Since it was first introduced, breast augmentation has topped the list as one of the most popular cosmetic procedures around the country and in our New York City practice. It increases the size of the breasts using implants made of silicone or saline to improve their shape, symmetry, and proportions. Each procedure is unique for every patient and there are different options available to help patients achieve their ideal breasts.
The Breast Augmentation Procedure
Breast augmentation, which is often called simply “breast enlargement,” is actually about more than just changing the measurable size, or cup size, of your breasts. It can also involve changing the shape of your breasts, adding fullness in places and even adjusting your areola size to match your new breasts. Changes can also include decisions about where to place the breast implants to achieve your appearance goals. There are two options: above the muscle and underneath the muscle, and each will give you a different final look.
Ultimately, having breast augmentation done is a very personal decision that can be as simple as increasing the size of your breast or can extend to achieving size and shape symmetry between your breasts, changing where and how they sit on your chest and giving you the overall visual appearance you want. The opposite to this surgery, breast reduction, is a very popular procedure as well.
Why get Breast Augmentation?
At one time, patients would seek out breast augmentation surgery simply to get bigger breasts. Today, there are both medical and aesthetic reasons to choose this procedure. Some patients have one smaller breast and one larger breast (breast asymmetry). Breasts can have a deflated appearance after childbirth and breastfeeding or from losing weight. Others need reconstruction due to a mastectomy, congenital defect, or illness.
Breast augmentation implants can correct all these issues by adjusting the position and size of the breasts to make them look natural and proportional. Every patient will have a different concern about their breasts, but Dr. Roland will work with you to help you get the best possible results.
Differences between Silicone and Saline Implants
Silicone implants are made of a gel contained inside a shell that mimics normal breast tissue. As such, these are generally thought to look and feel more natural. They are customized to match the size and shape you want prior to your surgery, then they are placed inside a pocket that Dr. Roland creates during the procedure.
Saline implants consist of a silicone outer layer and are filled with sterile saltwater. It comes in a variety of sizes, each of which can hold a different range of volume. The implant is empty when it is placed inside your breast and then is gradually filled with the saltwater solution until it reaches the right size. Saline implants are thought to give the breasts a firm and bouncier look.
Both implants are approved by the FDA and are widely considered to be very safe for patients. Silicone implants are only approved for patients over 22 years of age.
Good Candidates for Breast Augmentation Procedure
In general, if you are in good health in all other ways and you have reasonable expectations for the results of your breast augmentation, you are likely to be deemed a good candidate. In particular, if your breasts are smaller than you prefer, have variations in shape or size from one to the other, have lost mass after having your family or you are seeking symmetry following treatment for breast cancer, you are likely to be a good candidate to have breast augmentation.
However, in certain circumstances, Dr. Roland may recommend that you postpone having breast augmentation done as follows:
- If you plan to get pregnant or are pregnant, or you are currently breastfeeding or wish to do so in the future.
- If you have a strong family history of breast cancer.
- If you are currently taking any medications to thin the blood or prevent clotting.
- If you are currently being treated for an autoimmune or other serious health issue.
- If you are just beginning or are currently in the middle of a major weight loss regimen.
- If you smoke or drink heavily and are unwilling to reduce or stop for a period of time before and after your procedure (heavy tobacco and alcohol use can interfere with the body’s natural ability to heal after surgery).
If any of these situations currently apply to you, talk to Dr. Roland about the best time to schedule your breast augmentation procedure.
Preparing for the initial Breast Augmentation Consultation
Prior to your surgery, you will meet with Dr. Roland at least twice. The first time will be for your initial consultation. Dr. Roland will examine your breasts and discuss your goals for them. He will also discuss your options for reaching those goals and help you decide on the size, type, and placement for your implant. Once all these decisions have been made, Dr. Roland will walk you through the surgery process and answer any questions you have. You can also discuss any concerns or particular issues with him at this time.
The second time you meet with Dr. Roland will be centered around sizing your breast implants. Breast augmentation can increase the size of your breasts by at least one cup size or more, so you have some flexibility with choosing your implant size. The implant size is measured by the total volume of material inside the implant, usually referred to as ccs, or cubic centimeters. One cup size is equal to about 100-150 ccs of material, and implants can vary in size from 150-800 ccs. Ideally, your breasts should be proportional to your frame without making it obvious that you have implants. Dr. Roland can help you determine which size implants you need during this appointment if you aren’t sure what you want.
Dr. Roland did my breast augmentation 3 years ago. I feel so incredibly lucky to have chosen Dr. Roland as my surgeon. I was connected to Dr. Roland through a friend, and I am so grateful for the referral as we have so many options in NYC for cosmetic surgery. I had been uncomfortable with my chest ever since I was in middle school, and after having my surgery with Dr. Roland my only regret is that I did not do it ten years earlier!
