Chances are you probably have a friend, relative, or neighbor who has undergone breast augmentation. With its rising popularity and our year-round warm weather, breast augmentation is one of the most requested procedures at our plastic surgery practice. For the woman born with small breasts or the woman who finds her breasts have changed after childbirth or breastfeeding, breast augmentation can be a very rewarding procedure.
Women considering breast augmentation often have many questions about the procedure and the results they can expect. Choosing to undergo breast augmentation is a big decision, and our experienced board-certified plastic surgeon in Orlando—James Matas, MD—is dedicated to providing you with the guidance, information, and support you require along every step of your journey. During your personal consultation with Dr. Matas, you will have an opportunity to address any concerns you may have, discuss the results you hope to achieve, and review a surgical plan suited to your needs.
For women who may still be researching breast augmentation or looking for the right surgeon, we have provided answers to several of the most frequently asked breast augmentation and breast implant questions below. If you have further inquiries about breast augmentation, we encourage you to contact us at the Advanced Centre for Plastic Surgery to schedule a consultation with Dr. Matas.
Breast augmentation is a plastic surgery procedure that improves the size, feel, and shape of the breasts via the placement of breast implants either above or below the chest muscle. Women who desire larger, firmer, perkier, and/or more symmetrical breasts—or breasts that are more proportional to the rest of their body—often choose breast augmentation with implants to achieve their new look. The size, type, shape, and positioning of the implants are all customized to suit the patient’s unique figure, needs, and cosmetic goals.
Potential candidates for breast augmentation are women in good health who are at least 18 years old for saline implants and at least 22 years old for silicone implants (according to FDA requirements). Women who are well-suited for breast augmentation may have:
In addition, good candidates have adequate skin elasticity and muscle quality in order to properly support the implants and provide the desired results. During a consultation, Dr. Matas can thoroughly evaluate your health, expectations, and relevant anatomical factors to determine if breast augmentation is the right option for you.
Note: women with a significant, strong family history of breast cancer are counseled to consider the procedure very carefully because implants pose an interference with mammography.
Note: women who are 21 or under are not eligible to receive silicone-gel filled implants unless special criteria is met.
The process of choosing breast implants that are the right type, shape, and size for you should take into consideration a variety of factors, including your anatomical characteristics, desired results, and personal preferences. Dr. Matas offers a wide array of breast implant types, shapes, and sizes, and he will use his expertise to help guide you toward the most suitable choices for achieving your goals.
You have the option of choosing from three different types of breast implants for your breast augmentation procedure: saline, traditional silicone, and cohesive silicone-gel. Each type offers unique benefits and drawbacks, and the best option for you will depend upon your personal priorities/preferences, anatomy, cosmetic concerns, and ultimate goals.
The sections below detail chief differences between saline, standard silicone, and cohesive silicone-gel implants. During the consultation process, Dr. Matas will take the time to further discuss these choices with you, ensuring you are fully informed before you make your final decision. His vast breast augmentation expertise and experience help him recommend the type of breast implant that can deliver the high-quality results you desire.
FDA requirements indicate that women who are 18 and older may choose saline breast implants to augment their breasts.
Saline breast implants are comprised of a silicone outer shell filled with a sterile salt-water (saline) solution. Some women prefer saline breast implants due the body’s ability to harmlessly absorb the saline solution in the event of an implant leak or rupture. As an added benefit, saline implants are filled during breast augmentation surgery, allowing the volume to be slightly adjusted as needed to achieve an optimal result. In comparison to silicone, however, saline implants may not deliver the most natural-feeling or looking outcome for certain patients—particularly those with low body fat.
FDA requirements indicate that women who are 22 or older may choose silicone implants to augment their breasts, while women of any age may use silicone implants for breast reconstruction.
Traditional silicone breast implants are prefilled with a specific amount of a moderate-viscosity silicone gel. The consistency of the silicone gel is an important characteristic, as it gives these implants a shape, feel, and weight that is more closely associated with natural breast tissue (when compared to saline implants). While there have been concerns in the past about silicone implants, the next generation of silicone implants (approved by the FDA in 2006) adhere to stricter design, manufacturing, and safety requirements. The durable outer casing is made of a thicker, rubberized silicone and is tightly sealed during manufacture to better prevent leakage and/or rupture.
