What is Breast Augmentation?
If you are unhappy with the size of your breasts and are looking for enhancement, we offer breast augmentation for our patients in Washington D.C. and surrounding areas. Breast augmentation is a surgical procedure that uses silicone gel or saline breast implants to enhance the size and shape of your breasts. All of our Board Certified Plastic Surgeons at West End Plastic Surgery work closely with you to ensure your breast augmentation goes smoothly.
Ideal Candidates for Breast Augmentation
If you are in good health and have realistic expectations regarding the results of your breast augmentation surgery, you are an ideal candidate for the procedure. Although surgery can enhance the size and shape of your breasts, it is important to understand the limitations of the breast enhancement procedure.
At our Washington, D.C. office, our surgeons thoroughly discuss the procedure, along with its limitations, during your initial consultation. Some women who want breast implants to restore volume lost after having children may combine breast augmentation with other procedures as part of a Mommy Makeover.
If your breasts are sagging due to pregnancy, weight loss, aging, or loss of muscle tone, a breast lift, or mastopexy, can be performed to enhance your breast augmentation.
Benefits of Breast Augmentation Surgery
Women choose to have breast augmentation for many reasons. Breast surgery can:
- Enlarge your breasts to a more desirable size
- Correct a noticeable imbalance in the size of your breasts (asymmetry)
- Correct sagging or ptotic breasts
- Reconstruct one or more breasts after breast surgery
What Our Patients Say
“My first experience with Dr. Ruff was in 2014, when I had a consultation regarding Breast Enhancement. He was very professional and really took the time to listen to what I was looking. I was surprised on how comforting his approach was and how he explained my options so thoroughly. I had my breast augmentation later that year and am still so thrilled with the results! I would highly recommend him for ALL THINGS RELATED TO COSMETICS.” – Ashley L.
Breast Enhancement Consultation
Prior to scheduling your surgery, your surgeon and our staff will meet with you for a thorough consultation. We will evaluate your breasts and discuss how you want them to look after the procedure. With the guidance of the staff at West End Plastic Surgery, you will decide the type of implants to be used, as well as their size, position, texture, and shape.
Your surgeon and staff will:
- Review the various breast augmentation options with you
- Clearly discuss the potential risks of the procedure
- Outline in detail how we perform the surgery and what you can expect before, during, and after the procedure
- Provide detailed cost and payment information
- Discuss current FDA regulations governing the use of implants
- Answer all of your questions
You will need to provide:
- Details about your medical history
- A list of all medication you currently take, including over-the-counter medications such as aspirin, vitamins, and herbal supplements
- Information regarding your tobacco and alcohol use
Before & After Breast Augmentation
What Type Of Implants Should I Get?
Silicone Vs. Saline Breast Implants
All breast implants available in the U.S. today have a silicone outer covering called the shell. The choice comes down to the fill material, which can either be saline (a sterile saltwater solution) or silicone. The following table answers common questions for each type of implant.
When Are They Filled?
Filled after placement, so the volume can be adjusted and incisions can be tiny
Pre-filled and therefore require slightly larger incisions than saline
How Old Do I Have To Be?
At least 18, or any age for breast reconstruction
At least 22, or any age for breast reconstruction
What Do They Feel Like?
Firmer than silicone
Soft, doughy, and more like real breast tissue than saline
What Makes These A Good Choice?
If you want the smallest incisions or have sufficient breast tissue to cover the implant
If you have very little breast tissue, are thin, or want to minimize rippling
What Happens If There Is A Leak Or Rupture?
May not deflate at all and require an MRI to detect
What Makes These A Good Choice?
About $1,000 less than silicone
About $1,000 more than saline
Silicone Implant Options
Silicone implants continue to increase in popularity whether for primary breast augmentation or an elective implant exchange through revision breast surgery. West End Plastic Surgery offers only FDA-approved silicone breast implants, which generally fall into the following 2 categories according to their consistency:
- Cohesive silicone gel brands including Allergan Natrelle® and Mentor MemoryGel® feel soft and pliant, and they hold together even when cut (see image).
