Struggling to find the best breast augmentation surgeon? In light of the recent FDA updates relating to the regulations concerning breast implants, it seems like the perfect time to review what you know about breast augmentation surgery before you decide to go under the knife.
Breast augmentation is a surgery that can help improve your self-esteem and your confidence in your body. However, it is a procedure that could impact your whole life. So if you are someone considering breast augmentation, you will need to make sure you consider all the options available to you before you can come to a decision. An experienced and skilled surgeon That’s why choosing the best breast augmentation surgeon you can get is of utmost importance.
But with so many qualified and unqualified surgeons out there, choosing the best breast augmentation surgeon for you is easier said than done. However, having a clearer understanding of the breast augmentation procedure and what you can realistically expect, can really help you in this regard. So let’s take a closer look.
What Is Breast Augmentation?
Breast Augmentation or Augmentation Mammoplasty is a cosmetic surgery that involves placing saline or silicone implants into the breast to improve its size, shape, and volume. There are also structured implants that utilize both saline and silicone gel technologies. Due to the use of implants, the procedure is often referred to as breast implant surgery. There is also non-implant breast augmentation which involves the transfer of with the injection of autologous fat grafts. However, this is less common. In commonplace conversations, the procedure is also referred to as “breast aug” or “boob job”.
Breast augmentation is primarily for those who want to change the size, shape, or volume of their breasts. Some transgender and gender diverse people also choose breast augmentation to help affirm their gender identity, although only as a final step after having explored all social and medical transition options.
Breast Augmentation vs Breast Lift
Although the terms Breast Augmentation and Breast Lift are often used interchangeably, the two procedures are not the same. Breast Lifts do not involve the use of implants at all, but rather, the surgeon manipulates the existing breast tissue to lift and tighten the breast. However, it is common to get a breast augmentation procedure and a breast lift procedure to be done in combination.
Who Is Eligible For Breast Augmentation?
Breast Augmentation is FDA-approved for healthy patients who meet the minimum age requirements. As per FDA regulations, patients who are at least 18 years of age can choose to undergo Breast Augmentation with saline implants. However, only those who are over the age of 22 are eligible for silicone gel implants.
Types of Breast Augmentation Procedures
When it comes to Breast Augmentation, there are mainly two types - Breast Implant Surgery and Autologous Fat Grafting.
Breast Implant Surgeries
Four types of implants have been used so far in breast augmentation surgeries:
🔹Saline Implants: Implants filled with a sterile saline solution
🔹Silicone Implants: Implants filled with a viscous silicone gel
🔹Structured Implants: Implants that use nested elastomer silicone shells with saline between the shells.
🔹Teardrop or Gummy Bear Implants: Implants filled with a gel of thicker consistency comparable to gummy bears
👉Breast Augmentation Surgery With Saline Implants
Breast Augmentation Surgery with saline implants is considered to be the safest among all breast-implant surgeries. It is also one of the most popular breast-implant surgeries as it is a less invasive surgical technique.
The procedure involves the insertion of an empty, rolled-up silicone shell through a small surgical incision. Once the empty silicone shells are installed properly in the implant pockets, the surgeon then fills each implant with the sterile saline solution through a one-way valve. A saline implant can achieve “good-to-excellent” results, with increased size, smoother contour, and realistic consistency.
The only drawbacks with the saline implant are that there is more chance of cosmetic problems when compared to the technically superior silicone gel implants. Nonetheless, the greater safety offered by saline implants makes it an excellent choice. Also, for those with much breast tissue, saline breast implants can achieve an aesthetic result comparable to that produced by silicone breast implants.
👉Breast Augmentation Surgery With Silicone Implants
Breast Augmentation Surgery with silicone implants is quite popular and preferred by many, as they feel more like real breasts. This is thanks to the consistency of the silicone gel used in these implants.
The procedure, unlike saline implants, involves the insertion of a silicone shell pre-filled with viscous silicone gel. Since the silicone gel shells come pre-filled, the surgeon would be required to make a larger incision to insert it into the pocket depending on the size of the implant used. The surgeon will also have to properly plan that the incision scar remains invisible after the augmentation.
