Ideally, a board-certified plastic surgeon with many years’ experience doing breast surgery is usually the best. This surgeon will know how to judge what kind of implant is the best for you and where it should be placed.
I usually use a small incision that goes partly around your areola. Sensation is preserved and the scar almost completely disappears. Scars under the breast are usually not aesthetically appealing, and other approaches (eg, through the armpit) have inherent problems.
The new silicone implants achieve the most natural results. In my opinion, the “Gummy Bear” implants are too firm and saline implants are too round and ripple. If they break, the fullness of your breast disappears.
Fat injections into the breast can be done; however, they need to be repeated since fat often goes away. The results can give you lumpy breasts and the increase in size is minimal. I do not recommend this procedure.
I usually use a mild general anesthesia and place local anesthesia in the breast to reduce post-operative pain. You are asleep, feel no pain, and are not aware of the surgery taking place. At the end of the surgery, I use a long-acting local in the breast so you have almost no pain for 12 or more hours.
Implants can go either above or below the muscle. We used to put saline implants below the muscle to hide rippling, but now that we are using better silicone implants, I place most of them above the muscle. This minimizes pain and gives you more natural looking breasts. Having them placed under the muscle can be more painful and often results in a longer recovery.
If your breasts are droopy (ptotic), you may need to have a breast lift at the same time. A breast lift will result in more scars, but implants alone rarely give a good result when you have ptotic breasts.
The surgery is usually done in my AAAASF-certified operating room; you rest in the recovery room for a couple of hours and go home with a companion later in the day. The only bandage is a special bra and some gauze over the incisions.
You should rest for the first day or two; there is usually only minor discomfort and you will be given an analgesic if you need it. You will be given an appointment to return in 5-7 days. You can remove the gauze over the incision after 48 hours and shower. Keep the bra on 24/7 until you come for your follow-up appointment.
On your first post-op visit, I will inspect the incisions. There are usually no sutures to remove as I put them all on the inside. Your breasts may look fuller, but they will round out and drop over the first few weeks. It usually takes 3 months for all of the swelling and remodeling of the breasts to occur.
It all depends on the type of work you do. Usually you can return to work within the first week. I recommend you wait 2 to 3 weeks before starting strenuous activities or exercise. There is minimal down time with a well done augmentation.
No one has reported a true silicone allergy; silicone is considered one of the safest substances placed in the body. However, some people will form scar tissue around the implants called a capsule, which makes the breast feel firm. The occurrence of this ranges from 2%-10%. Capsules can be minimized and treated.
Yes. If a patient has a complaint, it is usually that they wish they chose a bigger implant. We try to pick the perfect size with you and work to make sure you are delighted with the result.