Breast Augmentation

What Is Breast Augmentation?

Breast augmentation is a plastic surgery procedure that involves the placement of breast implants or fat to enhance the size, shape, projection, firmness, and symmetry of the breasts. Each year, surgical techniques and breast implants themselves are continuously being refined, increasing the safety and reliability of the procedure. With the continued scientific research and development of proven methods, further advancements of breast implant options will be made in stride with the continuing medical education of qualified cosmetic plastic surgeons specializing in breast surgery.

Quick Recovery Breast Augmentation

“As a board-certified plastic surgeon, I specialize in quick recovery breast augmentation. I began to use these techniques in 2001 and I have seen a dramatic improvement in my patient’s recovery. The quick recovery method allows patients to raise their hands over their heads in the recovery room and to return to 90% of their daily normal activity in one to two days. I see all patients within 24 hours after surgery and most come in with smiles on their faces. My mission has always been to provide comprehensive and compassionate care for my patients and this breast augmentation method reduces recovery time with minimal pain and a quick return to 90% of normal activity. I have been performing breast augmentation for over 25 years and the quick recovery breast augmentation method is only possible with expert, careful surgery and specialized instruments. There is less trauma, and therefore dramatically less pain and recovery time. Most patients are back to work within a few days.

When women come in for a consult with me, most have heard horror stories of friends with pain for one, two, or even three weeks, who were unable to raise their arms to do such things as comb their hair or wash their face. Therefore, it is extremely gratifying to hear patients tell me that they had almost no pain and that they are back to work, caring for their children, or going about their normal activity.”

– Dr. Paul LoVerme

Breast Augmentation Before-and-After Photos

Age: 20 / Ht: 5’3” / Wt: 125 lbs
339 cc Implants
Silicone

Age: 24
Saline

What Types of Breast Implants Are Available?

Dr. LoVerme will help you review all of these options—in addition to discussing your desires and explaining the surgical procedure—when you come in for your consultation. He will give you his expert opinion as to the best plan and implant for you.

FDA-approved breast implants come in three types: saline, silicone-gel, and highly cohesive silicone-gel (“gummy bear”).

Silicone Breast Implants

The U.S. Food & Drug Administration (FDA) announced on November 17, 2006 the approval and availability of silicone gel-filled breast implants, ending a 14-year ban on the use of silicone implants for cosmetic breast surgery. Now, women over the age of 22 who are seeking cosmetic breast augmentation and those interested in breast reconstruction surgery are able to select silicone breast implants.

Silicone implants have a silicone rubber shell that is filled with a fixed amount of silicone gel. These implants come in a smooth or textured shell surface and vary in shape, profile, volume, and shell thickness. Silicone gel-filled implants are not adjustable, but come in a wide range of sizes to accomplish the goals and desires of all women.

When contrasted with saline-filled implants, silicone breast implants are widely considered to have a more natural look and feel due to texture similarities between silicone gel and breast tissue. Additionally, ripples in silicone gel implants are almost never palpable. Dr. LoVerme has helped many women change their implants from saline to silicone, and they universally report that their new silicone implants are more comfortable and lighter (a silicone implant will float if placed in a bowl of water).

Saline Breast Implants

Saline implants are filled with a saltwater-based solution and enclosed by an outer silicone shell. This implant option can often be an excellent alternative for patients who do not qualify for or are not interested in receiving silicone gel-filled implants.

Officially approved by the FDA in 2000, saline implants have a number of advantages and disadvantages when compared with silicone implants (which gained FDA approval in 2006). Though both types of breast implants share the risk of rupture, the saltwater solution inside of saline implants can be harmlessly absorbed by the body in the event of a leak or break. In addition to this benefit, the volume of saline implants can be modified (within a certain range) during augmentation surgery, depending on the patient’s unique needs and desires.

Despite these advantages, many women—particularly those who have a slender figure—tend to find that saline implants do not create a look and/or feel that is as natural as silicone gel. Furthermore, saline implants are still susceptible to several of the same risks as silicone implants, including wrinkles/ripples, capsular contracture, discomfort, infection, and even potential nerve damage.

