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Breast Augmentation

What is Breast Augmentation?

Breast augmentation is the most popular cosmetic surgery in America, with over 333,000 breast augmentation surgeries performed in 2017 according to the American Society of Aesthetic Plastic Surgery. As the most frequently performed aesthetic surgery since 2012, breast augmentation can be an incredibly rewarding procedure. Many women who undergo breast augmentation feel more confident in their appearance and more comfortable in their clothes.

Breast augmentation is a surgical procedure that enlarges the breasts through placement of an implant. It can be customized in a number of ways, including:

  • Size
  • Shape
  • Incision placement
  • Implant placement

If you feel your breasts are too small, uneven, asymmetrical, or have deflated after pregnancy or weight loss, you may benefit from breast augmentation. Philadelphia plastic surgeon David Bottger, MD has years of experience helping women obtain their ideal breast size and shape, and he would be happy to do the same for you.

What are the Benefits of Breast Augmentation?

Many women have either naturally small breasts, or breasts that have lost volume due to a life event such as pregnancy, weight loss, or simply age. Others may have concerns with their breasts because they:

  •      Are uneven
  •      Are asymmetrical
  •      Have poor cleavage
  •      Have a lack of projection

Breast augmentation can help with all of these issues. After having a breast augmentation procedure, many women feel more confident and attractive wearing a wider variety of clothing and swimsuits. They may also feel less self-conscious during social situations.

Who is a Candidate For Breast Augmentation?

The ideal candidate for a breast augmentation is someone considering the procedure for herself— not to satisfy anyone else in her life. In addition, a breast augmentation candidate is:

  • Over the age of 18
  • In good physical and mental health
  • Not pregnant or nursing
  • Understands the procedure and its risks and benefits

Breast augmentation can boost your confidence and appearance, but it is important to understand its limitations. If you are going into a breast augmentation procedure expecting it to solve your career or relationship problems, or to gain someone’s affection, you’re doing it for the wrong reasons. Breast augmentation should be pursued for one person: yourself. When done for the right reasons, it can be a life-changing and rewarding experience. With that said, it’s essential to know all of the potential results and benefits, as well as maintain realistic expectations. Dr. Bottger would be happy to answer all of your questions and will make sure you are well-informed about the procedure.

To see what kind of results you can expect from breast augmentation, please view our before-and-after photos.

Saline Implants

  • Filled with sterile salt water encased in silicone shell
  • FDA-approved for patients 18 and older
  • Round and smooth
  • Requires a smaller incision when compared to silicone implants
  • Less expensive than silicone implants
  • Immediately noticeable in the event of implant rupture

Silicone Implants

  • Filled with silicone gel encased in silicone shell
  • FDA-approved for patients 22 and older
  • More natural look and feel than saline implants
  • Less likely to wrinkle or ripple when compared to saline implants
  • Maintains shape in the event of rupture (may require periodic MRIs to check for rupture)

Round Implants

Will pool to the bottom of the implant when in the upright position: This round implant shape resembles that of a flattened sphere. Its main advantage is that it will maintain its shape even if it moves within the implant pocket. It can create a very natural form, as the fill material will pool in the bottom of the implant, creating a teardrop shape. Round implants can be smooth or textured.

Contoured Implants

Are textured to maintain shape and position: These contoured implants are shaped like a teardrop and have also been termed “gummy bear” or form-stable implants. They are always textured in order to maintain their shape and are filled with a thicker or more “cohesive” silicone gel. While contoured implants can provide potential advantages with certain breast shapes, the disadvantage is that if the implant moves or rotates, it will look misshapen and often require revision surgery. Additionally, these implants require larger incisions for placement.

Dr. Bottger will go into more detail about the benefits and drawbacks of smooth vs. textured implants during your consultation.

Incision Placement

There are a variety of breast implant incision options, including:

Inframammary

This type of incision is made in the fold under the breast. The incision is one to two inches long, and a pocket is made through it. This incision provides a direct approach, leaving usually an unobtrusive scar on the breast crease. It does not violate the breast tissue and because of this, it is associated with a lower incidence of capsular contracture or breast hardening.

Periareolar

This incision is made at the margin of the pigmented portion of the areola and the skin of the breast. The implant pocket is then created and the implant is inserted through the incision. Periareolar incisions have the benefit of usually high quality scars. However, this approach may not be advisable for women with small areolas or who are getting larger implants. Additionally, a higher incidence of capsular contracture or breast hardening is associated with this approach.

