Dr. vanVliet | Breast Augmentation

There are many ways of performing breast augmentation. Techniques vary with respect to implant type, incision location and selection of implant pocket. There are a large variety of implant styles (saline vs cohesive silicone gel; textured vs smooth shells; different shapes and, of course, different sizes). This can initially seem overwhelming and confusing for the patient trying to make a well-informed decision regarding breast augmentation. Of all the decisions, the most important is choosing your surgeon well. Dr. vanVliet implores her patients to do their home-work and to select a board certified Plastic surgeon, trained in all aspects of cosmetic and reconstructive breast surgery.

Although the objective of breast augmentation is to create a fuller and larger breast, it is important to also have it look and feel as soft and as natural as possible. Dr. vanVliet's primary philosophy is to respect the tissue constraints as they pertain to the patients wishes and concerns. She is adept with, and utilizes a wide variety of implant styles and surgical techniques to provide the best possible esthetic outcome. Dr. vanVliet will walk you through the decision-making tree, based on a thorough physical examination and interview. The best options as they pertain to your body habitus and your stage of life will be discussed.

Once the surgical plan has been finalized, the surgical procedure can be booked. Breast augmentation surgery is an extremely safe and relatively short procedure, lasting 1-2 hours. Dr. vanVliet prefers to conduct implant surgery under general anesthetic, and this will be conducted by a board certified anesthetist at Southlake Regional Health centre. Drains are used, but rarely, and this is determined intra-operatively. This is a same day procedure and Dr. vanVliet will assess you prior to your discharge home.

Healthy, emotionally stable women who are inherently dissatisfied with their breast size are good candidates for breast augmentation surgery. This may be due to genetics or due to changes in breast appearance as a result of pregnancy/ nursing, aging and gravity. Implant surgery is often utilized in breast reconstruction for congenital anomalies as well as following mastectomy or injury.

Breast augmentation can help achieve a fuller and more shapely breast. Although breast implants are designed to restore breast volume and shape they do not, however, significantly improve a sagging or descended breast. In these instances, a breast lift is often necessary , which can be performed preceding, or in conjuction to a breast augmentation procedure.

Patients undertaking breast augmentation should be aware that more surgery may be required in the future.

Dr. vanVliet will personally assess you prior to your discharge home the day of hospital. You will have an a special light dressing with an overlying compression bra. You will be provided with a prescription for antibiotics and pain medication, although your discomfort should not be severe. The compression bra provides support and comfort and helps minimize swelling . It also helps maintain optimal position of the implants in the early post-operative period. During the first week, in particular, it is important to convalesce and to minimize chest wall activity such as heavy lifting. Most people are able to return to work within a week of surgery. Gentle activity can be resumed in 2-3 weeks and high impact activity after a month.

Initially the breasts will seem very tight and upright. The incisions will be raised and red. Most of this will resolve quite quickly over the first 4-6 weeks, with ongoing gradual improvements over a full year.

Breast augmentation is a very safe operative procedure with minimal risks and complications. Nevertheless, as with any procedure, there is always the potential for complications related to surgery or reaction to the anesthetic. Acute but uncommon complications include bleeding and infection and this may necessitate corrective surgery. In the remote chance of infection, the implant may have to be removed, the infection treated with antibiotics, with subsequent replacement of the implant a few months later. The most common esthetic complications are related to implant malposition, capsular contracture or poor quality scarring. Capsular contracture refers to the development of a firm scar or capsule around the otherwise soft implant. This can make the breast feel firm and may cause distortion of the breast shape or malposition of the implant. This may necessitate further corrective surgery.

Implants are man-made and , although highly durable and reliable, will eventually fail through wear and tear. The cumultive failure rate is quoted at 1% per year. Therefore at 10 years of age there is a 10% rate of failure; at 20 years a 20% rate of failure. With saline implants the saline is simply and safely absorbed by the body. With cohesive silicone gel implants, also referred to as the "gummy bear" implants, the silicone will not migrate and there may be minimal change in the appearance or feel of the breasts. As it currently stands, the implant manufacturers guarantee the implants for the life of the patient and will replace an implant free of charge.

Visible or palpable rippling or folding of the implant or seeing the contour of the implant is very much a preventable esthetic complication. By choosing implant size and style well this esthetic complication is rare. Most women who notice rippling and folding of the implant are either very thin, or they have chosen too large an implant for their breast dimensions and skin quality. This can be corrected but will require further surgery, usually with downsizing of implant and/or changing implant style and pocket placement.

It is critical that patient's with esthetic issues related to their breast augmentation procedure, seek a qualified board certified Plastic surgeon to help them address their concerns in a comprehensive manner. Plastic surgeons are trained in all aspects of reconstructive and esthetic breast surgery and therefore bring a high standard of care and expertise to management of these issues.

Dr. vanVliet utilizes implants from Mentor Corporation. If you wish to find out more about implants and implant safety, please refer to their website: www.mentorcorp.com.