Cohesive Gel (Gummy Bear) Breast Implants

In February of 2013, the FDA approved the first anatomically shaped, highly cohesive, form-stable silicone gel implants (“gummy bear implants”). The availability of these implants has created new options for women who are considering their first breast surgery, replacement of old implants, or revision of a previous breast surgery. In November of 2014, the FDA approved more shapes of these form-stable implants—and in 2015 smooth, round, cohesive gel implants were introduced.

Cohesive gel differs from standard silicone by being more “cross-linked.” The crosslinking between molecules of silicone make it a bit thicker and firmer, enabling the implant to maintain its shape. The term “form-stable” refers to the tendency of these implants to have a constant shape. While the name “gummy bear” implant has been associated with these newer implants, they are not nearly as firm as gummy bear candies.

With cohesive gel implants there appears to be a greater ability to control shape, particularly with breasts that have little shape to themselves. There is also less of a tendency to ripple (though rippling typically has more to do with a patient’s tissues). Cohesive implants are a bit firmer than standard silicone gel breast implants; however, the only patients who seem to notice this are patients with looser and relatively pendulous breasts. Furthermore, cohesive gel implants also appear to have reduced rates of capsular contracture (hardening), break less frequently, and seem to be longer-lasting than regular silicone or saline breast implants.

In 2016, “soft touch” silicone gel was introduced by Allergan® for their INSPIRIA® smooth, round implants. Soft touch gel cohesiveness falls between regular gel and “gummy bear” implants, and is a great choice for many women who desire a softer, but still cohesive, implant.

While cohesive implants are excellent and have certain advantages, a great breast augmentation is about the surgeon and not the implant. No breast implant guarantees a great shape, freedom from rippling, avoidance of hardening, or any other problem that can occur. Gorgeous breasts are created through outstanding surgery. While understanding that the inherent advantages of these implants may help you achieve a better result, do not allow enthusiasm about just the benefits sway you. Satisfied patients with cohesive gel implants comprehend the advantages and disadvantages of these implants, and have made a fully informed decision—guided by Dr. LoVerme— that is right for them.

What Are the Different Breast Implant Shapes?

In addition to implant types, patients must also consider which breast implant shape can give them the new look they desire. Breast implants come in two shapes, either round or teardrop. The optimal shape is unique to the individual and will be dependent upon a variety of factors that are discussed during a consultation with Dr. LoVerme.

Round Implants

Silicone, saline, and highly cohesive silicone breast implants are all available in round-shaped models. They are available in five dimensions from low-profile to extra-high profile. Round is the most popular breast implant contour, and the results achieved with these implants are generally more spherical due to the implant’s symmetrical curves at the upper and lower pole of the breast. Round implants are typically better-suited for women who want fullness added to both the upper and lower portions of the breast. In addition to the round shape, the fill and projection of round implants can provide varied dimensions to one’s results, all of which will be discussed thoroughly with Dr. LoVerme.

Teardrop-Shaped Implants

Only highly cohesive silicone implants can be teardrop-shaped due to the gel’s unique ability to hold a steady form. These implants offer enhanced volume at the bottom portion of the breast and diminished fullness as they taper toward the upper pole, creating the teardrop-shaped profile that gives them their name. Teardrop-shaped breast implants generally create a more natural-looking breast slope and lower-pole contour, which many women find desirable.

It is important to note that if a teardrop-shaped implant were to rotate, then it could create a distortion of the breast shape. This rotation risk is very small, but it is not present with round implants and causes concern for some patients. Shaped implants require that they be sized properly, and therefore, the surgeon’s expertise is more important. If highly cohesive shaped implants are too big, the breast can look very tight and stuffed. If the implants are too small, the breast may not look correctly filled.

What Is the Breast Augmentation Consultation Like?

