Breast Augmentation

What is Capsular Contracture?

When our patients from Calgary and the surrounding areas are considering and researching breast augmentation with Dr. Frank, they will come across a term they probably have not heard before — capsular contracture. It is the most common complication after having breast augmentation, so in the last blog before a glorious Calgary summer, let’s get into just what this is and what happens. 

What is capsular contracture? 

The human body has one characteristic that is uniform for every person. If an artificial item, such as an artificial knee or a pacemaker, is placed under the skin, the body responds by surrounding the item with scar tissue. This is known as a tissue capsule. 

That’s what happens when breast implants are placed; the body builds fibrous scar tissue around it, the tissue capsule. This is because the body recognizes the implants as foreign objects. 

In most cases, the tissue capsule is soft or slightly firm (still not noticeable) and this helps keep the implants in place. But in some women, the scar tissue formation goes a little haywire and the tissue capsule becomes hard and dense. As it constricts it squeezes the implant. This is capsular contracture, and it can cause chronic pain and distortion in the shape of the breast. 

Signs of capsular contracture 

As the body continues to build scar tissue around the implant and the tissue capsule begins to squeeze the implant, you will have increasing firmness or tightness in the affected breast. This can evolve into chronic pain, restricted range of motion, and/or changes in the position and shape of the breast. 

Capsular contracture can start to appear as early as a few months after implants are placed or years later. There isn’t a set timeframe. 

How is capsular contracture addressed? 

In most cases, Dr. Frank will perform a capsulectomy for patients who are dealing with capsular contracture. During this procedure, he will enter through the original incisions and he will remove the existing implant along with the surrounding tissue capsule. He will then replace the implant back into the same pocket.  

If you’re feeling tightness in your chest and wonder if you could have capsular contracture, please give Dr. Frank a call at (403) 245-1228 to set up an appointment.

Removing Breast Implants

While breast augmentation continues to be a very popular procedure in Canada, with over 20,000 patients opting to increase their breast size with implants, more women are also opting to have their implants removed.

Dr. Frank performs breast implant removal surgery at his Calgary practice.

Concern about lymphoma

When Health Canada announced a ban on a certain type of textured implant manufactured by Allergan, the Biocell implant, that’s when many women started to consider having their implants removed. This wasn’t necessarily only women who had these Biocell implants.

These Biocell textured implants have been linked to a very rare form of cancer: anaplastic large-cell lymphoma. In the announcement, Health Canada called the cancer “breast implant-associated anaplastic large-cell lymphoma” (BIA-ALCL).

The occurrences of this lymphoma are exceedingly low — of the 40 million women who have had implants only between 300 to 500 have been diagnosed with genuine cases of anaplastic large cell lymphoma — but the news has brought implant removal to the forefront of the public consciousness.

Numbers

It’s hard to get precise numbers from Canada, but we can use the United States as an example of this trend toward removing implants. In the U.S., 313,735 women had breast augmentation in 2018.

In contrast, in 2008, the ASPS reported that 20,967 women had their breast implants removed. A decade later, that number had risen to over 29,000. That is still a small number versus having implants placed, but it is growing.

In 2019, ASPS reported the number of removal procedures was now at 33,764. That was still dwarfed by the 299,715 U.S. women opting for augmentation, but it has now crossed the line of being over 10 percent.

What will my breasts look like after I remove my breast implants?

After implants are removed, your breasts will not look the same as before you had implants placed. The weight and size of the implants stretches the tissue and causes changes in the rib area.

The appearance of your breasts will depend to a large degree if you’ve had a breast lift when your implants are removed. A breast lift has the goal of returning the breasts to a higher position on the chest. It removes excess sagging skin and repositions tissue as needed. The nipple/areola complex is usually moved to a higher position, as well.

With a breast lift, your breasts will be smaller, but they will not be sagging and overly flattened. That can be the result if the implants are removed without a breast lift.

If you have questions about breast implants, please call Dr. Frank at (403) 245-1228.

About the Recall of Biocell Textured Implants

As if the past year of the coronavirus haven’t made us all anxious enough, if you’ve also been considering breast augmentation you may have heard some other news that made you anxious. Health Canada and the U.S.’s FDA recalled a certain type of breast implant, and you’re now wondering what’s up with that.

