BREAST AUGMENTATION : QUESTIONS & ANSWERS

What type of implant does the doctor use?

We offer two types of implants: the saline implant, which is a pouch filled with a salty water, and the silicone implant, which is a pouch filled with cohesive gel.

Is it dangerous if the implant breaks?

If there is a tear in the saline implant, the water is absorbed by the body. In the case of the silicone cohesive gel, the gel is quite thick, therefore should not spill in the tissues around the breast.

What are the advantages and disadvantages between saline and silicon?

The advantage of the saline-base implant is that the scar is much smaller, only about a centimeter and a half. The implant is inserted empty and rolled like a cigar, then filled. The saline implant is soft, but not as much as the silicone one.
As for the silicone implant, it is very soft and supple to the touch, so it is ideal for women who have very small breasts (A cup) and not big enough to sufficiently cover the implants. The silicone implant is more expensive and the incision needed to insert it is longer, about for centimeters in length.

Is it painful?

There is no pain at all during the operation. There should be very little pain or discomfort after the surgery.

What kind of anesthesia?

Like with every other procedure, Dr Fanous utilizes local anesthesia with sedation (sedatives). You are 70% asleep and not 100% like in the case of a general anesthesia.

Do I see or hear anything during my operation?

You hear or see nothing at all.

Where is the scar?
How long is it?

In most cases, the incision is submammary. The scar is thus right under the breast, in the natural fold of the breast. It is thanks to Dr Fanous’ technique that he only needs to use a very small incision (1.5 cm), much smaller than the regular incision.

In the case of the silicone implant, the incision is about four centimeters long.

How many years are the implants good for?

Usually, the implants are good for a period of ten years or more. Regardless, it is possible for an implant to tear or deflate anytime after the surgery. Like a car, where you never know when or why you get a flat tire.

Do you do the incisions through the nipple?
If not, why not?

Dr Fanous sometimes uses this method with silicone implants, because the incision may be better concealed in the areola.

Do you do the incision in the armpit?

Occasionally, Dr Fanous will employ this method, where the incision is hidden in the armpit. Nevertheless, this incision is far from the breast. This means a hallway needs to be created from the armpit to the breast in order to insert the implant, where the implant tends to ascend in. Also, because the incision is higher and not lower than the breast, it is difficult to drain the blood that accumulates after the surgery, due to gravity.

Is the implant placed under the muscle?

With the regular technique, the implant is placed under ‘one’ muscle (the pectoral muscle). Dr Fanous prefers placing the implant under not only one but ‘three’ muscles. Therefore, the implant is completely separated from the breast by a wall of muscles.

Is it dangerous?
What are the risks of having breast implants?

The possibility of risks, like for any other surgery, is very minimal. There is less than 3% of risks every year, such as deflation, hardening of the breast (capsular contracture), infection, hemorrhage, irregularities, loss of sensation, etc.

When can I go back to work? When can I see the final results?

You will need one week of convalescence before returning back to work. You will be able to see the final result after six months. After the surgery, the implants are a little higher than the breast, and over the period of six months they gradually descend.

If I have a complication, do I have to pay again?

You only pay for the cost of the operating room and the anesthesia, but not for the cost of the procedure.

When can I resume my exercises?
Or lift my kids?

You may resume all your exercises after one month.

Do breast implants cause cancer?

No, there has never been any scientific proof associating breast implants to cancer.

Can I breast feed after my surgery?

Yes, you can breastfeed even after having breast implants. Because of Dr Fanous’ technique, the implant is completely separated from the breast by three muscles, although breastfeeding may cause a certain drooping in the breast later on.

Do I lose sensation in my nipples?

Usually, no. The loss of sensation in the nipples is rare.

How long is the surgery?

The surgery lasts approximately one hour and a half.

What happens if the implant deflates or ruptures?
What kind of surgery does this entail?
Do I have to pay again?

If an implant deflates or ruptures, it is nothing serious. If it is a saline-based implant, the saline water is simply absorbed by the body without any complications. If it is with silicone gel, the gel will stay in place since it is very thick. Consequently, a small surgery will be needed to replace the implant in question with a new one. Part of the cost of this procedure is covered by the company providing the implants, but the rest is covered by the patient.

Can I know the exact size of the implants before my surgery?

