What Are My Breast Implant Options?

Implant Types

There are generally two choices in implant fill material: silicone or saline implants. Below you will find the advantages and disadvantages of both silicone and saline implants. In addition, breast implants can have either a textured or smooth surface and each type has its role in cosmetic surgery of the breast. The type most appropriate for each case is explained to all patients by our cosmetic surgery team.

Where Are Breast Augmentation Incisions Placed?

There are four possible breast augmentation incision options through which the breast implant can be placed:

How is the Breast Augmentation Procedure Performed?

Breast augmentation is commonly performed on an outpatient basis at a hospital or surgical center while the patient is under general anesthesia. During the procedure, local anesthetics are used around the breast to block the nerves that produce pain before the surgery. Our experienced cosmetic surgeons frequently perform transaxillary endoscopic augmentation mammoplasty. The minimally invasive breast augmentation technique is performed by placing the incision in the armpit to ensure NO scars on the breast itself. The incision under the armpit heals quite well and after 1 year will likely be imperceptible. A precise pocket is created under the muscle with the assistance of a small video camera after which a silicone or saline implant is placed. Immediately after the implant is placed, the incision is closed in a layered manner to prevent implant exposure or scar widening.

If the patient desires, a pain pump that delivers continuous local anesthetic to the implant pocket can be placed and maintained for 3-4 days to help with the post-operative pain control.

Implant Placement

There are three options for implant placement when undergoing breast augmentation. The implant can be placed in the following places:

• Subglandular – Above the muscle, but under gland.
• Submuscular – Under the muscle. The amount of muscle coverage is individualized to each patient and depends on the location of the nipple preoperatively. By utilizing this dual plane technique, the nipple-areola complex can be raised without making further unnecessary incisions.
• Subfascial – Under the gland and fascia of the muscle.

What is Recovery from Breast Augmentation Like?

Every patient’s body heals differently, so the exact length of breast augmentation recovery periods vary. Post-operative recovery begins with plenty of fluids and resuming walking as soon as possible. Bandages are placed over the incision for about a week, though patients are able to shower the same day of surgery.

Patients are asked to take a short course of antibiotics after the operation to prevent an infection. A supportive bra is worn to help support the breast as the incisions heal and the implants settle into position.

As the incision begins to heal (after 3 weeks), there are a number of things you can use to help minimize the size and appearance of the scar. Massaging the scar with firm finger pressure will help minimize the appearance of the scar and decrease the swelling. In addition, paper tape and silicone gel sheeting have both been shown to help minimize the scars with time. Some commercially available products such as Mederma or vitamin E may also have some benefit.

Generally, patients can expect to resume their normal activities after about a week of downtime. You should refrain from any vigorous exercise for the first month to prevent postoperative bleeding. Since swelling takes time to fully dissipate, the final results of your breast augmentation surgery may not be apparent for several months.

How Much Does Breast Augmentation Cost?

Breast augmentation is customized to each individual patient’s needs. With that in mind, the cost of the procedure will not be the same for every patient. A variety of components are factored into the total price. The 2016 estimate from the American Society of Plastic Surgeons regarding the price of breast augmentation surgery is $3,719; however, it’s important to note that this estimate is usually based on the surgeon’s fee only and does not take into account the costs relating to operating room facilities, anesthesia, the complexity of the procedure, post-operative medications, the geographic area in which the practice is located, and other factors. The national average cost of breast augmentation with those factors included tends to hover in the $8,000-$12,000 range. At Florida Plastic Surgery Group, our average range is around $5,999-$6,999.

Again, breast augmentation surgery is a customized procedure; therefore, the overall cost is highly dependent on the individual’s needs and goals, and will vary between patients. Once you have completed your initial consultation with one of our surgeons and a preliminary treatment plan has been developed, a member of our team can produce an estimate of the total cost. We are committed to transparency at the outset, providing you with the clearest possible valuation of your procedure so that you will know what to expect. Our staff can talk with you about the price estimate and the many payment methods we accept to help you determine the most ideal option for your budget. Our cosmetic surgery team constantly evaluates multiple companies to find the most reliable financing options for our patients. Please view our plastic surgery financing page to learn about the options available to you.

What is the Best Age for Breast Augmentation?

Breast augmentation is a way for women of diverse ages to achieve the breast volume, symmetry, and balance they have always desired. In fact, women from 18-60 years of age and above have safely received breast augmentation and enjoyed the results. If you are a woman in her 50s, 60s, or beyond and you are in good general health, you are most likely a candidate for breast augmentation. If you are a young adult, you must be at least 18 years of age to receive saline breast implants and at least 22 years of age for silicone breast implants. Other factors concerning age and breast augmentation include:

Physical and Emotional Maturity

The main physical component to consider is your breast development. Many young women have fully developed breasts by the age of 18. However, some women do continue to physically develop into their twenties. It is best to receive breast augmentation only after your breasts have fully developed.