Since Dr. Frank has performed countless breast augmentation procedures for our patients from Calgary and surrounding areas, let’s use this blog to fill you in on what’s behind the recall. It’s worth mentioning also, that Dr. Frank has never offered or used textured implants in any of his procedures.

What is BIA-ALCL?

The first step came in March 2017 when the FDA first announced it had found evidence of a link between textured breast implants and a very rare form of cancer: anaplastic large-cell lymphoma. In the announcement, the FDA called the cancer “breast implant-associated anaplastic large-cell lymphoma” (BIA-ALCL).

Then in May 2019, Health Canada suspended the sale of Allergan Biocell breast implants. In July, the FDA followed suit with a ban. It made a voluntary recall request to Allergan for all of its Biocell textured implants.

What the FDA said

Health Canada and the FDA requested that Allergan recall all Biocell textured breast implants and tissue expanders due to risk of breast implant-associated anaplastic large cell lymphoma, a cancer of the immune system. Based on the currently available information, analysis demonstrated that the risk of BIA-ALCL with Allergan Biocell textured implants is approximately 6 times the risk of BIA-ALCL with textured implants from other manufacturers. That’s why Health Canada and the FDA instructed Allergan to stop distribution.

The ban applies only to this specific type of textured implant, Biocell. The same associations have not been found with other types of textured implants. It appears the lymphoma develops in the scar tissue that forms around the Biocell textured implants.

There is no recommendation for women to remove these implants, as the number of cases is exceedingly low. Still, women who have received Allergan Biocell macro-textured implants should be on the lookout for any signs such as swelling, lumps, and pain in the breast.

What is ALCL?

ALCL is a very rare cancer that can develop in any part of the body, most commonly the lymph nodes and skin. Research suggests that BIA-ALCL is usually found near the breast implant within the surrounding scar tissue, not in the breast itself. The lifetime risk for developing BIA-ALCL from a Biocell implant is estimated to be from one in 4,000 to one in 30,000.

How is BIA-ALCL treated?

This is still a very low risk. Plus, when BIA-ALCL is caught early it is usually curable. Treatment involved surgical removal of the implants and the scar tissue capsule.

Do you have questions about breast implants? Please call Dr. Frank’s office at (403) 245-1228 to schedule a consultation and he can fill you in.

Do Uneven Breasts Make You Self-Conscious?

Many women have uneven breasts. It’s a very common fact of anatomy affecting roughly one half of all women. But sometimes, asymmetry can make a woman feel self-conscious when naked or in a swimsuit. No one should feel that way about her body. To help get past these thoughts, Dr. Frank offers various options to even out the differences between breasts. This may require breast augmentation, a breast lift, or a breast reduction, depending, of course, on the patient’s individual situation.

So that you understand why your breasts may be uneven, here’s some information that may help.

Breast size fluctuates

You probably already know this, but your breasts are actually glands contained within your chest wall. Each breast weighs an average of seven to 10 ounces and is made up of from 12 to 20 lobes that branch out from the nipple, kind of like bicycle spokes. Each of these lobes has a central duct that opens at the nipple, the exit location for milk during breastfeeding.

You’ve no doubt noticed fluctuation in your breast size during ovulation and menstruation. Breasts usually are fuller, more even, and more sensitive during ovulation. This is due to your body retaining water and also the increased blood flow during that phase of your cycle. Then during menstruation, your breasts tend to shrink back to their normal shapes and sizes.

But why are they sometimes uneven?

Here are four reasons why your breasts may be uneven:

  • Anatomy

Normal anatomy is one reason. Most of our body parts aren’t exactly symmetrical. Look at your eyebrows — they’re likely to be a little different in size and shape. Your legs and arms probably aren’t even exactly the same length. It’s normal.

  • Puberty

Hormonal changes that are raging during puberty can initiate one breast to begin growing before the other. Then, since the body will trigger them to stop growing at the same time, you’re left with somewhat uneven breasts. Again, really normal.

  • Lumps

Lumps can develop in your breasts. Some come and go. Others you may want to have surgically removed. Most are benign and are caused by a variety of conditions or sometimes from a traumatic injury. Lumps can be fluid-filled sacs called cysts. They can be caused by fibrocystic breasts, where the breasts feel lumpy or rope-like. Or they can be due to fibroadenoma, a condition that causes breast lumps in adolescent girls and women under age 30.

