What Is Breast Augmentation?
Breast augmentation is among the most commonly performed cosmetic surgery procedures. Although breast augmentation is extremely popular, the reasons for selecting this procedure can vary from patient to patient. Some patients seeking breast augmentation are satisfied with the shape of their breasts, but simply want them to be a bit fuller. Other common personal reasons include breasts that are perceived to be underdeveloped, asymmetry of the breasts in size and/or shape, and changes after pregnancy or breastfeeding. Weight loss, aging, and childbirth can also affect breast volume. Breast augmentation can address all of these concerns by creating a more proportional shape and size, and can often boost self-esteem, as well.
Do I Need a Lift with My Augmentation?
Depending on your unique anatomy and aesthetic concerns, Dr. DiBello can help you decide if breast augmentation, breast lift, or a combination of the two is most appropriate.
Women who are experiencing a combination of breast ptosis (sagging) and volume loss are typically considered good candidates for a breast augmentation-mastopexy (BAM). By combining a breast lift with augmentation, excess skin can be removed, breasts can be elevated to a more youthful position, and volume can be restored with implants. However, if volume loss is the only concern, a breast augmentation alone may be the best choice. If adequate breast volume is present and enlargement is not desired, Dr. DiBello may suggest a breast lift without implants.
What Types of Breast Implants Are Available?
There are two types of breast implants: saline solution-filled and silicone gel-filled. Standard saline-filled implants come in a variety of sizes and profiles that can be tailored to your individual needs. Dr. DiBello exclusively uses smooth, round saline and silicone-filled breast implants. He no longer offers textured-surface breast implants of any kind, due to FDA concerns about breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL). Patients with textured-surface breast implants have shown an elevated rate of developing BIA-ALCL and an FDA announcement of these findings became public in 2019. Although the risk of BIA-ALCL is slight, your safety is among Dr. DiBello’s primary concerns and he takes every precaution to protect your health.
When considering breast implant augmentation surgery, it is important to understand that all implants, regardless of what they are filled with, will fail, or leak, at some point. When a saline implant fails or leaks, the saline solution is safely absorbed by your body and can be easily detected by you or your surgeon. When a silicone gel breast implant ruptures, it is referred to as a “silent rupture” because it is not possible to tell there is a leak without an MRI scan. The silicone gel may start leaking into surrounding breast tissue and need to be removed (since your body can’t absorb it), which can be quite complicated. To detect a silent rupture, the FDA recommends women with silicone gel-filled breast implants get an MRI every two to three years—for life.
Despite the fact that Dr. DiBello is trained and credentialed to use any and all of these devices in your breast augmentation surgery, it is due to these reasons that we typically recommend conventional and saline-filled implants at DiBello Plastic Surgery. Below, you can find some general information about each of these options. To help you determine if you are a candidate for breast augmentation, Dr. DiBello will take time during your consultation to advise you regarding the known risks associated with breast implants. Additionally, you will be provided with a significant amount of literature to ensure you are well-informed prior to the procedure.
Silicone Breast Implants
Silicone gel-filled implants were designed to provide a natural look and feel, with less chance of rippling. In 1992, silicone gel filled breast implants were restricted by the FDA for use in primary breast augmentation. Since 2006, the new generation of highly cohesive silicone implants were given conditional FDA approval for patients 22 years of age and older (approved for breast reconstruction in patients of all ages). The long-term study of the safety of these cohesive silicone gel implants was the major condition for the FDA approval, which is still currently ongoing. Because of the issue of silent rupture with the cohesive gel implants, the FDA recommends women with cohesive gel breast implants get an MRI every two years after having them placed. These MRIs are expensive and typically not covered by insurance companies. Unlike soft silicone implants of the past, these implants are filled with a firmer/thicker cohesive silicone gel that has inspired the nickname of “gummy bear” implants. Compared to the older silicone gel implants, these new gummy bear “form-stable” silicone gel implants are firmer and heavier, but the initial reports reveal that they have a significantly reduced rupture rate.
Saline Breast Implants
Saline implants have been extensively studied, and there is a great deal of scientific evidence supporting their long-term safety. For this reason, saline filled breast implants were never restricted from the market for breast augmentation by the FDA, and have been unconditionally approved since May of 2000. Compared to silicone gel implants, saline filled implants have a lower rupture and leak rate, and a decreased risk of capsular contracture. Saline implants consist of a silicone shell filled with a saline (salt water) solution, and are FDA approved for breast augmentation in patients who are at least 18 years of age (approved for breast reconstruction in patients of all ages). Since the saline implants can be filled after placement, the size of the incision is generally much smaller compared to an incision used for silicone gel filled implants. In the rare occurrence of a rupture or leak, the saline solution can be safely absorbed into the body. Ruptures, or leaks, can also be easily detected and addressed, due to the noticeable loss of volume in the affected breast, without the need for an MRI. Historically, saline filled implants were advertised to be associated with more rippling and a less natural, or firmer, feel when compared to silicone gel filled implants. That is no longer the case, especially with the development of the Moderate Plus Profile saline implant, which has a thicker silicone shell and offers a performance and natural feel similar to that of the classic silicone gel implants, while providing the safety and peace of mind of saline implants.
