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What is Breast Augmentation?

Breast augmentation is performed to add volume and fullness to the breasts through placement of implants. This can rejuvenate the shape and contours of the breasts while providing a curvier silhouette. Whether you are unhappy with the size of your breasts, you have experienced a loss of volume after pregnancy, or you would simply like to attain a better fit in clothing, breast augmentation is known for its exceptional results. As one of the most frequently performed plastic surgery procedures available, breast augmentation has helped countless women enhance their breasts and their confidence.

In your consultation, board-certified plastic surgeon Dr. Scott Miller will listen to your aesthetic goals and address any questions or concerns you may have about breast augmentation. His goal is to help you understand the pros and cons of the procedure, as well as how breast surgery will affect your body. Dr. Miller will explain your options regarding how the surgery is performed, including details about incision location, breast implant types, and the implant location. When necessary, a breast lift can be performed in tandem with breast augmentation. In any case, breast augmentation is fully customized to your individual needs to help you achieve naturally beautiful results.

Who is a Good Candidate for Breast Augmentation?

While breast augmentation is the premier solution to enhance the size and volume of the breasts, the procedure can also offer a myriad of additional benefits for patients who would like to:

  • Correct asymmetry issues and achieve a more balanced appearance
  • Attain a rounder, more rejuvenated breast shape
  • Restore the volume and contours often lost due to pregnancy, weight loss, and/or breastfeeding
  • Reposition/resize the nipples and areolas
  • Achieve a better fit for clothing and swimwear
  • Enhance confidence and improve body image

Breast augmentation is most successful for women whose aesthetic goals align with the list above. It’s also important for patients considering breast surgery to be relatively healthy and have no uncontrolled or significant medical conditions.

How is Breast Augmentation Surgery Performed?

A breast augmentation typically takes about one to two hours. The surgery begins with an incision made in one of the following areas:
  1. inframammary fold Image

    In the inframammary fold

  2. Around the areolas Image

    Around the areolas

  3. In the armpits Image

    In the armpits

The best approach for each patient depends on their unique needs and goals. This will be discussed during the consultation process. Once the incision has been made in the planned area, a pocket is then created either directly under the tissue or underneath the muscle. Breast implant sizers are placed and filled with air. This allows the patient’s size and shape to be evaluated and compared to presurgical goals before choosing the final implant. Then, the chosen implants are placed inside the pocket and the incisions are closed in layers, providing support to the outer incision and allowing for minimal scarring. Throughout the entire procedure, Dr. Miller pays close attention to aesthetic details, including symmetry, shape, and the natural contours of the body, in order to achieve naturally beautiful results.

What are the Different Types of Breast Implants?

Dr. Miller offers both saline and silicone breast implants in a variety of shapes, sizes, and cohesions. Each implant type carries its own distinct advantages, and during your consultation, he will help you understand which one will be the best option for your needs. Dr. Miller will answer all of your questions regarding the procedure and show you some of the implants that are available. Together, you and Dr. Miller will work together to select the most appropriate options for your breast enhancement so that the results will look naturally beautiful.

Saline Breast Implants

Saline implants are made of a silicone shell filled with a saline (salt-water) solution. Since they are filled after insertion into the breast, saline breast implants require a smaller incision for placement. These types of implants have been used for decades and provide beautiful results for patients with sufficient breast tissue.

Silicone Gel Breast Implants

Silicone implants consist of a silicone shell filled with a cohesive silicone gel. Many silicone implants are “form-stable,” meaning they retain their shape and contour regardless of movement. They are widely favored due to their resemblance in look and feel to natural breast tissue. As a result, silicone implants can provide excellent results in breast augmentation, particularly for patients who have thin skin or very little breast tissue. Silicone implants are FDA-approved for cosmetic use in patients 22 and older, and for reconstructive use for patients of any age.

  • Implant over muscle image

    Over the Muscle

  • Implant under muscle image

    Under the Muscle

Implant Placement: Above Vs. Under the Muscle

Your breast implants can be placed either over the chest muscle (subglandular) or under the muscle (submuscular), depending on your anatomy and personal preference. Saline and silicone implants both offer naturally beautiful results in either location for the right candidates.

Under the Muscle

For most patients, when implants are placed under the muscle, they provide a more natural look since there is more tissue concealing the implant. Placement beneath the muscle also allows for better mammography readings, as this location makes it easier to move the implant for a clearer view of the breast tissue. The submuscular method provides the added benefits of having a reduced risk of developing capsular contracture and a lower likelihood of interfering with breastfeeding.

Over the Muscle

For those who have sufficient breast tissue to cover the implant of choice, a subglandular, or over-the-muscle, approach is acceptable but does not offer the benefits of submuscular placement.
After you have expressed your aesthetic goals with Dr. Miller and he has had the chance to conduct a physical examination, he will provide a recommendation for which implant location is best for you.

What is Recovery from Breast Augmentation Like?

After breast augmentation, you will receive medicine to help manage swelling and reduce discomfort. Soreness and general weakness is normal for the first two to three days of recovery, but you should feel stronger as the healing process progresses. Other common reactions after surgery include swelling, tenderness, and bruising, but these feelings should gradually subside over the course of your recovery. Most patients are up and about one to two days after their procedure and light ambulation (standing, light walks, moving around the house, etc.) is encouraged. Exercise and heavy lifting should be avoided until six weeks after breast augmentation.

Patients often return to work four to five days after their breast augmentation, provided their jobs are not physically strenuous. Some degree of firmness and/or changes in nipple sensation are normal right after surgery, but the breasts will soften and regain sensitivity over time. Sutures are removed about one week after the procedure. Dr. Miller and his team will give you detailed post-operative instructions and closely monitor your recovery in follow-up appointments.