Although silicone implants are generally considered to be less safe than saline implants due to chances of capsular contracture, there have been five generations of silicone implants since it was first introduced in 1961. Modern advancement in silicone implant technology has helped fifth-generation silicone implants to achieve relatively greater rates of medical safety and technical efficacy than the earlier generation of implants.
👉Breast Augmentation Surgery With Structured Implants
Breast Augmentation Surgery with structured implants can be considered to be a middle ground between the saline and silicone gel implants. Structured implants utilize both saline and silicone gel technologies. The implant has an internal structure that consists of three nested rubber shells that support the upper half of the breast, while the spaces in-between the shells are filled with sterile saline solution.
The procedure involves the insertion of the structured implant through an incision. Once the implant is in place it is filled with the saline solution. Since the implant is inserted empty, it requires a smaller incision compared to pre-filled silicone gel implants. But due to the presence of the rubber shells, it would require a larger incision than what is required for empty saline implants.
The structured implant is quite new and has been approved by the FDA only since 2014. However, this type is quickly becoming popular as the patient gets the same natural feel that silicone gel implants provide, while also providing the safety allowed by the saline solution filler in case of rupture.
👉Breast Augmentation Surgery With Teardrop Or Gummy Bear Implants
Breast augmentation surgery with teardrop or gummy bear implants is preferred by many patients as they are highly cohesive and are known to retain their shape when compared to other breast implants. This is because the cohesive gel it contains is thicker than what you get with silicone implants. Often referred to as form-stable implants, they also leave the breasts naturally soft to the touch.
Just as with the other breast augmentation surgeries, the procedure involves the insertion of the implant through an incision. However, due to the teardrop shape, and the pre-filled gel, the options for where the incision is made are limited. The recommended location is the lower breast fold as it reduces the chances of contamination or damage. Owing to the shape, the length of the incision required might also be larger compared to other implants.
Gummy bear implants have lower rates of rupture and capsular contracture, however, they are not without disadvantages. If the implants rotate out of position, it could leave your breasts looking distorted. You will also need to size the implants properly as per your needs. If they are too big, the breasts will look too stuffed. On the other hand, if they are not big enough, the breasts won’t look properly filled.
Autologous Fat Grafting
Autologous Fat Grafting or Fat Transfer Breast Augmentation Surgery involves the injection of autologous fat grafts (adipocyte tissue).To put it in simple terms, it is a non-implant breast augmentation procedure that takes fat from other parts of the body using liposuction, which is then injected into the breasts.
During the procedure, the surgeon will first use liposuction to remove fat from other parts of the body. The removed fat is then carefully processed and purified using antibiotics before it is injected into the breast tissue. The longer the fats cells remain outside the body, the higher are the chances it will die from a lack of blood supply. As such the procedure requires an experienced surgeon with good technical skills to prevent the loss of cells and get the best results. Once the extracted fat cells are injected into the breast, they will incorporate into the adipose tissue, thereby increasing in size while still looking natural.
Fat Transfer Breast Augmentation Surgery is a good option for patients who want to enhance their breasts but don’t like the idea of getting breast implants. It is also a good choice for patients who want natural-looking results.
However, there are also certain disadvantages you’ll need to be mindful of before choosing this procedure. First of all, there is no standard procedure for Fat Transfer Breast Augmentation which means you will have to find an experienced and trustworthy surgeon. Secondly, there are limitations to how much you can increase your breast size. Usually, it is limited to one cup size. You’d also need enough fat on your body that is required for the procedure, which is why it is not suited for leaner patients. However, for larger patients, this could be an added advantage as you lose fat from unnecessary areas like the belly, thighs, and love handles, and also get an enhancement in the breast with a single procedure. It is also a scarless procedure as the incisions made are as small as 4 millimeters.