- Highly cohesive or form-stable silicone implants (also called “gummy bear” implants) such as Sientra® Silimed-brand, Mentor MemoryShape®, and Allergan Natrelle® 410 shaped implants feel soft and slightly firmer than cohesive silicone gel implants, and they retain their shape better when the patient is standing upright (see demonstration video).
See how a Mentor MemoryShape highly cohesive breast implant holds together when cut.
What Is The Right Size Implant For Me?
One of the first things women ask about when choosing breast implants is which size is right. Your surgeon will make the decision easy and often a fun process! They can help you figure this important choice out using several different approaches:
- Reviewing photos of women who are the size you want to be.
- Using a 3-D imaging software system that takes digital images of you and creates a simulation of what you might look like with various types and sizes of implants.
- Providing breast implant “sizers” for you to try on. These are like temporary silicone implants of varying sizes that can be placed into a stretchable bra and worn under a fitted, solid-color T-shirt. It’s a good way to visualize how you might look in clothes.
Once your surgeon has a clear understanding of the size you want to be, he or she will determine the implant size that will get you there, taking in account your existing breast tissue, breast skin, and chest wall anatomy.
Profile & Projection of Breast Implant
Both saline and silicone breast implants are available in various profiles, also called projections. An implant profile is a term that describes the width and depth of the implant. A low-profile implant (top) is wider and flatter than a high-profile implant (bottom), which is more narrow and projects farther (is deeper from front to back). Depending on the implant brand, there are other projections that fall in between the high and low profiles.
These options enable Dr. Ruff to help you attain your desired breast shape in a way that fits naturally with your unique breast anatomy, the width of your chest, and the way your breasts sit on your chest. Properly chosen, the right implant profile can enhance your breasts in the way you want, such as increasing fullness at the top of the breasts or filling out the cleavage between the breasts.
Breast Implant Shape
Another option for both silicone and saline implants is the shape, which can either be round or shaped (also called anatomical, teardrop, or contoured). Round implants increase overall breast fullness and are a popular choice. Teardrop implants reflect a natural breast shape with a gentle slope and more fullness at the bottom.
Breast implants are made with either smooth or textured surfaces. Smooth implants can slide around freely in the implant pocket. Textured implants are made to help the body to adhere to the implant surface and prevent the implant from shifting. Because shaped implants must be oriented with the narrower end at the top of the breast, they are made with textured surfaces. Round implants are available with textured surfaces as well, which may prevent a complication called capsular contracture.
Breast Augmentation Procedure
Your breast augmentation procedure will be performed in our state-of-the-art surgical suite or at one of the area hospitals where our surgeons operate. Dr. Ruff, Dr. Ramineni, Dr. Hannan and Dr Patrick and their staff are dedicated to ensuring your complete comfort during and after the procedure. The surgery generally takes 1 to 2 hours to complete. It is performed under general anesthesia.
During the procedure, the surgeon makes a small incision in each breast area in order to insert the implants. Your individual anatomy determines the best place for incisions. Your surgeon will make every effort to place the incision in a way that minimizes any resulting scars. Once the incision is made, your surgeon lifts the breast tissue and skin to create a pocket to hold the implant. The pocket will be either directly behind your breast tissue or beneath your chest wall muscle.
Either silicone or saline implants will be centered beneath the nipple. They may use an innovative device called the Keller Funnel™ to insert the implants. This device, which looks much like a pastry bag, enables them to minimize the incision size and insert the implants without touching them or using force.
Your surgeon may inject a local numbing medication called EXPAREL® into the surgical areas to provide pain relief after surgery for approximately 72 hours. The incisions are closed and may be taped to add support. A special surgical bra placed over the breasts keeps them in the best position for healing.
Breast Augmentation with Silicone Implants by Dr. Paul Ruff
Breast Enlargement with Fat Transfer
An increasingly popular option for breast enlargement is using fat taken from other areas of the body to enlarge the breasts. Our Board Certified Plastic Surgeons expertise in this fat transfer technique offers their patients a soft, natural alternative to breast implants.
