Breast Augmentation

Breast Augmentation with Dr. Eric Pugash

Breast augmentation is an operation to enhance the size and shape of the breasts and improve body proportions. The operation can be carried out in women who are naturally small-breasted, as well as those whose breasts have changed as a result of weight loss or childbirth. The goal of breast augmentation surgery is to create a more feminine, proportioned breast. As an accomplished Vancouver breast augmentation surgeon, Dr. Eric Pugash has many years’ experience delivering exceptional breast augmentation results for his patients. To view before-and-after photos of his patients, please visit the breast augmentation photo gallery.

Dr. Pugash is a talented Vancouver breast augmentation surgeon. He offers all currently-used implants, including cohesive silicone gel devices in both round and tear-drop shapes. Please note that Canadian law requires patients to be at least 22 years-old in order to receive silicone gel implants.

Dr. Pugash is also experienced in all the currently used breast augmentation incisions, including the nipple incision and the minimal-incision armpit surgery. By offering patients a variety of implant types and incision placement techniques, Dr. Pugash gives them the freedom of choice regarding their surgical procedures.

Preparing for Breast Augmentation Surgery

As a leading Vancouver breast implant surgeon, Dr. Pugash believes that thorough patient preparation is an important aspect of a successful surgery. He takes into consideration the size and shape of the breasts, the quality of the skin, and the placement of the nipples in helping you plan your procedure. If your breasts appear saggy, Dr. Pugash may recommend a breast lift in conjunction with your breast augmentation.

Individual factors and personal preferences will help you and Dr. Pugash determine your desired breast size. Dr. Pugash will use photographs and implant sizers to help you choose the implant that will give you the desired result.

He will also talk to you about placing the implants behind or in front of the chest muscles, and suggest the best choice for you.

The discussion will also cover the type of implant that is best for you. Dr. Pugash has extensive experience with all available implants: salinecohesive gel, and highly cohesive gel devices (so-called ‘gummy bear’ implants).

Your Breast Augmentation in Vancouver

Dr. Pugash performs breast augmentation on an outpatient basis at Skinworks, False Creek Surgery Centre, Cambie Surgery Centre and Valley Surgery Centre. Patients usually return to non-strenuous activities in seven to ten days, and can resume exercising two weeks after surgery.

Dr. Pugash will provide complete care following your surgery to ensure that you are comfortable, return to your activities quickly, and obtain the best possible result. He will remain accessible during the recovery period to answer any questions you might have, and to address any concerns. His goal is to make you feel relaxed and completely cared for during the healing period.

Who is a Candidate for Breast Implants?

The ideal candidates for breast implants are women with naturally small breasts, as well as women who have lost breast volume after pregnancy and nursing or through weight loss. If you are considering breast augmentation you should be in good health and have specific, reasonable expectations of surgery. You should be also able to describe the results you desire.

Please note that saline implants are approved for use in women over the age of 18, and silicone gel implants are permitted in women over the age of 22.

How to Choose Your Breast Implant Size

Breast implants are measured in cubic centimeters (cc’s). One ounce contains a bit less than 30cc’s. In order to choose the best implant size, you and Dr. Pugash will need to consider factors such as your anatomy and goals. Dr. Pugash will use photographs and implant sizers to help you choose the implant that will give you the best result.

Dr. Pugash headshot

Meet Dr. Pugash

Ready to turn back the hands of time, enhance body contours or conceal aesthetic imperfections? Schedule a consultation with Dr. Eric Pugash today to learn more about how Dr. Pugash can help you achieve your aesthetic goals.

Dr. Pugash has built a busy cosmetic surgery practice that thrives on the referrals of satisfied patients. He and his staff take pride in their friendly office atmosphere, thorough patient education, and meticulous care both before and after surgery.

Incisions Used in Breast Augmentation

Dr. Pugash uses three primary incision patterns when performing breast augmentation. The areolar incision encircles the lower portion of the areola (dark tissue surrounding the nipple). The inframammary incision is placed within the crease underneath the breast. The endoscopic axillary incision is made within the armpit. The incision pattern that Dr. Pugash recommends depends on your build as well as the type and size of implant.

Armpit Incision

The armpit, or transaxillary incision for breast augmentation is placed high in the axilla (armpit). While patients often believe this technique results in breast enhancement with no scarring, this is not true. The armpit incision is made within a natural skin fold under the arm. This approach to breast implant placement leaves no scars on the breast; rather, the scarring is in the armpit. Patients must understand that this is the only breast augmentation scar that may be visible in public, especially if they are wearing a sleeveless top or bathing suit.

