Who is a candidate?
Patients who seek Augmentation Surgery usually range between the ages of 20 to 50. These are women who are seeking improvement, not perfection, in the way they look. Breast implants are most commonly used to enhance small breasts, balance asymmetrical breasts, or uplift breasts after pregnancy or fluctuating weight. Although breast augmentation can enhance your appearance and self-confidence, you should be realistic about your expectations and discuss them with Dr. Van Laeken.

Preparation for Surgery
It is very important that Dr. Van Laeken is aware of the state of your general health prior to surgery. Please let her know of any allergies you have, medications, herbal supplements, or vitamins you are taking as well as the reasons for taking them. It is also important that you inform Dr. Van Laeken if you have a tendency for Keloid scarring (thick, wide, or raised scars).

If you are a smoker, we encourage you to abstain from smoking before your surgery for at least 14 days. Smoking can interfere with the blood flow to the skin, and will inhibit the healing of the incisions.

Depending on your age as well as your general health, pre-operative testing such as a blood test, an ECG, or a mammogram may be required.

It is important that you avoid taking vitamin E, anti-inflammatories or aspirin products for 2 weeks prior to surgery. These products are anti coagulants, and could lead to hematoma formation and bleeding during the surgery.

Most patients who have sedentary jobs plan to take 1 week off work. If your job involves a great deal of physical activity Dr. Van Laeken can advise you as to how much time you should take off.

Procedure
Dr. Van Laeken operates at several different hospitals, but generally performs Breast Augmentation Surgeries at False Creek Surgical Centre or Vancouver Plastic Surgery Centre. These are both state of the art, fully accredited private surgical facilities.

The operation is usually performed as a day care procedure under general anaesthesia.

A small incision is made either around the edge of the areola (peri-areolar), or in the crease under the breast (infra-mammary). Through this incision an implant filled with a saline solution or silicone gel is inserted into a pocket created behind the breast. This pocket can be created in two places: directly under your breast tissue (sub-mammary placement), or underneath the pectoral muscle (sub-pectoral placement).

Dr. Van Laeken will close the incision and place a bandage dressing on you. This dressing will be in place for one week.

Recovery
There will be swelling and bruising for the first few days after surgery. This is normal and should disappear within 2-6 weeks after surgery.

Dr. Van Laeken recommends that when you arrive home from the surgical facility you get into bed and rest for the first 24 hours. Try to keep activity to walking to the bathroom and back for the first 24 hours. Do not raise your arms above your head for the first 24 hours. Gradually increase activity as tolerated. No pulling, pushing, or lifting for 5 to 7 days.

You will be given a prescription for pain medication, take as directed. If your implant was placed under the muscle you may experience more pain. Ice packs or frozen peas to your breast may help relieve some discomfort.

Following surgery your breasts will feel swollen and the dressing will feel tight. This is normal. It is very important to leave the dressing on without disturbing it. It provides compression and prevents bleeding after surgery.

Do not shower until after the dressing is removed, you may have a bath but do not get the dressing wet.

Your first follow up appointment is in the office 1 week after surgery to remove the dressing.

The second visit is in another week (10 to 14 days after surgery) to remove the stitches. At the visit, you will be instructed how and when to commence breast massage. The breast massage is important to do to control the scar tissue that forms around the implant. After 3 weeks you may begin to wear an under wire bra.

Most patients usually return to work 7 to 14 days after surgery depending on the kind of work they do. If your work involves heavy lifting, pushing, or pulling you may be required to be off work longer. Dr. Van Laeken can advise you as to how much time you should take off.

The final results of the surgery will be evident approximately 6 weeks after surgery.

Potential Complications
There are risks associated with any type of surgery. Although the incidence of complications is rare, Dr. Van Laeken feels that all patients should be informed of the potential complications prior to proceeding with surgery.

Haematoma - Blood can gather under the skin and cause a blood clot. If this does occur, Dr. Van Laeken can drain the area. Indications of a haematoma are a firm, painful lump that causes colour change in the skin. This rarely occurs after 48 hours post operatively.

Infection - A small percentage of women develop an infection around the implant. Signs of infection are localized heat, redness, fever, and pain. Dr. Van Laeken can prescribe antibiotics to treat the infection. Occasionally the area will need to be drained. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.

Changes in Nipple Sensation - The sensation of the nipples could be altered temporarily or permanently. Nipples may become hypersensitive, or even numb. These symptoms usually disappear with time, but may be permanent in some patients.

Keloid Scarring - Keloid scars are thick, wide, or raised scars. Cortisone injections can help correct this, but occasionally the scar requires surgical revision to make it acceptable.

Asymmetry - Symmetry is not always achieved.

Rippling - It is not uncommon to be able to see and/or feel the edges of the implants, particularly saline implants. In some patients, placing the implant below the pectoral muscle may reduce rippling. Be prepared that you may experience some rippling with breast augmentation surgery.

Capsular Contracture - The most common problem with breast augmentation occurs when the scar tissue or capsule around the implant contracts. Capsular contracture can cause the breast to feel hard, and may distort the shape of the implant. This problem is associated with a hardened capsule, and does not mean that the implant was placed improperly at surgery. Vigorous massaging may help alleviate some of the contracture, however, in severe cases revision surgery is required to remove the scar tissue, and sometimes it is necessary to replace the implant.

Rupture of Implant - Although rare, an implant may break or leak. If a saline implant ruptures, it will cause the breast to go flat, and your body without any harm will absorb the salt water. If a break occurs in a gel-filled implant, it may be difficult to detect any change. The silicone gel may either remain in the scar tissue surrounding the implant or migrate into surrounding tissue. You may notice a change in the shape or firmness of the breast. In both cases, revision surgery would be required to replace the implant.

Mammography Screenings
Breast implants change the way mammography is done to detect cancer. When you request a mammogram, be sure to go to a radiology center where technicians are experienced in the special techniques required to get a reliable x-ray of a breast with an implant.

Notify Dr. Van Laeken If After Surgery You Notice: