Breast augmentation is a surgical procedure that uses a silicone gel or saline breast implants to enhance the size and shape of your breasts. Dr. Paul G. Ruff IV, M.D., F.A.C.S. works closely with you to ensure your breast augmentation goes smoothly.
If you're in Washington, D.C. and breast augmentation, is something you're considering, request a consultation online to meet with Dr. Ruff, or call his office at (202) 785-4187 to schedule a consultation.
Why Breast Augmentation?
Women choose to have breast augmentation for many reasons:
- To enlarge their breasts to a more desirable size
- To correct a noticeable imbalance in the size of their breasts (asymmetry)
- To correct sagging or ptotic breasts
- To reconstruct one or more breasts after breast surgery
Before & After Breast Augmentation
For more photos of our patients, please view our photo gallery.
Are You a Good Candidate 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 his Washington, D.C. office, Dr. Ruff thoroughly discusses 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.
Your Consultation With Dr. Ruff
Prior to scheduling your surgery, Dr. Ruff and his staff at will meet with you at length. We will evaluate your breasts and discuss how you want your 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.
Dr. Ruff and staff will:
- Review the various breast augmentation options with you
- Clearly discuss the potential risks of the procedure
- Outline in detail how the surgery is performed 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 be asked 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
Paul G. Ruff IV,
Personalized, compassionate patient care is the foundation of West End Plastic Surgery's philosophy. Our board-certified surgeon, Dr. Paul G. Ruff IV embraces innovative techniques to ensure our patients get the best treatments available.Meet Dr. Ruff Request a consultation
How Breast Augmentation Is Performed
Your breast augmentation procedure will be performed in our state-of-the-art surgical suite or at one of the area hospitals where Dr. Ruff operates. Dr. Ruff and his 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.
The doctor makes a small incision in each breast area in order to insert the implants. Your individual anatomy determines the best place for incisions. Dr. Ruff makes every effort to place the incision in a way that minimizes any resulting scars.
Once the incision is made, Dr. Ruff 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. He may use an innovative device called the Keller Funnel™ to insert the implants. This device, which looks much like a pastry bag, enables him to minimize the incision size and insert the implants without touching them or using force. Dr. Ruff 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.
Fat Transfer Breast Augmentation
An increasing popular option for breast enhancement is using fat taken from other areas of the body to enlarge the breasts. Dr. Ruff's expertise in this fat transfer technique offers his 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
Dr. Ruff uses 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. Dr. Ruff uses a microcannula – a specialized instrument – to perform dozens of tiny injections, layering the fat so that the results look beautifully natural.
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.
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 Dr. Ruff.
What to Expect During Breast Augmentation Recovery
|Shower or Bath||Day After Surgery|
|Back to Work||Few Days After Surgery|
|Driving||Usually Within a Week After Surgery|
|Physical Contact With Breasts||3 to 4 Weeks After Surgery|
|Strenuous Activity||3 Weeks After Surgery|
|Fading of Scars||Several Months to 1 Year|
Immediately After Your 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.
The First 24 to 48 Hours After Your Surgery
During the first 24 to 48 hours after your procedure, you will feel tired from the anesthesia and sore from the surgery. Dr. Ruff prescribes 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.
The First Two Weeks After Surgery
You will notice a marked improvement in your comfort level during the first few weeks after your surgery. Some things to keep in mind include:
- Any bruising you experience will usually disappear in about 2 weeks
- Some patients experience a burning sensation in their nipples, which generally disappears within 7 to 14 days after surgery
- Your stitches will be removed within 10 to 20 days after surgery
- You should sleep on your back for the first week after surgery to help keep your implants in the best position possible during initial healing. Placing pillows on either side of your body often helps ensure that you do not roll onto your side while sleeping.
During the first 2 weeks after surgery, you should also:
- Wear the specialized elastic bra at all times, even while sleeping, to help hold your breasts in the correct position. You may take the elastic bra off to shower or bathe, but must put it back on immediately after drying off. If the bra is too tight, call Dr. Ruff immediately – bras that are too tight can cause skin problems.
- Avoid heavy lifting and straining for at least 2 weeks.
Resuming Your Normal Routine
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 Dr. Ruff.
- 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.
Things to Be Aware of After Your Surgery
Your breasts may heal at different rates. One breast may swell, one may feel less comfortable, or the shapes of your breasts may look different. This is normal. However, when your body is fully recovered your breasts will look very similar and natural.
You may hear or feel a "sloshing" sensation after surgery. This is not the implant; it is fluid that has accumulated in the area around the implant immediately after surgery. Your body will naturally absorb this fluid within a few weeks.
The skin of your breasts may appear shiny due to swelling. Within a few weeks, the swelling will disappear and the skin will return to a normal appearance.
What Are Possible Side Effects or Risks?
Like all surgical procedures, there are risks associated with breast augmentation. During your pre-surgical consultation with Dr. Ruff, your individual risks will be assessed and discussed and it will be determined 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. Dr. Ruff and his staff will be with you every step of the way to ensure a safe and pleasing outcome.
How Long Will the Results of Your Breast Augmentation Last?
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.
Questions You May Have
Are there other procedures that could be done along with breast augmentation to enhance the size and shape of my breasts?
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.
Will my insurance coverage pay for my breast augmentation 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.
Are there alternatives to breast augmentation surgery?
Currently, no other intervention exists that provides the results possible with breast augmentation. The Brava® system uses suction and time to "grow" more breast tissue. Reports have noted minimal to modest improvements, but long-term implication and stability are, as yet, undetermined.