Dr. DiBello is a highly knowledgeable, very skilled surgeon. He clearly explains the procedure at hand and takes the time to address all questions and post surgery care. I have recommended Dr. DiBello to family and friends. I sought a total of 4 opinions prior to deciding to having surgery and I was only comfortable working with Dr. DiBello.
What Are My Options for Breast Implant Shape?
The breast implant options at DiBello Plastic Surgery are all round-shaped and have a smooth outer texture. Anatomically shaped and other textured-surface breast implant models were previously available; however, health concerns officially announced by the Food and Drug Administration in 2019 have linked these types of breast implants with a slightly elevated risk of developing breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL). For enhanced patient safety, Dr. DiBello no longer uses these controversial breast implants.
Round, smooth saline-filled and silicone gel-filled breast implants come in a variety of sizes and projections to create the look you desire. In addition, Dr. DiBello may suggest combining implants with fat transfers to create an even more natural-looking end result. Breast augmentation fat transfer techniques can also be used alone to achieve highly customized breast enhancement using fat harvested from other areas of your body via liposuction. The liposuctioned fat is purified and then carefully injected into the breasts to create the size, symmetry, and shape that aligns with your goals. The results achieved with breast augmentation fat transfers typically offer the most natural look for patients seeking full, soft, precision-contoured breast enhancement.
When you meet with Dr. DiBello, he will discuss the advantages of each breast implant option available to you and may explain how fat transfer can help enhance shape. He will work closely with you to determine which combination is best for attaining your aesthetic goals, as well as creating the most natural appearance for your unique body frame.
How Is Breast Augmentation Surgery Performed?
When performing breast augmentation surgery, incisions are carefully and strategically placed to keep scars as inconspicuous as possible. In your consultation, Dr. DiBello can discuss the different incision options with you and determine which method is most appropriate. These options can include:
View our breast augmentation 3D animation to learn more about this procedure and get a better idea of what to expect.
Which Breast Implant Placement Should I Choose?
There are three primary options for breast implant placement:
- Dual-Plane Insertion, in which the implants are placed partially behind the pectoral muscle and partially behind the breast gland
- Subglandular Insertion, in which the implants are placed above the pectoral muscle
- Submuscular Insertion, in which the implants are placed between the chest muscle and the chest wall
The ideal placement of your implants will depend on the existing degree of tissue, as well as your unique anatomy and goals for the outcome of surgery. Dr. DiBello will determine this part of your surgery after a thorough evaluation and one-on-one discussion of your needs.
What is Breast Augmentation Recovery Like?
After surgery, breasts will appear “fuller” and more shapely in contour. Due to swelling, they may appear a bit larger than you anticipated, but this should gradually subside over the weeks following surgery. You may experience some mild to moderate discomfort in the first few days after the procedure, but this can typically be managed with medication. After returning home, Dr. DiBello recommends about an hour of rest, but encourages patients to get up and move around a bit (carefully) shortly afterward. Strenuous activity should be avoided for about six to eight weeks, but most patients can return to their daily routine after approximately two weeks. In your initial consultation, Dr. DiBello can provide you with more specific guidelines based on your individual case, and can answer any questions you may have. He will also provide you with personalized aftercare instructions, which should be carefully followed to ensure ideal results and avoid potential complications.
What Will My Breast Augmentation Scars Look Like?
The location and shape of scars following breast augmentation will depend on the incision type used. Regardless, Dr. DiBello takes great care to place all breast augmentation incisions in a way that gives them the best chance of becoming as discreet as possible, once healed. Certain factors can potentially affect the way the scar heals, such as one’s genetic makeup, personal diet, and how closely post-operative instructions are followed. Ultimately, resulting scars are typically undetectable, and most patients are so pleased with their overall results that scars are not a concern.
How Long Do Breast Implants Last?
While the breast implants Dr. DiBello uses are well-designed and rigorously tested for longevity, breast implants are not permanent and they will eventually require replacement. If you do not experience any complications, breast implants can potentially last up to ten years or more before replacement is advised. Dr. DiBello only recommends and uses FDA approved saline and silicone gel-filled implants that carry lifetime warranties for leakage and provide financial assistance if a leakage occurs within the first ten years of implantation.
Can I Breastfeed After Breast Augmentation?
