Breast Augmentation

You deserve to love your body, and we can help you achieve that goal. If your breast size has never been what you would like, or the size and shape of your breasts has changed with age or after pregnancy and nursing, breast augmentation may be an excellent path back to confidence. We have mastered the art form of body transformations through breast enhancement, and we are happy to share details of this procedure with you.

What is Breast Augmentation?

Breast augmentation is a popular cosmetic breast procedure that is performed to increase the size and shape of the breasts using FDA-approved implants, silicone sacs filled with either saline or silicone.

Saline breast implants are approved for use in women over the age of 18. The silicone shell is un-filled when placed beneath tissue, then filled with a sterile solution. One of the reasons that women may choose saline implants is the perception of safety. The liquid, if it does leak, is naturally expelled by the body. However, the consistency of the saline fluid may affect the natural feel of the breasts.

Pre-filled silicone gel implants are approved for patients age 22 and older. The viscosity of the gel within the silicone shell is denser than a saline implant, and thus tends to feel more natural to the touch. The most cohesive of the various types of silicone gel implants is referred to as the “gummy bear” implant.

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Breast Augmentation Candidates

There are several reasons that women may choose to have breast augmentation surgery. One is that their natural breasts are small. Breast augmentation is also beneficial for women whose breasts have lost fullness and shape after pregnancy and nursing. Implants placed either beneath superficial tissue or beneath the muscle can correct the appearance of asymmetry from one breast to the other and, finally, breast augmentation may be a vital aspect of reconstruction after breast cancer treatment.

During your consultation with Dr. Fisher, all of your options will be discussed. If you’re uncertain about the exact look you desire, observing images in our Before and After gallery can aid in your decision. We will do this with you here in the office so that we may guide you in looking at images that resemble your natural anatomical shape.

The goal of breast augmentation surgery is to enlarge the size of your breasts, and to create a shape that suits your body structure. Working together, we can help you realize your best body.

Breast Augmentation Procedure

Breast augmentation involves the placement of the selected implant beneath either breast tissue or beneath muscle. To situate the implant, a pocket is made in the appropriate area. Once the implant is placed or filled, the small incisions are closed. During your consultation, we discuss your preferences in the type of incisions used for your procedure.

Important considerations in breast implant surgery:

  • Your body frame. A certain type of breast implant or cup size will look entirely different from woman to woman based on her height, weight, and frame.
  • Natural breast shape. The shape of your breasts is determined by factors such as the diameter of your chest wall and the amount of existing breast tissue, as well as any amount of asymmetry. These factors do not change when implants are in place, though the shape of your breasts may improve.
  • When you look closely at one breast compared to the other, you may notice asymmetry, or imbalance. One breast may be slightly larger or it may have a different shape. We do our best to counteract asymmetries when we can. However, it is important to know that some degree of differential from breast to breast may remain, or may even become more pronounced.
  • Natural breast size. Your existing structure will dictate the range of implant sizes that would be appropriate for your frame. This is more about the ability of your skin and connective tissue to accommodate the implants than about proportion. Also, cup size is not an accurate measurement of what is possible with breast augmentation, so we do not use this as a guide.
  • Breast position. Breast augmentation enhances the shape and size of the breasts, but it does not affect positioning. If breasts have become saggy, mastopexy, or breast lift surgery, may be performed either as an alternative to or in combination with breast augmentation.

Crisalix 3D Imaging for Breast Augmentation

Dr. Orna Fisher uses 3D imaging technology for patients looking to undergo breast augmentation. Dr. Fisher is now a Crisalix surgeon, using the 3D simulation for patients to get a visual of what their breast augmentation results will look like. This technology is use during the consultation process to help patients experience their post-operative results before they have their cosmetic surgery procedure.

How long do breast implants last? 

Breast implants can last from 10 years on up to a lifetime. There is no strict guideline for replacement. The primary reason that replacement would be necessary at any point in time would be implant failure, such as leakage or rupture. In some cases, a woman chooses to have implants replaced for personal reasons such as changes to the shape of breasts due to aging or pregnancy. Also, there are cases in which a revision surgery is requested in order to decrease breast size, replacing large implants with a smaller size.

What is the difference between saline and silicone implants?

Saline implants are empty silicone shells that are filled during augmentation surgery. This type of implant deflates over time, at a rate of about 1% each year. Also, because saline is a watery consistency, this type of implant may feel more obviously unnatural to the touch.

Silicone implants are pre-filled to specific sizes. The viscosity of the silicone that is held within the implant shell may feel more like natural breast tissue. Also, because silicone is more cohesive, this type of implant is better at retaining its shape. There are different consistencies available today, with the most cohesive referred to as the gummy bear implant.

Is there a “best” position for breast implants?

Breast implants may be positioned either above the pectoral muscles, or beneath them. Sub-muscular placement holds the advantage of disguising minute imperfections in implants, and a decreased risk of capsular contracture (implant hardening). However, sub-muscular implants will move when the pec muscles move; so raising your arm, for instance, could cause slight movement in the breast. Any type or shape of implant can be placed in either position. During your consultation, Dr. Fisher will discuss your lifestyle habits and personal preferences in order to assist you in determining the best position for your implants.

What are the different coatings for implants?

Implants may be textured or smooth. A large majority of breast augmentation procedures involve sub-muscular placement, which has a lower rate of capsular contracture. For this reason, smooth implants are sufficient for the desired result. Several years ago, textured implants, which feel like soft sandpaper on the outer shell, were developed to mitigate the risk for implant hardening. The texture on the shell causes the implant to attach to surrounding tissue, whereas smooth texture does not. The cases in which textured implants are most often used is when a patient chooses a shaped implant, such as a teardrop, versus the standard round implant.

Breast Augmentation Recovery 

Immediately after breast augmentation surgery, a compression garment will be applied. This garment will need to be worn for several weeks in order to support healing tissues and manage post-operative swelling and bruising.

Antibiotics may be prescribed, as well as pain medication. It is important to follow the dosing instructions on medications and not wait to see how pain feels. Typically, a large degree of discomfort subsides in the first 48 hours after breast augmentation.

While it is important to resume physical activities as your doctor clears you, walking should be a normal practice starting immediately after surgery. Walking short distances throughout the day minimizes the risk of blood clots forming in the legs due to inactivity.

Breast Augmentation Results

The results of breast augmentation surgery become more apparent as swelling subsides and the implants settle in their pocket beneath the muscle or breast tissue. At first, breasts may have a higher profile and firmer shape. This will diminish to a natural resting place and softer feel as tissues around the implant heal.


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Schedule a Consultation

There are numerous aspects of breast augmentation surgery to discuss, from the placement of incisions to the general risks of surgery to what you can expect during recovery.

If you’re ready to maximize your shape, we should talk! Call to schedule your appointment at our office in Palo Alto, CA at ‭650.321.2629‬.

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