Axillary

An axillary incision is made through a crease in the armpit. The advantage of this approach is that no scars are left on the breast. However, because this is a remote approach, it is associated with a higher degree of fold asymmetries requiring revision surgery. Also, control of bleeding and optimal pocket dissection can be impaired.

Umbilical

An umbilical incision is made in the belly button. A special instrument is used to tunnel from the incision to the breasts. Dr. Bottger generally does not perform this type of incision, as the lack of visualization creates a greater chance for asymmetrical pockets. In addition, bleeding cannot be controlled as well, which may lead to post-operative problems. It also necessitates use of saline implants only.

Breast Augmentation Recovery

Breast augmentation recovery varies from person to person, but generally most of Dr. Bottger’s patients are up and moving within a day. The recovery timeline usually proceeds as follows:

Immediately following your breast surgery in Philadelphia, a dressing and elastic bandage are applied and must be worn for 24 to 48 hours. After this, you will switch to a support bra. Swelling and bruising after breast augmentation is normal, and most of the time, should disappear within a few weeks.

Strenuous activity and heavy lifting should be avoided for approximately three weeks, although you can perform light exercise—such as walking—immediately after your surgery. It’s normal for your breasts to feel somewhat firm after breast augmentation. This firmness diminishes with time.

Your breasts may seem to sit too high on your chest after surgery. Give it time, and they will descend into a more natural position.

How Long Do Breast Implants Last?

The lifespan of breast implants depends largely on the type of implant placed, as well as the implant manufacturer. The likelihood of complications arising, such as capsular contracture (the formation of scar tissue), implant rippling, or implant rupture, varies among silicone and saline implants. It is typically very obvious if saline implants leak or rupture, as they will deflate and the breasts will appear asymmetrical. Silicone implants generally maintain their shape in the event of rupture, often making the problem difficult to recognize. For this reason, the FDA has recommended that patients with silicone implants undergo periodic MRIs to ensure they are still intact. It should also be noted that there is no scientific evidence stating a ruptured implant is associated with any systemic disease.

Most implants can last over ten years and implant replacement is not required if there are no complications and the breast implants remain in good condition. Ultimately, implants do not need to be replaced as long as there are no issues—however, it’s important to be proactive about the condition of your implants. Always remember to schedule an examination with a board-certified plastic surgeon if you have any concerns.

Breast Augmentation vs. Breast Lift

Breast augmentation and breast lift are two separate procedures that accomplish different things. Dr. Bottger performs both of these procedures, often at the same time, but it is important to know the difference between the two.

Breast augmentation, also known as breast enlargement or breast enhancement, is a procedure solely designed to make the breasts larger and more symmetrical. This is accomplished most often through the use of silicone or saline breast implants.

A breast lift or mastopexy, on the other hand, is performed to lift sagging, drooping breasts. If your breasts have started to succumb to gravity and drop down on your chest, a breast lift can restore them to a more youthful position.

Breast augmentation will not significantly lift sagging breasts, and a breast lift will not make small breasts larger. However, when performed together, Dr. Bottger can both lift your breasts and enlarge them. Combining these two procedures is popular among many different patients, particularly older women and post-pregnancy patients whose breasts have lost volume and begun to sag.

How Much Does Breast Augmentation Cost?

The total cost of breast augmentation ranges from $7,000 to $8,000, depending on the type of implants selected, the surgical technique used, and the overall complexity of the procedure. While quotes for breast augmentation vary depending on your geographic location, the overall price is generally comprised of fees for the surgeon, anesthesia, surgical facility, the implants themselves, and post-operative care. After assessing your unique needs in a consultation, our Patient Care Coordinator will be able to provide you with an accurate quote of your expenses and walk you through your payment options.

For those interested in paying for treatment over a period of time, we accept plastic surgery financing through CareCredit®. This highly reputable healthcare lending company can make the cost of breast augmentation more affordable by allowing qualified applicants to pay off their treatment in installments, offering an array of low- to no-interest payment plans to choose from. For more information about our accepted payment methods, or to speak to a member of our team, please reach out to our office today.

Why Choose Dr. Bottger As Your Breast Augmentation Surgeon?