The rapid recovery breast augmentation method begins at the time of the first consultation. After meeting with our coordinator, you will view a short video about breast augmentation surgery. Our plastic surgeon will review your medical history and complete a full breast examination. Then, 3-dimensional (3-D) photography, combined with revolutionary new software, will allow Dr. LoVerme to preview a close approximation of what your breast augmentation results could look like. The process starts with a VECTRA® 3-D session, which produces a 3-dimensional photograph of you. Then, using Sculptor software, Dr. LoVerme is able to simulate the expected results of a variety of aesthetic breast procedures, including breast augmentation, breast lift, and breast revision. The 3-dimensional photograph is processed and displays a virtual model on the computer monitor. This digital figure can be rotated on the screen and viewed from almost any angle. The software then allows Dr. LoVerme to apply simulation tools that change the size, shape, and position of your breasts to achieve the desired appearance. He is also able to insert specific breast implants to give a realistic image of the final result. During your consultation, you will also have the opportunity to try on implants in a bra for an approximate simulation of size and shape.

After a detailed discussion, physical examination, 2-D and 3-D photography with breast implant simulation, and trying on implants, Dr. LoVerme will develop a customized surgical plan based on YOUR desires and anatomy. All of your questions will be answered, including those about implant type, shape, size, position, and incision placement.

TouchMD at Home

Following your consultation, we will upload the breast augmentation video, your 2-D and 3-D photos, before-and-after patient photographs, and your own computer simulations to a secure portal on TouchMD, which you can review in the privacy of your home. Educational videos and a gallery of Dr. LoVerme’s patients can also be put on the portal for you.

How Is the Breast Augmentation Procedure Performed?

Breast augmentation is typically performed at our AAAASF-accredited, office-based Surgical Suite. The procedure usually requires one to two hours and is done on an outpatient basis. Breast augmentation is painlessly performed under local anesthesia with intravenous conscious sedation (IVCS). You are usually awake and ready to leave the facility within an hour after your surgery is completed.

Typically a two hour procedure
Usually awake and ready to go home within an hour after your surgery

The Keller Funnel™

To remain at the forefront of our field, The LoVerme Center has a history of commitment to adopting some of the latest plastic surgery technologies. The Keller Funnel™ is one of our newer tools, giving our breast augmentation patients an additional approach to achieve the exceptional results they expect from our practice. Dr. LoVerme is Keller Funnel™ Certified, providing our patients with an innovative method of implant delivery. The main benefits of using the Keller Funnel™ include:

  • Reduced incision lengths
  • Less visible scarring
  • Added options for incision placement
  • Minimized risk for implant damage
  • Reduced risk for capsular contracture

A comprehensive pre-operative consultation; 3-D imaging; expert, careful, no-touch technique surgery; use of the Keller Funnel™; unique post-operative exercises; and smaller incisions allows Dr. LoVerme to achieve his goal for you:

  • Make every outcome positive
  • Make every result expected
  • Make every experience pleasurable and comfortable

With the Keller Funnel™, Dr. LoVerme is able to perform silicone gel breast augmentation using a smaller incision that is similar in size to those used for saline implants. Because the incision required for placement is smaller, there are also more ways in which the scar can be concealed—an advantage that is particularly beneficial for women who scar easily. In addition, the Keller Funnel™ technique exerts less force on the implant during the procedure, placing less pressure on the implant shell and reducing the risks of post-operative complications. This “no-touch” implant technique also minimizes the chances of capsular contracture (excessive scar tissue forming around the implant) while increasing patient comfort during the recovery period.

Breast Augmentation Incisions

There are three different types of incision patterns that Dr. LoVerme can use to place implants during breast augmentation surgery. These incision options include:

  • Periareolar Incision – The periareolar incision is a curved incision made along the lower border of the areola within the darker pigmentation. This incision carries an increased risk of capsular contracture.
  • Inframammary Incision – The inframammary incision is made along the bottom crease of the breast where the breast meets the chest wall. This is the most common incision.
  • Transaxillary Incision – The transaxillary incision is a small incision made within the underarm area (armpit). For the best control of the pocket, an endoscope is necessary for performing this surgery.

