Breast augmentation is a popular procedure in which breast implants are placed, either above or below the chest muscle, to create the appearance of larger breasts, improve breast symmetry, and enhance breast shape. For the most natural-looking and long-lasting results, our plastic surgeons prefer breast implant placement below the chest muscle, which also reduces the risk for complications such as rippling or capsular contracture. Using a variety of breast implant types, shapes, and sizes—combined with advanced incision strategies and implant placement techniques—our plastic surgeons execute highly customized surgical plans designed to deliver breast augmentation results that look and feel as natural as possible.
Women choose to undergo breast augmentation for a variety of personal reasons. Most breast augmentation candidates wish to address one or more of the following cosmetic concerns:
The size, shape, and symmetry of the breasts—as well as the proportions of the figure—can all be improved with breast augmentation. For the majority of our patients, breast augmentation surgery also has the added benefit of boosting self-confidence and self-esteem. Oftentimes, breast augmentation candidates are mothers who have lost substantial breast volume due to weight fluctuations, pregnancy, and breastfeeding. It is common for these women to incorporate a breast augmentation with breast lift surgery to achieve comprehensive rejuvenation of the breasts.
Breast implants come in a broad array of shapes, sizes, textures, and materials to suit your needs and goals. Each type of implant offers a range of benefits, and the more you know about what is available, the easier it may be to determine which option is best for you.
Due to the softer, more responsive feel that mimics the texture of natural breasts, most patients prefer silicone implants. For breast reconstruction after mastectomy, our surgeons are more likely to recommend silicone than saline for a more natural-looking result. Made of a thick silicone gel that significantly reduces the risk of leakage, silicone implants are associated with a lower risk of capsular contracture—a condition wherein scar tissue develops around the breast, making it feel hard—and rippling. As a result of the unique composition, silicone implants come pre-filled, and they typically require a larger incision than saline. If you are 22 years of age or older and have a thin frame with little breast tissue coverage, silicone may provide a better outcome.
In addition to round implants, shaped variations are also available. One of the most popular of the shaped styles is the anatomical cohesive gel—or “gummy bear”—implant. Made of strong cohesive silicone gel, these textured implants have a teardrop shape that is designed to resemble the natural contours of a woman’s breasts. The “gummy bear” implant may also retain its shape better than other implant types, and studies have proven a reduced risk of rippling or rotation. As with round silicone implants, you must be 22 years of age or older for anatomically shaped cohesive gel implants. Your surgeon may recommend the “gummy bear” implant as an option in your breast reconstruction.
Saline breast implants are comprised of a saline (saltwater) solution, so in the rare event a tear or rupture occurs, the body will harmlessly absorb the filling. Saline implants come in many sizes and shapes, and they can be filled after insertion to create the most symmetrical and aesthetically appealing outcome possible. Saline implants can be placed in patients 18 years of age or older, and they may be best for individuals who have an ample amount of breast coverage. Saline implants are lower in cost than most other options.
There are many factors that play a role in determining the best implant for your anatomic indicators and desired outcome. Our experienced plastic surgeons can help you find the right option based on a comprehensive evaluation and collaborative consultation.
Prior to breast augmentation surgery at Regional Plastic Surgery Center, our patients meet with one of our highly skilled breast augmentation surgeons for a private consultation. It includes an examination of the unique characteristics of the patient’s breasts, including size, shape, and skin elasticity. When you arrive for your initial consultation, one of our board-certified plastic surgeons will discuss your concerns and cosmetic desires in thorough detail. They will then take this information and create a customized treatment plan that can optimize your results. Your safety is our top priority. If there is sagging of the breasts, your cosmetic surgeon may recommend a breast lift procedure be performed at the same time as the breast augmentation procedure.
During your private consultation, we ask that you carefully describe your cosmetic goals to your surgeon. The enhanced breast appearance you want to achieve with breast augmentation surgery affects which implant size, shape, and projection your surgeon recommends. Your doctor will work closely with you to select implants with dimensions that align with your final goal, as well as determine the surgical technique that can best deliver your desired outcome.
Most patients will benefit more from placement under the chest muscle wall, while others may attain improved results with placement on top of the muscle. Both implant placement options have unique benefits, all of which you can discuss with your plastic surgeon during the consultation process.