Your decision to have breast augmentation surgery should also be guided by your emotional maturity. In addition to choosing the procedure for your own interests and not to please another person, you should have realistic expectations of what the procedure may achieve. Although you may experience improved social interactions because you feel more confident in your body, breast augmentation should not be used to correct severe feelings of low self-esteem.

Ultimately, the best age for you to receive the procedure depends mostly on your discussion with one of our plastic surgeons who are experienced in providing breast augmentation to women of many different ages.

Breast Augmentation with a Lift

For women who would like to reduce signs of breast ptosis (sagginess) in addition to enhancing the size and volume of the breasts, a breast augmentation combined with a breast lift may be the ideal solution. This procedure, medically known as an augmentation-mastopexy, involves the placement of breast implants as well as removal of excess, inelastic breast skin that may be causing a sagging appearance. The remaining skin is tightened and the breasts lifted to a higher position for a firmer, more youthful aesthetic. Combined with breast augmentation, this procedure can provide a more comprehensive rejuvenation, restoring fullness, shape, and projection.

Learn more about breast lift with implants procedures.

Research the Plastic Surgeon’s Qualifications Prior to Your Consultation

Here are some of the steps you can take in order to gauge the level of qualifications in the surgeon you are considering against other potential candidates. It’s always good to begin this research before you schedule the initial consultation:

• Take a look at his or her education and training
• Find out what other patients have to say by reading testimonials and recommendations about the surgeon
• View before-and-after breast augmentation photos. This can give you a general idea of the results that can be achieved

What You Should Learn During the Consultation

There are some things you can do to prepare for your initial consultation that can help you evaluate the surgeon and determine your comfort level with his or her expertise. Be sure to bring a list noting all over-the-counter and prescription medications you are taking, as well as herbal and vitamin supplements. You should also note all doctors you are currently seeing, and be upfront about any history of complications/conditions experienced by you or members of your family in the past. Never be afraid to ask questions – a good plastic surgeon will be completely honest and forthright with you at all times. Here are a few questions that can help you in your evaluation:

• How many times have you performed this procedure during the last year?
• What are the risks and the potential complications associated with this procedure?
• What kind of support does your practice provide after surgery and during the recovery process?
• Do you recommend this procedure for my specific body type? Why?
• What can I do if I don’t like the outcome?
• What can I expect in terms of the recovery process? What kind of pain medication do you often prescribe to deal with discomfort effectively?
• What is the overall cost of the treatment?
• What kind of financing options are available through your practice?

An open discussion with your potential surgeon is vital to determine whether you feel comfortable moving forward. Research into the surgeon’s background and credentials and evaluating how you feel about his or her expertise after the consultation can go a long way toward narrowing down your choices and feeling confident in your decision.

Additional Breast Augmentation FAQs

Will I have to massage my implants after surgery?

• There are different opinions amongst plastic surgeons in regard to the benefits of massaging your implants to prevent capsular contracture. There have been no reputable studies demonstrating a benefit, so our plastic surgeons at Florida Plastic Surgery Group do not ask patients to massage their implants, as it results in unnecessary discomfort. In addition, if you have textured implants, massaging will be counterproductive since the purpose of the texturing is to allow tissue growth.

Will I be able to breastfeed after a breast augmentation?

• According to studies, only about half the women with no prior breast surgery who attempt to breastfeed are able to do so. With the inframammary and minimally invasive breast augmentation (transaxillary) techniques, none of the breast tissue or glands are injured. Therefore, if a woman was able to breastfeed before her surgery, she could continue to breastfeed afterward.

Will I lose sensation in my nipples?

• This is a very common breast augmentation question. The way your surgery is performed is critical to preserve the sensation to the nipples. The periareolar breast augmentation does have a slightly increased chance of changes in nipple sensation. However, if performed properly, all the techniques will result in normal nipple sensation for the majority of women. Patients should note that during the healing process and as the swelling resolves, nipple sensation may be diminished, but any lost sensation generally returns with time.

What is capsular contracture?

• Capsular contracture is the hardening of the capsule around the breast that can occur months to years after surgery. There are generally 4 grades of capsular contracture, depending on the severity. The result is either one-sided or bilateral breast firmness as well as elevation of the breast mound.

What causes capsular contracture?

