Breast Augmentation Questions

What is breast augmentation?

Breast augmentation is a popular cosmetic surgery that is designed to create a more desirable breast size and shape. The surgery is also an option for women with asymmetric breasts. An inch and a half incision is placed either in the lower breast fold, areolar border or axilla and a saline or silicone gel breast implant is placed usually under the pectoralis muscle. 

Who is a candidate for this surgery?

The best candidates for this surgery are women over the age of 18 and who are in good health. It is an ideal solution for women who wish to restore the appearance of breasts that have lost their shape and volume following pregnancy or weight loss.

If you have gone through one or more pregnancies or lost a significant amount of weight, significant excess skin and sagging may exist and you may need to consider a breast lift. This would be determined at the time of the breast implant consultation.

What can be done when breasts begin to sag?

When breasts of a normal size begin to hang or sag, Bryn Mawr Breast Implant Doctor Dr. Bottger can sometimes use breast implants alone to improved shape and projection. If the skin of the breasts has been irreparably stretched, a breast lift, or mastopexy, may also be necessary to trim away the excess skin and tighten the remaining skin for a more optimal shape. 

What are the risks of breast augmentation?

Any type of surgery, cosmetic or otherwise, carries the risk of infection. This one is no exception. Other complications include bleeding or hematoma, excessive firmness of the breasts, loss of nipple sensation, rippling, asymmetrical shape, deflation or rupture of the breast implants, and unfavorable scarring. Significant complications are possible but not frequent.

There is presently no scientific evidence linking breast augmentation to breast cancer or any other systemic disease.

Will I be in pain following the surgery?

Each patient tolerates pain differently. Many women relate discomfort following breast augmentation to discomfort following a C-section. Some describe it as an ache others report more significant pain. Dr. Bottger knows that every patient tolerates pain differently, and he will prescribe the appropriate medication based on your particular level of discomfort.

How long is the surgery?

It generally takes one to two hours to perform a breast augmentation procedure.

Patients can expect to remain in the recovery room for several hours following surgery before discharge.

Where will the incision be placed?

During your consultation Dr. Bottger will go over the choices available for the location of your incision. The type of incision will depend on several factors, including breast implant type, patient preference and individual anatomic characteristics, all of which will be discussed during your consultation.

Read more about the types of Incisions Dr. Bottger uses for Breast Augmentation.

What are the different types of breast implants available for breast augmentation?

Currently, both saline and silicone gel breast implants are approved for use in the United States.

There are several different types of saline and silicone gel breast implants with variable surface texture and shape. These include textured and smooth surface implants and round and teardrop shaped implants. Dr. Bottger has extensive experience with all these implant types and will choose a device depending on each patient’s anatomic characteristics.  In the majority of cases, the smooth round implant gives the most natural result with less chance of visible rippling or shape abnormalities. 

Silicone gel breast implants have recently been approved by the FDA for the use in all breast augmentation surgeries.

Following the surgery, how long is recovery?

Recovery time will vary for each patient. For more information, read about breast augmentation recovery.

When can I start exercising?

Moderate movement (slow walking) is recommended on the second day following the surgery. Patients should avoid aerobic exercise for a full two weeks after surgery. Unrestricted exercise (weight-lifting, sports, aerobics) can be resumed after three weeks.

When will my breast implants need to be replaced?

The main reason to replace a saline breast implant is a deflation.  This would be recognized by a gradual decrease in breast size over days or weeks.  This does not represent a health risk as the saline solution is absorbed by the body harmlessly.  Other indications for replacement would be to change breast size or for a complication such as positional asymmetry, capsular contracture, or visible rippling. Rupture of a silicone gel breast implant may or may not be clinically evident. If this were to occur replacement may be recommended.

How do I choose breast implant size?

Ultimate breast size is an individual choice.  We have a number of methods for determining which breast implant size and volume will achieve the desired final cup size.  Viewing before and after breast implant photos of patients with similar body type and breast shape is the first step.  Next, breast dimensions are measured, which allows us to determine the range of implants which are most appropriate.  Finally, implant sizers, which are sample implants of varying volume, are placed in an appropriately sized bra and the general final appearance can be simulated with different garments of clothing.  Using these three modalities provides the most accurate approximation of final breast size. more information

Which is the best plane for breast implant placement?

Implants may be placed in either the subglandular plane (under the breast tissue) or submuscular plane under the chest wall or pectoralis muscle). With saline implants the submuscular plane is preferred in most patients. The implant has better soft tissue coverage and is less likely to display visible or palpable rippling. Additionally muscle coverage reduces capsular contracture or firmness and interferes less with mammograms. With silicone gel breast implants, either the submuscular or subglandular plane can be utilized, depending on each patient's individual anatomic characteristics.

Can I breast feed after Breast Augmentation surgery?

Breast augmentation should not significantly affect the ability to breast feed. The ability to breast feed successfully varies from woman to woman with or without implants.

Should I be concerned that the breast implants will rupture?

Saline breast implants are extremely durable.  It is estimated that implant rupture rates are approximately 1% per year.  If the implant should rupture, your body will naturally and harmlessly absorb the saline or salt-water solution and the implant can be replaced.  The implants used by Dr. Bottger are under warranty and if they deflate the patient will be supplied a replacement implant and reimbursed a portion of the cost of a secondary procedure.

What are the differences in results between silicone gel and saline implants?

Although the majority of women are happy with their results whether they choose saline or silicone gel implants, there are some differences in the results.

Saline breast implants have the advantage of placement through somewhat smaller incisions and more varied locations. They are also filled at the time of surgery and the size can, therefore, be "fine tuned" intra-operatively.

This can be particularly helpful if there is breast asymmetry. The down side of saline implants is a somewhat firmer breast and, also, a greater likelihood of implant palpability or visibility known as rippling.

Silicone gel breast implants by contrast, tend to create a softer, more natural breast. They are also rarely associated with visible rippling. The down side of gel implants is the requirement for a slightly longer incision and potentially more restriction on incision placement.

What does the surgery cost?

If you are considering breast augmentation, please contact our office to find out more about the cost of the surgery.  We offer several financing alternatives for our patients.

If you are interested in having breast augmentation surgery or would like to learn more, contact our office today to schedule an initial breast augmentation consultation to speak with Dr. Bottger. He will be able to answer all of your questions regarding the procedure, recovery and expectations.

Additional questions:
Breast Augmentation Surgery
Who is a candidate for breast augmentation?
What can be done when breasts begin to sag?
How do I choose breast implant size?
Which is the best plane for breast implant placement?
What are the different types of breast implants available for breast augmentation?
What are the differences in results between silicone gel and saline implants?
Breast Implant Incision Options
Where will the incision be placed for my breast augmentation?
What are the risks of breast augmentation?
How long is breast augmentation surgery?
Will I be in pain following breast implant surgery?
Breast Augmentation Recovery
Following breast implant surgery, how long is recovery?
When can I start exercising after breast augmentation?
Can I breast feed after Breast Augmentation surgery?
Should I be concerned that the breast implants will rupture?
When will my breast implants need to be replaced?