Breast augmentation is a plastic surgery procedure that uses high tech, man-made, Health Canada approved prosthetic devices, called a breast implant to augment the volume, proportion and shape of the breasts.
Before and After Gallery
Med - High
Breast augmentation is one of the most common procedures performed in North America. A common and erroneous perception about implants is they are always obvious and unnatural. While it’s true, some women opt for a size that is large and obvious, many patients opt for a more natural appearance. With the help of an Dr. Mulholland, your breast augmentation results can appear as subtle or dramatic as you would like.
Breast Augmentation Before and After
What is Breast Augmentation?
Dr. Mulholland has been an innovator and pioneer in augmentation, with the use of the Vectra® 3-D Pre-Op Breast Imaging, to help patients decide which size and shape of implant best suit their conscious and subconscious goals for the beautiful figure, shape, and proportion enhancement.
Augmentation can also be performed with one’s own fat tissue. Fat can be harvested from areas where there are excess focal regions of fat accumulation and be purified and transplanted, through injections to the breast. Generally, fat transplantation is recommended for those that want a modest half cup size enlargement and is also good for fat grafting over implants that are already in place to enhance contour or camouflage implant edges, or correct asymmetry.
Breast augmentation is by far the most popular and Dr. Mulholland has been performing augmentation surgeries for 20 years.
The most preferred implants selected by patients are cohesive silicone based and, depending upon the size selected, they are inserted through the inframammary fold or under-the-breast incisional approach.
Augmentation is a relatively quick procedure; usually performed in approximately 60 to 90 minutes. The procedure is performed as an outpatient under light IV sedation or general anesthesia.
The various breast implant insertion incisions: The Trans-axillary, Peri-areolar, and Trans-umbilical are all more commonly used for the saline breast implant procedure, while the infra-mammary incision is most commonly used for the “Gummy Bear”, cohesive silicone gel breast implants There are a few reasons why breasts may lack volume and projection. Some factors include genes, aging or after breastfeeding.
The most common incisions include the under-the-breast or inframammary incision; the trans axillary or through-the-armpit incision; the periareolar or areolar incision; and the transumbilical or through-the-belly-button incision.
The armpit, periareolar and belly button incisions can be used when saline or salt water breast implants have been selected, as the shell can be rolled up and inserted through an small telescope (also called an endoscope) and the implant inflated with saline (sterile salt water) when the breast implant is in the pocket, which allows for small incisions.
Generally, for any moderate- to large-sized silicone, cohesive gel breast implant, the under-the-breast, inframammary incision is the optimal incision selected, as the cohesive gel breast implant is often too big to put through the smaller saline incision locations.
Implants for Breast Enlargement
Once the incisional approach has been decided, then a pocket must be made for the breast implant. The breast implant pocket may be under the breast gland or under the pectorals chest wall muscle. It could also be a combination of both which is called the “dual plane”. The breast pocket’s location is often based on the characteristics of the patient’s chest tissues.
There are many types of shapes, sizes, and materials:
- teardrop (called anatomic)
- low viscosity gel
- highly cohesive and form stable silicone gel implants. It is now possible for a woman to select different heights, projections, and widths within each breast implant classification to achieve an individualized and natural appearance.
The vast majority of breast augmentation patients tend to have thin upper chest walls with visible ribs and collarbones and, therefore, the under-the-pectoralis-major-muscle also called “under the muscle” pocket is generally the most favorable, providing soft tissue camouflage and coverage at the breast implant-chest wall juncture.
Patients who have a large amount of glandular tissue that is somewhat deflated and mildly droopy, a sub-glandular, or under the breast gland and over the muscle pocket may be used, which is on top of the pectoralis major chest muscle, to give the breast enhanced projection shape and form.
After Selections Are Done
Once the pocket has been decided, the breast pocket is dissected and the implant is inserted into the pocket. A drain may or may not be used to facilitate removal of fluid from the pocket and, in general, a water-tight soft tissue incision closure is performed. The sutures used are mostly absorbable and removal is not necessary.
In the under-the-breast, inframammary incision, the scar ends up being the new inframammary refold and the incision usually can’t be seen in the standing, sitting or even lying down positions, without the breast itself being lifted. In order to assist in the selection process, Dr. Mulholland may use computer simulation surgery to give you the best possible sense of what breast implantation surgery results can be achieved.
The surgery itself takes approximately two hours to complete and is most often performed under IV sedation. A general anesthetic is usually not required. Most breast augmentation patients who have their surgery performed under a light IV sedation have no recollection of the procedure.
The IV sedation or general anesthesia is always performed by a fully certified anesthesiologist who cares for your medical condition while Dr. Mulholland performs the procedure.
Find the Right Combination for Your Body
As we age, there is a natural soft tissue deflation and loss of body and facial fat. Loss of body fat and shrinking of the breast gland can result in inadequate breast volume and projection for many women.
If your breasts lack volume and proportion because of hereditary causes, natural aging, or post-baby deflation, breast augmentation implantation surgery may be the appropriate procedure for you.The social, professional and lifestyle benefits of breast implants and breast augmentation surgery are well-documented in medical literature.
No amount of diet and exercise or will increase your breast size. In deciding whether to proceed with surgery, patients must be realistic about the proportional enhancement and enlargement breasts can bring to their figure, shape, and form.
Silicone Cohesive Gel vs Saline Impalnts
The “gummy bear” or cohesive gel implants have the advantages over saline for having more natural feel and texture and they have a lifetime warranty provided by the manufacturer.
