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Breast Augmentation

Home/Surgical Procedures/Breast/Breast Augmentation

Length: 1–2 hours
Anesthesia: IV Sedation
Inpatient/Outpatient: Outpatient
Potential Side Effects/Risks: Temporary soreness and numbness, ripples in implant, leak of saline, rupture of silicone
Principal Benefits: Uplifted and more shapely breasts and overall more proportioned appearance.

What is Breast Augmentation?

Breast augmentation is a procedure to enlarge the size of your breasts using a saline-filled or silicone implant. Breast augmentation not only increases breast size, but it can also heighten self-esteem – especially in women who have long thought of enlarging their breasts. We have seen time and again the uplifting of spirit, confidence, and self-image following breast augmentation. The recovery is often relatively rapid, and patients can choose from saline or silicone implants depending on their personal preferences and individual needs.

We invite you to learn more about breast augmentation by exploring the informational sections and media provided below. Please contact our practice today to schedule a consultation with our experienced plastic surgeon.

Who Is a Candidate for Breast Augmentation?

Most of our patients who have breast augmentation desire to improve their appearance in clothing, without clothing, and in bathing suits. While some women have never filled out their bras the way they would like, others have lost volume in their breasts following pregnancy. We tailor each operation to the particular build of the woman. Some women who have had children or who have experienced weight loss have a degree of breast droop that requires a breast lift (mastopexy) combined with breast augmentation.

During your consultation, we will discuss with you our recommendations for implant position (above or below the muscle), the optimum incision location, and the different options of implant types. Additionally, breast augmentation can be performed as a single procedure in our office or in conjunction with other cosmetic procedures such as liposuction, tummy tuck, and facial plastic surgery. If you have a variety of cosmetic concerns, your plastic surgeon will take the time to discuss the available methods for achieving your goals.

“My breasts look amazing and look how I always wanted them to look! Dr. Houssock was very transparent with me from the consultation and every visit I had with her after. I felt very comfortable the entire time and I am very happy with the decision I made to get a breast aug. I loveeeed how Dr. Houssock called me to check on me after my procedure! That really showed me she cares about the wellbeing of her patients.”
Anonymous

What Are the Different Types of Breast Implants?

Traditional Silicone Breast Implants

FDA-approved in 2006, traditional silicone gel breast implants were redesigned for enhanced safety after older models were taken off the market. Today’s silicone implants feature a more rupture-resistant silicone rubber shell filled with silicone gel. For many patients, silicone breast implants can provide an exceptionally natural look and feel. Implant manufacturers offer a wide range of sizes/volumes and projections to accommodate the unique needs and cosmetic goals of a broad spectrum of breast augmentation patients.

Gummy Bear Breast Implants

Cohesive silicone gel breast implants, which are also called “gummy bear” breast implants due to their form-stable silicone gel, are the latest form of silicone breast implants to be FDA approved. These firmer gel implants offer patients round and anatomically shaped (tear drop) implant options that are available in a wide range of sizes and profiles. For certain patients, anatomically shaped models can provide a natural-looking breast slope and enhanced lower pole fullness.

Saline Breast Implants

Saline breast implants, which are comprised of a silicone rubber shell filled with a sterile salt-water solution, can provide a suitable option for breast augmentation patients who do not want silicone or who desire a placement strategy that requires saline. Unlike silicone breast implants, which contain a fixed amount of gel, the amount of solution contained in saline breast implants is adjustable at the time of surgery. Additionally, if a saline implant ruptures, it is immediately detectable (while silicone leaks typically occur more slowly), and the leaked solution simply absorbs harmlessly into the body.

If you are unsure about which breast implant type is best suited for your needs, do not worry—Dr. Carrie A. Houssock will take the time to explain your choices and recommend an option that aligns most closely with your goals and priorities.

What Size Breast Implants Should I Get?