I work in the plastic surgery industry myself, and have worked for one of the top plastic surgeons for breast augmentation / reconstruction in the city. I have seen many breast surgery results and complications, so I know an amazing result when I see one. I think that my case was a bit complicated – I had always been very small and asymmetrical. None of the other doctors that I saw in consultation really seemed to see the aesthetic problems as I was seeing them, and I liked that he understood my concerns for having extremely-natural looking results. He recommended doing a partial lift on one side to correct the asymmetry, but also he wanted to adjust the incisions on the other side so that the scarring (which has been minimal) would match the lifted side to create a more natural look. I saw 4 other surgeons in consultation and none of them suggested a lift or addressed how my scars would look after they faded with time. He was also very thorough in assisting me in choosing the right size implants, and was extremely concerned about ensuring that the final size would work well with my lifestyle and personality. His bedside manner is truly impressive – I felt completely taken care of during the entire process and felt like the office staff was family. Again, because I work in the cosmetic surgery industry (both on the administrative side and clinical side), I know what good service and surgical talent is, and I give Dr. Roland and his practice an A++!
Frequently Asked Questions about Breast Augmentation
Where are the Implants placed during surgery?
Breast implants can be placed underneath your natural breast tissue (subglandular placement) or underneath the pectoralis major muscle (submuscular placement). Either placement option is considered safe for both types of implants. The decision on which placement to use will be based on your musculature and body type as well as the size of the implants you want.
Subglandular placement is preferable for larger implants or for patients who want to have perkier-looking breasts. Because the implant sits on top of the muscle instead of underneath it, the implant moves easier with your body and muscle contractions. This placement is also less invasive, which means it has a shorter recovery time.
Submuscular placement is best for smaller implants and for patients who have very little natural breast tissue. It gives the implants a more natural appearance because it has more of the patient’s natural body tissues covering the implant. The muscle tissue also provides better support and protection to the implant. This placement is more invasive than subglandular placement, so it will have a longer recovery time. There is also a limit to how large an implant can be, especially if the patient is more muscular.
Where are the Incisions made?
Incisions can be made in the armpit, around the areola, and at the crease on the underside of the breast. The choice of incision will vary depending on the size of the implant, the placement of the implant, and your body type. After making the incisions, Dr. Roland will create a pocket for the implant under the breast tissue and/or under the muscle. The implant will be placed inside the breast and adjusted until the breast is the right shape and in the right position. Once everything is in place, the incisions will be closed with sutures and then bandaged. After your incisions heal, the scars will be inconspicuous or concealed.
How long is the Recovery?
The first two or three days after surgery will be the most difficult. Your breasts will be sore and swollen, and you might need drainage tubes to help with the fluid buildup. You can manage the pain and swelling with ice packs and by keeping your upper body elevated whenever possible. Dr. Roland can also prescribe pain medications if necessary. After you make it through the first few days, it will be easier to move about. Most patients are able to return to their jobs and resume light activity after seven to ten days. More strenuous activity should be avoided for at least four weeks.
What are the Complications for Breast Augmentation?
Complications associated with this procedure include pain, swelling, a change in nipple sensitivity or milk production, capsular contracture, and implant rupture. Capsular contracture is a condition in which the scar tissue forms around the implant. This causes the skin to tighten around the implants, creating an irregular or uneven look to your breasts. Implant rupture occurs when there is a leak or breakage in the implant. This usually happens as a result of injury rather than implant malfunction. If you have a saline implant, a rupture will cause the implant to deflate and the saline solution will be absorbed into your body. If you have a silicone implant, a rupture may be less obvious, so it’s important to have your implants checked periodically. Typically the silicone will stay around your breast tissue, but if it begins moving away from your breasts, it may cause serious problems.
All of these complications can be serious, but they are also rare. Breast augmentation is a very safe procedure and most patients have little or no issues following the surgery. If you should have any concerns during or after your recovery, make sure you consult with Dr. Roland.
What options do I have for Types of Breast Implants?
There are two main types of breast implants available to patients today: silicone and saline. Each type has its strengths as noted here. You will be able to discuss the best implant choice for your goals during your consultation with Dr. Roland.
Silicone implants have had a colorful history, but today they are still the most popular choice, and even more so because the new silicone implants are completely safe to use. They come in a variety of shapes and sizes to meet your personal appearance goals. Silicone implants will deliver a softer, more natural shape and feel to the breast after augmentation.
Saline breast implants are filled with a salt and water solution which is in a safe concentration for your body’s health. Saline implants will deliver a round breast shape that feels firm to the touch.
Are there other procedures associated with Breast Augmentation?
Yes! In fact, sometimes Dr. Roland will recommend including a breast lift in your surgery to help you get the best possible results.
About Dr. Donald Roland
Dr. Roland is recognized as one of the leading plastic surgeons in the New York City, NY, area. With more than two decades of expertise as a board certified plastic surgeon, Dr. Roland maintains a busy schedule of patient consultations, surgeries, teaching and lecturing. His clientele includes patients from around the world.
Dr. Roland is one of just a handful of surgeons in the world who has extensive training and surgical expertise with the use of pulsed magnetic energy to produce healthy blood vessels. He is also a published author and sought-after researcher who conducts his research out of the prestigious New York Eye and Ear Infirmary of Mount Sinai.
To contact Dr. Roland’s New York City, NY, office for a consultation, call us at 212-744-9400.