  • Breast cancer

Generally, this applies to women whose breasts have been even, but suddenly begin to become more and more asymmetrical. Sudden changes in the size, shape, and appearance of one of your breasts can be a symptom of breast cancer and needs immediate attention from your gynecologist.

Now you know that asymmetrical breasts are not abnormal in the least. Still, if they’re affecting the way you see yourself and make you feel self-conscious, you may want to consider one of your surgical options with Dr. Frank to even out your breasts. If so, call us for a consultation, (403) 245-1228.

Common Questions about Breast Augmentation

Breast Augmentation Calgary ABThe decision to have breast augmentation is a big one, and it will change your life. Dr. Frank’s patients have lots of questions when considering this surgery. Here are the answers to a few of the more common questions. Of course, if you have other questions, call us and schedule a consultation.

How long will my implants last?

Although it would be nice if they lasted forever, like any manufactured product, breast implants have a lifespan. At some point the implants will rupture or begin leaking and will need to be replaced. How long will that be? Manufacturers warranty their implants for 10 years, and will generally reimburse patients for failure prior to that timeframe. But the lifespan of patient implants can vary wildly.

If you opt to have breast augmentation, you’ll need to expect to have at least one replacement surgery in your lifetime. You should expect to need to replace your implants every 15 to 20 years. Implant durability is increasing, so these lifespans could lengthen. Replacement surgery is much easier than the original augmentation surgery, as Dr. Frank can enter through the original incisions.

How will I know what size to choose for my implants?

Some women think implants are sized similar to bra sizes, but this isn’t the case. Implants are sized by the amount of material filling the implant shell, measured in cubic centimeters (ccs). For instance, an implant could be 300 ccs. Dr. Frank & our breast augment nurse, will help you determine which implant will be best suited for the enhancement you are looking for.

When can I return to normal activities after my augmentation surgery?

Most patients are surprised when we tell them they can return to work approximately 3-5 days after surgery. One very important facet of recovery is wearing a support bra 24 hours a day for one full month after your surgery. It can be tempting to not follow these instructions, but it is important so as not to place any stress on your incisions. Otherwise, normal activities can resume in 2-3 weeks, but any impact exercise will need to wait for at least one month. Upper body exercise, such as lifting weights, will need to wait for six weeks.

Dr. Frank’s Calgary patients are very satisfied with their augmentation surgeries. If you want to add some shape to your figure, maybe it would be right for you. Call Dr. Frank at (403) 245-1228 to schedule a consultation or with any questions you may have.

Textured Implants and Cancer

On March 21, 2017, the U.S. FDA made a safety announcement about a link between textured breast implants and a very rare form of cancer: anaplastic large-cell lymphoma. In the announcement, the FDA called the cancer “breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL).

Since then, the ante has been upped. On May 28 of this year, Health Canada suspended the sale of Allergan Biocell breast implants. In July, the U.S. FDA followed suit with a ban.

Dr. Frank does not use textured implants, but wants his patients to know about this move from Health Canada.

What Health Canada said

Health Canada issued its May suspension citing research that, compared to other implants, found patients with textured implants had a higher risk of breast implant-associated large cell lymphoma (BIA-ALCL), a rare cancer that affects the immune system.

Health Canada had previously issued an announcement of textured implants and BIA-ALCL, but not a ban. The group then received reports of new cases of BIA-ALCL. When a safety review was conducted in 2017, Health Canada knew of only five confirmed Canadian cases. Since that time, that number of confirmed cases has risen to 26.

The suspension means that Allergan is no longer allowed to sell its Biocell macro-textured implants in Canada, and all unused implants are to be sent back to the manufacturer.

There is no recommendation to remove textured implants, as the number of cases is exceedingly low. Still, women who have received Allergan Biocell macro-textured implants should be on the lookout for any signs such as swelling, lumps, and pain in the breast.

What is ALCL?

ALCL is an uncommon cancer that can develop in any part of the body, most commonly the lymph nodes and skin. Research suggests that BIA-ALCL is usually found near the breast implant within the surrounding scar tissue, not in the breast itself. The lifetime risk for developing BIA-ALCL from a textured implant is estimated to be from one in 4,000 to one in 30,000. At this point, the type of implant (silicone or saline) doesn’t seem make a difference. It is the implant texture.

How is BIA-ALCL treated?

