During the whole process of Breast Augmentation, there are many different choices that must be made in order to leave you with an optimal result that transforms the appearance of your breasts. Selecting the right implant, the right approach, and the right placement all affect what the final breast enhancement will look like.
Preparation is 90% of the process. The surgery itself is just an execution of a well thought-out plan.
You will arrive at our facility in Toronto 2 hours prior to your surgery to allow our nurses to check you in, give you any medication that may be required prior to the surgery, and to allow you to relax in our pre-surgical room. Once the Operating Room is ready, Dr. Jugenburg will come into the pre-surgical room to speak with you. You will have a chance to ask any last minute questions that you may have.
Dr. Jugenburg will then take pre-surgery photos and mark your breasts. Next, you will meet with our Anesthetist, who will perform one last check to ensure you are safe to have the surgery. Finally, you will be taken into the Operating Room, which has by now been set up for your Breast Augmentation surgery.
All our Breast Augmentation surgeries are performed under general anesthesia. You will be fully asleep and completely unaware of anything; you will not feel any pain. The anesthesia begins with the insertion of an intravenous (IV) line by the Anesthetist. Through this line you will be given induction medication to relax you and to put you to sleep. During the procedure, you will also receive liquid and any medications necessary through this line. The General Anesthesia is maintained throughout your procedure by gases that you will inhale through a mask.
Our Anesthetist uses laryngeal masks, meaning that we do not need to insert a tube into your throat (trachea), unless absolutely necessary. The benefit of this is that you will not wake up with an uncomfortable throat, which is common with endotracheal tubes (tubes in your throat). Once the surgery is finished, the Anesthetist will turn off the gas and you will start to wake up over the next 60 seconds or so. During your sleep, we use various sophisticated monitors to ensure that you are fully comfortable and completely unaware of any surgery.
Once you are asleep, your chest is cleaned with an antiseptic solution, and sterile drapes are placed all around to maintain a bacteria-free environment. We inject local anesthetic (freezing) into the breast area, so that when you wake up from the general anesthesia your breasts feel frozen and you have minimal discomfort. Next, a small incision is made (at the breast fold, around the areola, or through the armpit) to create a tunnel from the skin to the space under the breast. A breast pocket is created, which is an empty space either above or below the chest muscle (pectoralis major) into which the breast implant is inserted. This space is washed out with an antibiotic solution. Next, the breast implants are removed from their sterile packaging and inserted into the breast pocket. Please note a breast implant is NOT inserted into your existing breast, but UNDER your existing breast. Both ‘under the muscle’ and ‘over the muscle’ implant placements are under the breast tissue itself.
We use a special instrument called a Keller Funnel to perform the No-Touch Technique, which means that the implant is transferred from its sterile packaging directly into the sterile breast pocket. This limits the chance of a contamination and potential infectious complications after the surgery. It is just one of the countless measures we take to ensure you walk away with beautiful, worry-free breast enlargement. Once the implants have been inserted, we meticulously check for symmetry and make any adjustments necessary to give you the best symmetry possible. Finally, we use absorbable sutures to close the incisions. Bandages are placed around your chest and wounds, a surgical bras put on you to hold the implants in place, and we inform the Anesthetist that it is time for you to wake up.
Once you are awake, you will be transferred to the Recovery Room where a highly skilled nurse will monitor you as you wake up. Most women spend 30 – 45 minutes in the recovery room until they are fully awake and ready to leave our facility. For further information on your recovery, please refer here.
After your surgery, you will have scheduled follow-up visits at the Toronto Cosmetic Surgery Institute to allow us to monitor your progress and healing. Your initial follow-up visits are with one of our expert nurses; once your wounds have healed, Dr. Jugenburg will see you again to monitor the progress of your implants as they settle in. Follow-up visits are very important and we ask that you do not miss them. They allow us to ensure that your scars heal beautifully, that your breast implants settle in as expected, and that ultimately, you are left with the perfect breast enlargement.
In certain instances, additional procedures may be recommended at the time of a breast augmentation in order to enhance the cosmetic outcome. These can include a breast lift, breast reshaping, correction of shape or volume asymmetry, correction of tuberosity and others.
Breast lift is the most common additional procedure I recommend to my patients (only when I deem it beneficial). This does NOT apply to all patients, only to those who have droopy breasts. Some women do not realize they have droopy breasts, or they assume implants will lift their breast. Others simply do not want to consider a breast lift in order to avoid the scars of a breast lift. However, when a breast lift is recommended, it is so that it helps to reshape the breasts and make the breast tissue and the breast implants align.
The above image is an example of a patient who requested a breast augmentation only and declined a breast lift. Her breasts were fuller, but not lifted.
Note that the implant added volume to her breasts but did not lift her nipples. Her nipples remained as low as they were before surgery, thus making her look good when wearing clothes but not when naked.
4 months after the breast augmentation she returned to get a breast lift done, to correct her breast shape.
Dr. Jugenburg is a highly experienced plastic surgeon who always takes the time to get to know his patients and their needs before committing to any kind of surgery. At your consultation, you will have the opportunity to meet with Dr. Jugenburg, and let him know about the look you want to achieve. The doctor will guide you through the whole breast augmentation process: from the preparations you will need to make, through to the surgical procedure and aftercare. You will have the opportunity to ask any questions and raise any concerns you might have with Dr. Jugenburg and his team of highly qualified and friendly healthcare professionals.
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