Salt-water, saline implants have been around for 30 or 40 years and have the longest history. The problem is that the salt water lacks the viscosity to retain the shape in certain positions, particularly bending over. One can often see the collapse of the shell with ripples or visible rib-like structures under the skin. The cohesive gel can hold the shape of the implant structurally in all positions
Saline implants do have a risk of rupturing approximately 2% per breast, per year and eventually, as you age it will likely rupture and have to be replaced.
Our Preference: Cohesive Gel Implants
Cohesive gel implants come in a wide variety of shapes, heights, widths, and projections. The cohesive gel implant comes with a lifetime warranty that there will be no structural integrity faults within the breast implant and any fatigue or failure of the structural integrity results in a complimentary procedure on the compromised site.
The first week is characterized by pain and discomfort, but by the third or fourth day, gentle breast massage can start being performed to soften the implant pockets. After leaving the clinic, you will go home in an elastic breast band or soft, supportive bra. The band or bra helps keep the breasts in the correct position. Initial discomfort is controlled with oral medication. There may be some sutures that need to be removed.
Light activities can be resumed almost immediately. Aerobic activities and upper body strength training can be resumed in approximately six weeks. The patient will be shown breast massage techniques which involve massaging the implants within the breast pockets during the post-operative period.
The massaging reduces the frequency of wrinkling and the risk of capsule formation. In the first two to three weeks, the implants generally tend to appear to swollen and ride a little too high and take two to three weeks to drop down into the pocket and assume a more natural appearance.
In general, by six weeks, most patients can return to full activities, including exercises which involve pectoralis major muscle, such as push ups.
The results of an augmentation performed with cohesive gel silicone implants, may well last the rest of your life. If your augmentation was performed with a fat transplantation, there’s a natural loss of fat substance and volume as women age and there may be a loss of breast shape and volume over the 5-10 years following the fat grafting procedure.
You can expect larger and shapely breasts. Dr. Mulholland’s aesthetic style is natural-looking and proportionate breast enhancement. In general, modern augmentation involves pre-operative 3-D imaging with a tremendous amount of patient participation selecting the size and shape of the breast implant. By selecting the size and shape that best fits their figure, shape and form, most patients are ecstatic with their results.
Cost and Payments
Starting cost for Breast Augmentation in Toronto is $7500-$9000. The complete cost for your augmentation will depend on a few factors such as:
- Type of Implant
- Size of Implant
- Incision Site
- Doctor and Staff Fees
- Usage of the Vectra 3D Imaging
The procedure is not covered by insurance as the procedure is considered as an elective surgery. As a patient, you are required for payment.
At our clinic, we accept cash, cheque, credit card and financing which are outlined in our payment policy sheet.
To learn more about special financing options, please contact our office.
If you’re looking for more information about breast augmentation or any other cosmetic or surgical procedure you can continue browsing our website to learn more. If you have any questions regarding your face and body treatment options, don’t hesitate to call us to schedule an appointment. Our SpaMedica Toronto office can be reached at 1-877-695-2835. Alternatively, you can book a consultation online.
Who is a good candidate for breast augmentation procedures?
Ideal patients have realistic expectations and vision for their breast augmentation. Give careful consideration to the advantage of having implants to create more volume, projection, proportion and figure enhancements.
Good candidates have often tried diet and exercise to achieve ideal figure, shape, and form and generally use breast augmentation surgery to increase the projection and volume of the breast to better match their shoulders, hip and waist ratios.
Contraindications to breast augment surgery may include unrealistic expectations, medical diseases that prevent general anesthesia and various severe and advanced forms of multiple sclerosis and ALS, scleroderma, rheumatoid arthritis or other immune diseases.
Is drain required post-surgery?
Generally, a drain is inserted for augmentation and the patient may go home approximately four hours after their procedure. The drain is important since it helps to decrease tissue swelling, turgor, and discomfort. Our staff will remove the drain after 2-3 days.
How long does the breast augmentation procedure take?
The procedure takes approximately 60 – 90 minutes.
The procedure is performed under a light IV sedation and most patients are usually ready to go home approximately two hours after completion of the operation.
Is breast augmentation painful?
Breast augmentation often involves dissection under the pectoralis major muscle and there are significant pain and comfort for the first 2-3 days and then the discomfort becomes more of a “bruised sensation”.
In terms of ranking the order of discomfort with breast augmentation, Toronto Breast Augment patients generally rank child-bearing as number 10/10 in pain; an 8/10 would be a tummy tuck, with repair of the rectus abdominis muscle; a 6/10 may be laser resurfacing of the face; followed by breast augmentation. The pain of the dissection under the muscle and placement of the implant in that location is generally short-lived – 48 to 72 hours – after which most patients are fine using a nocturnal narcotic and anti-inflammatory medication during the day.
Breast augmentation pain lasts approximately 48 hours, whereupon there’s a significant decrease in discomfort and the patient is able to gently massage the breast and start decompression breast massage exercises.
What shape breast implants are available and how do I decide what shape and size is best for me?
Breast implants, either saline salt-water filled or the cohesive “gummy bear” solid silicone cohesive gel breast implants come in round and teardrop shape. In general, round breast implants provide the most natural and attractive shape for those individuals who have some loss of upper pole volume and some flattening of the upper pole projection following weight loss, age, breastfeeding or combinations of those physiologic processes.
Occasionally, individuals with very little glandular material may benefit from an anatomic teardrop-shaped breast implant and the 3-D VECTRA® imaging helps decide which shape is best for you.