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What is Breast Augmentation?

Breast augmentation involves placing an implant either under the breast tissue itself, or under the pectoralis muscle and breast. It can create better symmetry between your breasts, and balance the rest of your figure. Selection of the placement of the implant is a process you’ll discuss with board-certified plastic surgeon Kristen Yee, MD, FACS, as she may recommend a particular location depending on your body type.

Choosing Breast Implants

Implant size is an issue you will discuss in person with Dr. Yee, based on your preferred level of fullness as well as on your individual body shape and type. Another matter you can consider prior to your visit is implant type. In earlier years, the only choices were silicone and saline (and for some time, only saline!) but now there are more.

Silicone Implants

The traditional silicone implant is still a first choice for many women. It is composed of silicone gel in a thicker silicone shell. It feels more natural than a saline implant, which is part of the reason for its popularity. Over time, the silicone shell can break, and the liquid silicone, if not contained in the capsule the body makes around the implant, can migrate into the adjacent soft tissues. Sometimes this is not noticeable to the patient at all, for years in some cases, and in other patients the body can try to wall off these areas of silicone and develop firm areas that then prompt evaluation by a physician or surgeon. The liquid silicone is not harmful (and any association with autoimmune or other diseases has been disproven), but some patients don’t like the idea that this could happen.

Cohesive Silicone “Gummy Bear” Implants

To address the concerns of silicone leakage, a new kind of implant filled with a thicker, cohesive silicone was developed within the last 10 years. These implants feel firmer, and have less wrinkling as a result. If the silicone shell should break, the silicone inside will not leak; it is firm like a gummy bear, or jello, and will not travel into the local tissues. These implants come in the traditional round shapes, as well as anatomically shaped. Some companies also offer different levels of firmness (and therefore natural feel), but all of these remain intact if the shell breaks.

Saline Implants

For anyone concerned about issues with silicone, saline can be a good choice. Saline implants can be placed through very small incisions, which can be nice if a larger implant is planned. If a saline implant ruptures, the body simply absorbs the salt water, which is compatible with your body chemistry, and unfortunately it can become obvious in a short period of time that the silicone shell has broken. They typically don’t feel as natural as a silicone implant, but if you already have a good amount of breast tissue this may not be noticeable.

Breast Augmentation Procedure

Dr. Yee only uses incisions around the nipple (peri-areolar) or under the breast (inframammary) because these give her greater control over implant location; not everyone is a candidate for the peri-areolar incision.

Typically breast augmentation is performed under general anesthesia, and is an outpatient procedure.

Breast Augmentation Recovery

Dr. Yee recommends you have someone stay with you the night after surgery, as the anesthetic wears off; you might be drowsy and need help getting up. You may return to work in 3-5 days with some limitations on physical activity. You should not do any lifting over 10 pounds for 3 weeks, or any high impact aerobic workouts or increasing your heart rate above 100 beats per minute for 3 weeks. Walking is fine.

Frequently Asked Questions:

Can you breastfeed after breast augmentation?

If the inframammary incision is used, it should have no effect on the ability to breastfeed; sometimes women who have had the periareolar incision have difficulty lactating. The presence of silicone is generally considered safe for the baby.

Is sensation to the nipple and areola affected after breast augmentation?

Yes, it can be diminished or lost. In most situations, after 3-6 months, some sensation can return but it is difficult to predict, and sensation may be different on each side. The inframammary incision has the lowest risk of affecting nipple sensation.

How can I get the cup size I want?

Generally plastic surgeons don’t promise a cup size, because cup sizes vary between bra manufacturers, and also depend on the chest wall circumference. It’s helpful to try on shaped bras prior to your consultation so you have an idea of what volume you would like, and then based on trying on implants in the office, and your own measurements, together with Dr. Yee you can choose a good size for your desired look.

Is breast augmentation covered by insurance?

Having implants placed to increase the size of your breasts, or to make them more even, is not covered by insurance.

For personalized recommendations, please schedule a consultation with Dr. Yee.