This is still a very rare risk. Plus, when BIA-ALCL is caught early it is usually curable. Treatment involved surgical removal of the implants and the scar tissue capsule, as the lymphoma appears almost always to be only in the scar tissue capsule.

Do you have questions about your implants? Please call Dr. Frank at (403) 245-1228 for more information.

Women are Happy with their Augmentation Surgery

Breast Augmentation CalgaryThe last few blogs we’ve covered the ins and outs of breast augmentation. The procedure is among the top cosmetic procedures performed in Canada, with around 20,000 augmentation procedures being done each year. That’s not anywhere near the yearly 300,000 procedures in the U.S., but it’s still sizeable.

Dr. Frank likes his patients to have all the information possible about any potential procedure. To that end, this month we’ll share some statistics about breast augmentation. They are taken from American women, as statistics are easier to gather with the larger numbers involved. Still, it should give you a good idea of five reasons why breast augmentation keeps increasing in popularity, both in the U.S. and Canada.

#1 Extremely high satisfaction rates

Women who have had breast augmentation are routinely surveyed in the months and years afterwards. They report incredibly high rates of satisfaction. A recent survey from the American Society of Plastic Surgeons reports that 98 percent of women felt their augmentation either met or exceeded their expectations. Over 90 percent of the women also said they felt the procedure increased their self-esteem.

#2 Easy recovery

Breast augmentation surgery does not involve a difficult recovery. Most women are able to return to work after just a few days of recovery. The pain is not acute, and is often related to being similar to the feeling after a rigorous upper body workout.

#3 Implants are proven to be safe

Before any implants were initially approved the FDA in the U.S. and Health Canada studied them extensively. Later, in the 80s, when there was some concern about silicone and safety, even more rigorous research was done and found no link between health issues and silicone breast implants. Plus, modern silicone gel is now very cohesive, meaning it usually adheres to itself and doesn’t leak out into the breast pocket if the implant ruptures.

#4 Duration

Implant durability is continuing to improve. Although most implants will need to be replaced at least once in a patient’s life, there is no specific timeline. Manufacturers guarantee their implants for at least 10 years, and many patients have implants that can last double that time. Plus, replacing implants is not difficult as Dr. Frank can simply enter through the same original incisions to remove the old implants and place the new ones.

#5 Variety of options

There are a variety of implants available from different manufacturers. These vary by the size, the shape, and the projection. This allows patients to choose an option that fits their goals, rather than adapting to a one-size-fits-all approach.

If you’re interested in augmenting your breasts, please call Dr. Frank at (403) 245-1228 to schedule a consultation.

Don’t Forget the Gummy Bear Implant

Breast Augmentation CalgaryIf you’ve been considering having breast augmentation, you know you have many decisions to make beyond just the overall procedure. We covered many of those decisions in Dr. Frank’s December blog.

Of course, you’ll need to choose the type of implants you want. Most women think of choosing between saline and silicone implant options. But there really is another choice that is different enough to merit almost its own category, the gummy bear implant. Dr. Frank wants his patients to have as much information as possible, so here’s some information on these implants.

What is a gummy bear implant?

Gummy bear implants are relatively new to the Canadian market, but they’ve been used in the U.S. and Europe for nearly 20 years. After years of use throughout the country, Health Canada finally approved the use of gummy bear implants in October 2006. These implants retain their shape, unlike other implant choices, because the gel is thicker than traditional silicone implants. In addition to “gummy bear implants” they are also known as cohesive, form-stable, or highly cohesive.

Cohesive silicone gel

There is some misunderstanding about what “cohesive gel” breast implants really are. In reality, all silicone implants sold today use a more “cohesive” silicone gel than implants from the 80s and early 90s. Only the most cohesive, i.e. thicker, are deemed to be “gummy bear implants.” To get an idea of the density, if a cohesive implant is cut in half, there is no gross movement of gel, and the implant maintains its shape.

Safety

Gummy bear implants have a lower rate of capsular contracture and rupture. Like traditional implants, gummy bear implants can rupture, although the gel tends to stay within the implant. Rippling is far less prevalent with cohesive implants than with traditional silicone implants, although this is usually related to how much tissue is atop the implant.

Are you considering breast augmentation? Call Dr. Frank at (403) 245-1228 to schedule a consultation and you can discuss whether gummy bear implants would be right for you.

