Duncan B. Hughes, MD

Dr Hughes and his entire team were very knowledgeable. I knew instantly that this was the team to perform the procedures I was seeking when I met them. I honestly believe his entire team is a big part of their successes but I also know he is highly intelligent and confident (very important to me) in his skills.

I had encapsulated 325 silicon implants (Dr law did them locally in 2009) one of which was ruptured, diastasis recti corrected and a hernia (had no idea of this) that he repaired and a left labia repair as well. While I know it was a tall order for one surgery, Dr Hughes never wavered in his confidence or his ability to make me look and feel fabulous again. He also fixed a nipple issue from my previous surgeon. Over and over he went above and beyond to ensure I was very satisfied with my results.

He and his team are very easy to talk to but at the same time he was very honest in what he thought was best and what results would and would not work. The hard part, I think of plastic surgery is sometimes not telling you what you want to hear but what is realistic and best for your health. Dr. Hughes did just that! I am only 3 days post op but I feel little to no pain in my labia or breasts which is amazing for the amount of work my breasts required. From the beginning he and his team took more than adequate time to address all questions and concerns. I am beyond pleased at this time and hope to come back and post some post op pictures for reference. If I ever need anything in the future or give a referral, Dr. Hughes is the only plastic surgeon in the area I would recommend.

I got a breast augmentation and am very happy with my results!!!! Dr. Hughes is amazing and helped me get the results I wanted! He answered all of my questions and helped me understand everything from pre-op to post-op. I was a little worried and concerned at first, but Dr. Hughes helped me understand every step of the procedure which helped me feel a little less anxious and worried. Post op I realized I had nothing to worry about…3 months later I have been nothing but satisfied with the results. I feel more confident in my body and am happy I got this procedure done!!! Thank you so much Dr. Hughes!!!!

Dr Hughes is always very easy for me to work with. He is a skillful and dedicated surgeon. I have had a few procedures done with him and will trust him to do more work for me in the future.

As an incentive for posting a review, this reviewer received an entry into RealSelf’s monthly $500 gift card giveaway.

Dr Hughes is a talented plastic surgeon. I had an upper and lower bleph done, and I couldn’t be happier with the results. I work in the medical field so I was extremely careful who I allowed to work in my face. He is easy to talk to, explains everything perfectly, and exudes confidence (important to me). For people on the fence about getting any kind of plastic surgery done, I recommend booking a consultation with Dr Hughes.

My comfort always came first and the team was very supportive and encouraging. I completely trust the Doctor and would come back to discuss any needs in the future before I went anywhere else, even though I do not even live in the area anymore!

I went to see Dr Hughes to treat capsular contracture over a year ago, 13 years after my initial breast augmentation surgery. I used to be a Clinical Coordinator for a Plastic Surgeon and have intimate knowledge of the risks and outcomes related to breast augmentation and revisions. My initial breast augmentation was performed by a different surgeon in another state. I had known of my capsular contracture for years before seeking intervention. After exhaustive research I selected Dr. Hughes for a few reasons - he is double board certified, has his own surgical suite, has a good reputation, and the before/after pictures on his website exceed anyone in the area.

Dr. Hughes provided a noninvasive treatment program, with the advice to escalate to a surgical intervention once necessary. His staff was incredibly accommodating. I ultimately had surgery with Dr. Hughes and have had an amazing result. My case ended up being fairly complicated as I had a ruptured implant- creating inflammation and scar tissue. Dr. Hughes did a fantastic job of removing the scar tissue, replacing the implants, and improving the look and feel of my breasts.



I would recommend Dr Hughes to anyone considering breast surgery. Beyond his wonderful bedside manner and easy to follow treatment plans, his team, his facility, and his skills as a cosmetic surgeon are among the best in the country.



