What is breast augmentation surgery?
Breast augmentation surgery, also known as augmentation mammoplasty, breast enlargement, or breast enhancement, is one of the most frequently performed cosmetic surgery procedures in the United States.
Breast augmentation increases or restores breast size using silicone gel implants, saline implants, or fat transfer. Breast enlargement with implants has a long and proven history of satisfying women who want to enhance or restore balance to their figures. See Dr. Restifo’s Breast Augmentation Before & After Gallery here.
Please note: Although many doctors perform cosmetic procedures, you need to know that plastic surgeons, facial plastic surgeons, and cosmetic surgeons are not the same thing, plus board-certification matters. Learn more about specialization here. Also be sure to watch the video: How to Avoid Unqualified Practitioners.
Dr. Restifo is a Harvard-educated, board-certified plastic surgeon with over twenty-five years of experience performing surgery with excellent results. He does breast augmentation procedures (sometimes combined with a breast lift) two or three times a week on average.
Watch Real Patient Testimonials!
Watch our videos “Which is the Better Implant: Saline or Silicone?”, “Breast Augmentation for Extremely Fit Women“, “How Do I Figure Out the Implant Size That Will Work for Me?” and “Straight Talk About Shaped Implants“.
Am I a good candidate for breast augmentation?
The most common reasons why people consider breast augmentation include:
- You feel your breasts are too small for your body frame
- You want a firmer, fuller, or better-proportioned figure
- Your breasts have lost volume and firmness due to pregnancy, age, or gravity
- The size and/or shape of your breasts have been negatively affected by weight loss
- Your breasts are noticeably different in size and you want to restore symmetry
- You feel self-conscious wearing a swimsuit and form-fitting outfits
You are likely a good candidate for breast augmentation if you are in good health and have realistic goals and expectations.
Dr. Restifo’s Approach to Breast Augmentation
Fully Customizable Breast Enhancement
We know that every woman is unique in both her desires and her body shape. With that in mind, we take the time during the pre-operative consultations to learn what each patient hopes to gain from breast augmentation surgery and to decide which implant type and implant placement is best for her. In this way, every one of our patients enjoys completely customized treatment designed with her specific goals in mind. We use Vectra® 3D imaging to make it easy to envision possible results.
Dr. Restifo and his staff aim to ensure your experience is as safe and as comfortable as possible, and that you receive the best possible results. See Our Before & After Gallery here.
Breast augmentation can achieve dramatic and beautiful results on its own as well as in conjunction with other cosmetic surgery or non-invasive procedures. Sometimes combining breast augmentation with a breast lift will yield more satisfying results.
Frequently Asked Questions – Breast Augmentation
A.There have never been more choices for breast implants. Specific implants will be suggested based on your body shape, medical history, lifestyle, and beauty goals. The following options are available for augmentation:
- Saline-filled breast implants are filled with sterile salt water. They are filled at the time of surgery to allow for a shorter incision and for minor modifications in implant size.
- Silicone-filled breast implants are filled with soft gel and are available in a variety of shapes. All silicone breast implants are pre-filled and may require a longer incision for implant placement.
- The IDEAL IMPLANT is a new structured implant that has a series of implant shells nested together and two separate chambers that hold the saline. This internal structure controls movement of the saline and supports the implant edges to reduce folding and wrinkling. The IDEAL IMPLANT has been in clinical use since 2009 and combines the natural feel of a silicone gel implant with only saline inside for safety and peace of mind. Learn more about the IDEAL IMPLANT. *IDEAL implants are not currently available.
- Cohesive gel silicone implants, also known as “gummy bear” or “form stable” implants, are filled with a cohesive silicone gel which makes them feel thicker and firmer than traditional silicone implants. This enables them to retain their shape better.
- Shaped implants, also called “teardrop” or “anatomical” implants have less fullness in the upper part and more fullness in the lower part, mimicking the shape of a real breast. They have advantages and disadvantages compared to other implants. Watch Dr. Restifo’s video “Straight Talk about Shaped Implants” to learn more.
- Autologous fat transfer is a procedure that removes fat through liposuction from an area of your body in which there are abundant fat cells, and after a process of refinement, the fat cells are injected into your breast. This procedure is far less common than augmentation using breast implants, and only a select number of patients are good candidates. Watch Dr. Restifo’s video “Straight Talk about Fat Injections into the Breasts” to learn more.
Here are some factors that influence what breast implant is right for you:
- Your anatomy, including your body frame and existing breast tissue
- Your preferences related to size and incision placement
- Your goals for breast augmentation
- Your lifestyle
A.In a breast augmentation surgery using implants, Dr. Restifo will make an incision, lift the breast tissue, create a pocket in the breast area and place an implant in the pocket. The creation of this pocket is very important because it determines where the implant will “live”.
Dr.Restifo will recommend implant placement based on your anatomy, type of implant, and any other factors that will enhance your safety and satisfaction. The implant is placed in a pocket either:
- Underneath the pectoral muscle, which is located between the breast tissue and chest wall
- Underneath the breast tissue and on top of the pectoral muscle
Implant placement beneath the muscle of the chest offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture and less interference with mammogram examinations.
A.Breast augmentation is a long-term way to achieve an ideal, youthful figure. Issues following breast augmentation surgery are uncommon and usually minimal, however they may include:
- Capsular contracture
- Swelling and pain
- Changes in nipple sensation
- Milk production
- Change to the implant as a result of injury, activity, or the normal passage of time
Implants do require monitoring and will eventually need to be replaced. If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water. Regular monitoring of breast implants after breast augmentation is recommended to ensure continuing breast and implant health.
