Breast
Augmentation Mammoplasty

For patients who were born with underdeveloped breasts or who developed sagging atrophic breasts after breastfeeding, breast augmentation can produce very gratifying results. Breast augmentation is achieved with the use of breast implants. The commonly used implants are saline implants and silicone implants. Saline implants are less expensive and can be placed through smaller incisions. However, there is a possibility that it may need to be replaced in 10-15 years. The new silicone cohesive gel implant is available in Canada. It gives a better, more natural result and it is permanent. It is however more expensive. The size and shape of implants are chosen through careful measurements of the patient's chest anatomy before surgery.

The implant can be placed under the breast gland (sub mammary); under the big chest muscle ( sub pectoral); surrounded by chest muscle ( sub muscular); or under the facia of the chest muscle ( subfascial). Dr. Wong will advise the patient of the best possible placement of the implant according to the conditions of the patient's existing breast. The goal is to produce the most optimal result with breast with the best projection, softness and appearance.

The approach to create the implant pocket can theoretically be done through incisions under the breasts (infra-mammary), around the areola (peri-areolar), at the armpit (trans-axillary), or around the bellybutton (trans-umbilical). We use the peri-areolar or trans-axillary approach most of the time. We believe these approaches provide the best results with the least conspicuous scars.

Dr. Wong routinely uses the most technologically advanced implant (typically the cohesive gel textured implants) that there is no need for breast massage after surgery. With 25 years of experience and many hundreds of successful cases, hard capsular contracture in Dr. Wong's hands is extremely uncommon.

Mastopexy is sometimes necessary to lift up sagged breasts during augmentation mammoplasty. The simplest approach with the least scarring is through the peri-areolar approach (the donut lift). A small implant is usually placed simultaneously during the lifting procedure. This combined approach of lifting and augmentation is ideal for patients whose breasts have become small and saggy after breast-feeding.

The common complications of this procedure such as capsule contracture, asymmetry, hematoma and infection can be easily minimized if patients follow Dr. Wong's instructions thoroughly.

Reduction Mammoplasty

Reduction mammoplasty is usually covered by OHIP for functional reasons. Dr. Wong routinely refers this operation to a colleague of his who specializes in this procedure.