• There has been no clear cause for the development of capsular contracture, but some evidence suggests that micro-infection of the breast pocket may predispose some patients to develop capsular contracture.

How can capsular contracture be prevented?

• There is no foolproof way to prevent capsular contracture of the breast. However, there are a number of techniques to minimize the chance of developing capsular contractures. The placement of older generation silicone implants in the subglandular position did result in a slightly increased risk of developing capsular contracture. Therefore, if you choose to have silicone implants, the placement of the implants in a subfascial or submuscular (under the muscle) position is recommended.In addition, since there seems to be a correlation with bacteria around the pocket and the development of capsular contracture, the utmost attention to sterilization is important. Our plastic surgery team tries to eliminate any bacteria by using anti-bacterial solutions to wash out the pocket and to coat the implant prior to implant insertion. In addition, the implant is opened and touched by a surgeon only after new gloves washed in an antibiotic solution are worn and the implant pocket is ready. This ensures almost no contamination from the skin or air.

Can capsular contracture be treated non-surgically?

• There are no proven non-surgical means of treating capsular contracture. There have been a number of drugs and modalities that have been used with anecdotal reports of success. A leukotriene inhibitor named Accolate™ has been used by many plastic surgeons, but the potential side effects (i.e. liver damage) outweigh the limited unverified benefit. One of the newer less, well-known non-surgical methods of treating capsular contracture in the early stages of its development is the use of transdermal non-steroidal anti-inflammatory patches. Please ask our plastic surgery team for more information about this nonsurgical treatment.

What is the surgical treatment of capsular contracture?

• Generally the implant is removed and the scarred capsule is surgically removed from the breast. The implant pocket is then thoroughly washed with antibiotic solution and the implant replaced. A site change is also frequently performed if the implant was originally above the muscle to help reduce the chance of recurrence of the contracture.

Are breast implants safe?

• When performed by a board-certified and experienced plastic surgeon who uses high-quality, FDA-approved breast implants, breast augmentation surgery can be an extremely safe procedure. With that in mind, no surgical procedure or implantable device is completely free of risk. Our surgeons are extensively trained and skilled with these treatments, and they work diligently to minimize the risk of complications. We will explain all aspects of breast augmentation with you during your initial consultation and go over all of the potential risks and benefits associated with breast implants so you have a clear understanding before making your decision.

How painful is breast augmentation?

• Since major surgery is required to perform breast augmentation, a certain degree of discomfort is not uncommon during the recovery process. However, this is often relatively minimal and manageable as the breasts heal. Medication may be prescribed to alleviate discomfort while recovering, and the majority of pain typically begins to dissipate after the first two to three days following surgery. Many patients are able to stop using medication after four to seven days once the discomfort has significantly faded.

How much do breast implants weigh?

• The best answer to this question is: not really enough to have much of an effect on a patient’s overall weight. Both silicone and saline implants are rather light in weight—the solution inside the implant’s shell is typically only about one to two pounds, and may even be less than that in some cases. Overall, even in larger implants, the total amount of weight is so small that it should not cause significant weight gain.

What do breast implants feel like?

• Breast implants are designed to look and feel as natural as possible. The feel will differ between silicone and saline breast implants; however, both of these implant types have seen major advances over the years and are designed to feel like natural breasts. While silicone implants are known to offer a more natural feel due to their composition, the fact is that both silicone and saline implants have distinct advantages. Ultimately, a variety of factors – including the size, type, and placement of the implants, as well as the current amount of fatty tissue in the breasts – will determine how the implants will feel. Our doctors will develop a treatment plan designed to provide results that look and feel as natural as possible.

How should I sleep after breast augmentation?

• To avoid adding any unnecessary pressure to your breasts after breast augmentation, it is recommended that patients sleep on their back for several weeks. Prior to surgery, patients may be instructed to go ahead and begin sleeping on their back to become more comfortable with the position. We may also advise patients to place pillows behind the back to prop up their upper body while sleeping. These recommendations are only temporary and are necessary to ensure the best possible healing for the breasts during the recovery process.

What type of bra should I wear after breast augmentation?

• The type of bra patients should wear after breast augmentation is dependent on each individual’s unique needs. Immediately after surgery and in the weeks that follow, the breasts will likely be swollen, sensitive, and somewhat tender. To control these effects and to aid in maintaining the intended shape and position created by the breast augmentation procedure, some patients will be instructed to wear a special surgical bra during recovery. Others may be advised not to wear a bra at all for a specified period of time. Our plastic surgeon will provide instructions regarding the use of a bra after breast augmentation surgery based on your needs and what is best for the healing process.

  If you have any additional questions about breast augmentation, please contact us for an initial consultation.