One of the most frequently performed cosmetic surgery procedures in the U.S., breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of saline or silicone implants in the breast.
Patients elect to undergo breast augmentation for many different medical and aesthetic reasons, including balancing breast size, compensating for reduced breast mass after pregnancy or surgery, and correcting a congenital breast defect. Under our doctors' expert care, patients enjoy great-looking, natural-feeling breasts that are one or more cup sizes larger after the operation.
Breast augmentation can achieve dramatic and beautiful results on its own as well as in conjunction with other cosmetic surgery or non-invasive procedures. We sometimes recommend combining breast augmentation with other procedures such as a breast lift for more satisfying results. This is most commonly recommended to treat any sagging that has resulted from aging or pregnancy. During this combined procedure, some breast tissue is removed, the breast skin is tightened and lifted, and an implant is inserted.
Fully Customized Breast Enhancement
Every woman is unique in both her desires and her body shape. With that in mind, your doctor will take the time during the pre-operative consultations to learn what each patient hopes to gain from breast augmentation surgery and to decide which implant type, size and placement is best. In this way, each patient enjoys completely customized treatment designed with her specific goals in mind.
During your consultation, you will make decisions together about the type, size, incision and placement of your implants. Your anatomy plays a major role in these decisions. Your doctor will talk with you about the options for breast augmentation surgery - depending on your current measurements, your body frame, and your expectations.
Saline and Silicone Gel Breast Implants
Breast implants are silicone shells filled with either saline (salt water) or silicone gel. Both implant types are very safe, and each offers its own advantages. Your doctor will help you decide which kind is right for you. During surgery, the implants will be placed behind each breast, underneath either the breast tissue or the chest wall muscle.
An advantage of saline breast implants is that, if ruptured, the saline (salt solution) is dissolved by the body. A disadvantage is that saline breast implants may appear less natural in small-breasted or reconstructive patients. This is especially important for very thin women who have little breast tissue to cover the implant, or for women who have a breast injury or need breast reconstruction.
Silicone gel-filled breast implants may provide a more natural feel and is the implant choice of most of our patients. After many years, the U.S. Food and Drug Administration (FDA) has approved silicone breast implants for breast augmentation surgery. We are proud to offer patients the option of silicone gel-filled breast implants, since they are much softer and feel more natural than saline-filled breast implants.
Breast Augmentation Surgery - Placement Options
Breast implant placement beneath the muscle of the chest offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Possible disadvantages include need for drainage tubes and elevated pain in the first few days following surgery. Your doctor will help you decide which option may be best for you.
In the TUBA procedure, implants cannot be placed beneath the chest wall.
After the implants have been inserted and positioned beneath the nipples, the incisions are stitched closed, then taped and bandaged. In a few days, these bandages may be replaced with a surgical bra.
Breast Augmentation Surgery - Incision Techniques
The breast augmentation procedure lasts one to two hours and is typically performed with general anesthesia. Incisions are made in inconspicuous places on the breast to minimize scar visibility. These incisions may be located:
- In the armpit (transaxillary). To perform breast augmentation with a transaxillary incision, the incision is made in the natural folds of the armpit tissue. A channel is then created up to the breast. This procedure is sometimes performed with an endoscope, or a small tube with a surgical light and camera embedded in the end, to provide visibility through the channel. The biggest advantage of breast augmentation with a transaxillary incision is that the scar is not on the breast.
- In the crease on the underside of the breast (inframammary). Breast augmentation with an inframammary incision is performed with an incision made under the breast and close to the inframammary fold. The incision is made here to secure proper placement of the implant, but also to reduce scar visibility. An advantage of breast augmentation with an inframammary incision is that the surgeon works close to the breast, allowing for optimal visibility while working.
- Around the areola, the dark skin around the nipple (periareolar). The goal of breast augmentation with a periareolar incision is to place the incision in the transition area between the dark areola and surrounding breast skin where it can be hidden. As with the inframammary incision, this incision allows the implant to be placed in precise pocket formation and provides for absolute controlled bleeding.
After the incision, a pocket is created for the breast implant. The implant is slid through the incision and then centered behind the nipple.
Saline implants may also be placed endoscopically through an incision in the navel. This minimally invasive breast enhancement technique is known as a transumbilical breast augmentation or TUBA approach.
Breast Implant Shape and Profile
When choosing breast implants, shape is an important consideration. The two basic breast implant shapes are round and teardrop. Breasts differ greatly from woman to woman, so the ideal breast implant shape for each patient must be determined with care.
- Round Breast Implants. Of the two breast implant shapes, the round breast implant is the most common type used for breast augmentation. Many women choose round implants because they tend to provide the greatest amount of lift, fullness, and cleavage. Some women, however, feel that the results produced with round implants appear artificial, so they seek out more natural-looking alternatives.A round breast implant can have a smooth or textured surface. Due to a round implant's symmetrical shape, it does not pose the risk of implant rotation. Round implants come in three different variations of shape: low, medium, and high profile. A higher profile can enhance the forward projection of the breasts, which would otherwise require larger breast implants with wider bases.
- Teardrop Breast Implants. As the name indicates, a teardrop breast implant, also known as a contoured breast implant, is shaped like a teardrop. Breasts attain a more gently sloping contour with teardrop breast implants. Although the upper portion of breasts that have teardrop implants are not as full as breasts that have round implants, teardrop-shaped implants often provide greater projection by volume. For women who want more naturally shaped teardrop breasts, these implants may be the ideal choice. A teardrop implant requires a textured surface to prevent rotation because breasts can become distorted if the implant rotates. This is not a concern with round breast implants.
Our doctors perform all of their operations with great care and precision, ensuring that patients can enjoy a quick and healthy recovery.
Because breast tissue is stretched and separated during breast augmentation surgery, and because implants are inserted through incisions, the breasts will be bruised, sore, and swollen after surgery. Most patients also feel tired after breast augmentation surgery, but this usually passes in a day or two. You can expect to wear a surgical bra for several days. It may also be recommended that you wear an athletic or support bra until the swelling has subsided.
Heavy lifting or straining should be avoided after breast augmentation surgery because this can cause the breasts to swell and increase pressure. You can typically return to work within two weeks and to full activity shortly after. Stitches are removed in a week to 10 days after breast augmentation. Any post-operative pain, swelling, and sensitivity will diminish over the first few weeks. Sensation in your nipples may be reduced temporarily, but should return to normal as your breasts heal.
After healing, some permanent scarring may remain, although scars from breast augmentation incisions will typically begin to fade in a few months and will continue to fade for months or years. Scars are usually small and inconspicuous. We strive to make them as unnoticeable as possible.
Complications following breast augmentation surgery are uncommon and usually minimal. Although rare, some complications that may occur include capsular contracture, swelling and pain, infection around the implant, change in nipple sensation, decreased milk production while nursing, and breakage or leakage of the implant (implant rupture) as a result of injury. Regular monitoring of breast implants after breast augmentation is recommended to ensure continuing breast and implant health.