At Peel Haus, we are pleased to offer breast augmentation for patients in the DC, Maryland and Virginia area. Breast augmentation is one of the most popular procedures performed at our Washington, DC plastic surgery practice. For many women, breast size and shape are an important part of their self-image. If you would like to improve the appearance of your breasts, then breast augmentation may be a great option for you.
Our plastic surgeons have many years of experience performing breast enhancement procedures. She can help you sort through your numerous surgical options and help you select the best implants for your goals and lifestyle. Call us to schedule a free consultation to learn if you might be a good candidate and what options might be best to help you reach your goal of fuller, more beautiful breasts.
Breast augmentation —— also known as augmentation mammoplasty — is surgery to increase breast size. It involves placing breast implants under the breast tissue or chest muscles. During breast augmentation surgery, our board-certified plastic surgeon will make an incision in one of three possible places: the crease under your breast (inframammary), under your arm (axillary), or around your nipple (periareolar).
After making an incision, she will separate your breast tissue from the muscles and connective tissue of your chest. This creates a pocket either behind or in front of the outermost muscle of the chest wall (pectoral muscle). The surgeon will insert the implant into this pocket and center it behind your nipple. Saline implants are inserted empty and then filled with sterile salt water once they’re in place. Silicone implants are pre-filled with silicone gel. When the implant is in place, one of our plastic surgeons will close the incision — typically with stitches (sutures) — and bandage it with skin adhesive and surgical tape.
Many of the results of Breast Augmentation are internal, such as more self-confidence and greater self-esteem. A breast augmentation can:
All women have some degree of breast asymmetry, but for some, the differences in breast size are so noticeable that it can affect a woman’s self-confidence and make shopping for clothes difficult.
Breast augmentation is a great way to balance out uneven breasts. You can choose a different breast implant size, shape, and profile for each breast, which means that this surgery will allow you to have evenly matched breasts that will fit well into clothing, bras, and bathing suits.
Some women are born with small breasts that do not provide the curves, cleavage and shape that they would like A breast augmentation can add volume to a woman’s silhouette, so that everyday clothing, as well as swimsuits and evening where will be filled out as she desires.
With age and after breast feeding, many women notice that their breasts sag and lose the volume they once had. A breast augmentation, especially when done with a breast lift can restore the youthful shape your breasts once had.
Breast implants can help balance your entire body. Women who have larger hips and smaller breasts may feel that their body looks unbalanced or bottom heavy. Undergoing an augmentation to create a larger bust size can create a better proportion.
One of the benefits of breast augmentation is making shopping for clothing more enjoyable. You will have better proportion so that clothing won’t need to be tailored. You will be able to show off a larger chest low cut tops, swimsuits and more fitted looks.
Breast augmentation is a deeply personal procedure, and it’s important that you’re doing it for yourself and not for someone else, even if that person has offered to pay for it. Patient satisfaction is high, specifically when they want the procedure themselves.
Anyone who is in reasonably good mental and physical health can be a candidate for breast implants. However, you are likely not a good candidate for this surgery if:
You may be a candidate for breast augmentation if:
Saline breast implants are filled with sterile salt water. Should the implant shell leak, a saline implant will collapse and the saline will be absorbed and naturally expelled by the body. Saline breast implants provide a uniform shape, firmness, and feel, and are FDA-approved for augmentation in women age 18 or older.
Structured implants are filled with sterile salt water, and contain an inner structure that aims to make the implant feel more natural.
Silicone breast implants are filled with silicone gel. The gel feels a bit more like natural breast tissue. If the implant leaks, the gel may remain within the implant shell or may escape into the breast implant pocket. A leaking implant filled with silicone gel will not collapse.
If you choose silicone implants, you may need to visit your plastic surgeon regularly to make sure the implants are functioning properly. An ultrasound or MRI screening can assess the condition of breast implants.
Silicone breast implants are FDA-approved for augmentation in women age 22 or older.
Form-stable implants are sometimes referred to as gummy bear breast implants because they maintain their shape even when the implant shell is broken. The silicone gel inside the implant is thicker consistency than traditional silicone gel implants. These implants tend to be firmer than traditional implants.