Updated on 6 Apr 2023:
I went to see Dr Hughes to treat capsular contracture over a year ago, 13 years after my initial breast augmentation surgery. I used to be a Clinical Coordinator for a Plastic Surgeon and have intimate knowledge of the risks and outcomes related to breast augmentation and revisions. My initial breast augmentation was performed by a different surgeon in another state. I had known of my capsular contracture for years before seeking intervention. After exhaustive research I selected Dr. Hughes for a few reasons - he is double board certified, has his own surgical suite, has a good reputation, and the before/after pictures on his website exceed anyone in the area.

Dr. Hughes provided a noninvasive treatment program, with the advice to escalate to a surgical intervention once necessary. His staff was incredibly accommodating. I ultimately had surgery with Dr. Hughes and have had an amazing result. My case ended up being fairly complicated as I had a ruptured implant- creating inflammation and scar tissue. Dr. Hughes did a fantastic job of removing the scar tissue, replacing the implants, and improving the look and feel of my breasts.

I would recommend Dr Hughes to anyone considering breast surgery. Beyond his wonderful bedside manner and easy to follow treatment plans, his team, his facility, and his skills as a cosmetic surgeon are among the best in the country.

My experience so far with Dr. Hughes has been amazing. I am going in for a very difficult procedure in July and Dr. Hughes has been nothing but up front with me. I was nervous about the procedure and post-phoned it until I could have the appropriate recovery time. Dr. Hughes met with me again and I brought my husband. I and my husband had a ton of questions and Dr. Hughes answered them with so much knowledge and authority that I am no longer nervous, but very much looking forward to having this procedure done with him! I will post pictures of my amazing results.

As an incentive for posting a review, this reviewer received an entry into RealSelf’s monthly $500 gift card giveaway.

I’ve considered breast implants for several years now. And when I say considered, I mean I devoured articles about Breast Implant Illness, watched videos of the actual procedure, and read the stories of women who explanted. I asked all my friends what they thought of theirs (all unequivocally loved their choice) and also if they ever felt any negative side effects like brain fog or reduced immune function (all no). I read lots of reviews from women saying it was the best thing they ever did for themselves. I tried really hard to educate myself and hear both sides. Ultimately, I decided against them because I was ready to go on a journey of self love. So for several years I celebrated my natural, small, deflated goddess breasts that gave milk to 3 beautiful children for a total of 4 years.

As much as I love and appreciate my body for everything it has done, more recently I’ve felt the longing for my boobs of yore. I’ve been missing the fullness, the youth, and the vitality of voluptuous breasts. When my best friend pulled the trigger on her implants, I got to walk with her through her entire journey. I drove her to her surgery and cared for her afterward. I watched her confidence skyrocket. I was so happy for her, and I knew it was my turn.

I chose the same doctor she saw, Dr. Hughes of Synergy in Raleigh, NC. I got to see his work on my friend which gave me a lot of confidence in him. He had also done some other, more minor procedures with me so I knew I could rely on his expert hands for beautiful results.

My goal look was full and sexy but still natural. I wanted to be able to look classy in a dress without drawing the wrong type of attention. My friend, I felt, had gone way too large for her frame so I made sure to tell him that I wanted to stay in proportion to the rest of my body. I’m athletic and enjoy heavy weightlifting, so we decided to go over the muscle. I had plenty of breast tissue from having children to cover the upper pole and make it look natural.

My surgery was this past Thursday. The process was simple and smooth. He took a few photos, marked me up while pointing out parts of my anatomy and explaining how they might influence the outcome, reviewed my wish pics with me and sent me off to the OR. All the nurses at his practice are amazing. I was very comfortable on the warm table, and before I could even close my eyes, I was already being wheeled out of the building by my friend.

We went with a 405cc moderate profile silicone implant over the muscle on my left side, and 445cc on my right (my right breast has always been smaller, and my doctor said the tissue was a bit more restricted than the left as well). I’m very happy with the decision to go over the muscle. I did a lot of research on the two placements. I’m thankful my doctor performs both and suggests the appropriate technique for each individual rather than doing the same procedure for everyone.