Women who want to recontour and enlarge their bustlines with no breast scarring may choose this method. Dr. Pugash makes an incision in the armpit fold to create a channel to the breast. He then positions the implants through the channel to an area behind the breast tissue and big chest muscle.

Areolar Incision

The areolar incision is made along the lower edge of the areola. Both saline and silicone gel implants can be placed through this incision, except in patients with very small areolas where it may be difficult to place silicone gel devices. These are already filled, in contrast to saline implants which are inserted nearly empty and filled once in the breast.

Inframammary Incision

The inframammary incision is usually well hidden under the breast once the healing process is completed. This incision appears to be associated with relatively low rates of capsular contracture, and can be used in subsequent operations without deforming the breast.

Recovering from Breast Augmentation

Dr. Pugash provides complete care following your surgery to ensure that you are comfortable, return to your activities quickly and obtain the best possible result. He will remain accessible during your recovery to answer any questions you have and address any concerns. His goal is to make you feel relaxed and completely cared for as you heal from surgery.

The breasts may be sore or swollen immediately following surgery, but Dr. Pugash will prescribe pain medication for any discomfort. He will also ask you to wear a surgical garment to help your augmented breasts heal. Most patients usually return to non-strenuous activities in seven to 10 days and may resume exercising two weeks after surgery.

6 Tips for Better Breast Augmentation Recovery

You’ve had your surgery, and now it’s time to take care of yourself. The following tips help promote a great recovery.

You must be in the care of a responsible adult for the first 24 hours after surgery. You will be able to move around and are encouraged to resume self-care quickly. However, you are unlikely to be cooking or cleaning for most of the first week. Driving is discouraged for at least a week until you are off pain medications and feeling clear-headed.

Dr. Pugash will provide surgical garments that will help you achieve the best possible result. Wear them as instructed.

Dr. Pugash generally instructs his patients to avoid cardio for two weeks and upper body fitness for six weeks.

Dr. Pugash believes that patients need to get the best sleep possible. He generally encourages patients to find the sleeping position that works best for them. Asking patients to try to sleep in an unfamiliar position is usually to ask for sleep-deprived patients.

Until all wounds are completely healed, avoid pools and spas.

Make sure to attend all your follow-up visits after surgery. It is generally a good idea not to travel for the first month or two, as this may make monitoring of your healing difficult.

Complications and Risks

Although the vast majority of Dr. Pugash’s breast implants Vancouver patients recover quickly and do not experience any complications, various surgical risks cannot be eliminated completely. The potential risks of breast augmentation surgery include reactions to the anesthesia, blood accumulation that may need to be drained surgically, and infection. Changes in nipple or breast sensation may result from breast augmentation surgery. Breast implants might also interfere with the process of mammography, although this is less a problem when the implants are placed behind the muscle.

Patients should also understand that a scar capsule forms around the implant as part of the natural healing process. This capsule may sometimes tighten and compress the implant, causing the breast to feel firmer than normal. Capsular contracture can cause discomfort or changes in the breast’s appearance. In such cases additional surgery may be needed to modify or remove the scar tissue, or to remove or replace the implant.

While the risks inherent in any surgery cannot be eliminated entirely, Dr. Eric Pugash and his medical team minimize them by adhering to the strictest safety protocols. As a result, their Vancouver breast augmentation patients consistently achieve excellent aesthetic results in a safe, speedy manner.

To learn more about breast augmentation with Dr. Pugash, or to get more information on other procedures he offers such as Vancouver tummy tuck and mommy makeover, contact his practice today.

Breast Augmentation FAQs

Dr. Pugash answers the following breast augmentation questions most frequently:

Experts agree that most women who have breast implants can successfully breastfeed. However, if you are planning to breastfeed, it’s important to bring this to Dr. Pugash’s attention during your initial consultation so he is aware of your intentions and can design your surgical plan around your goals.

Everyone heals at a different pace, and it’s important to listen to your body and not force any activities if you don’t feel ready. However, most breast augmentation patients return to non-strenuous jobs a week to 10 days after surgery. If your job is more physical and requires tasks like bending and lifting, Dr. Pugash may advise you to wait longer to return to work.

Today’s breast implants are designed to last many years — approximately 10 to 15 years for saline implants and 15 years or longer for gels. Patients must understand that, in most cases, they will undergo more than one procedure during their lifetime.

Any surgical procedure will result in some scarring. However, thanks to advances in breast augmentation surgery, Dr. Pugash can place implants with smaller and more discreet incisions than ever before. The scars fade and flatten over time until they are barely visible. Also, Dr. Pugash will provide you with a scar treatment product to apply after surgery.