A.Prior to your consultation, you will be asked to fill out a complete medical history, which includes information about:
- Medical conditions, both past and present
- Current medications and supplements
- Previous surgeries and medical treatments
- Mammogram results from within the past year (for patients over 40)
- Family history of breast cancer
- Current use of alcohol, tobacco and recreational drugs
- Weight fluctuations
During your initial consultation, Dr. Restifo will listen to your goals, needs, and concerns. He will evaluate whether you’re a good candidate for breast augmentation based on your anatomy and physical health, and will determine a treatment plan based on your expectations. He will also be candid about whether he can achieve the outcome you desire.
After you’ve discussed the size and shape of breasts that you desire, Dr. Restifo will work with his assistant to measure and photograph your breasts for your medical record. He will also evaluate the following:
- Current size and shape of your breasts.
- State of your skin’s elasticity.
- Quality and quantity of existing breast tissue.
- Current size and location of your nipples and areolas.
After the examination, you will be introduced to the Vectra® 3D imaging system which will enable you to see how different implants will look on your body.
If your breasts are drooping significantly, Dr. Restifo may also recommend a breast lift (mastopexy) in conjunction with breast augmentation to achieve the best overall outcome. See Dr. Restifo’s video “Implant, Lift or Both” for more information.
If you are planning to lose a significant amount of weight, be sure to mention this in the initial consultation. Also be sure to mention any plans to get pregnant, in either the near or distant future. It is ideal to stabilize your weight before undergoing surgery to get the best possible results.
A.Dr. Restifo is committed to each patient’s safety and satisfaction, and he stays well-informed regarding breast implant options and surgical techniques for breast augmentation.
Recently, a lot of press has been given to BIA-ALCL and unfortunately there is significant misinformation on blogs and social media. Accordingly, Dr. Restifo recommends the following round-table VIDEO discussions by esteemed colleagues and board-certified plastic surgeons for patient education: Improving Patient Safety Part 1 & Part 2. Dr. Restifo only uses smooth implants.
It is important for women who have had breast augmentation to have periodic examination by a board-certified plastic surgeon to monitor their implants. Dr. Restifo is happy to see patients anytime after surgery for many years.
We recommend you maintain your regular mammogram schedule within six months of surgery. For patients with silicone implants, MRIs are recommended after three years, and then every other year thereafter.
We also recommend that you return to see Dr. Restifo at your 10-year surgery anniversary.
Although breast augmentation is safe and all implants come with a limited manufacturer’s warranty, it’s important to understand that sometimes issues can arise, like implant deflation, rupture, or capsular contracture.
If revision is necessary for a covered reason, having an extended warranty can offset revision costs. We recommend purchasing this coverage for $200-$300 based on your specific implant choice.
A.An incision can be made in one of three places:
- In the armpit (transaxillary)
- In the crease on the underside of the breast (inframammary)
- Around the areola, the dark area surrounding the nipple (periareolar)
Dr. Restifo aims to minimize the appearance of scarring and will work with you to determine the best incision point based on your overall beauty goals.
Scars from breast augmentation incisions will begin to fade in a few months and will continue to fade for months or years. Our postoperative instructions include information about scar therapy.
A.Breast augmentation is typically long-lasting, however lifestyle and life-stage both play a role in how long the results of your surgery will last. Your breasts can change due to a number of factors, including:
- Weight fluctuations
- Time and gravity
After several years, some patients undergo a breast revision to exchange implants, or a breast lift to restore a more youthful shape and contour. In general, implants do not need to be changed until they demonstrate deflation (saline) or internal disruption (silicone).
A.Prior to your surgery, Dr. Restifo will ask you to:
- Stop smoking at least six weeks before undergoing surgery to better promote healing.
- Contact your primary care physician to schedule a preoperative physical for the following tests required for your surgery:
- A recent complete history and physical with medical clearance for surgery and general anesthesia
- Labs complete with CBC, PT, PTT
- Current EKG and report of the reading for patients over the age of 50 or those with a cardiac history
- A mammography report completed within the last year (for patients over 40)
- Any other exam that you or your physician feel is indicated
- Avoid taking aspirin and certain anti-inflammatory drugs (e.g. ibuprofen, naproxen) that can increase bleeding.
- Fill any prescriptions he provided prior to surgery (though you won’t need them until afterwards).
- Hydrate well both before and after the surgery for safe recovery.
- Purchase a front-closure sports bra.
- Arrange for a ride home after surgery.
- Plan to have someone to stay with you for at least the first 24 hours following surgery.
Full preoperative instructions can be found under Patient Resources.
A.Most patients feel tired and sore after breast augmentation surgery for the first day or two. Some discoloration and swelling may occur, but this usually passes relatively quickly. Some patients feel an increased tightness and sensitivity in the breasts, and skin may feel warm or itchy. Dr. Restifo will prescribe specific medications that will increase your safety and comfort during healing.
Many patients return to work within one week, although we recommend that patients wait a minimum of two weeks before driving. Patients should walk as early as the day of surgery, but should also refrain from lifting, pulling or pushing anything greater than five pounds for one month. We also recommend avoiding high impact aerobic exercise or upper body workouts for six weeks.
Stitches are removed in a week to 10 days after breast augmentation. Any post-operative pain, swelling and sensitivity will diminish over the first few weeks.