Breast Augmentation

The main goal of augmentation is to improve body contour by placing implants to enhance or enlarge the breasts. Breast augmentation may also be combined with a breast lift (mastopexy) to treat breast ptosis (sagging). Ptosis may occur after having had children or with significant weight loss, or may occur naturally with time.

Many patients have questions concerning the safety of breast implants. After reviewing our information here, we recommend that you visit, a site maintained by the American Society of Plastic Surgeons. The site contains the latest information about breast implant safety and provides information that we trust.

During the consultation process, we discuss your goals with regard to breast size and shape. Generally it is possible to recommend an implant size that will help the patient achieve the desired final cup size. We encourage you to try on implants in our office to help make the final decision about appropriate implant size. The final shape of the breast obviously depends a good deal on the beginning breast shape. We can help obtain the desired result with proper selection of the size and type of breast implant that is utilized.

If there is a significant amount of sagging or ptosis present, then a breast lift may also be combined with breast augmentation. This can help achieve not only a fuller breast size but a more upright shape.

The augmentation procedure is performed in our office operating suites under general anesthesia and takes one to one and half hours.

The Augmentation Procedure
There are different types of incisions that can be used:

1. The inframammary incision is made in the natural crease line underneath the breast and generally allows very accurate placement of the implants. The incision line is usually well hidden in the crease of the breast and fades nicely with time.

2. The peri-areolar incision is made around the margin of the areola and may be disguised by the natural contrast between the darker areola skin and the lighter skin of the breast.

3. The trans-axillary incision is located underneath the arm. This incision is very well hidden but does introduce a slightly greater risk of asymmetrical placement of the breast implants.

The choice of the incision we use is influenced by medical considerations and also your postoperative goals. Our medical team will work closely with you to create your desired look.

Most of the implants that we use are saline or salt water implants. These implants have a shell of solid silicone. After the implants are properly positioned, they are inflated with a sterile salt water solution. This solution matches the consistency of natural body fluids so that if the implant does break or leak in the future, the saline is absorbed harmlessly by the body.

Usually the implant is placed in a pocket created deep to the pectoral muscle of the chest wall. There are several advantages to placing the implant underneath the muscle. The implant usually is better hidden and thus is less conspicuous. There also seems to be reduced risk of having a capsular contracture (scar tissue) form around the implant which would cause the breast to be too firm. Implants placed in a submuscular position also seem to sag less with time and better maintain their original placement. In certain situations, it may be advantageous to place the implants on top of the muscle underneath the breast tissue.

Whether inserted above or below the pectoral muscle, the nipple remains connected to the milk producing tissues of the breast. This is an important consideration for those patients who plan to nurse at some point after surgery.

When comparing right and left sides, most women have differences in the size and shape of their breasts before surgery. Generally, this natural asymmetry will still be present to some extent after surgery, although sometimes placement of the implants may help minimize these differences.

Implants generally do not last a lifetime. There is a risk of implant deflation which increases as time goes by. Currently, major implant manufacturers will provide one or two new implants should an existing implant leak. Also for a period of several years, the implant manufacturers will help pay for the cost of replacing one or both implants should a leak occur. Implant manufacturers also offer enhanced warranties for a small additional fee, and we provide you with the details of these warranties.

Although we generally use saline filled implants, some patients may prefer or benefit from silicone gel implants. These implants are currently available under investigational protocol and likely will be more widely available in the near future. Additionally there are new implants being developed including cohesive gel implants which may be available in the future. These implants may offer the advantage of a more natural feel of a silicone gel implant with minimized risk for leakage because the silicone material has the consistency of jello and holds together if the shell is damaged.

Before and After

Patient 1, Surgeon: Dr. Dunagan

Before After
Before After
Before After

Patient 2, Surgeon: Dr. Yates

Before After
Before After

Patient 3, Surgeon: Dr. Alison

Before After
Before After

For a personal look at a breast augmentation, visit the Patient Stories section.

We have choosen to include a few photos of breast surgery on our website. Our free Information Book contains many more patient examples, showing a wide variety of pre- and post-surgical body shapes.

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