Breast Enlargement Surgery Options

I read a bunch of great doctor posts on hear for breast enlargement. one thing I can not find is a really simple explanation of options, like a numbered list. I really do appreciate you doctors taking time to help us! ~Alice

Doctor Answers 11

Breast Augmentation Options?

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Thank you for the question.

Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” and "feel" will be optimal.

2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.  Make sure you're working with a well experienced board-certified plastic surgeon.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.

4. The size and model of breast implant used may  make a  significant difference in the final outcome,  including the presence of rippling/palpability  of the implants.

I hope this helps.

Breast implant question

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I would have you review the breast implant options at the web sites of Mentor or Allergan so you can empower yourself with the knowledge to decide what may be best for you. Surgeons have different opinions on what is best. In my hands young healthy females usually select an arm pit incision (so no breast scar) and I use smooth moderate plus saline implants under the muscle. Good luck and please see a board certified plastic surgeon for consultation.

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 62 reviews

Options for enlarging the breast

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OPTIONS  1) implant vs no implant

                    2) Implant: Saline vs silicone implant

                    3) Implant above  or below the muscle

                    4) No implant: your own fat transfer: somewhat controversial

Obviously there are a lot of details involved.  Talk to your board certified Plastic surgeon.

All the best,

Talmage J. Raine MD FACS

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon

Breast Enlargement options

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Dr. Rasmussen gave such a thorough answer that I don't have much to add, but I will reinforce a few points.  Given the wealth of information on the internet, it is tempting to go to your consultation with a preconceived idea of the size  and style implant that you want based on images you have seen online.  I would advise you to find a really good PS who will spend time finding out what your goals are, doing a thorough examination and then make recommendations based on YOUR exam and your wishes.  The implant that works great for a friend may not be the right size and style for you. 

Just to be complete, since you asked about all breast enlargement options, fat transfer is worth mentioning.  While it isn't for everyone, for some patients using your own fat to enlarge the breast is a consideration for some women. This avoids  the use of an implant, and you also may appreciate the liposuction that is necessary to harvest the fat for fat transfer.  The amount of enlargement that can be achieved is somewhat limited, however.  Best of luck.

Laurence Weider, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 102 reviews

Breast implants best answer for breast enlargement

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If one is self conscious about the size of one's breasts and desires larger breasts, I think breast implant surgery is the best option.  I do not think that suction applied to the skin of the breasts work.  I do not think that exercise to enlarge the pectoralis muscles really works that well either.  Definitely, I would not recommend injecting a foreign material into the breasts to enlarge them.  Injection of one's own fat may work but I believe the fat gets absorbed over time.  Therefore, breast implants are the best option.  They are safe and generally permanent.  One can breast feed afterwards.  Mammograms and self examination can be done afterwards for early detection of breast cancer.  Implants do not cause breast cancer.  They come in a variety of sizes and shapes.  I recommend a consultation with a board certified plastic surgeon to determine the best option for you.

James Tang, MD
Houston Plastic Surgeon
3.4 out of 5 stars 18 reviews

Breast Enlargement Options Made "Simple"

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Here's a "simple" numbered list of options for breast augmentation.

1.  Incision: inframammary fold / periareolar /  transaxillary (armpit) / "TUBA" (bellybutton)

2.  Pocket:  submammary / subpectoral

3.  Implant type:  saline / silicone gel

4.  Implant surface:  smooth / textured

5.  Implant shape:  round / anatomic (teardrop)

6.  Implant projection(profile):  low / moderate / high

7.  Implant size: too many to list

8.  Implant manufacturer:  Mentor / Allergan

9.  Inherent risks of implants:  rupture / capsule contracture

Although this may seem "simple" there are pros and cons to each of those items listed, which is why  it is difficult to "make it easy".  As ethical plastic surgeons, we are obligated to discuss all of those things with our patients so you can make an educated decision.  I guide my patients to what I believe clinically will be the best option for them, but they are an integral part in the decision making process.  Of note, many of my recommendations are based on the individual's anatomy, so while a smooth, round, moderate profile saline implant beneath the pectoral muscle may be a perfectly fine option for one woman, it may be a poor choice for someone else. A thorough consultation including your desires, medical history, exam, options, anticipated results, limitations, risks, and recuperation are all necessary before scheduling surgery. Final details including size can be confirmed at your preoperative office visit.  Remember one important detail about breast augmentation...the general shape of your breasts prior to surgery will be similar afterward, merely an enlargement of that shape. Good Luck!



Jana K. Rasmussen, MD
West Palm Beach Plastic Surgeon

Breast augmentation and - decisions, decisions!

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Alice, your options are as follows:
Saline or silicone
Under or over the muscle
Incision choices – such as under the breast or around the nipple
Size and style of implant

Your most important “option” or choice however is picking your surgeon. Experience matters! Choose a board certified plastic surgeon and he/she will help you with this very important decision.  Best of luck.