Dr. Bottger takes great pride in helping his breast augmentation patients improve their appearance and self-confidence. He settles for nothing less than providing you with the exceptional quality of care and results that you deserve. In order to ensure you achieve the highest levels of patient satisfaction, he makes the following commitment to you:

Additional Breast Augmentation FAQs

Will I have noticeable breast augmentation scars?

The shape and size of scars after breast augmentation can vary, but most patients find that scarring is virtually imperceptible and/or easily covered with a bra or bikini top. Depending on which incision is used for your procedure, your scars may either appear within the natural crease of the breast fold, around the borders of the areola, or hidden in the underarm. All three of these locations can be very discreet.

Are there any breast augmentation complications I should be aware of?

While there are many women who experience decades of use with their breast implants, there are certain non-life threatening complications that may warrant an implant update or exchange:

  • Implant rippling: refers to the edges of the implant being seen or felt through the skin. This is much more common with saline as opposed to silicone gel implants. Also, it occurs more frequently in thinner patients with less breast tissue. Rippling usually does not present a health concern, but many patients opt to exchange their implants for aesthetic reasons if the edges are palpable. Dr. Bottger decreases the risk of rippling by placing implants underneath the chest muscle, allowing for a higher degree of coverage in patients with thin breast skin.
  • Implant rupture: a relatively rare complication that involves a tear or break in an implant. Although implant rupture is visually noticeable for patients who have saline implants, there is generally no medical concern since the harmless saline solution can be absorbed into the body without posing a safety risk. In contrast, many types of silicone implants tend to keep their shape in the event of rupture and the only evidence would be the development of breast hardening (capsular contracture) or a change in shape.
  • Capsular contracture: the formation and hardening of scar tissue around an implant. Depending on a number of factors, the contraction of scar tissue may cause cosmetic changes, and/or result in symptoms like tightness and breast soreness.

If necessary, all of these complications can be treated with breast revision surgery to alleviate symptoms and restore a normal breast appearance. Dr. Bottger will discuss the risks of breast augmentation in more detail during your consultation.

What is capsular contracture and how can it be prevented?

Capsular contracture is the body’s reaction to the presence of a medical device or foreign object in the body, resulting in the formation of protective scar tissue or a “capsule” around the object. This response is not unique to breast implants, and capsular contracture can occur with any type of prosthesis placed in the body. In many cases, the development of a scar capsule is asymptomatic and can help keep the implant in place; however, hardening or tightening of the capsule can lead to an irregular breast appearance and/or discomfort. Capsular contracture is generally categorized in one of four grades of severity.

Based on research, doctors and scientists believe capsular contracture is less likely when the implant is placed sub-muscularly within a pocket of the chest muscle through either a lower breast crease or inframammary incision. Use of a Keller Funnel® for insertion, combined with antibiotic pocket irrigation at the time of surgery, can also reduce the risk of capsular contracture. Dr. Bottger will go over different measures that may help prevent capsular contracture prior to surgery. Since scar tissue typically develops during the healing process, you can reduce the risk of scar tissue formation by refraining from smoking.

What is BIA-ALCL and should I be worried about it?

BIA-ALCL is a very rare cancer of the immune system that has recently been associated with some types of textured implants. This correlation only applies to certain implants, and the Allergan® corporation has since offered a recall of their BIOCELL® textured implants—the main implants linked to cases of BIA-ALCL.

We understand the concern that this information can cause some individuals, but Dr. Bottger stresses that BIA-ALCL only affects 1 in 20,000 women with breast implants and the condition has not commonly involved smooth implants, which comprise 90 percent of implants placed in the country. The FDA does not advise removal of breast implants, and we encourage patients to simply remain aware of symptoms such as pain, lumps, breast asymmetry, and swelling after fully healed. If you do not notice any breast changes, you have no reason to worry. However, it is important to maintain the recommended number of regular breast exams and continue to perform routine self-exams to check for any irregularities. Please don’t hesitate to reach out to our friendly team if you would like more information about BIA-ALCL or if you have any other concerns.

Can I breastfeed with breast implants?

If you were able to breastfeed before surgery, there is a strong likelihood that this will not change after breast augmentation. That said, it’s important to note that not all women are able to breastfeed initially.

If you are interested in breast augmentation, Dr. David Bottger serves patients in Philadelphia, Upper Darby, Springfield, and surrounding areas. He can help you achieve the natural-looking results you desire with a treatment plan tailored to your goals. Please contact Dr. Bottger if you have any questions, or if you would like to schedule a consultation.