I am now two and a half days post op. The healing is going well so far. My right side is a bit angrier than the left because it got a larger implant and was a bit of a problem child during surgery, but it’s nothing major. If this is the worst they’re going to look, I’m freaking stoked. Dr. Hughes gave me EXACTLY what I wanted as far as size and projection. I am absolutely in love with them!
Updated on 5 Oct 2021:
I have seen Dr. Hughes for an earlobe reduction surgery, Bellafill for acne scarring, and a breast augmentation (in that order). I also get my Botox done at his practice. My initial experience with him is what made me feel so confident in choosing him for my breast augmentation. Whenever I would come in for a different procedure, he was happy to talk to me about an augmentation and answer questions until I was ready to book a full consultation.

I always felt like a priority to him. Dr. Hughes has an excellent bedside manner and his knowledge and confidence immediately put me at ease. For the augmentation, he really listened to me. He remembered all the comments I had made about my ideal outcome over the course of an entire year, even before I decided to pull the trigger. Then when the day finally came, it’s like he read my mind in order to give me exactly what I wanted. I am so in love with my new look, and so thankful to Dr. Hughes and his wonderful staff for everything they have given me. I’m a client for life!



Updated on 23 Aug 2023:
It’s been 2 years! I have really enjoyed having breasts. I haven’t experienced any negative symptoms. However, I am getting a revision done in two months for a couple of reasons: 1) the 45cc difference between my right and left breast has become more noticeable over time and I’d like them to be even 2) because I have lower body fat, I have experienced significant rippling all around my breasts from top, sides and bottoms, and 3) I would like to go bigger. I am hoping a larger implant will give me more cleavage and cover this little bare spot on my left side where my chest wall causes the breast to migrate down slightly. Dr. Hughes is confident my issues can be corrected with a little capsule work and different sized implants.

Updated on 24 Aug 2023:
The thought of significantly larger breasts has become more and more appealing to me over the past few days. Initially, I wasn’t sure how large I wanted to go but after surfing RealSelf and seeing the reviews of women who went big (550-750cc) I’m starting to feel super excited about the idea. Surgery is only 48 days away!!

Updated on 29 Sep 2023:
My doctor asked me to upload more photos of my wish breasts. I feel like this website is hard to navigate from my phone so it was taking me forever to find good wish pics. I finally found a surgeon who does a lot of XL implants and was able to pull some photos from her website so here they are.

Updated on 21 Nov 2023:
I finally had my breast revision and implant exchange yesterday. It was actually scheduled for October 12th but I got sick the week before. Feeling like it had cleared up, I went in for my surgery. I did a bunch of research that said a mild cough or slight runny nose would be okay for anesthesia, but it wasn’t. I had bronchospams while anesthetized and had to be pulled from the OR. So we rescheduled for yesterday.

The procedure went well. There was no capsular contracture. Dr. Hughes did some extra work on my left breast to fix the issue with my protruding ribcage on that side, hence why it looks a little different. These pics are only 1 day post-op so there is a good bit of swelling.

We were originally thinking 650cc but once he place the sizers in the OR, he decided to take it up to 745cc which is the largest implant they have in the office. I’m really glad he did because obviously my wish pics convey my desire for XL implants. I feel like they fit my frame extremely well without being cartoonish.

I’m happy we went under the muscle this time as well. I think the look is perfect. I’m in a good deal of pain but I’m managing it with oxycodone and Tylenol extra strength right now.

I’m a massage therapist by trade so I’m taking at least 6 weeks off work to heal and recover.

I had a breast reduction with Dr. Hughes almost a year ago, and it truly changed my life! I am 22 and I had been thinking about having this procedure since 5th grade. I have always had back pain and trouble breathing because of the weight on my chest. It was so frustrating trying to find clothes that fit right, and I was tired of buying clothes sometimes 3 sizes too big because of my chest. When I was 18 I started researching the best place to go. I was so nervous and I had so many questions, but I never felt comfortable enough to ask them at consultations. 