Dr. Pugash generally prefers silicone gel implants, since they are lighter, have less rippling, and last longer than saline implants. The size is chosen in the office – patients try on implant sizers to identify the size that they find most pleasing. The chosen profile is the one for which the implant width best matches the breast width.

Patients can upload three photos to the Crisalix website. Crisalix then constructs a 3-D image of the patient’s chest. Dr. Pugash will demonstrate simulated surgical results at the time of the consultation.

The most important rule of breast augmentation is this: the breasts look the same after surgery as before, just bigger. You end up with a larger version of what you currently have. This means that many things don’t change very much, including the cleavage and the placement of the breasts on the chest. Of course, it is the job of the surgeon to make the result as beautiful as possible, but always remember that it’s surgery, not magic!

Dr. Pugash prefers to keep the surgery as simple as possible. In many cases, droopy breasts can be made to appear lifted, even with implants alone. In some cases, however, there is enough extra skin that a breast lift is unavoidable. Dr. Pugash will advise you on what will work best.

The breasts are sore for up to a week, mostly due to the placement of the implants under the chest muscles. Dr. Pugash does everything possible at the time of surgery and after to help make the recovery as easy as possible. He asks his patients to not exercise for 2 weeks, and to not do upper body fitness for 6 weeks.

The no-touch technique refers to the avoidance of touching the implant in the operating room. The implant is poured from its packaging directly into the Keller funnel and from there into the breast. This protects the implant from contamination and potentially reduces the risk of complications.

Silicone gel implants, because they are filled with a thick gel, have a reasonably authentic feel. A saline implant feels like what it is: a bag of water.

Loss of nipple sensation, or loss of sensation anywhere on the breast, is a risk of the surgery. The risk is the same regardless of where the incision is made.

The Keller funnel allows the surgeon to squeeze the implant through the small opening of the funnel into the breast through a relatively short incision. Also, the insertion is relatively gentle, lessening stress on the implant. Finally, the funnel protects the implant from contact with the skin, reducing bacterial contamination and the risk of complications.

Most patients return to most non-strenuous jobs one week after surgery. Patients should still expect to be a bit tired and sore, but a week is typically a good time to get back to the routine.

Dr. Pugash asks his patients not to do cardio for 2 weeks and upper body fitness for 6 weeks after surgery.

The most common early complication is hematoma, which is a buildup of blood around the implant. This usually, but not always, occurs in the first 24 hours. One or two patients in a hundred will develop a hematoma and have to return to the operating room for drainage. The most common late complications are capsular contracture, or hardening due to a scar tissue buildup, and aesthetic problems such as malposition.

Dr. Pugash’s philosophy is that his primary goal is a happy patient. However, he will use his judgement to help patients avoid making poor choices such as excessive size.

As the patient, you are in control of the size choice. You will try on implant sizers in the office and select the size that you find the most pleasing. However, from time to time, Dr. Pugash will use his judgement if he believes you are making a choice that will not work out for you in the long term. He is happy to take the time to have an honest discussion so that you are happy with your size for many years after surgery.

Yes. Dr. Pugash will explore the options to find the one that will best suit you and your lifestyle.

Every implant will break if given enough time. A saline implant will usually drain out within 10 to 15 years of surgery. This is easy to detect, since the breast deflates. A silicone gel implant will break typically within 15 to 20 years. In this case, the gel doesn’t go anywhere, as it’s held in place by the scar tissue that has formed around the implant. Implant failure will be detected by changes in the appearance or feel of the breast, or with mammograms or other imaging including MRI.

Yes. Mammograms are easier to do when the implants have been placed under the chest muscles.

The breasts usually feel very tight after surgery, especially in younger women who have not been through pregnancy. You will not hurt anything with any movement that you would normally do in your daily living. The tightness will disappear, and the breasts will eventually feel completely normal.

Dr. Pugash will provide a surgical bra to be worn for one month after surgery.

Yes, in nearly every case. Dr. Pugash has done the surgery under sedation (twilight anesthesia) in exceptional cases.

You must have a responsible adult to take you home from the clinic and to stay with you the first night.

Breast implants are not lifetime devices. Saline implants typically last 10 to 15 years, and silicone gel devices usually need to be replaced after 15 to 20 years.

Most patients know the process: check out surgeons’ websites for large photo galleries, and go to patient review sites. Patients should also remember that a long wait list is usually a good sign.

Dr. Pugash is with you every step of the way. He will personally do all your pre-op teaching and sizing, and every one of your post-op visits. He is available and will respond to any post-op concerns. Dr. Pugash has one of the largest breast practices in the country because he takes good care of his patients and strives for excellent results.