In contrast to saline implants, the volume of silicone implants cannot be adjusted during surgery. It is also more difficult to visually tell when a silicone implant is leaking or has broken, as there may be no obvious change in implant shape or volume.
Cohesive silicone-gel breast implants, also called “gummy bear” implants, are the latest type of breast implants to be FDA approved (2013). They are filled with a firmer, thicker gel than standard silicone gel implants. This unique form-stable gel allows the implants to consistently retain their shape and helps reduce the risk of rippling, capsular contracture, leakage, and rupture. Aesthetically, these implants tend to provide more control over the shape the augmented breasts take on. In 2014, the FDA approved anatomically-shaped versions of cohesive-gel implants to provide patients with a broader range of options. They are firmer to the touch than traditional silicone gel and saline implants; however, for patients who are the right candidates, these implants can feel very natural. While cohesive gel implants generally last longer than any other type of implants, they also typically come with a higher price tag.
Patients can choose between either round or teardrop-shaped breast implants, which are available in a wide variety of sizes, fill levels, and projections. Selecting the most suitable shape depends mainly upon breast anatomy and the desired outcome. At your consultation, Dr. Matas can thoroughly explain the benefits and drawbacks of each option, as well as clearly illustrate the results you can expect to achieve.
The vast majority of breast implants are round and come in all fill types: saline, standard silicone gel, and cohesive silicone gel. The round contour of these implants provides fullness in all directions, enhancing volume and shape at the upper and lower poles of the breast. Round implants are also able to rotate within the breast pocket without causing aesthetic changes to the breast. The specific volume, fill-level, and projection of the round implant will also affect the dimensions of the augmented breast.
Teardrop-shaped (also called anatomical) breast implants are always made of cohesive silicone gel due to its ability to maintain a consistent form. As the name indicates, these breast implants have a teardrop-shaped side profile that provides volume in the lower portion of the breast, gradually tapering upward. Teardrop-shaped breast implants can create a natural-looking breast slope and overall shape that is well-suited for women who desire subtle projection and contour enhancement. Anatomical breast implants come with a small risk of rotation, which can potentially distort the shape of the breast—though this is rare when augmentation is performed by an experienced surgeon.
During the initial consultation, Dr. Matas will consider the following factors: breast implant size, implant type (saline versus silicone-gel filled), implant shape (round versus anatomic, low profile versus high profile), placement of the implant (under the muscle-subpectoral or over the muscle-suprapectoral) and placement of the incision (under the breast in the fold-inframammary, under the armpit-transaxillary, or around the nipple-periareolar).
He will ask you about your motivations for breast surgery and with assess your physical and emotional health. Additionally, he will review information you provide about previous surgeries, previous pregnancies/breastfeeding, past and current medical conditions, as well as nutritional supplements, herbal remedies, and pharmaceutical medications you take.
He will carefully examine your breasts and chest wall with consideration for the following factors: amount of breast tissue you have to cover your implant, thickness and symmetry of the chest (pectoralis) muscles, position of your nipple areola in relation to the breast tissue, degree of sag, and thickness of skin and skin tone. He will also take specific measurements of your chest area to scientifically determine the space available for the implant to fit.
Dr. Matas will recommend the exact procedure or procedures needed to bring about the desired result, outlining the size, style, and placement of the implant, location of the incision, the type of anesthesia, where the surgery will be performed, and the risks and possibility of complications. If a woman has a significant sag or looseness of skin, he may also recommend that a mastopexy—or breast lift—be done at the same time.
Dr. Matas will advise you to avoid taking aspirin, ibuprofen products, Vitamin E, and certain herbal medications before surgery, as these can often cause increased bleeding or have undesirable effects with anesthesia. He may also ask you to discontinue upper body workouts in order to reduce muscle strength before surgery. If you require a breast lift, and you are a smoker, he will require that you discontinue smoking one month prior to surgery for proper healing.
Once a surgical plan has been established, you will be provided with the financial details, along with a suggested plan of action should you decide to take the next step towards breast augmentation surgery.
Most often, breast implants are placed through a small incision made within the crease on the underside of the breast, called an inframammary incision. In other cases where the inframammary approach is not ideal, Dr. Matas may choose to place the incision along the inside periphery of the areola (peri-areolar incision) or even along a skin crease in the underarm (transaxillary incision). During your consultation, Dr. Matas can further discuss your incision options and explain which approach he recommends and why.