Shaped gummy bear breast implants have more projection at the bottom and are tapered towards the top. If a shaped implant rotates, it may lead to an unusual appearance of the breast that requires a separate procedure to correct. Placement of gummy bear implants requires a slightly longer incision in the skin.
Round breast implants tend to make breasts appear fuller than form-stable implants. Higher profile options can give even more projection. There is less concern about the implants rotating out of place because round implants are the same shape all over. There is less of a scar with these than with teardrop-shaped implants because smaller incisions can be made to place this shape of the implant.
These breast implants have a more natural look, in that the bottom is fuller than the top of the breasts. As the name suggests, this gives the breasts a more tear-dropped shape. Women who want their breast augmentation to look natural often choose this type. The fullness of the breast is not lost; it is simply concentrated more in the bottom portion of the breast.
Smooth breast implants are the softest feeling. They can move with the breast implant pocket, giving more natural movement. Smooth implants may have some palpable or visible rippling under the skin.
Textured breast implants develop scar tissue to stick to the implant, making them less likely to move around inside the breast and become repositioned. Additionally, the texture offers some advantage in diminishing the risk of a tight scar capsule.
Please note that breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) occurs most frequently in patients who have breast implants with textured surfaces. Discuss all benefits and risks of your breast implant procedure with your board-certified plastic surgeon. Understanding all potential risk factors will help with better decision-making that is best for you and your health.
Breast augmentation is an effective way to enhance the appearance of your breasts. While generally safe and designed to be long-lasting, the American Society of Plastic Surgeons states that implants are not considered “lifetime devices.” On average, today’s implants are designed to last more than a decade, with the chance of rupture increasing by one percent each year. So, the older your implants are, the greater your risk of rupture or other complications. In many cases, breast implants can remain in good shape for 20 years or more. Every patient is different, and the life of your implants will depend on your body and how you take care of your implants.
Our plastic surgeons have performed numerous breast augmentation surgeries and can recommend the best placement option to achieve your breast augmentation goals. That said, it is important for breast augmentation patients to understand the pros and cons of the two different placement options.
Also known or referred to as “over-the-muscle” placement, the subglandular placement technique is when the implant is positioned between the chest muscle and the existing breast tissue areas. The over-the-muscle positioning is done so the implant lies below the glands of the breast, thus providing the ability for the patient to breastfeed in the future.
PROS: Patients tend to have less movement of the implants during physical activity, as well as less discomfort immediately following the surgery.
CONS: The appearance can be more artificial. In addition, during mammograms the readings may be less accurate. Also, patients may experience a higher rate of capsular contracture, which occurs when the scar tissue or capsule that normally forms around the implant tightens and squeezes the implant.
Also known or referred to as “under-the-muscle” placement of the breast implant, the submuscular placement technique is when the implant is positioned partially under the pectoralis major chest muscle.
PROS: Patients experience more accurate mammograms. In addition, the submuscular placement tends to produce a more natural appearance and a reduced rate of capsular contracture.
CONS: Some patients experience more discomfort post-surgery and have a longer recovery.
The Role of the Chest Muscle
The muscles in the chest play an important role in breast augmentation procedures with regard to the optimal placement of the implants. Each individual patient will vary in the amount of muscle they have, and this could be a factor in determining whether subglandular or submuscular placement is best.
In many cases, women who have very developed chest muscles will be better suited to over-the-muscle positioning of the implants, as there can be a distortion of the breasts as the chest muscles move and are flexed. In these cases, subglandular placement is recommended.
You will be taken to post-op immediately after your breast augmentation surgery. You will be coming out of anesthesia and will be on pain medication. Depending on your situation, you may be kept overnight at the hospital or you may be able to go home. You will need someone to drive you home afterward and stay with you for at least 24 hours.
At the time of surgery, you will be placed in a special post-augmentation bra designed to support your new breasts. This bra also has a strap that presses down from above in order to help your implants reach their final position more quickly. This bra should be worn at all times, night and day, for two weeks. You may remove it to shower or to launder the garment. Your plastic surgeon will send you home with detailed instructions for changing bandages, cleaning incision sites, showering, and other post-op activities.
Your plastic surgeon will send you home from the hospital with a prescription for pain medicine. You will be on narcotic pain medicine for around 2 to 3 days following the surgery and NSAIDs (Motrin, Advil) are recommended for any pain after this time. You will be able to drive once you have stopped taking narcotics.