With our Vectra 3D imaging system, you can view three-dimensional renderings of how your breast augmentation results may look. This advanced technology allows you to virtually “try on” various sizes and types of implants to make well-informed decisions about your new figure. Vectra 3D can also show you a “preview” of how your breast augmentation results may look when combined with a breast lift. This technology serves as a valuable tool for you and your surgeon, facilitating doctor-patient communication that can ultimately lead to the most satisfactory results.
During the consultation with your breast surgeon, it is important to be candid regarding medical history such as previous breast surgeries, biopsies, mammogram results and family history of breast cancer. Although there is no evidence that breast implants could lead to breast cancer, there are surgical techniques that our surgeons can use to lessen the risks that breast implants could interfere with future mammograms.
Pregnancy and weight loss can alter the shape of the breasts. As such, it is important to discuss any weight loss or pregnancy plans with your surgeon. There is no evidence that breast implants negatively affect a woman’s ability to breastfeed. Whether breast implants are placed above or below the chest muscle, they can be carefully positioned so as not to interfere with breastfeeding. If you become pregnant after breast augmentation and wish to breastfeed your child, you will likely be able to do so (given you are physiologically capable of breastfeeding to begin with).
Prior to the breast augmentation procedure, our cosmetic surgeon provides detailed preoperative instructions. Patients who smoke will be instructed to stop smoking well in advance of the breast augmentation surgery. Medications – such as aspirin – that are associated with bleeding should also be avoided. Our breast implants patients may also be asked to have a pre-surgical mammogram.
Breast enlargement is usually performed as an outpatient surgery. Our breast augmentation patients are under general anesthesia for the entire breast augmentation procedure. Typically, our surgeons recommend that breast implants be placed below the chest muscle for natural-looking, long-lasting results. Submuscular positioning offers many benefits including optimal implant coverage and reduction of implant complications such as rippling and/or capsular contracture. Additionally, placement below the muscle can also improve the accuracy of mammograms, which is a concern for many women. When possible, our surgeons use very small incisions to reduce the appearance of visible scarring for our patients.
Incisions are made as discreetly as possible, usually underneath the breast near the crease, in the armpit, or in the areola area. Spaces are created for the breast implants either above or below the pectoral muscle, and then the chosen breast implants are inserted into these spaces.
Most of our breast augmentation patients are up and about within a day or two and can shower within 24 hours after surgery. Strenuous exercise is discouraged for 3 weeks. Dressings will be removed at your first postoperative visit within 5-10 days after surgery. Bruising and swelling are common but fade away rather quickly. Residual swelling usually disappears in a few months. It is very common to have an altered sensation of your breasts, and this usually returns to normal within a few months. Although arm movements are restricted, most breast augmentation patients return to non-vigorous work and activities within a few days. Your cosmetic surgeon will decide when vigorous activities can resume.
The location of any scar tissue after breast augmentation surgery mainly depends on the incisions used to accomplish the procedure. The experience and expertise of our surgeons helps to keep scar tissue minimal and well hidden. Incisions are either placed within the darker skin of the areola (periareolar), along the natural bottom crease of the breasts (inframammary), or within the underarm crease. In each of these cases, the incisions are often fully or partially camouflaged/concealed, which leads to very little—if any—visible scarring once they have healed and matured. Properly caring for your incisions and taking your antibiotics as prescribed after surgery are both very important steps for preventing infections that can lead to more pronounced scarring. If you are interested in looking into effective ways to treat scars non-surgically, we offer laser skin treatments at our medical spa that can help reduce the appearance of scar tissue.
As with any surgery, there are risks associated with breast augmentation. At our facility every possible precaution is taken to ensure patient safety and reduce the chances of complications occurring. Risks include bleeding, infection, and an adverse reaction to the anesthesia. Sensitivity of the breast or nipple may occur but usually returns to pre-surgical levels in a short time.
Once healing has occurred, breasts will be fuller and shapelier. Breast implant quality and durability has dramatically improved in recent years. Our plastic surgeons find that most breast implants now last 20 or more years before replacement is needed due to leakage or rupture.