Options With Breast Augmentation Surgery
Breast Implant Incisions
The incision is the point through which the surgeon inserts the breast implants. This entry point is also used to create pockets where the implants are to be installed. Based on the type of implant the incision to insert the implant can be made in various areas. Keeping aesthetics in mind, the incisions are usually made in inconspicuous areas. However, the type of implant and procedures may limit the opportunities available to you.
There are usually five acceptable options for how the implant may be placed inside the breasts:
Inframammary Incision (Under the breast fold)
Inframammary incisions or incisions made under the breast folds are by far the safest option when it comes to breast implants. Statistics show that inframammary incisions have the lowest rate of complications compared to all other incisions, as it offers the surgeon easy access and visualization for creating a precise implant pocket. It is also easier for surgeons to place the breast implant either over the breast muscle, partially under the breast muscle, or completely under the breast muscle.
The inframammary incision is also one of the best options aesthetically when designed and planned in such a way that it sits perfectly in the future breast fold after augmentation. During the procedure, an incision is made underneath the breast in the breast crease, which can be small or large, depending on the type of implant. The incision can be as small as 1.5 inches in length if inserting rolled-up saline implants. However, it can be as long as necessary for inserting larger pre-filled silicone gel implants. That’s why the inframammary incision is the most suited among all the incisions for silicone gel implants. It is also the best choice for the new teardrop or gummy bear implants.
Periareolar Incision (Along the edge of the nipple)
A periareolar incision is a breast augmentation incision in which the incisions are made at the edge of the outer areolar area, following the curve that separates the darker skin of the nipple from the rest of the breast. Once the semi-circle-shaped incision is made, a pocket is created by the surgeon, and the implant is slid in place through the incision. After the implant is placed and centered into a good position, the incision is closed in layers.
Periareolar breast augmentation is chosen by many due to the comparative safety of the procedure compounded with the well-hidden incision. Since the incision is made quite close to the implant location, it becomes easier for the surgeons to place the implants precisely and aesthetically. And although the incision is made directly on the breast, the darker color and texture of the areolar border allows the scar to be camouflaged quite well, even to the extent that it becomes virtually invisible. But perhaps the biggest and most unique advantage of the periareolar incision is that it can be reused in case of future surgeries on the breasts.
That being said, the periareolar incision is not without its disadvantages. This type of incision is best suited for saline implants. However, if it is possible to make a large enough incision within the border of the areola, silicone implants can also be inserted. But there are limitations to the size of silicone implants that can be inserted according to the anatomy of the patient. This incision is more likely to cause loss of sensation in the nipple area and can sometimes lead to difficulties in breastfeeding. Also, if the scars don’t heal well after breast augmentation, it may look much more obvious. That’s why it is important to choose an experienced surgeon to perform this procedure.
Transaxillary Incision (In the armpit)
Transaxillary Incision refers to the placement of the incision under the patient’s armpit. Once the incision is made, the surgeon then inserts a saline implant through a channel that is made to reach the breast tissue. Here, the implant is placed either beneath the breast tissue or beneath the breast muscle. Patients choosing this incision method should be in perfect health and not suffer from medical conditions that would make the surgery a potential health risk.
Transaxillary breast augmentations are one of the popular options when it comes to breast implants as there is no direct incision made on the breasts themselves. The main advantage of this type of incision is that the scar remains hidden in the underarm, making it difficult for others to recognize that a breast augmentation procedure has been done. Patients are allowed to wear all kinds of undergarments and tops without worry. But it may be visible when wearing a bikini or a swimsuit if the arm is lifted. However, if there are concerns about the armpit scar, the surgeon can make the incision as small as possible. The scar will also typically fade with time.
Nonetheless, there are a few disadvantages that you’d need to be mindful of before choosing a transaxillary breast augmentation. Firstly, only saline implants can be used for the procedure as the incision is not made on the breasts directly. Secondly, since the incision is made far from the breasts, surgeons have lesser control and the chances of malposition of the breast implant are higher. Only highly experienced and skillful surgeons are able to do this procedure, which could affect costs. As such, it is important that patients choosing transaxillary breast augmentation have realistic expectations when it comes to the results.
