Cosmetic Surgery Excellence

Realself Answer: Breast Augmentation silicone vs. saline implants, risks, expectations

Thank you for your interest in breast augmentation surgery.   There are many options for this surgery including incision placement: submammary, periareolar, transaxillary, umbilical and the incision which I use: transareolar.  If you look at my website:  you can see a close up of the areola which shows that this scar is barely visible due to the irregularity of pigment of the areola.  We have never had a sensory loss to the nipple either.  The other techniques have a a reported 2.2% risk of sensory change or loss, with the risk greatest with transaxillary approach.  The scars are visible with any surgery but most noticeable in the inframammary position.  The recovery is dependent on your personal pain threshold and the technique you choose.  The submuscular technique was used initially to reduce the risk of capsular contracture.  Now that the new silicone implants have nearly the same risk of capsular contracture above or below the muscle, this technique is not as beneficial. The risk of movement of the implant with arm use and activity is very high with this technique. Many patient’s develop asymmetry which is more obvious under the muscle, most notably is the double bubble effect where there is a bulge below the muscle which creates a very unnatural appearance on the breast.  The placement of the implant under the breast tissue creates a very aesthetic breast and the recovery is much easier.  The patient should not do any heavy lifting, exercise, jogging, sit ups or anything that could raise the blood pressure for at least 4-6 weeks.  Prevention of a bleed is critical to reducing the risk of capsular contracture.   I like you to bring in photos of breast that are just right, too small and too big and I will order in sizers and a range of implant sizes so that the final result is what you want.  This takes time but is well worth it if you are thrilled with the breast and have what you want.  It is very important not to do the surgery quickly, but to take time to do the surgery correctly so the implant position is optimal, medial placement takes more time to dissect but this is critical to maximize cleavage, the size is correct, symmetry and other issues are addressed at the time of surgery.  The additional cost of 30-45 minutes during the initial surgery to be meticulous is much less than completely redoing the surgery because of shape, position or size concerns. The cost is 6+-8+ K depending on the type of implant you choose, etc.  I hope this is helpful and look forward to meeting you soon!

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