Breast Augmentation

Breast augmentation is a plastic surgery procedure designed to enhance volume, contour, and shape in the breasts. With the precise placement of silicone or saline breast implants, women can effectively rejuvenate the appearance of their breasts and feel more confident about their overall body proportions. There are many options for implants and incision placement that can enhance your silhouette naturally, balance your figure, and improve your appearance in certain types of clothes. Breast augmentation remains one of the most frequently performed surgical cosmetic enhancement procedures and is one of Dr. Dana Coberly’s areas of special focus here at our practice. Our board-certified plastic surgeon is extensively trained and experienced with breast enhancement procedures and will customize your breast augmentation treatment plan to achieve your goals while producing results that look both natural and beautiful.

Breast Implant Types, Shapes, and Sizes

Silicone gel and saline breast implants are available in the United States and approved by the FDA. The implants are all smooth and round. Textured implants are no longer available. All of the implants are round and are available in many different sizes and projections. The “projection” is how much the implant projects forward compared to the base of the implant. The base of the implant is against the chest wall and should match the width of the chest so that the implant does not stick out too far on the side.

Implants are available in low, moderate, moderate plus, high, and ultra high projections, depending upon the brand. Dr. Coberly will take measurements to help you choose the best implant for you.

Saline Breast Implants 
Saline breast implants are approved by the US Food and Drug Administration for women 18 years of age and older who are considering breast augmentation, and for women of any age who are undergoing breast reconstruction procedures. Saline implants have been utilized for decades and are still a very popular option. They are made of a silicone outer shell, which encases a saline solution inside. In the event of a rupture, the saline should be harmlessly absorbed into the body. One of the advantages of saline breast implants is that they can often be filled after they have been inserted into the breast pocket. When this is possible, the incisions to place them may be smaller, leading to less noticeable scars. Additionally, this can be helpful for enhancing symmetry between the breasts and making the results more proportionate.

Silicone Breast Implants 

Silicone gel implants for breast augmentation have been FDA-approved for all women over 22 years old for many years, and are approved for breast reconstruction patients of any age. The newest implants to be approved are 5th-generation gel implants made by Allergan, and are called “soft touch” implants. They are soft enough to feel natural, but thick enough to prevent most rippling.

Many silicone gel implants are made with cohesive gel—these implants are also known as “gummy bear” implants. This means that the gel is thicker than older-style implants and that it wants to stick together.

Silicone gel and saline implants can be placed under the muscle. The implants can be placed completely under the pectoralis major muscle or partially under the muscle. When the bottom part of the muscle is released, it is called a dual plane technique. This lets the implant sit in the correct position under the breast.

Will Having My Breast Implants Placed Under the Muscle Hurt More?

Placing the implants under the muscle is no more painful than putting them over the muscle. The technique used to make the pocket for the implant determines how much discomfort you will have after surgery. A long-lasting pain medicine can be injected during surgery to make you more comfortable for the first three days after the procedure.

Placing the implants under the muscle is no more painful than putting them over the muscle. The technique used to make the pocket for the implant determines how much discomfort you will have after surgery. A long-lasting pain medicine can be injected during surgery to make you more comfortable for the first three days after the procedure.

Breast augmentation with fat injections is a technique which can enhance the size and appearance of the breasts using the body’s natural fat instead of breast implants or in combination with breast implants. This treatment, also called fat transfer or fat grafting, involves taking excess fat cells from one area of the body (usually the abdomen, thighs, hips, or “love handles”) via liposuction and transferring extracted fat cells to the breasts. With this “natural breast augmentation” approach, women essentially receive two benefits in one: body contouring in another area of the body to produce enhancement of the breasts.

While breast augmentation with fat injections can be a wonderful option for some patients, it may not be ideal for others. As a standalone breast augmentation procedure, this treatment can only provide mild to moderate breast enlargement (typically about one cup size). However, it can also be helpful for some individuals as an adjunctive treatment with breast implantation by enhancing the results to create improved symmetry and the most natural appearance possible.

Dr. Coberly can talk more with you about this option during your initial consultation and help you determine whether breast augmentation with fat injections may be ideal for your needs and goals.

If your nipples are already in the correct position, or not too saggy, then a mastopexy (breast lift) is usually not needed. Sometimes the skin is too stretched from breastfeeding or weight changes and a lift will be recommended. An examination is required to determine if you need a lift and what type of lift is best for you. A breast lift will have incisions around the areola, and possibly from the nipple down to the fold under the breast, and sometimes also in the fold. The implants can often be placed utilizing the same incisions made for the breast lift component of this procedure, depending on the specific technique utilized.

Once you have been evaluated by Dr. Coberly during the consultation she will be happy to talk with you about whether a breast lift with augmentation is an option worthy of exploring based on your needs and the aesthetic goals you are hoping to accomplish.

Breast augmentation involves surgery with anesthesia and will require a recovery period following the procedure. Most women only need pain medicine for a few days after surgery. The chest feels tight and you may feel pressure against your chest. We want you to wear a bra for one month after surgery. You may remove it to shower the day after your procedure. We will let you know which bra we want you to wear so that you get the best results. Swelling and a degree of numbness in the breast areas can be expected for at least a few weeks after breast augmentation surgery; however, any significant pain and discomfort usually dissipates within a few days after the operation and can be controlled with medication. We also offer Exparel®, a numbing medicine that can be injected at the time of surgery to reduce your pain level for three days after surgery. This treatment reduces the need for post-operative narcotics and allows patients to recover faster with fewer side effects.

You should not exercise or lift anything heavier than 10 pounds for one month after surgery. Normal activity is fine, and walking is encouraged. Depending upon your need for narcotic pain medication and your occupation, you may be able to go back to work after two or three days. Some patients take a whole week off. Be sure to check with your work to see if you can go back with restrictions, and if light duty is available if needed.

Tranexamic Acid (TXA) is a medication given during surgery to help prevent bruising. Our patients who receive TXA during surgery have less post-operative discomfort, less bruising, and a quicker recovery.

Where scars will be located and how noticeable they will be is understandably one of the most common questions asked by patients who are considering this procedure. The answer is completely dependent upon which surgical technique is utilized to place the implants. If the implants are placed through an incision made in the underside of the breasts, there will be a noticeable scar in that area; however, Dr. Coberly is careful to close the incision in such a way that the resulting scar is as light as possible. All scars fade over time, and it is important to keep the scar in the crease or fold under the breast for the best long-term results. A periareolar incision (one that’s made in the area around the nipple), typically results in a small scar that may blend into the natural pigmentation of the skin in this region, making it less noticeable. In many cases, the least visible scarring results from the transaxillary breast augmentation technique since the incision is made in the armpit; however, the transaxillary approach is not the most common since it can only be utilized in certain circumstances, and can only be performed for patients who are having saline breast implants placed. This scar is more visible for the first six months and may require more coverage with clothing during the healing period. While there will be some degree of noticeable scarring after breast augmentation, it is important to note that Dr. Coberly will perform advanced suturing techniques to make them as discreet as possible. Additionally, scars tend to fade to a certain extent over time.