Trans-Umbilical (Through the belly button)
Trans-Umbilical incision refers to the placement of the incision in the patient’s navel. Once the incision is made, the surgeon inserts a deflated saline implant through the short 2-centimeter incision. This approach enables the placement of the implant without scars on the breast, much like the transaxillary breast augmentation procedure.
The trans-umbilical breast augmentation procedure is less common due to the complexity of the procedure. The surgeon inserts the implant through the incision without the visual assistance of an endoscope, which makes precise placement technically difficult. The procedure is only applicable for saline implants as pre-filled silicone implants are incompressible and cannot be inserted through the small incision.
Trans-abdominal (Through the abdomen)
The Trans-abdominal incision refers to the placement of the incision in the patient’s abdomen. Trans-abdominal breast augmentation is a procedure that is done simultaneously with an abdominoplasty. During the procedure, the breast implants are tunneled into the dissected implant pockets through the incision that is made for the abdominoplasty.
As such, this procedure is suited for those who want to undergo a breast augmentation and tummy tuck at the same time. It is ideal for patients with mild-to-moderate breast sagging. This combination of breast augmentation and abdominoplasty offers the patient the unique opportunity, not only to have both procedures during the same operative session but also through the same incision
Breast Implant Positions
During the breast augmentation procedure, once the incision is made, the surgeon creates a pocket in the breast by separating the breast tissue from the muscles and the connective tissues of the chest. The resultant pocket created is where the implant is finally placed and centered behind the nipple.
These pockets are usually created in two different areas for breast implant placement:
Submuscular Placement (Under the pectoral muscle)
Submuscular placement refers to the placement of the implant partially under the pectoralis major chest muscle. This technique tends to result in a more natural appearance. In addition, patients can get more accurate mammograms and the chances of capsular contracture are also lesser. However, this breast implant placement technique could require a longer recovery time, and patients may experience slightly more discomfort after surgery.
Subglandular Placement (Over the pectoral muscle)
Subglandular placement refers to the placement and positioning of the implant between the chest muscle and the existing breast tissue areas. This technique of placing the implant over the muscle is done to ensure that the implant lies below the glands of the breast, allowing the patient the ability to breastfeed in the future. In addition, patients tend to experience less movement of the implants during physical activity and also less discomfort after the surgery. However, after this breast implant placement technique, mammogram readings become less accurate and the chances of capsular contracture are also higher.
Breast Implant Size
Breast Implants are made in different shapes and sizes to accommodate various body types. To understand the size of a breast implant, there are three measurements that need to be considered - the profile, the volume, and the diameter.
Breast Implant Profile
The profile of an implant is the distance an implant projects outward from the chest wall.
Low Profile Breast Implants
Low-profile implants have the least amount of projection and lie the flattest. This type of implant results in a wider breast with lesser projection. This is the best-suited profile size for patients with wide breasts that desire volume in the cleavage and upper breast areas.
Medium/Moderate Profile Breast Implants
Medium or Moderate profile breast implants are the best suited for average size patients. It has a projection that lies between low-profile and high-profile and seems closer to natural breast size. It will also give a moderate amount of cleavage.
High Profile Breast Implants
High-profile implants have the highest amount of projection without exceeding what can be called the natural range. This type of breast implant results in a pointy, round breast. As such, High-Profile breast implants are best suited for patients with narrow breasts.
Very High Profile Implants
Very high profile implants are intended for those with eccentric tastes. These implants exceed the natural range and will instantly attract attention. However, this type of implant could be difficult to maintain.
Breast Implant Volume
Breast implant volume refers to the amount of space the implant occupies and is measured in cubic centimeters, rather than cup sizes.
Breast implant sizes start at around 125cc which is around half a cup size. 80cc breast implants are also available, but the truth is, they are hardly ever requested. On the opposite end of the spectrum, the size of breast implants goes way beyond 1200cc. However, these will only be suitable for women of larger build. The most commonly requested breast size typically falls within the 300cc to 500cc range.
Here is a size chart that can help give you an idea about which size to choose.