You are the person who will live with your breast augmentation results on a daily basis, and the decision for size is a very personal one. We will recommend a size based on your anatomy, individual body type, personal preferences, and the appearance you envision. Some women prefer a more natural look while others may seek a fuller aesthetic, and we are happy to work with you to find the size and shape that meets your enhancement goals. You are welcome to bring in photos or an exemplary bra size to your consultation with Dr. Houssock to demonstrate your desired look and size. Additionally, we invite you to view our before-and-after breast augmentation photos as a resource.

How Long Do Breast Implants Last?

Modern, high-quality breast implants are designed to last for decades; however, it is important to note that they are not lifetime devices. For the best results, Dr. Houssock generally recommends that patients vigilantly monitor any changes to the feel and/or appearance of their breasts. She also advocates that patients have their implants examined after around a decade. After this time has passed, Dr. Houssock can check your implants to make sure they are still functioning optimally, and you may even elect to have your implants replaced with a different type or size at this time.

What Are the Breast Augmentation Incision Options?

At our practice, Dr. Houssock typically prefers to use an incision in the crease underneath the breast for breast augmentation. The reason for this is, first and foremost, safety and consistency. Although an incision around the areola is appealing in many cases, this approach does have an increased likelihood of capsular contracture. Another option is an incision in the armpit; however, this approach does not provide the flexibility needed to manage the breast crease positioning, which is critical in many cases. Our surgeon has never used the belly button as an incision option, and this choice is limited to saline implants. Dr. Houssock believes that the breast crease incision affords a maximal exposure and excellent healing with the highest safety.

There are other considerations to explore when choosing the type of incision to use, and these factors are discussed in detail at the time of your consultation. Of course, additional decisions to make include whether to place the implant above or below the (pectoralis) muscle and the size and type of breast implant to use. You and your surgeon will have a lot to discuss while customizing a plan that best fits your needs and goals.

How Is the Breast Augmentation Procedure Performed?

Prior to your breast augmentation procedure, you will be prepared for surgery and placed under IV sedation. To begin, your plastic surgeon will make the appropriate incision, which is most often an incision along the lower breast crease (also called the inframammary crease). Through this incision, the breast pocket is created in the desired area (either above the muscle, below the muscle, or partially above and below the muscle [dual plane]), and the breast implant is inserted within. If saline implants are used, the implant shells are filled with the appropriate level of solution. Finally, the incision is closed and the process is repeated on the other breast.

Overall, the breast augmentation procedure takes approximately one to two hours to complete.

What Is Recovery after Breast Augmentation Like?

Most breast augmentation patients have only moderate soreness for a few days, but this improves quickly thereafter. Contrary to what you read on the Internet, breast augmentation patients at our practice truly have very little pain post-operatively. Most people take off only three to five days from work to recuperate, but strenuous physical activity may need to be limited for longer in order to promote optimal healing.

Will I Need A Breast Lift with My Augmentation?

Some women may require a breast lift with implants (augmentation mastopexy) in order to obtain adequate lift and fullness. Typical candidates for a breast lift with implants are women who have both lost volume in the breasts and want to reverse the effects of ptosis (sagginess of the breasts) – a condition that can develop with age, weight loss, or past pregnancies. Generally, if the nipple is at or below the breast crease, the breast skin can be excised and the “breast skin envelope” made tighter. The scars on the breast that result from this lift are considerable, but usually heal very well. With the excess skin removed, the breasts rise to a more youthful level.

Is Breastfeeding Possible After Breast Augmentation?

Most patients who have breast augmentation at our practice do not have problems breastfeeding, regardless of the placement of the breast implant. When a breast augmentation is performed by a qualified plastic surgeon like Dr. Houssock, techniques can be used that should help preserve the milk ducts and other lactation functions. It is important to communicate plans for future children and prospective nursing with your surgeon, as this can be a significant part of creating a treatment plan. For example, if surgical intervention of the nipple shape and repositioning is desired, that portion may need to wait until after family planning is complete, as it may have an effect on the internal structures that support breastfeeding.

Will I have Scars after Breast Augmentation?

Because breast augmentation is a major surgery, some degree of scarring can be expected. That said, Dr. Houssock carefully places incisions so that they produce as little scarring as possible. As a result, scars that do appear are usually virtually undetectable and tend to fade to a flesh color in the months following surgery.

