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Breast Augmentation

  • Length:1–2 hours
  • Anesthesia: IV Sedation
  • In Patient/Out Patient: Out patient
  • Potential Side Effects/Risks: Temporary soreness and numbness, ripples in implant, leak of saline, rupture of silicone
  • Principal Benefits: Uplifted and more shapely breasts and overall more proportioned appearance.

Breast Augmentation Overview Video

Breast augmentation is a procedure to enlarge the size of your breasts using a saline-filled or silicone implant. Breast augmentation not only increases breast size, but also heightens self-esteem, especially in women who have long thought of enlarging their breasts. We have seen time and again the uplifting of spirit, confidence, and self-image following breast augmentation. The recovery is relatively rapid. Saline or silicone implants are options for our patients and depend on personal preference and individual needs. The newly designed silicone implants are now available and offer an excellent alternative for selected patients.

Most of our patients who have breast augmentation desire to improve their appearance in clothing, without clothing and in bathing suits. While some women have never filled out their bras the way they would like, others have lost volume in their breasts following pregnancy. We tailor each operation to the particular build of the woman. Some women who have had children or who have experienced weight loss have a degree of breast droop that requires a breast lift (mastopexy) combined with breast augmentation.

We will discuss with you our recommendations for implant position (above or below the muscle) the optimum incision location, and the different options of implant types. Breast augmentation can be performed as a single procedure in our  office or in conjunction with other cosmetic procedures such as liposuction, tummy tuck, and facial plastic surgery.

Did You Know?
One of Dr Vogel’s breast augmentation patients was portrayed on the cover of Playboy Magazine! Stephanie is seen in the middle of the group and is of course wearing our Baltimore Raven football team signature gloves!
Playboy Cover

Breast Augmentation Incision Options

At my practice, I prefer to use an incision in the breast crease for breast augmentation. The reason for this is, first and foremost safety and consistency. Although an incision around the areola is appealing in many cases, this approach does have an increased likelihood of capsular contracture. Another option, an incision in the arm pit, does not provide me with the flexibility to manage the breast crease positioning which is critical in many cases. I have never used the belly button as a incision option and this choice is only available for saline implants as well. The crease incision affords a maximal exposure and excellent healing with the highest safety.

There are other considerations to consider when choosing the type of incision to use and we will discuss this with you in detail at the time of your consultation. Of course other decisions to make include whether to place the implant above or below the (pectoralis) muscle and the size and type of breast implant to use. We will have a lot to discuss and will customize a plan that best fits your needs and goals.

Breast Augmentation Patient Review Video

Dr. Vogel Explains the Use of Computer Imaging Technology During Consultation for Breast Augmentation

Dr. Vogel Explains the Dual Plane Breast Augmentation Technique

Excellent communication with your plastic surgeon and his staff plays a vital role in the success of your breast surgery. To learn more about our plastic surgeon and breast augmentation options, please contact James Vogel, MD to schedule a consultation today.

Dr. Vogel Answers Frequently Asked Questions

My breasts have a tubular shape. Is this normal?

Yes, this is a common variation on breast shape. Typically a breast has a pyramid shape, but some people have breasts that have a shape closer to that of a tube. The appearance of the breast in this situation typically includes some breast tissue pushing against the areola and expanding it, a tight, narrow breast base near the chest, and a short distance between the bottom of the areola and the infra-mammary crease. This tubular appearance can be improved with breast augmentation and some additional skin tailoring.

Below is an example of this type of improvement in the Tubular breast shape.

How can I avoid capsular contracture (hardening of the breast implants due to scar tissue build up)?
No one really knows why this occurs in some breast augmentation patients, and it cannot be 100% eliminated. Some theories state that contracture is related to a variety of factors, these include: low-grade infection, inherent scar formation tendencies by the patient, or location of the breast implant above or below the muscle. We take every possible precaution to avoid these potential problems that might lead to contracture. In addition, we are big believers in massage of the breast implants following surgery. It is known that massage softens scar tissue and our patients have a very low rate of contracture.
Is it better to have the breast implants placed above or below the muscle?
Some surgeons only place the breast implants below the muscle, others only above. We will recommend what is best for you based on the way your breasts appear and the look you desire. Sometimes a Dual Plane approach is the best customized option for you (see the video above). During your thorough breast augmentation consultation, we will decide on what method is best for you.
What size breast implants should I be getting?
You are the person who will live with your breast augmentation results on a daily basis, and the decision for size is a very personal one. We will recommend a size based on what you tell us you are looking for. You may wish to bring in photos from publications to demonstrate a desired look and size. Some women prefer to appear totally natural and others prefer a fuller look. We are happy to provide both options.
Am I able to breast feed after I get implants?
Most patients who have breast augmentation at our practice do not have problems breastfeeding.
Are silicone implants better than saline implants?
Both saline and the new cohesive silicone gel implants are excellent, improved from those used years ago and offer different benefits. Most patients these days are requesting silicone implants because they do appear and feel more natural. On the other hand, the saline implants are less expensive and can be placed through smaller incisions because they are filled after the implant is placed under the breast as opposed to the silicone implants which are pre filled. We will be happy to offer you both options if you are undecided and we will make sure you understand all of your options regarding the type of breast implant to choose.
Are silicone implants safe?
The answer is Yes. Although there was much concern and controversy 5-10 years ago regarding the safety of liquid silicone in breast implants, the FDA has since failed to uncover any health risks from silicone implants and the earlier restrictions for use have been removed. In addition, the implants we now use different are improved from the older generation of implants. The implants we now use are cohesive silicone gel implants and when cut in half, there is no free flow of silicone gel and in fact they demonstrate a texture that resembles a “gummy bear” candy. We will be happy to discuss this topic with you during the consultation as well.
Are mammograms less effective when breast implants are in place?
Breast implants do hide a certain amount of breast tissue on mammography. Additional mammographic views are recommended to maximize the amount of breast tissue seen, however. This does mean additional radiation at the time of mammography but the total amount is certainly not excessive. Digital mammograms and MRI’s do not produce radiation and offer excellent breast analysis.
If my breasts droop is a breast lift needed?
Generally, if the nipple is at or below the breast crease, a lift (mastopexy) can be beneficial. Weight loss or past pregnancies are the most common causes for breast droop. The medical term for breast droop is ptosis. To achieve a lifting of the breast, the breast skin is excised and the “breast skin envelope” is made tighter. The scars on the breast that result from this lift are considerable but usually heal very well. With the excess skin removed, the breasts rise to a more youthful level. Some women may require a breast implant (augmentation mastopexy) as well in order to get adequate lift and fullness.
What is recovery like?
Most breast augmentation patients have only moderate soreness for a few days, but this improves quickly thereafter. Contrary to what you read on the Internet, breast augmentation patients at our practice truly have very little pain postoperatively. Most people take off 3-5 days from work to recuperate.
Can I speak to some of your previous patients who had this surgery and get a reference?
Absolutely, we would encourage this. My past breast augmentation patients are my greatest endorsement. The staff in our office will gladly arrange this for you.
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