Note, however, that there is no standardization when it comes to cup sizes and sizes vary by the manufacturer.
Breast Implant Diameter
How Much Does Brest Augmentation Surgery Cost IN USA
The average cost of Breast Augmentation Surgery in the United States is around $5000. However, this is only part of the total price and does not include other related expenses such as medical tests, prescriptions for medication, anesthesia fees, hospital fees, and surgical facilities costs.
The cost of Breast Augmentation Surgery in the US could also vary significantly depending on multiple factors including:
Cost of Breast Augmentation Surgery with Saline Implants
Saline implants are the most commonly preferred for Breast Augmentation Surgery due to their relative safety. As such, the cost of breast augmentation surgery with saline implants in the US starts at around $4000, which is the lowest among implant procedures. This is because saline implants are done with silicone shells that come empty that costs less for the surgeon to purchase. The sterile saline solution is filled in after insertion.
Cost of Breast Augmentation Surgery with Silicone Implants
Silicone implants are often the most requested for breast augmentation surgery because they “feel more like real breasts”. However, since the procedure involves the insertion of a silicone shell that comes pre-filled with silicone gel, the procedure is a bit more expensive. The cost of Breast Augmentation Surgery with silicone implants in the US is typically around $5000, or generally around $1000 more than saline implants.
Cost of Breast Augmentation Surgery with Teardrop or Gummybear Implants
Teardrop or Gummybear implants are preferred by some due to their relatively higher thickness which helps them to “look more like real breasts”. Initially, teardrop or gummy bear implants were only available as part of clinical trials and typically cost between $5000 to $6000. However, teardrop or gummy bear implants have received FDA approval since 2013. Today the cost of teardrop or gummy bear implants in the US starts at around $7000, making it the most expensive among breast-implant surgeries.
Cost of Breast Augmentation Surgery with Structured Implants
Structured implants are a more recent innovation and have been approved by the FDA only since 2014. Due to the relatively lower number of surgeons and facilities offering structured implants, the cost of breast augmentation surgery with structured implants in the US typically starts at around $6000.
Cost of Fat Transfer Breast Augmentation
Since Fat Transfer Breast Augmentation is a procedure that does not involve implants, the cost of Fat Transfer Augmentation in the US typically starts at around $3000. However, with additional liposuction fees, the total cost could go above $9000, making it even more expensive than breast-implant surgeries.
Success Rate Of Fat Transfer Breast Augmentation
Fat Transfer Breast Augmentation surgery has a good success rate with fewer complications or needs for corrective surgery when compared to implant-based breast augmentation procedures. According to published graft retention rates, there is a 50 to 90 percent graft survival rate with this procedure. However, it will require a surgeon with extensive experience with fat transfer surgeries to limit the time the fat cells remain outside the body to maximize the number of fat cells preserved during the procedure to achieve the best possible result.
Breast Augmentation Recovery Process
Chances Of Getting Scars After Breast Augmentation
All incisions will initially result in scarring. However, most scars fade away with time. Further, all breast augmentation procedures are done with the intention of hiding the scars as much as possible.
Transaxillary (armpit), Transumbilical(belly button), and Transabdominal (abdomen) breast augmentation procedures hide the scars the best, as the incisions are made nowhere near the breasts. However, these are technically complex procedures and have limitations when it comes to the preciseness of the results.
Periareolar (nipple) incisions remain camouflaged in the darker area of the areola, while the Inframammary incisions remain hidden in the breast folds. The chances for visible scarring are higher for these two procedures.
However, they are also the safest procedures and easiest for surgeons to perform. As such you get precise and aesthetically pleasing results with these two procedures. A technically skilled and experienced surgeon will be able to complete the procedure with no visible scarring and the best outcome.
Swelling After Breast Augmentation
Swelling and soreness are normal and quite likely for a few weeks after the breast augmentation surgery. The swelling will peak at around three to four days after the surgery, but some swelling may last for up to three months.
Most patients find that swelling will have gone down by the third week.