Decisions Beyond THE Decision with Augmentation

Breast Procedures Calgary, ABBreast augmentation is a very popular cosmetic procedure in terms of numbers of procedures. But beyond that, it has one of the highest satisfaction ratings of any cosmetic procedure. If a woman has always felt dissatisfied with her breasts, whether that stems from size, asymmetry, or any other reason, augmentation surgery can really change her self-esteem and body image.

Deciding to move forward with breast augmentation is a big decision, but Dr. Frank reminds his patients that there will be other decisions to be made beyond the initial yes or no.

The choices can sometimes feel daunting — How do I know what to choose? — but Dr. Frank will provide information and help you with each decision.

Implant type

You’ll first choose your implant type: saline, silicone, or cohesive silicone. Each option has its own pluses and minuses.

Saline implants can be placed through a smaller incision, as they are filled once placed into the breast pocket. If they rupture, the body simply absorbs the saline water. Saline implants do have a higher incidence of wrinkling. Plus, if they rupture, you’ll still need replacement surgery to remove and replace the deflated shell.

Silicon implants have become more popular than saline. They are generally thought to feel the most like natural breast tissue. However, if they rupture, the silicone needs to be removed. Most of today’s silicone gels are far more cohesive, however, and stay in or near the implant shell.

Cohesive silicone implants (commonly known as gummy bear implants) are a new addition to the implant options. They are filled with thicker gel, hence the gummy bear name.

Implant size and shape

Beyond the type of implant, you’ll need to decide on the size and the shape of your implants. Some patients believe they will select their implant size based on the same sizing system used with bras. That’s not the case. Implants are sized based on the amount of the substance filling the implant. For instance, implants may be 350 ccs. That is cubic centimeters. The most popular sizes are generally between 330 and 400 ccs.

You’ll also need to choose projection. As an example, these are the five styles available with the Allergan Natrelle Inspira breast implant line:

  • Smooth Round Low Profile (widest base/lowest projection)
  • Smooth Round Low Plus Profile
  • Smooth Round Medium Profile
  • Smooth Round Full Profile
  • Smooth Round Extra-Full Profile (narrowest base/highest projection)

All manufacturers have similar options. Currently, the two most popular styles with these Allergan implants are Full Profile first and Medium Profile second.

There are other choices you’ll make, such as do you want to place your implants atop or beneath the pectoral muscle? Again, Dr. Frank will help you with all of these so that come the day of your surgery, you’ll be calm and excited for your new figure.

Do you have questions about breast augmentation? Would you like to schedule a consultation with Dr. Frank? Call us at (403) 245-1228 to make an appointment.

Working out after Breast Augmentation

Breast AugmentationBreast augmentation is a popular procedure that we conduct to help our patients gain the confidence they wish to feel in their physical appearance. One attribute that is shared among a good number of women who seek this procedure is a desire to stay physically fit. Breast augmentation gives them the complementary curves that top off their beauty goals. When exercise is an important aspect of a woman’s life, she may find it challenging to allow herself full recover from her surgery. “When can I work out?” is one of the most common questions we hear as we prepare for this body-enhancing procedure.

The techniques employed in the placement of breast implants is so precise and gentle that most patients feel able to return to normal activities relatively quickly. This can be good, but it can also create confusion in the area of exercise. We submit that our patients do the following:

  • Wait until the post-op follow up visit to even think about hitting the gym, or the yoga studio, or whatever form of exercise is preferred. We provide post-operative instructions for a reason, and one of the top details is to postpone exercise until cleared by Dr. Frank. Trust the timing of your return to exercise.
  • Let your body be your guide. Once you are medically cleared for your return, pay close attention to what your body has to say about your workout routine. Give a little extra rest when needed. In fact, schedule that day off when you do nothing more than take a nice relaxing walk.
  • Go easy on the upper body. Upper body exercises can stress the muscles in the chest and arms, those that have been disrupted in surgery. Resist the urge to reach for your former weight, and start your post-surgical workouts with lighter weights that are gentle on these muscles as they build up their strength.
  • Get support. In the first few days after breast augmentation, you may have relied on a few close friends or family members to help you. Now, your biggest support is a good sports bra. This is necessary regardless of the type of exercise you do, even yoga can put strain on recuperating muscles and tissues.

Is breast augmentation something you have always wanted to do? Learn more about this procedure by calling our Calgary office at (403) 245-1228.

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