Most women are very happy with the results of their breast augmentation. We encourage you to view our gallery of breast augmentation before and after photos to view the type of results our surgeons can achieve.
The overall cost of breast augmentation will vary depending on the needs of each patient. Our team has to consider a variety of factors when tallying the final price, including the extent of a patient’s concerns, the work necessary to meet their needs, the surgical techniques used, and the type of breast implants. Our team will be able to provide a better estimate of the total cost of your procedure at your initial consultation when a comprehensive plan can be developed. Our practice offers financing options for patients to pay for their procedure as well, including CareCredit® and United Medical Credit.
The weight of your breast implants is dependent upon the volume of the implant, the weight of the shell, and the material it is filled with (saline, silicone gel, or cohesive silicone gel); however, each of these materials is roughly similar in weight per 100cc—more or less around 100 grams or 0.22 pounds. This means that two 375cc silicone breast implants would add approximately 1.65 lbs of weight. Since the exact answer will depend on the specific size and type of implant, your plastic surgeon can likely provide a more precise weight at the time of the consultation.
Generally speaking, saline implants have a firmer feel than silicone-filled models, which are considered to have the most natural feel of all. Several other factors can impact the way breast implants feel, including the amount of body fat present in the breasts, the breast implant placement, and how well the implants were sized for the patient. Our surgeons have extensive experience in guiding patients toward the right type and size implants for their anatomy and personal goals. They also have superior expertise in developing custom breast augmentation plans that prioritize a natural feel in addition to a natural look.
It is typically recommended that you avoid putting direct, prolonged pressure on the breasts for the first four weeks after surgery, which means that sleeping on your stomach or side can be problematic initially. Instead, we suggest sleeping on your back during this time, with your upper body slightly elevated to help reduce swelling.
You do not have to wear a bra following surgery or during your recovery. However, if you do wish to wear a bra within the first six weeks, we recommend choosing a loose-fitting bra that does not have underwire. It is also helpful to make sure the bra is easy to put on and take off.
There is no set schedule for when implants need to be replaced—the right time will generally be evident to you and/or your surgeon. If you are not experiencing complications, such as implant rippling or rupture, your breast implants will likely not have to be replaced for approximately ten years, if not longer. That said, any issues that do arise typically require that your breast implants be replaced soon thereafter, and your surgeon can help you skillfully navigate the breast augmentation revision process.
It is important to be informed about the details of your breast implant manufacturer’s warranty—many warranties cover the cost of implant replacement under certain circumstances. A knowledgeable member of our team can answer any questions you have about breast implant warranties and the coverage they offer.
Capsular contracture is a defect that can occur when the capsule surrounding the breast implants becomes thicker and tighter. This condition can result in excessive firmness, hardening of your implants, and even pain. When capsular contracture develops, breast implants may look disfigured or move around to a higher section on the chest. This effect can make your breasts appear unnatural and constricted. To treat capsular contracture, surgeons may remove the implant and the capsule altogether and replace them, if the patient chooses to do so. The risks of this condition happening can be minimized by ensuring your breast augmentation is performed by a board-certified and experienced plastic surgeon, such as the highly-trained professionals at our practice in Dallas.
BIA-ALCL is rare and the risk of developing this condition is very minimal. BIA-ALCL, or Breast Implant Associated Anaplastic Large Cell Lymphoma, forms in the fluid and scar tissue around the breast implant with some cases suggesting it can spread throughout the body. This condition is typically associated with BioCell® implants that have been voluntarily recalled by Allergan®. This specific type of textured implant is no longer in circulation. Our surgeons are experienced and stay informed on breast surgery trends in order to ensure the highest standard of safety for our patients.
Patients who were able to breastfeed before breast augmentation will likely be able to breastfeed after their procedure. Generally, patients may be advised to seek breast implants only after they have had children and completed the nursing process. This is because the results from breast augmentation can be compromised by the effects of pregnancy and breastfeeding. However, if patients want to breastfeed after receiving breast implants, the surgery should not inhibit this possibility as long as your desires were communicated to your plastic surgeon prior to the procedure. Our surgeons can design breast augmentation to help ensure that the function of the milk ducts are not compromised. It should be noted that some women are unable to breastfeed due to other factors unrelated to breast augmentation surgery.