Breast Augmentation Questions and Options

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Some of the options to consider are saline vs. silicone implants, smooth vs. textured implants, submuscular vs. subglandular implant placement, and incision location.  You will also want to discuss implant size, and perhaps try on some implants at your consultation.

Andrew P. Giacobbe, MD
Buffalo Plastic Surgeon

Breaast surgery options and my preferences

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Implant size is a complex decision process determined based on your desires, anatomy, practicality, availablility, picture review (i.e., Nicole's site), etc. This is usually determined at the time of the initial consultation but may need to be adjusted intra-operatively.

As of November of 2006, women over the age of 22 years old are eligible to receive silicone breast implants under the guidelines established by the FDA. This requires you to review and complete prepared materials and informational brochures.

Surgery is about 1-2 hours but the entire process takes about five hours and is performed on an outpatient basis.

I generally prefer smooth implants placed under the muscle using an incision around the areola or under the breast. Although I was trained using the axillary incision (armpit), in my experience I generally do not use it because: 1) if the scar is bad it is very visible in a t-shirt or bikini whereas a breast scar is not and 2) there is more bruising and 3) there is a higher risk of asymmetry.

The TUBA (transumbilical approach) is attractive because of the location of the scar but it is generally used to place implants in the subglandular (not submuscular) position and I prefer the submuscular approach. I have found that the submuscular location results in: 1)more tissue covering the implant for a more natural look 2) improved mammograms when compared to the subglandular implants and 3) decreased rate of capsular contracture. I reserve the textured implants for patients with capsular contracture or in patients with significant breast tissue and ptosis requiring a subglandular placement. Anatomic implants may sound sexy but they are textured (and more likely to be palpable); they have also rotated resulting in an abnormal look. I generally avoid these but use them for breast reconstruction. 

There are risks to crossing the street or flying in an airplane and, of course, there are risks to any surgical procedure. These risks can occur regardless of surgeon or technique. These include but are not limited to: infection, hematoma, discomfort, wound breakdown, hypertrophic scar formation, asymmetry, unfavorable healing, implant infection exposure, rupture, deflation, palpability, visibility, distortion with muscular contraction, capsular contracture, interference with mammography or surgical evaluation of breast masses, interference with nipple sensation with nursing and aging, need for secondary surgical revisions, and inabiltity to guarantee a specific cosmetic result. Although many other claims of diseases associated with silicone breast implants have been reported these have not been substantiated by major studies.

We generally recommend that you take a week off work and avoid strenuous physical activity for three weeks. Certain dressings may be required during this time. You will be instructed in breast implant exercises.

The surgery can be done in several different places (hospital, office surgical suite, or surgicenter) and the prices vary accordingly with the last being the most affordable.

Although I understand your desire to obtain the price; I can't give you a fixed price for several reasons. Prices depend on:

  • What kind of implant do you want? (range anywhere from $400 up to $2000)
  • Do you want it performed in an office, surgicenter or in a hospital setting?
  • Do you want a nurse, a surgeon, or a Board Certified Anesthesiologist to perform anesthesia?
  • Do you want me to provide you with dressings & garments or do you want to buy them?
  • Are there consultation fees or charges for postoperative visits?
  • Do you want a pain pump?
  • Would you like an extended warranty on the implant?

Depending on these factors Breast Augmentation can range anywhere from $4000 up to $10,000. Think about it and make the right choice. For your information our typical costs averages about $6000-7000 and include surgeon's fees (initial consultation, accredited outpatient surgicenter, saline filled smooth round implants, certified anesthesiologists, post-operative visits and initial garments and dressings). Silicone implants tend to add an additional $1000 to the fees. Many other options are available and prices do vary accordingly.

We use financing through a lending institution. Your rate depends upon your credit rating and generally averages about 14.9%. Arrangements for the financing are carried out exclusively between you and the finance company. Your terms of payment can be flexible. However, we do expect you to pay prior to scheduling surgery.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast Augmentation Options - Questions about breast Implants

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You are very wise to be asking many questions prior to a consultation for breast augmentation surgery

There are many different considerations for women considering breast augmentation surgery. The following is a partial list of considerations

Cohesive silicone gel vs. saline breast implants

How many cc's? - deciding on implant volume

Incision locations

Subpectoral vs prepectoral implant position

Breast augmentation after pregnancy

Special considerations: asymmetry, tuberous/constricted breasts, etc

Recovery and downtime

Avoiding capsular contracture

Breast augmentation alone or breast augmentation with breast lift

Most importantly, selecting the right plastic surgeon for your breast augmentation surgery

Take time researching the websites of any plastic surgeon you are considering trusting with your well-being and appearance.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.