How to Choose the Right Breast Augmentation Surgeon

The decision to undergo breast augmentation can be a daunting one, but choosing a qualified breast surgeon can mitigate a great deal of anxiety. For this reason, we suggest you extensively research each potential surgeon, from their education to their patient reviews to examples of their surgical results. It is especially important to choose a surgeon who is certified by the American Board of Plastic Surgery (ABPS), as certification with this organization signifies the proper training to perform cosmetic surgery.

Dr. Houssock not only holds certification with the ABPS, but she is also renowned for her exceptional results in plastic and reconstructive surgery. Her research has been featured in a number of medical publications. In addition, she is a recipient of several prestigious awards, and was recently named one of “America’s Best Plastic Surgeons of 2021” by Newsweek. Her ability to combine extraordinary surgical results with a compassionate, warm bedside manner make her an ideal choice to perform your breast augmentation surgery.

How Much Does Breast Augmentation Cost?

At our Baltimore-area practice, the average price range for breast augmentation surgery is between $8,500 and $8,900 for saline or silicone breast implants. Depending on the details of your surgical plan, your overall cost for breast augmentation surgery might be higher or lower than our stated average. Factors that may affect the pricing of your operation can include:

  • The complexity of the procedure
  • The brand, type, shape, and/or projection of the chosen breast implants
  • The incision and implant placement plan
  • Any additional procedures such as a breast lift, tummy tuck, or liposuction
  • Sedation expenses
  • Post-operative medications

If you are interested in finding out how much a customized breast augmentation would cost, we encourage you to schedule a consultation with Dr. Houssock. At the end of your appointment, you will receive a detailed quote for your unique surgical plan. Our friendly and knowledgeable office team can also talk with you about scheduling your procedure, the payment options we accept, and plastic surgery financing opportunities offered through third-party lenders. We are happy to answer any of your questions and look forward to helping you achieve your aesthetic goals.

Complementary Procedures to Breast Augmentation

There are several cosmetic procedures that can help to further complement the new proportions and contours of a breast augmentation for an improved overall aesthetic. A few of the most common procedures include a breast lift (mastopexy), liposuction, or tummy tuck (abdominoplasty)—or a combination of these procedures within a mommy makeover for a more comprehensive treatment plan. During your consultation with Dr. Houssock, she will be happy to discuss all of your cosmetic goals and make recommendations for other enhancements you may be interested in pursuing.

Answers to Frequently Asked Questions

My breasts have a tubular shape. Is this normal?

Yes, this is a common variation on breast shape. Typically a breast has a pyramid shape, but some people have breasts that have a shape closer to that of a tube. The appearance of the breast in this situation typically includes some breast tissue pushing against the areola and expanding it, a tight, narrow breast base near the chest, and a short distance between the bottom of the areola and the infra-mammary crease. This tubular appearance can be improved with breast augmentation and some additional skin tailoring.

Below is an example of this type of improvement in the tubular breast shape:

How can I avoid capsular contracture (hardening of the breast implants due to scar tissue build up)?

No one really knows why this occurs in some breast augmentation patients, and it cannot be 100% eliminated. Some theories state that contracture is related to a variety of factors, these include: low-grade infection, inherent scar formation tendencies by the patient, or location of the breast implant above or below the muscle. We take every possible precaution to avoid these potential problems that might lead to contracture. In addition, we are big believers in massage of the breast implants following surgery. It is known that massage softens scar tissue and our patients have a very low rate of contracture.

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

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an extremely rare type of lymphoma (cancer that starts in cells that are part of the body’s immune system) that can develop in the scar capsule around certain breast implants. Symptoms that have been linked with BIA-ALCL most commonly include swelling in the breast area due to fluid collection, a mass in or near the breast, pain near the breast implant, fever, night sweats, swollen lymph nodes, or changes in breast appearance. Patients experiencing these symptoms should contact their surgeon or physician right away to ensure proper care and evaluations are performed as soon as possible. With this in mind, please note that this condition is extremely uncommon; in fact, as of 2024, the FDA has reported that BIA-ALCL has only been associated with a very small number of textured breast implants worldwide.*

Is it better to have the breast implants placed above or below the muscle?