Dr. DiBello places all implants behind the chest muscle, which separates the implants from the actual milk ducts. Breast implants, both saline and silicone, have been studied extensively and have been shown to be of no medical risk to babies breast-fed by or born to women with breast implants. Breastfeeding may be affected by the location of the incision to place the implants, however—for example, an inframammary (breast crease) incision will disturb less breast tissue than a periareolar (around the nipple) incision. Women who have the ability to breastfeed prior to the procedure should not experience any obstacles in doing so as a result of breast augmentation. It is possible, however, that the ability to breastfeed may be interrupted by naturally occurring challenges unrelated to surgery. If you are concerned about breastfeeding, the best thing to do is to share your thoughts with Dr. DiBello so that he can have an in-depth discussion with you about this topic. Dr. DiBello is very experienced in breast augmentation and other breast surgeries and understands how important it is to retain the ability to breastfeed. He can take additional precautions when patients express heightened concern about breastfeeding children in the future.
How Do I Choose the Right Breast Surgeon?
In order to achieve the best possible outcome from your breast augmentation surgery it is vital to choose a breast surgeon who possesses the credentials, knowledge, skill, and experience necessary to create optimal results while prioritizing your health and safety. Dr. DiBello recommends researching plastic surgeons thoroughly and making sure the ones you decide to meet with are first and foremost board certified by The American Board of Plastic Surgery (ABPS). Board certification by the ABPS tells you that a plastic surgeon has met and continues to meet the highest standards in the field with regard to integrity, safety, and patient care. When you meet with surgeons in person, it is important to ask a lot of questions and get a feel for how the surgeon treats his or her patients—after all, you will be trusting this person with your body and health. Make sure to ask about the surgeon’s level of experience performing breast augmentation and their track record of safety. Reviewing before-and-after photos of patients can also be a very helpful indicator of whether or not they can meet your expectations.
In his practice as a board-certified plastic surgeon, Dr. DiBello welcomes patients’ questions and strives to provide answers that are thorough and easy to understand. His vast experience in breast augmentation is evident in the number of breast augmentation procedures he has performed and the consistently outstanding results he has been able to achieve. Over the years, he has amassed extensive knowledge about breast implants, breast augmentation techniques, and cosmetic breast concerns, all of which is evident when you meet him in person to discuss the procedure. His patients find his approach reassuring and warm, and he is able to inspire confidence in individuals of all ages. When you visit Dr. DiBello for your consultation, he can show you many before-and-after photographs of patients with cosmetic concerns and goals that are similar to your own. This offers you the opportunity to see what your results could potentially look like; however, Dr. DiBello emphasizes that each patient is different and results are always unique. If you are interested in meeting with Dr. DiBello to discuss plastic surgery, we welcome you to schedule a consultation.
How Much Does Breast Augmentation Cost?
At DiBello Plastic Surgery, the typical cost for breast augmentation with conventional saline implants is approximately $6,400 to $6,900. The average price of breast augmentation with silicone gel implants is approximately $7,500 to $7,900. While many price quotes available online only reflect the surgeon’s fee, the estimates above include a variety of factors, such as Dr. DiBello’s fee as performed at a local hospital, implant costs, and the facility fees (which include anesthesia, operating room, and pre-admission testing). These figures are only estimates, and the precise fee for your individual case can only be provided after Dr. DiBello consults with you.
Additional Questions About Breast Augmentation
Will breast implants help with sagging?
While breast implants can provide shape, fullness, and volume to the bustline, they are not designed to combat breast sag (known medically as ”ptosis”). Patients who wish to achieve both effects may be eligible for a procedure known as augmentation-mastopexy, or a breast lift with implants. Dr. DiBello can determine your candidacy for this comprehensive breast enhancement surgery after an evaluation of your cosmetic goals.
How do I sleep after breast augmentation?
In most cases, Dr. DiBello advises patients to sleep on their back during breast augmentation recovery. This may feel awkward at first, but this position is typically necessary to keep pressure and strain off of your new implants. In order to make sleeping on the back feel more natural, you can use pillows to support your body on either side.
How long after breast augmentation can I swim?
To reduce the risk of infection, Dr. DiBello recommends that you refrain from swimming, hot tubbing, taking a hot bath, or otherwise submerging your implants in water for at least four weeks.
How soon can I exercise after breast augmentation?
While it is essential to get sufficient rest during your breast augmentation recovery, it is also important to keep your body in motion, albeit carefully, to facilitate proper healing and reduce the chance of blood clotting. That said, you should avoid strenuous exercise or activity for at least six weeks, or until Dr. DiBello deems it safe for you to resume.
Will breast implants interfere with mammograms?
With or without implants, a mammogram is the same basic procedure, except with implants some additional views are necessary to complete the study. You should follow the recommendations of your doctor as far as screening mammography, but be sure to tell your doctor or technician that you have implants prior to the test. Implants above the muscle obstruct the view of the breast and are not able to be moved out of the breast picture, while implants behind the muscle are typically able to be displaced by the technician to get a more complete view of the breast. For this reason, Dr. DiBello prefers to place the implants behind the pectoralis muscle.
For more information about breast augmentation and implants, or to schedule a consultation with Dr. DiBello, please contact our practice today.