Breast Augmentation

Breast augmentation is one of the most frequently performed cosmetic surgery procedures in Canada. It can give women with small or unevenly-sized breasts a fuller, firmer, more-proportioned look through the placement of implants in the breast. Women may elect to undergo breast augmentation for many different medical and aesthetic motivations, including balancing breast size and compensating for reduced breast mass after pregnancy or surgery. The procedure may be combined with others such as a breast lift.

Implants are silicone shells filled with either saline (salt water) or silicone gel. They are placed behind each breast, underneath either breast tissue or the chest wall muscle. The procedure lasts one to two hours and is typically performed with general anesthesia.

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Breast Reconstruction

It is often possible to construct a breast mound after mastectomy for cancer or other diseases. The procedure is commonly begun immediately following mastectomy, or alternatively, reconstruction may be done even years after the mastectomy (delayed reconstruction). There are pro and cons to both types. Breast reconstruction following mastectomy is covered under MSP.

Women whose cancer has been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to resolve these issues first. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.

The reconstruction may require several operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.

There are several ways to reconstruct the breast, both with and without implants. Your general surgeon and plastic surgeon will review with you the possible options.

In addition to the complications possible from any surgical procedure (bleeding, fluid collection, excessive scar tissue, or difficulties with anesthesia), there are some risks inherent in breast reconstruction that uses an implant, including infection around the implant, if an implant is used, and capsular contracture, when the scar (capsule) around the implant tightens, causing the breast to feel hard. Treatment for capsular contracture varies from "scoring" the scar tissue to removing or replacing the implant.

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Breast Lift

A breast lift, or mastopexy, is performed to return youthful shape and lift to breasts that have sagged as a result of weight loss, pregnancy, loss of the skin's natural elasticity or simply the effects of gravity. The procedure can also reduce areolar size (the dark skin surrounding the nipple), and it can be combined with breast augmentation for added breast volume and firmness. Breasts of larger size can be lifted, but results last longest when the breasts are originally small and sagging.

Women planning to have children are advised to postpone surgery since pregnancy and nursing can counteract its effects by stretching the skin. However, mastopexy typically would still allow breast feeding.

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