The procedure, sometimes called fat grafting, is a 3-step process completed during a single operation that takes up to 2 hours. Fat transfer breast augmentation includes:
- Liposuction to collect the fat from another area
- Purifying the fat
- Injection into the breasts
All of our surgeons use a liposuction technique called VASERlipo™ that is ideal for harvesting fat in grafting procedures. This precise and gentle approach to liposuction excels at preserving the viability of the fat cells once they are injected into the breasts. Your surgeon will use a microcannula – a specialized instrument – to perform dozens of tiny injections, layering the fat so that the results look beautifully natural.
A good candidate for this natural approach to breast augmentation desires a modest increase in the size of her breasts. For example, a patient who wants to increase from an A cup to a B cup would benefit from the fat transfer technique. Patients who want a larger boost are better candidates for implants or serial fat grafting procedures. The best way to know if fat grafting is a good approach for you is to consult with your surgeon.
Patients recovering after fat transfer breast augmentation experience some discomfort in the area of the body where the liposuction is performed. Otherwise, the recovery is generally quite comfortable, and most patients return to work or their regular activities within a few days.
Dr. Ruff Discusses Fat Transfer Vs. Implants
Recovery After Breast Augmentation Surgery
In most cases, patients are ready to go home shortly after the procedure. Because you may be a bit sleepy after the anesthesia and will experience a good deal of soreness in the area of your incisions, it is important for someone to drive you home after your surgery. You may also want to have someone stay with you for the first few days after the surgery.
During the first 24 to 48 hours after your procedure, you will feel tired from the anesthesia and sore from the surgery. Your plastic surgeon will prescribe pain medication to alleviate much of your discomfort, which usually improves rapidly after the first 2 days.
You can take a shower or bath the day after your surgery; however, don’t let the bandages covering your incisions get wet for more than a minute or so. You can remove the special elastic bra (placed over your breasts after the surgery) during your shower or bath, but it must be worn at all other times (even while sleeping) for the first 2 weeks after your surgery.
If gauze dressings have been placed over your breasts during surgery, they will be removed after a few days. Your first post-operative visit usually takes place 2 to 3 days after surgery. Subsequent visits are scheduled every 1 to 2 weeks for the first 6 weeks and then every 1 to 2 months for the next 6 months. In addition, a massage program will be demonstrated at the first or second post-operative visit. This program is to help ensure implants remain soft and should be performed 4 to 5 times a day for the first 6 months after surgery.
Guidelines For Your Breast Surgery Recovery
Everyone heals at different rates and you are the best judge of when you are ready for certain activities. Here are some general guidelines:
- You can most likely return to work or school within 3 to 5 days after your procedure unless your work is strenuous.
- You can resume driving as soon as you can turn the steering wheel without pain, usually within a week for cars with power steering and a little longer for manual steering.
- Two weeks after surgery, you can begin to sleep without the special elastic bra you’ve been wearing. However, you should continue to wear this bra during the day for 4 to 6 weeks after your surgery, unless otherwise instructed by your surgeon.
- When you begin to wear your own bras again, you will probably be more comfortable wearing a bra without underwire support until your incisions are healed.
- You should always wear a bra, except while sleeping, for 4 to 6 weeks following your surgery. At your follow-up appointment, the doctor will let you know when you can begin to go without a bra.
- Strenuous exercise can begin about 3 weeks after surgery. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
- The scars on your breasts should be protected from sunlight for at least a year after surgery.
Breast Augmentation Results
Results of your breast augmentation are long-term. However, keep in mind that as your body ages, your breasts may sag somewhat and the skin may wrinkle over time. Many patients wish to have their implants adjusted over time to maintain as youthful a figure as possible, but this is not a necessity.
Risks of Breast Surgery
Like all surgical procedures, there are risks with breast augmentation. During your pre-surgical consultation with your surgeon, we will assess and discuss your individual risks and determine if you are a good candidate for breast augmentation.
As with any surgery, you can help reduce the risks associated with your breast augmentation by closely following the instructions provided to you by our staff. Your surgeon and their team will be with you every step of the way to ensure a safe and pleasing outcome.
Will Insurance Cover My Breast Surgery?
Except in cases of reconstruction, breast augmentation is considered a cosmetic treatment and, therefore, is not covered by your insurance. You are responsible for the full payment for your procedure. Cost and payment information will be discussed in detail with you during your initial consultation.