Breast enlargement, also known as breast augmentation, consists in inserting an inflatable implant (prosthesis) either behind the breast tissue or the chest muscle (on which the breast lies) in order to increase the volume and/or to enhance the shape of the breast.

There are several types of breast implants available and all are made of a soft outer shell filled with either a saline solution or with silicone gel.

Saline Solution

Saline is a 0.9% sodium (salt) concentration in sterilised water. Saline can easily be reabsorbed by our system. In case of a leak, saline does not cause any harm, since it is similar in composition to the liquid that makes up 70% of our body.

Silicone Gel

The breast implants made in the 60s were filled with silicone gel. This type of gel, which is at the heart of the controversy over the safety of these implants, is now prohibited by the Department of Health until the medical review boards of Canada appointed to make a ruling on their safe use, announce their final decision.

There are three types of conventional incisions through which to insert the breast implant. Once the incision is done, the pocket is prepared to receive the implant using specific surgical instruments.

Transaxillary (under the armpit)

• Precise technique by Endoscopic Surgery
• Lower risk of excessive bleeding
• The preferred technique of the majoriry of Dr. Bernier's patients
• 2.5 cm scar under armpits, hardly visible if at all
No scarring on the breast
• Massages can be administered in days following the surgery
• Lessened risk of sensitivity loss in nipples as nerves are directly visible
• Technique that can be combined with a breast lift
  
  

Periareolar (around the areola)

• Non-Endoscopic surgery
• Technique that can be combined with a breast lift
• Increases risk of excessive bleeding
• Scar might be visible on some patients
• Higher risk of losing sensitivity in nipples caused by poor visualisation of sensitive nerves
• Higher risk of infection caused by insertion through the mammary glands
• Possibility of mammographic abnormalities caused by scar formation on mammary gland
  

Inframammary (in the fold under the breast)

• Non-Endoscopic surgery
• Increases risk of excessive bleeding
• Higher risk of losing sensitivity in nipples caused by poor visualisation of sensitive nerves
• Scar might be visible
• Risk of inappropriate positioning of the scar (scar above the mammary fold)
  

Once the incision has been made, special surgical instruments are used to prepare the pocket for the insertion of the empty implant, which is to be placed either under the breast (glandular) tissue or the chest muscle. Once in position, the implant is then filled with saline (aseptic transfer) until the desired size obtained. The surgery lasts about 1 hour and a half and is done under general or local anaesthesia. The convalescence period for a breast implant by endoscopic surgery is about one week.

Behind Chest Muscle

• Better overlap for implant
• More natural appearance
• Lower risk of feeling saline implant folds
• Ideal in patients with little breast tissue
• Better view of breast tissue when undergoing mammography
  

Behind Breast Tissue

• For patients with a large amount of breast tissue
• Technique often used for silicone gel implants
• High risk of feeling saline implant
• Diminished view of breast tissue when undergoing mammography folds