You could also have more swelling if the implants are placed under the chest muscle, if you have larger implants, or if you have a pre-existing medical condition like diabetes. Smoking can also slow down the recovery process and cause the swelling to last longer.
Any general discomfort can be alleviated with cold compresses and prescription medication. Wearing a compression bandage or a sports bra for extra support can help. A medical bra that gently compresses the breasts can also help reduce the swelling and accelerate the healing process.
However, swelling that is uneven could be a sign of something more serious such as hematoma. In case you experience significantly more swelling or pain on one side, it is best to speak to your surgeon as soon as possible.
Hematoma After Breast Augmentation
Hematoma is a complication of breast augmentation surgery that happens to around 2% to 10% of patients. It usually occurs within three days after the surgery. Hematoma is bleeding that occurs when a blood vessel starts leaking into the space made for the breast implant. This complication is noticeable within a 5 to 10 minute period and could cause the breast tissue to enlarge up 2 to 3 times.
Hematoma is typically caused due to the rupture and leakage of blood vessels which are particularly fragile after a breast augmentation surgery. It can also be caused due to inadequate homeostasis during surgery or an acquired, congenial, or drug-related coagulation disorder. It can happen regardless of how well the procedure is done, which is why it is important to follow the post-operative recovery recommendation put forward by the surgeon.
Getting adequate rest and staying away from strenuous activities will go a long way in helping prevent hematoma after a breast augmentation surgery. Patients should also avoid being exposed to excessive heat even though it may feel good on the body.
Working Out After Breast Augmentation
It is best to avoid working out during the first few weeks after the breast augmentation surgery. This will help avoid complications like a hematoma. You could resume light exercise as early as one week after the procedure, provided your surgeon gives you the green light. You can resume strength training that excludes pectoralis muscle contraction after this period. However, once you begin to work out again, it is important that you start slow. You can gradually return to completely unrestricted training after around 12 weeks. Also, keep in mind that each individual case is different and is dependent on how successful the procedure was and how well the body responds. So make sure you have the approval of your surgeon before you begin working out again.
How To Select The Best Breast Augmentation Surgeon?
Choosing the right surgeon is one of the most important, if not the most crucial decisions one has to make when planning for breast augmentation. The right surgeon can tell you exactly what you need, even if you don’t know it yourself, and can make the process quite smooth. Besides, breast augmentation surgery involves many choices that can impact the rest of your life, which is why an experienced surgeon can save you from making ill-informed decisions that could have serious repercussions.
However, selecting the best breast augmentation surgeon is not as difficult as it may seem. All you need to be mindful of is selecting a board-certified plastic surgeon who is a member of the American Society of Plastic Surgeons (ASPS).
Members of the ASPS receive board certification from the American Board of Plastic Surgery (ABPS). The ABPS is recognized by the American Board of Medical Specialities (ABMS), which has been approving medical specialty boards since 1934.
Besides, ASPS members would have completed at least 6 years of surgical training following medical school and a minimum of 3 years of plastic surgery residency training. They would have also passed all comprehensive oral and written exams, graduated from an accredited medical school, completed continuing medical education, including patient safety, every year, and also performed surgery in accredited, state-licensed, or Medicare-certified surgical facilities.
So choosing a member of the ASPS will ensure that you will get a trained and highly qualified surgeon who is board-certified.
Be aware that there are quite a few unqualified organizations and individuals offering breast augmentation services at lower rates. Stay away from these to avoid serious repercussions. Also, note that there is no ABMS recognized certifying board that has “cosmetic surgery” in its name.
So, Is Breast Augmentation Surgery Worth It?
After years and years of research and development, breast implants are today approved by the FDA and considered to be generally safe, when done by a skilled and qualified surgeon. There are various options available to you regarding the type of procedure, type of breast implant, size and shape of the implant, and much more. An experienced surgeon can help you choose the is best potions suited to you.
So in conclusion, breast augmentation surgery, if done by the best breast augmentation surgeons in the country, can surely yield you the best results without compromising your health and safety, and give you the physical enhancement you’ve always dreamed of.