Breast Augmentation

augmentation mammaire - Dre Elise Bernier

Breast enlargement is for women with underdeveloped breasts and women who have lost their glands after pregnancy or loss of weight. It consists of introducing a prosthesis through a small opening that will go under the gland or the pectoral muscle.

This prosthesis can be filled with a saline solution or silicone. There again, a good assessment of your condition will allow you, after discussion with your surgeon, to determine the access route, implant site, type and volume of the prosthesis matching best your expectations. 

You also need to understand that your effort does not end on the day of the procedure. You also need to assume the responsibility of observing your surgeon’s recommendations and going through regular checkups afterward.

Where will the incision for breast augmentation be made?

Incisions can be made in the periareolar region, the inframammary fold and the armpit. Each incision has its particular features.

  • Periareolar region: This is where the thin skin allows fine and near-invisible scarring since it is located in a natural colour-transition site. This area also allows the superior juxtaposition of the tissues, which reduces the risk of exposing the implant. 
  • Armpit: This area is preferred by those who refuse to have a scar on the thorax; the incision heals well and leaves hardly any trace. But there are drawbacks with this particular area: longer surgery time, occasional difficulty reaching a vessel that bleeds with the risk of having to resort to a counter-incision, higher risk of altering the areola and the arm’s internal side sensitivity, as well as the sometimes slightly too high position of the prostheses.
  • Under the breast: This is the classic site for an incision because the scar will be relatively well concealed in the natural fold under the breast. However, the scar will, in general, be of inferior quality compared to the areola or armpit areas; it is also the most visible for the spouse.
  • The umbilicus (TUBA): A site increasingly popular because it leaves only a tiny scar between 12:00 and 6:00 in the umbilicus. According to some articles, there are also the advantages of being less painful, having a lower risk of infection, hematoma, and hard shell formation (capsular contraction).

It should be noted that the site has little or no influence on the risk of loss of sensitivity, which seems to be attributed to other factors: technique used, size of the implants, anatomical variations.

Where can breast implants be inserted?

There are two possible positions: under the gland or the muscle.

  • Behind the pectoral muscle: This procedure is usually necessary when implants are used that could be too visible (small waves) or palpable under a small gland and have a limited skin thickness (under 2 cm). The muscle covering the upper position of the implant provides, when relaxed, a milder and more natural transition between the thorax and the breast.

    The use of pectorals causes visible mobilization of the prostheses, which is nevertheless beneficial by reducing the risk of capsular contraction complications. When your natural breasts tend to drop with age, mainly if left without good bra support, a double contour may appear as the prostheses will remain under the muscle and in a higher position.
    However, in some cases, the strength of the pectoral muscle could accelerate the inferolateral descent of the implant.

  • Behind the mammary gland (in front of the muscle): It is possible to use only local anesthesia and preferably silicone implants for this position. The breast will have a rounder look at its upper pole but, with time, the implant and breast will tend to droop together. Over time, this may prove more natural, albeit with some reduced upper pole fullness. Implant position behind the mammary has also increased the risk of capsular contraction.

Silicone or saline breast implants?

Breast implants, although now highly sophisticated, will never imitate mammary tissue with accuracy. You have to be aware of this and accept its limitations and complications specific to implants, such as limited life span, ruptures and hardening of the breasts. 

They are not a permanent solution; they undergo aging that may require replacement in the future (approximately 10 to 15 years). Rejection can also occur in a small number of cases. Hardening of the breast is then observed. Finally, for each year following the surgery, 1% of these implants will rupture prematurely.

To find out which implants would suit your breast augmentation, please read our blog post about breast implants.

Need more information about breast augmentation?

Contact us if you have any questions or a consultation with Dr. Bernier in Montreal, Sherbrooke or Val-d’Or.

She will discuss with you your expectations and the most realistic way to achieve them.