Dr. James will examine your breasts taking into consideration factors such as the
size and shape of your breasts, the quality of your skin and the placement of your
nipples. If your breasts are sagging, a breast lift may also be recommended.

Breast implants can makes it more difficult to read mammograms. Women at risk of
breast cancer will need to consider this prior to making a decision about whether to
have implants. Saline filled implants can be placed under the chest muscle so that
they will interfere less with mammograms, but other factors also need to be
considered. Dr. James will discuss this with you fully.

Breast augmentation is usually performed on an outpatient basis so it is important
to arrange for someone to drive you home after surgery and to stay with you the first
night following surgery.

Individual factors and personal preferences will help you and Dr. James determine
your appropriate breast size, the location of incisions, and whether the implants will
be placed on top of or underneath the chest muscle.

In 1992, the FDA decided that silicone gel-filled implants would not be generally
available for cosmetic breast enlargement. Currently, all women in the USA
undergoing breast augmentation receive saline-filled implants which consist of a
silicone shell filled with sterile saltwater.

Recently, new cohesive silicone gel implants became available in Canada. Health
Canada has determined that cohesive silicon gel implants are safe for use. The
cohesive gel does not seep, run or shift. Silicone gel implants tend to give a more
natural appearance than saline implants: they feel like real breast tissue. Cohesive
silicone gel implants do not normally ripple or fold as saline implants sometimes do.
Silicone gel implants have been available in Europe for several years and have an
excellent safety record. If you prefer to receive cohesive gel silicone implants rather
than saline implants, please discuss this with Dr. James during your consultation.) 

Once the incision is made, Dr. James creates a pocket into which the implant will
be inserted. This pocket is made either directly behind the breast tissue or
underneath the pectoral muscle which is located between the breast tissue and
chest wall.

After surgery, some discoloration and swelling will occur initially, but this will
disappear quickly. Most residual swelling will resolve within a month. After breast
augmentation surgery, it is often possible to return to work within just a few days or
a week.

Some potential complications of breast augmentation include reactions to
anesthesia, blood accumulation that may need to be drained surgically and
infection. Although rare, an infection that does not subside with appropriate
treatment may require temporary removal of the implant. Changes in nipple or breast
sensation may result from breast augmentation surgery, though they usually are
temporary.

When a breast implant is inserted, a scar capsule forms around it as part of the
natural healing process. The capsule may sometimes tighten and compress the
implant, causing the breast to feel firmer than normal. This is called capsular
contracture. Capsular contracture can occur to varying degrees. If it is severe, it can
cause discomfort or changes in the breast's appearance. In such cases, more
surgery may be needed to modify or remove the scar tissue, or perhaps remove or
replace the implant.

Breast implants are not lifetime devices. They cannot be expected to last forever.
Surgery will be required to replace your implants, if they rupture.

Except in the event of implant deflation, the results of your breast augmentation
surgery should be long-lasting: the lifetime of implants is thought to be 10 - 20
years.