How Long Does Breast Augmentation Last?

On average, breast implants typically have a shelf-life of approximately 10 to 15 years, but many patients experience good results for 20 years and beyond. Implants generally don’t have to be replaced unless a complication arises over time, such as rippling, rupture, or capsular contracture (the hardening of scar tissue around the implant). In these cases, a breast revision procedure can allow patients to upgrade to a newer type, shape, or size of implant, or remove their breast implants altogether. If you wish to remove your implants without replacing them, a breast lift may be necessary to address stretched breast skin as well as restore the breasts’ former shape. Every breast augmentation patient experiences a different lifespan for their implants depending on the type of implant placed. However, there is usually no need to exchange implants unless it is an individual’s personal preference or clinical problems are experienced. Periodic MRIs are recommended to monitor the condition of silicone or silicone gel implants, as both implant types are designed to keep their shape in the rare event of rupture.

Will I Have Breast Augmentation Scars?

Every surgical procedure will likely result in some degree of scarring; however, it is typical for scars to fade and gradually become more and more indistinguishable over time. Scars from breast augmentation can be very discreet and are usually hidden within the natural contours of the skin and breasts. The shape, size, and location of your scars will depend on which incision is used to place your implants. A periareolar incision is the most common technique, and allows resulting scars to blend well into the areola region’s change in pigmentation once incisions are fully healed. The inframammary incision is also a common technique that allows the incision to be hidden within the breast fold. Lastly, the transaxillary approach utilizes incisions within a fold of the armpit. You can diminish the prominence of your scars with the medical-grade skincare products offered at our San Diego practice. Dr. Miller or one of our experienced aesthetic professionals can suggest the best formulation for your unique skin type to encourage the fading of surgical scars.

How Much Does Breast Augmentation Cost?

Your breast augmentation expenses will be determined by the type of implants used, the technique used during surgery, and the overall complexity of your procedure. These factors will be determined once Dr. Miller has the chance to evaluate your needs in a consultation. Afterwards, our Patient Care Coordinator will provide you with a personalized quote based on the details of your treatment plan. To give patients a wider range of payment options, our practice accepts plans through CareCredit® — a leading plastic surgery financing company that can make the cost of breast augmentation more manageable. Offering qualified applicants a range of flexible payment plans with low monthly installments, CareCredit® can allow individuals to pay for their surgery over a period of time rather than in one lump sum. If you have any questions about the price of breast augmentation, or if you would like to schedule a consultation, please reach out to our practice to speak to a member of our team.

Breast Augmentation and Lift

Many patients who see Dr. Miller about increasing their breast volume also express a desire to attain a more youthful breast positioning as well. A breast lift with implants is a unique combination procedure designed to minimize the appearance of breast drooping by lifting the breasts and adding volume with implants, improving the overall breast shape. This surgery can address the volume, projection, positioning, shape, and contour of the breasts all at once for the utmost rejuvenation. This is typically a popular treatment option for women who seek extensive breast enhancement, or those who wish to restore their pre-pregnancy breast appearance. For the right candidate, a breast lift with implants can provide the benefits of both a breast augmentation and a breast lift during one operation and recovery period.

Unmatched Patient Satisfaction

Dr. Miller is an amazing artist. His work is absolute perfection! His personality is so down to earth and he really listens to his patients. I would recommend Dr. Miller to everyone. He gives a nature result. Thank you Dr. Miller for making the surgery so easy.

Sandy Kelley

May 16, 2017


Additional Breast Augmentation FAQs

How do I sleep after breast augmentation?

Dr. Miller will instruct you to sleep on your back after breast augmentation to avoid disrupting your implants and incisions. This is necessary during the initial recovery process. Propping up pillows can help prevent you from unintentionally rolling on your sides or stomach during the night.

What is capsular contracture?

Capsular contracture refers to hardened scar tissue around your breast implants. The formation of scar tissue around implants is normal and not necessarily a cause for concern alone, but patients can experience tightness, swelling, and general discomfort when the scar capsule hardens and squeezes the breasts. This may also cause the breasts to change shape or appear higher on the chest wall. Capsular contracture can be addressed through breast revision surgery if you’re experiencing uncomfortable symptoms or notice changes in the way your breasts look/feel.

What’s the best post-op breast augmentation bra?

A surgical bra with wide, comfortable straps and a front-facing closure is the best option to protect your incisions, reduce swelling, and support your new breast contours. You will be instructed to avoid wearing underwire bras for at least six weeks after your procedure. During your first follow-up appointment, your surgical dressing will be removed and you will be placed in your post-surgery bra. This should be worn, day and night, for six weeks after your surgery. Dr. Miller will further explain the best type of bra to facilitate your recovery in person.

How long after breast augmentation can I swim?

We instruct patients to wait at least six weeks after their breast augmentation before submerging their breasts in any kind of water. Showering is fine; however, swimming pools, jacuzzis, bathtubs, and ocean water should all be avoided above the waist. Making sure your incisions (and body) are fully healed before attempting any cardio activities is key to preventing complications and infections, as well as maximizing your results. You will receive detailed instructions on activity restrictions after your surgery.

Can I breastfeed with breast implants?

By placing the incision along the bottom edge of the areola, Dr. Miller is able to avoid the milk ducts and the main nerve to the nipple, offering the greatest chance of maintaining breastfeeding ability with ease. The vast majority of patients who receive breast augmentation maintain breastfeeding function. However, there is always the possibility of difficulty with breastfeeding for a woman, even if she has not had breast augmentation. Also to note, with age and pregnancy, breastfeeding after the procedure will likely affect the volume and shape of the breasts, potentially changing the final outcome of your breast augmentation and creating the need for a secondary treatment in the future.