-implant-bullet-wound-wellness-intl-scli/index.html
Although any breast surgery can influence capacity to produce milk, most women will be able to breast feed after breast augmentation | breast implant surgery. However, this may be reduced if combined with a mastopexy. Using an access incision at the base of the areola may reduce breast feeding capacity more than an incision in the lower fold of the breast owing to greater disruption of your natural milk ducts. The most important feature to note is that even without prior breast surgery, milk production can vary from person to person, and from right to left.
All body tissues descend with time as the skin becomes less elastic and the weight of tissues lower with gravity. Larger breasts will descend at a faster rate than smaller breasts.
No, unfortunately. You are not a candidate for surgery at this time.
The active use of nicotine products is a strict contraindication to undergo elective breast surgery. Nicotine is a potent vasoconstrictor (i.e. it shrinks blood vessels) and can substantially reduce blood flow to a healing wound. In extreme cases, healing issues can lead to infection, implant exposure, and potential need for implant removal. If combined with a mastopexy, nicotine use dramatically increases the incidence of areola or nipple loss.
Dr. Ratanshi requests that patients who consume any nicotine products, including cigarettes, vaping, chewing tobacco, etc. cease completely for at least 6 weeks before they can be considered a candidate for surgery.
Yes. You can remove your breast implants at any time. However, removal of breast implants placed for cosmetic reasons is subject to private fees.
Dr. Ratanshi prioritizes patient safety and satisfaction above all. He is a double subspecialty-trained Plastic Surgeon and regularly performs aesthetic and reconstructive breast and body surgery as part of his practice. Dr. Ratanshi aims to utilize the latest evidence-based techniques and technology to deliver exceptional results. Dr. Ratanshi is committed to making your journey to enhanced beauty as comfortable and rewarding as possible.