Breast Implant Placement Options

Breast implants can be placed either over or under the chest muscle. At the time of the consultation, Dr. LoVerme will discuss which option will be better for your particular situation.

Over the Muscle
Under the Muscle

What Can I Expect Breast Augmentation Recovery to Be Like?

Although you may experience discomfort or sensitivity in the days after surgery, the rapid recovery approach relies on you doing daily stretches and exercises designed to reduce the degree of discomfort. In the past, traditional approaches to breast augmentation required patients to wait up to several weeks before feeling normal again. Now, with the benefit of Dr. LoVerme’s quick recovery approach to breast augmentation, our patients are typically returning to daily life and enjoying their new look in a matter of days. Most patients are back to work in three to five days. Exercise and heavy lifting are limited for four weeks.

Will I Have Noticeable Breast Augmentation Scars?

Dr. LoVerme does his best to ensure that there is minimal visible scarring after your breast augmentation. Each incision pattern he uses offers a certain degree of camouflage once it has healed and the scar tissue has matured. For those with periareolar incisions, the scar tissue should blend into the darker skin tone of the areolae. Women with inframammary incisions typically find that their scars are well-hidden within the breast crease and are covered by the lower pole of the breast. Finally, those who receive transaxillary incisions have no visible scar tissue on the breasts—just scars concealed within each underarm crease.

How Long Do Breast Implants Last?

Breast implants are not permanent devices and may eventually need to be replaced. Most women are able to keep their breast implants for ten years or more before implant exchange might be necessary due to rupture or other integrity-related issues. All implant manufacturers offer warranties, though the specifics vary based on the particular breast implant model you choose. Dr. LoVerme can discuss more details about implant lifespans and warranties during your personal consultation.

Can You Breastfeed with Breast Implants?

Most women can breastfeed following breast augmentation. While some may supplement with formula (this is common in women without implants as well), none of the incisions should prevent breastfeeding. Implant placement under the muscle allows for an extra layer of protection between the implants and the milk ducts, better mammograms, and a more natural look and feel.

How Much Does Breast Augmentation Cost?

Breast augmentation surgery starts at $4,200 at the LoVerme Center for Plastic Surgery. Since each breast augmentation is customized to meet the individual patient’s needs, costs can fluctuate. The final cost will take into account a number of variables, including implant type, anesthesiologist and facility fees. At the completion of your pre-operative consultation, our coordinator will be able to provide you with an accurate quote for the cost of your breast augmentation. Our office also offers a number of financing options for patients who are seeking a method of payment that works comfortably within their budget.

Additional Breast Augmentation FAQs

Patients typically have many questions for Dr. LoVerme before deciding to undergo breast augmentation. To provide you with as much helpful information as possible, we have included many of Dr. LoVerme’s answers to common questions about breast augmentation and breast implants:

Am I a good candidate for breast augmentation?

Ideal candidates for breast augmentation are in good overall health and seek to add volume to the breasts. Dr. LoVerme will perform a physical exam to make sure you are healthy enough for surgery and that breast augmentation is the best procedure for achieving your unique goals. Some patients who seek to address sagging of the breasts may benefit more from a breast lift, while others may benefit from a breast lift with implants. Oftentimes, mothers will choose breast augmentation as one component of a more comprehensive Mommy Makeover.
Am I too old for breast augmentation?

Over the past few years, more and more women between 35 and 60 years old have sought to improve the appearance of their breasts. They usually want to return their breasts to the size and shape they had in the years BC (before children). However, many of these women commonly ask: “Do older women really get breast implants?” Perhaps it’s not talked about like it is among women 21-30, but breast surgery among older women is just as common. Statistics from the American Society for Aesthetic Plastic Surgery reveal that 49% of women undergoing breast augmentation are over 35 and nearly 15% are over 50. In addition, 75% of breast lifts and 59% of breast reductions are performed on women over 35.

For more information on this topic, please visit our page devoted to breast surgery popularity among different age groups.

How do I choose the right shape/size breast implant?