In general, the size of the implants will vary from 300cc to 400cc. Most clinics do not keep a stock of implants; they will evaluate the approximate size and will then order the implants, one pair at a time.

Dr Fanous prefers using a ‘test balloon’ during the surgery. He fills it with water to evaluate the necessary quantity to obtain the best natural result possible. We have the freedom of doing so since we keep a stock of over a hundred implants of different volumes at all times. It’s like having the supplier at our clinic!

That is why the doctor can only suggest an estimated size before the surgery.

What is the ideal size for a breast?
Who decides: Dr Fanous or the patient?

As a general rule, an ideal size for a breast is that of a C cup (it will vary between a small, medium or large). It is Dr Fanous who decides, during the operation, the exact size of the implant, because the size of the breast is not the most important factor in the result.

What are the most important factors for a good result?

The first priority is for the breasts to “look natural”. The second priority is for the nipples to be symmetrical. The third is the softness and suppleness of the breast. And finally, the last priority is the size of the breasts.

After the surgery, can we change the size of the implants?

No, the size of the implants cannot change once the surgery is over. It would have to be a completely new surgery!

BREAST AUGMENTATION : OTHER INFORMATION

Two different circumstances most frequently create an interest in surgical breast enlargement, often called "breast augmentation." The first involves congenital underdevelopment of the amount of naturally existing breast tissue.

The second situation is caused by a natural loss of breast volume, which follows a large weight loss or childbearing.

Anatomy of the Breast

The breast is made up of fatty, glandular and fibrous tissues. Within it are blood vessels, milk ducts, fat, glands and sensory nerves. A layer of fat surrounds the breast to give it a soft consistency and contour. Beneath the breast there are muscles that assist in arm movement. Women’s breasts vary greatly in both size and shape. The size and shape of your breast are determined by the amount of breasts tissue and fat present in them. It is also affected by factors such as age, past pregnancies, genetics and skin elasticity.

After surgery, the two breasts may vary, one being slightly different from the other. Such variations in size and shape are normal and they occur in most women.

Breast Implants

Saline implants have an outer pliable envelope enclosing saltwater liquid (saline) or silicone gel (cohesive gel). Saline is much like the fluid that makes up 70% of the human body. If the implant should leak and the saline is released, it can be safely absorbed by your body.

Silicone gel implants have a more natural consistency and are less likely to rupture.

The Body’s Reaction to Breast Implants

The body will form a fibrous tissue shell, made from collagen, around the surface of the implant. This is called the capsule. Capsule formation is a normal reaction to any implant. In some women, the collagen capsule can contract, causing a condition known as "capsular contracture". This results in a firmer, harder breast, which may cause discomfort, pain and deformity. In some cases, some implants deflate or rupture in the first few months after being implanted and some deflate after several years; yet some seem to be intact 10 or more years after the surgery. It is not known, in the case of saline implants, when deflation is most likely to happen.

The Surgical Incision and Placement Choices

Usually breast implants are surgically inserted utilizing one of three traditional incisions: the inframammary incision, the periareolar incision, or the transaxillary incision. All of these incisions allow the implant to be placed either submuscular (below one or more chest muscles) or subglandular (between the chest muscles and your breast tissue).

We use a special Technique : The Mini-Incision

This is a very small incision made in the skin fold below the breast or in the nipple (areola), and the breast implant is inserted under all the muscles through this tiny incision, using fine instruments (endoscopes). The breast tissue is not disturbed, and the short scar may be well concealed.

An additional option that patients with ptotic or sagging breasts may elect to have during the breast implant surgery is a mastopexy (breast lift). This procedure involves making incisions around and below the nipple to lift it upwards.

Recovery Period

During the first 24 to 48 hours after your surgery, you will experience discomfort. Your breasts will be tender. Although every woman’s recovery time is different, you should be able to resume many of your regular activities within one week. Should any problems occur after surgery, contact us immediately. This is especially important if your temperature is elevated, or one of your breasts is noticeably more swollen, tender to touch, painful, red or inflamed.

Potential Risks

There are inherent complications with breast augmentation as there are with any surgery. These risks include: deflation, infection, hematoma, delayed wound healing, capsular contracture, shifting of the implant, changes in feeling in the nipple and breast, making breast tumors harder to find on X-Rays, calcium deposits in the tissue around the implant, additional surgeries, etc...