When I was referred to Dr. Hughes I was very nervous because of past experiences. When I got there all of my worries were put to rest. I am the type of person that wants to know everything that could go wrong. He was the only doctor to talk me through any unlikely complications. But with everything that could have gone wrong, he offered a solution. I felt like I was heard, and that truly meant so much to me. He walked me through the procedure and what would happen on the day of. I felt no pressure whatsoever, Dr. Hughes and Nurse Lynn were so genuine, it was truly the best experience. I left feeling so excited about the surgery! 

The day of the surgery I felt more prepared and ready than I thought I ever would. The staff at Synergy made me feel incredibly welcomed and relaxed. Dr. Hughes and Nurse Lynn walked me through the procedure one last time to ensure that I knew everything that was going to happen. What I liked the most was Synergy has an operating room in the office! I was able to do everything at Synergy, and that made everything feel way less scary. I got to walk into the operating room when I was ready and meet everyone who was involved in the procedure. Every single person welcomed me with a smile and introduced themselves. 

I cannot stress enough how much this experience meant to me. Dr. Hughes and his team at Synergy have made such a huge impact on my life. I never would have thought that surgery could be easy, but at Synergy you are truly heard and they really do want the best for you. I want to thank Dr. Hughes and everyone at Synergy for changing my life. If you are thinking about plastic surgery, Dr. Hughes is one of the most talented, compassionate, and attentive surgeons. His attention to detail is hard to come by and it shows through his work. The passion that he shares made it a very easy decision to choose Synergy.

