Breast Augmentation

Breast Augmentation

What is breast augmentation?
Many women express a desire to have more fullness in the upper half of their breasts, more cleavage and a better appearance both in clothes and bare. Breast augmentation surgery enhances breast size and shape, as well as improves breast balance and symmetry. Women seek breast augmentation for many reasons, but the most common include:

• Underdevelopment of breast size
• Post pregnancy and post breastfeeding deflation with a loss of both volume and shape
• Feeling that breast shape is droopy
• Age-related loss of breast volume


Your initial consultation will be with Dr. Eckhaus, and will start with a medical history and examination. If you are a candidate for this type of surgery, Dr. Eckhaus will go through a detailed discussion about the surgery itself, the recovery, and answer all questions that you may have. Dr. Eckhaus will discuss the which type of implant is best for you (saline or silicone), the options regarding the size of implant, the location of scars, implant location (above or below the muscle) and the risks and benefits of the surgery.

After your consultation (which is typically 30-45 minutes), you will meet with Carolyn, our patient care coordinator who will provide you with an estimate outlining the cost of the surgery.

Dr. Eckhaus strongly encourages a second office visit to answer any further questions and review the information from the initial consultation.

Pre Surgery Instructions

Before the procedure
No aspirin or blood thinning medications for two weeks prior to surgery. Fasting begins at midnight the night before surgery. Any medications that you take in the AM may be taken with a sip of water (except for blood thinning medications). If you get ill prior to surgery please notify us.

The Surgery

During the procedure
Breast augmentation surgery is performed under general anesthesia (you are asleep) and takes roughly 1.5 hours. It is day surgery performed either at Ajax Pickering Hospital or Clinic 360 (private surgery clinic at Leslie and Eglinton). There is no overnight stay. On the morning of surgery, Dr. Eckhaus makes all the markings on the chest wall and breast in the pre operative room.

After Your Surgery

Post procedure
Most patients are very comfortable immediately after surgery because of the use of local anesthetic at the time of surgery. In the recovery room, you will already have on a two-layer wrap as well as a compression bra that stays on for the first few days.

On your first post-operative visit (most often on the 2 nd or 3 rd day), Dr. Eckhaus will remove the two layer wrap and gauze and you are then able to shower. The compression bra is worn for 2 weeks day and night (24 hours per day for 2 weeks), and following this only during the day for an additional 2 weeks.

The majority of swelling subsides in the first 3 weeks. You should refrain from upper body exercise for 4 weeks, but gentle lower body exercise may begin at 2 weeks. Patients typically require 2-4 days of downtime.
While In Hospital or Clinic
You will be in the recovery room anywhere from 1-3 hours where the team will ensure you are comfortable, eating and drinking, walking and able to urinate.
On discharge home
Immediately upon discharge from the recovery room, you are encouraged to rest under supervision and start a light diet as tolerated.

You will have been given a prescription for antibiotics that is started when you return home from surgery and is taken for 1 week.
Day 1
You should be up and walking, drinking fluids, taking your antibiotics and pain medication as described below. Increase activity as tolerated, but there is no heavy lifting for 4 weeks. Do not change the dressings until your first post-operative appointment.

What do I take for pain? If you have pain, you are encouraged to start with:

• Two Tylenol extra strength (total of 1000 mg of Tylenol) and one Advil extra strength (400 mg of Advil) to be taken at the same time as they work by different mechanisms and work very well together.
• You can take the above three pills (two Tylenol extra strength and one Advil extra strength) every 8 hours around the clock for the first day or two. This is often sufficient for pain medication and can avoid the need for stronger medications such as narcotics (Percocet, Tylenol #3 etc.).
• However, you will also have a prescription for a stronger pain medication that can be taken as needed if the Tylenol and Advil combination mentioned above does not suffice. This stronger pain medication may be taken on top of the above regimen. Please ensure the maximum dose of Tylenol in 24 hours does not exceed 4000 mg.


** Please be aware that with any medication and particularly Advil (a type of non-steroidal anti-inflammatory) there are risks of allergy, severe allergy, gastrointestinal bleeding and stomach ulcers. Taking your medication with food can sometimes help with some of the stomach symptoms.

An initial wrap and post-operative compression bra are left in place for 2-4 days. During this period of time, you may use a hand held shower or sponge bath but the dressings must stay dry.
First post-operative appointment
The initial dressing change is done on day 2 to 4 after surgery. The gauze and tight wraps are removed and the white steri strip tapes are left on. Dry gauze or padding is used daily to protect the tapes from the compression bra band.

In the first two weeks following surgery, the post-operative compression bra is worn 24 hours a day (day and night, except for the shower). You are given two compression bras so that they can be alternated and washed.

An upper band may be used for implants that are placed below the muscle to keep a downward force on the implants for the first 2 weeks.

The subsequent two weeks (week 3 and week 4 following surgery), the compression bra is worn during the day only.
Second post-operative appointment
The second appointment is close to 2 weeks after surgery and the white steri strip tapes will be removed. Dry gauze once daily is used for the next week and then you will start the silicone gel sheeting for scar management (given to you at this appointment).

Post-operative swelling and bruising begins to subside after 7 days but can take up to 2-3 weeks.

Though most of the swelling will have subsided by week 3, you are advised to wait 4-8 weeks to be re-sized for a new bra.
 

BREAST AUGMENTATION
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