Expect soreness, tenderness, and sensitivity during recovery, especially during the first six weeks post-op. After two weeks, you may stop wearing the surgical bra and wear a compression bra. This should be worn both night and day for an additional two weeks. After four weeks from the date of your surgery, you may stop wearing a bra at night, although some women continue to wear one at night. Continue to wear a supportive, non-underwire bra for two more months before returning to underwire bras.
For the first six weeks, you will not be able to exercise or do any heavy lifting and should sleep on your back or side during this time. If you have young children, you will want to enlist help to assist with childcare, as picking up children (or heavy objects for that matter) for the first six weeks is strongly advised against. However, driving, cooking, or shopping is often manageable after a week or two. Some patients opt to take a few weeks off work for recovery. If you have a physically demanding job, it’s especially important to take plenty of time off so that you don’t jeopardize your recovery. You will also want to avoid exercise during this time for the same reasons.
It’s important to line up help for at least two or three days once you’re home following surgery. You will be prescribed pain medications and have somewhat limited mobility. Having someone to help around the house during the initial period after surgery can make recovery significantly easier. Plan to take a week off of work and other responsibilities after your surgery. You will need this time to rest and recover. You will need to rest and sleep at an angle for the first few days of recovery and will be given instructions to move about to help prevent any blood clots.
Complications from breast augmentations are extremely rare, with the most common being infection of the incision site. Your plastic surgeon will discuss how to minimize the risk of infection during your consultations but if you think your incisions may be infected, call us immediately. To lower your risk of infection, avoid taking baths, swimming, or using hot tubs for the first two weeks post-surgery. You’ll be able to shower the day after your surgery.
You might have an infection if you have a fever or notice warmth and redness in your breast. If this happens or if you have shortness of breath or chest pain, please contact our office as soon as possible. You’ll have a post-op appointment with your plastic surgeon one week after surgery.
Other breast augmentation risks include:
Correcting these complications might require more surgery, to either remove or replace the implants.
Breast Implant-associated Anaplastic Large Cell Lymphoma
The U.S. Food and Drug Administration (FDA) has identified a possible association between breast implants and the development of anaplastic large cell lymphoma (ALCL), an uncommon cancer of the immune system. The condition is known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). The FDA believes that women with breast implants that have textured surfaces have a very low but increased risk of developing BIA-ALCL. However, that doesn’t mean that these implants cause BIA-ALCL. Further research is needed to understand the relationship between the condition and breast implants.
Breast Implant Illness
Systemic symptoms ― sometimes called breast implant illness ― may be associated with breast implants. The exact relationship of these symptoms to breast implants is not clearly understood. Reported signs and symptoms include fatigue, memory loss, skin rash, trouble concentrating and thinking clearly, and joint pain. Removal of the breast implants may reverse the symptoms. Research to determine the link and the cause is ongoing. Talk to your plastic surgeon if you have breast implants and experience any of these signs and symptoms.
If you notice any changes to your breasts or implants, talk to your plastic surgeon. Ongoing follow-up visits and appropriate screening tests can detect and address possible complications related to breast augmentation surgery.
All of the factors below should be taken into consideration when making your surgery plans, and it can be helpful to think about what works best for you, as well as for anyone who will be helping you during the healing process. This can help you plan the ideal time for your breast augmentation and recovery.
There are many important factors to consider when scheduling breast augmentation:
If you are a generally healthy person but wish to enhance your breasts, breast augmentation may be the great option for you. Call us to schedule a consultation with one of our plastic surgeons who can answer any additional questions you have about breast augmentation options.
A $50 deposit is required to secure all appointments. This deposit will be used towards your treatment.
As a courtesy to others, please arrive for your appointment 15 minutes early. Because we’re on a strict schedule, patients more than 15 minutes late may need to be rescheduled.
We understand that scheduling conflicts may arise. Please be courteous and reschedule or cancel for a full refund at least 24 hours prior to your appointment date. Any cancellations made after this period is subject to a penalty of your $50 deposit.
All balances of payments must be made in full at the time of your treatment. If payments are not made, an additional $50 will be charged to your bill weekly and your account may go to collections.
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