During the consultation process, Dr. LoVerme will carefully review your cosmetic goals and use VECTRA® 3-D imaging technology to help determine which size, shape, and implant type can best meet your needs. These realistic 3-D images can give you a preview of the results you can achieve with breast augmentation. A special bra that allows you to “try on” implants can also help you make an informed decision.
Do breast implants interfere with pregnancy?

Breast implants have a soft silicone shell filled with either saline or silicone gel. Many implanted medical devices are made from this same non-reactive material. Breast implants do not harm or pose a risk to normal pregnancy. In addition, while the breasts will usually increase in size during pregnancy, this process does not involve or affect the implants themselves. Augmented breasts are more resistant to the loss of volume and shape that often accompany pregnancy and breastfeeding. Because the augmented breasts maintain more of their volume (the implant volume does not decrease), women with implants are less likely to see drastic changes.
What are the main distinctions between each implant option?

The outer shell of both silicone and saline implants is made of a solid silicone material. Solid silicone is widely used in implantable medical devices. Any of the implants can be textured, but all shaped implants must be textured. This prevents the implant from turning within the pocket and may decrease the risk of capsular contracture. Silicone gel implants are filled with silicone gel, which is a semi-solid substance. Saline-filled implants are filled with the same kind of saltwater that is used in I.V. fluids.
Are silicone implants safe?

In 1999, a landmark report undertaken by the Institute of Medicine (IOM) concluded that silicone implants do not cause major health problems such as lupus, fibromyalgia, or rheumatoid arthritis. And while no one can ignore the fact that silicone—and saline—breast implants may cause localized problems for some patients, numerous scientific studies over the years have shown that silicone gel-filled implants are both safe and effective for breast augmentation and reconstruction. In fact, silicone gel breast implants are widely used in 60 countries around the world, including across Europe.

In the past decade, a number of independent studies have examined whether silicone gel-filled breast implants are associated with connective tissue disease or cancer. The studies, including a report by the Institute of Medicine and the findings of the FDA, have concluded there is no convincing evidence that breast implants are associated with either of these diseases.

What is the history of shaped implants?

In the 1980s, there was a popular teardrop shaped implant developed by Surgitek. Dr. LoVerme used many of these implants, and published a paper on the surgical technique of inserting these implants. The implants had a nice teardrop shape. They were covered with a polyurethane layer outside of the silicone shell, and when you held them in your hand, they felt like they would maintain their shape. When initially implanted, the results were gorgeous; but, soon the implants lost that great shape. The implant gel was not stiff enough to control the shape of the implant. Shaped saline implants were also tried but, when implanted, looked round because the saltwater could not maintain the shape. The goal was to create a gel breast implant that could maintain that shape over time and resist breakage. It was clear that the shell alone could not do it. The gel itself would have to be able to hold its own shape.

Once a gel was developed that could hold a shape, it became possible to make a great number of shapes in a particular volume. This gives the surgeon unprecedented control of breast shape, allowing greater possibilities in creating a shape that is most attractive for a woman, or to correct pre-existing deformities of a woman’s own breast shape. Each of the three companies who manufacture these implants in the United States had to carry out a trial of these implants for the FDA.

Is there a variance in quality among implant manufacturers?

There are currently three companies that manufacture breast implants sold in the United States: Allergan (Natrelle), Mentor, and Sientra. All are quality implants and all are FDA approved. All offer warranties which vary slightly and are different for saline implants versus silicone implants.
Are implants used solely for augmenting the size of the breasts?

Breast implants can serve one or more of a number of purposes; breast cancer victims can use breast implants for reconstructive purposes after mastectomy, or women with asymmetrical breasts may use a single breast implant to balance the difference in size. Following pregnancy, many women opt for breast implant surgery to correct reductions in breast size. Some women want a better shape to the breast with more upper-breast fullness, but do not desire larger breasts. For these women, Dr. LoVerme uses the reduction/augmentation technique to give the improved contour and lift, without size change. And of course many breast implant candidates are interested in creating a more flattering contour or size.

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