Some surgeons only place the breast implants below the muscle, others only above. We will recommend what is best for you based on the way your breasts appear and the look you desire. Sometimes a dual-plane approach is the best customized option for you. During your thorough breast augmentation consultation, we will decide on what method is right for you.

Are silicone implants better than saline implants?

Both saline and the new cohesive silicone gel implants are excellent, improved from those used years ago, and offer different benefits. Most patients these days are requesting silicone implants because they do appear and feel more natural. On the other hand, saline implants are less expensive and can be placed through smaller incisions because they are filled after the implant is placed under the breast—as opposed to the silicone implants which are pre-filled. We will be happy to offer you both options if you are undecided, and we will make sure you understand all of your options regarding the type of breast implant to choose.

Are silicone implants safe?

The answer is yes. Although there was much concern and controversy 5-10 years ago regarding the safety of liquid silicone in breast implants, the FDA has since failed to uncover any health risks from silicone implants and the earlier restrictions for use have been removed. In addition, the implants we now use are more advanced than the older generation of implants. The implants we now use are cohesive silicone gel implants and when cut in half, there is no free flow of silicone gel and in fact they demonstrate a texture that resembles a “gummy bear” candy. We will be happy to discuss this topic with you during the consultation as well.

Furthermore, please rest assured that we only use tested, FDA-approved breast implants for the safety of our patients.

Are mammograms less effective when breast implants are in place?

Breast implants do hide a certain amount of breast tissue on mammography. Additional mammographic views are recommended to maximize the amount of breast tissue seen, however. This does mean additional radiation at the time of mammography, but the total amount is certainly not excessive. Digital mammograms and MRIs do not produce radiation and offer excellent breast analysis.

How painful is breast augmentation?

Because patients are sedated, they typically experience little to no discomfort during the surgery itself. With this in mind, you can expect a certain degree of tenderness immediately following the procedure, but this should fade as you heal if you adhere to your aftercare instructions.

What do breast implants feel like?

Silicone and saline breast implants made with high-quality materials are designed to feel very natural and comfortable when settled within the body. Although the specific type of implant and placement strategy may impact how they feel, patients usually acclimate to their new breast implants fairly quickly after a brief adjustment period.

How should I sleep after breast augmentation?

For the first few weeks after breast augmentation surgery, patients are advised to sleep on their backs in an elevated position (about a 30-degree angle) propped up by pillows or other means of support. This is a very important part of the healing process as it limits strain on the incisions and breast implants, helps reduce swelling, and improves circulation—all of which are essential to a safe and speedy recovery.

What type of bra should I wear after breast augmentation?

During your recovery from breast augmentation, you will be advised to wear a loose-fitting bra or bralette. After this initial healing phase, Dr. Houssock often recommends a sports bra; this type of bra can provide optimal support and comfort, as well as minimize movement and help preserve the results of surgery.

How long until I can swim after breast augmentation?

After a breast augmentation, it is generally best to wait at least four weeks before swimming or engaging in intensive exercise. This timeframe should encourage your incisions to heal sufficiently and reduce the risk of infection and other complications. Moreover, you will need to rest following the procedure.

What if I change my mind about breast implants later in life?

In the event you wish to remove your implants for any reason, you may be a candidate for breast implant removal surgery. Alternatively, many women pursue a breast implant exchange when they want to switch to a different implant type, size, or shape. No matter your particular case, Dr. Houssock is proficient in this type of procedure and would be glad to go over your options with you.

Can I speak to some of your previous patients who had this surgery and get a reference?

Absolutely; we would encourage this. Our past breast augmentation patients are our greatest endorsement. The staff in our office will gladly arrange this for you.

Medical References*

American Society of Plastic Surgeons

Breast Augmentation Before-and-After Photos

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