I wish I would have posted before my surgery so I could share my nerves, questions, and the thoughts going through my mind at the time but since my consultation, the surgery, and my healing it just about complete I figured I would write a review about my experience since when I was looking for other peoples thoughts and ideas about the surgery it helped me so much. After my review ill post pictures that I took in order from the consult to the healing status, I am at now, hoping it helps someone! :)
I went to my consultation on June 30th. I was SO nervous. I started out with a very flat, deflated A cup... probably a AA. I have three children and breastfed all of them. My consult was very quick. I knew I wanted my boobs way bigger, D, DD, something around that size. I tried on the sizers and the 300ccs were too small for me. I tried on a 420CC implant and thought to myself...WOAH! I put the implant sizers in my sports bra that I wore to the appointment and after the DR showing me what I could look like with that size on the screen, we decided to go up a little to 415CC.
I made my appointment for July 20th. So I had a little less than a month to wait for the big day. During the time I was waiting for my surgery I started having second guesses on my size. I have had so many friends say they wish they would have gone bigger and this is what I was afraid of. I contacted my Drs office and told them I wanted to see different sizes. I was on this website it seemed like every day looking through photos and reading people's opinions on the sizes they got. After looking through my new "what I could look like pictures" that my Drs office put on my MYTOUCH account. I started leaning towards 450CC and even looked at the 485CC. I had a few friends tell me that those sizes would be HUGE on me and that I would hate it. Deep down I did want my boobs that big but was changing my mind slowly from the advice of a few friends.
My breast augmentation surgery was scheduled for 1:30. I checked in at about 1 pm. I wasn't allowed to eat or drink past a certain time but I have had three c sections so I knew that was coming and didn't mind that part. I go into my appointment and meet with a nurse who gives me new underwear, socks, a cover, and a hat to put on (I even have a picture of that too lol). We go over everything that is or could happen and I am signing away. My DR comes into my room to draw on my chest. While talking to him I told him I wanted to change CCs again. He told me not to get too caught up in the CC number. Before your surgery, you will be looking for "goal photos". What do you want to look like at the end of all this? The size, the shape, and my pictures were pretty much all the same look. Perky...round...big... basically.
It's surgery time and sure enough, my nerves come flooding out of me and I am starting to cry on the table. It was a lot of emotions at this time. I was scared, I was so excited because I have been flat chested my entire life and I couldn't believe this was finally happening. My Dr, Dr. Hughes, and his staff were amazing. They comforted me, they made me feel better, and I knew I was in good hands with them.
The funny part is that when I woke up... the first thing I asked (that I remember) is "how many CCs did you get in" haha. When she replied "We put in 560CC" I passed right back out, I was happy lol
Recovery :
this was the worst part for me. I have had other friends have the same surgery and their experience didn't seem as harsh as mine but this was no walk in the park. I left the surgery center at 4ish and I don't remember much after that. I do remember not being able to even open my eyes until I got home, I just could not wake up. I took my pills and passed out. The first 5 days were absolute hell for me. My chest was so swollen, which I knew would happen. I had bags of ice on top and on the sides just to help with some of the pain. I stayed on top of my pain pills but just one was not working. My DR called me the night of the surgery. Asked how I was doing and let me know I could take 2 pills instead of 1 and that helped a little more but then I added Tylenol into my schedule as well to try and get rid of some of the pain I was enduring.
Getting up was a pain in the ass well. The first few days my husband and my oldest daughter would put their hand under my butt and push me up as I held their hand. This was the only way I was getting out of my bed because my bed is so low to the ground. A few days later I would kind of roll to get out of bed but this hurt until a few weeks after the surgery.
Sitting up while sleeping was HORRIBLE. I had a few pillows behind me and one of those "husband pillows" where there are sides to it and it allows you to be tilted upwards. I had an airplane pillow around my neck. I just could not get comfortable, it was horrible. This was the worst part for me. I am a side sleeper and just wanted to sleep on my dang side!! But doing this hurt so bad. Even just slightly turning my body was a pain.
I am now about 7 weeks post-op and I finally feel good. I really started feeling much better after my 5 days. I didn't have too much swelling. Not much bruising. It was just a lot for my body to get used to. Even though my implants were 560CC I am now a DD. I am so thankful my DR went with what I wanted my pictures to look like because my breast augmentation is exactly what I wanted. This is why the pictures you find are so important. I am so very thankful I didn't listen to anyone about what I should do. If I would have gone with a smaller implant it wouldn't have been what I wanted and I would have been super disappointed. So do whatever makes you happy! If you want big ol' boobies, get them! In my opinion, I rather get a little "too big" than too small.

Updated on 4 Sep 2021:


Updated on 4 Sep 2021:
I’m updating with my pictures since I couldn’t post them in my first post.

Updated on 4 Sep 2021:

Updated on 5 Sep 2021:
Dr. Hughes was amazing. His appointments are quick and to the point. He definitely knows what he is doing. My breast augmentation went so well and they look so perfect, I can't thank him enough. His bedside manner was what really put him at 5 stars. You can tell her cares.



Updated on 22 Sep 2021:
Thought I would update with my 2 month pictures. It seems like it has been way longer but only 2 months.

Updated on 26 Sep 2021:
I added my wish pictures that a few people were asking for! Also a before picture.
I wanted them full, round, and not too extremely high. He did exactly what I had envisioned.

Updated on 6 Nov 2021:
I went bra shopping and ended up with a 32DDD. Could have gone with a 34DD but needed the band to be smaller. This will probably be my last update for a while. They are pretty much in their spot they will stay in. I’m super happy with them and I hope these reviews helps others! I’ll probably update again around 6 months or so. I have just been wearing of free sports bras, thin tanks, or no bra at all. By 2 months I was pretty much back to normal! My size was definitely not too big and I wouldn’t have been mad if they were even a little bigger. Hope this helps :)

Updated on 14 Jan 2022:
I am officially 6 months post surgery me this will be my last review. I can do everything I could do before. I love how they turned out! Hope my review helps someone =]