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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.

What is Breast Augmentation?

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.

We invite you to learn more about breast augmentation by exploring the informational sections and media provided below, or simply contact our practice today to schedule a consultation with one of our experienced plastic surgeons.

Who Is a Candidate for Breast Augmentation?

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.

During your consultation, 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. Additionally, 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. If you have a variety of cosmetic concerns, your plastic surgeon will take the time to discuss the available methods for achieving your goals.

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

What Are the Different Types of Breast Implants?

There are three different types of breast implants to choose from when planning the details of your breast augmentation procedure. Each option has unique advantages and drawbacks that are important to explore with the help of your plastic surgeon. The right type of implant for you will depend on a variety of factors you and your surgeon will discuss during the consultation.

Traditional Silicone Breast Implants

FDA-approved in 2006, traditional silicone gel breast implants were redesigned for enhanced safety after older models were taken off the market. Today’s silicone implants feature a more rupture-resistant silicone rubber shell filled with silicone gel. For many patients, silicone breast implants can provide an exceptionally natural look and feel. Implant manufacturers offer a wide range of sizes/volumes and projections to accommodate the unique needs and cosmetic goals of a broad spectrum of breast augmentation patients.

Gummy Bear Breast Implants

Cohesive silicone gel breast implants, which are also called “gummy bear” breast implants due to their form-stable silicone gel, are the latest form of silicone breast implants to be FDA approved. These firmer gel implants offer patients round and anatomically shaped (tear drop) implant options that are available in a wide range of sizes and profiles. For certain patients, anatomically shaped models can provide a natural-looking breast slope and enhanced lower pole fullness.

Saline Breast Implants

Saline breast implants, which are comprised of a silicone rubber shell filled with a sterile salt-water solution, can provide a suitable option for breast augmentation patients who do not want silicone or who desire a placement strategy that requires saline. Unlike silicone breast implants, which contain a fixed amount of gel, the amount of solution contained in saline breast implants is adjustable at the time of surgery. Additionally, if a saline implant ruptures, it is immediately detectable (while silicone leaks typically occur more slowly), and the leaked solution simply absorbs harmlessly into the body.

If you are unsure about which breast implant type is best suited for your needs, do not worry—Dr. James E. Vogel or Dr. Carrie A. Houssock will take the time to explain your choices and recommend an option that aligns most closely with your goals and priorities.

What Are the Breast Augmentation Incision Options?

At our practice, Dr. Vogel and Dr. Houssock typically prefer to use an incision in the crease underneath the breast 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 is an incision in the armpit; however, this approach does not provide the flexibility needed to manage the breast crease positioning, which is critical in many cases. Our surgeons have never used the belly button as a incision option, and this choice is limited to saline implants. Dr. Vogel and Dr. Houssock believe that the breast crease incision affords a maximal exposure and excellent healing with the highest safety.

There are other considerations to explore when choosing the type of incision to use, and these factors are discussed in detail at the time of your consultation. Of course, additional 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. You and your surgeon will have a lot to discuss while customizing a plan that best fits your needs and goals.

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

Dr. Vogel Explains the Dual Plane Breast Augmentation Technique

How Is the Breast Augmentation Procedure Performed?

Prior to your breast augmentation procedure, you will be prepared for surgery and placed under general anesthesia. To begin, your plastic surgeon will make the appropriate incision, which is most often an incision along the lower breast crease (also called the inframammary crease). Through this incision, the breast pocket is created in the desired area (either above the muscle, below the muscle, or partially above and below the muscle [dual plane]), and the breast implant is inserted within. If saline implants are used, the implant shells are filled with the appropriate level of solution. Finally, the incision is closed and the process is repeated on the other breast.

Overall, the breast augmentation procedure takes approximately one to two hours to complete.

What Is Recovery after Breast Augmentation 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 only three to five days from work to recuperate, but strenuous physical activity may need to be limited for longer in order to promote optimal healing.

How Much Does Breast Augmentation Cost?

At our Baltimore-area practice, the average prices for breast augmentation surgery are $5,800 for saline breast implants and $6,950 for silicone breast implants. Depending on the details of your surgical plan, your overall cost for breast augmentation surgery might be higher or lower than our stated average. Factors that may affect the pricing of your operation can include:

  • The complexity of the procedure
  • The brand, type, shape, and/or projection of the chosen breast implants
  • The incision and implant placement plan
  • Any additional procedures such as a breast lift, tummy tuck, or liposuction
  • Anesthesiology costs
  • Post-operative medications

If you are interested in finding out how much a customized breast augmentation would cost, we encourage you to schedule a consultation with either Dr. Vogel or Dr. Houssock. At the end of your appointment, you will receive a detailed quote for your unique surgical plan. Our friendly and knowledgeable office team can also talk with you about scheduling your procedure, the payment options we accept, and plastic surgery financing opportunities offered through third-party lenders. We are happy to answer any of your questions and look forward to helping you achieve your aesthetic goals.

Breast Augmentation Patient Review Video

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.

Breast Augmentation Before-and-After Photos

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