Breast implants can be placed either above or below the chest muscle (called the pectoralis muscle). The placement that provides the most natural-looking results will depend upon your unique physical characteristics, the size and shape of the implants, fat distribution, and skin quality/elasticity. Based on the physical examination performed during your consultation, Dr. Matas can discuss which combination of implant type, size, and placement will help you achieve the natural appearance you desire.
An incision is typically made beneath the breast that measures about 2” in length. If the implants are being positioned under the muscle, then a portion of the pectoralis muscle is opened to allow access beneath it. A pocket is then developed over the rib cage and below the muscle where the implant will be positioned. If the implants are being positioned over the muscle, the pocket is developed over the muscle and under the breast tissue.
In some cases, breast sizers are inserted first before final determinations are made with respect to implant size. To permit the smallest incision possible, a partially filled implant is inserted through the incision into the pocket, filled to the proper volume and positioned correctly.
Note: silicone-gel filled implants arrive pre-filled by manufacturer and do not require filling.
If there was asymmetry noted between the breasts, Dr. Matas may adjust the fill volume of one or both implants to compensate for this difference. Once the implants are properly positioned and he is satisfied with the appearance of both breasts, the incision is closed using several layers of dissolvable sutures. A butterfly is used on the skin’s surface, so there are no visible sutures. The procedure takes approximately 2 hours and is typically performed as an outpatient surgery under general anesthesia.
You will be discharged wearing a supportive, comfortable surgical bra with front closure. Once you get home, you will want to rest for the remainder of the night. There is moderate pain associated with this procedure, but the discomfort can be managed by taking the prescribed pain medication and applying ice packs as directed.
Initially, you may feel tightness in your chest due to your skin adjusting to your new breast size and post operative muscle tightness. There will also likely be bruising, mild swelling, and sensitivity to physical contact. The day following surgery, you will be asked to perform several breast massage techniques that will help your implants shift into desired position.
Implants placed under the muscle may cause more discomfort than over the muscle, and you may have to restrict arm motion for a few days. Some patients experience a temporary change in nipple sensation, though this is usually resolved within a matter or days or weeks. Most patients return to office work within 5-7 days, although you should avoid any strenuous activities that raise your pulse and blood pressure for at least 2 weeks. Strenuous upper body activities, such as tennis, weightlifting, or water-skiing, typically can be resumed after about 6 weeks.
“I elected to undergo breast augmentation after several consultations with surgeons throughout Florida. It is clear that I made the right choice with your facility! Everyone made sure I received the best individual attention and showed concern for my hopes and listened to my questions. I sincerely appreciate your time and expertise, and the new look I am enjoying!”
Breast augmentation incisions are chosen based on which will deliver the best results while leaving the most inconspicuous scar. The three incision options that Dr. Matas provides—inframammary, peri-areolar, and transaxillary—each offer a certain degree of self-concealment:
Breast augmentation incisions may appear reddish and puffy during the first phase of healing, but as the skin repairs further and scar tissue matures, incision lines should fade and flatten significantly.
The approximate price range for breast augmentation is $4,550 to $5,550 at our Orlando practice, though the exact cost will depend on the unique details of each patient’s surgery. For every augmentation, we base our pricing on the shape and type of the breast implants being placed, surgeon’s fee, facility fee, and the cost of anesthesia. If you are curious about the estimated price of your desired procedure, we encourage you to explore our free cost analysis option or schedule a consultation with Dr. Matas.
When performed correctly by an experienced plastic surgeon, breast augmentation should have no bearing on a patient’s ability to breastfeed, assuming they are able to do so. Dr. Matas can customize your breast augmentation procedure to avoid disruption of the mammary glands. Most often, he chooses to combine the inframammary incision with submuscular implant placement to help prevent any interference with breastfeeding abilities.
We expect you’ll be quite pleased with your new appearance, as this procedure has a very high satisfaction rate among patients. Having fuller, firmer, and shapelier breasts may also increase your self-confidence and improve your feelings as a woman. It can also make shopping more enjoyable, as many patients report that clothes fit better after breast augmentation. If you had a difference between each breast before surgery, you will find them to be closer in appearance.
Whether you are ready to schedule your consultation, or just have general questions, we are here for you! Ask our surgical coordinator, Normajean, today.