• What is Breast Augmentation?

    Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman’s breast for a number of reasons:

    – To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
    – To restore breast volume lost due to weight loss or following pregnancy
    – To achieve better symmetry when breasts are moderately disproportionate in size and shape
    – To improve the shape of breasts that are sagging or have lost firmness, often used with a breast lift procedure
    – To provide the foundation of a breast contour when a breast has been removed or disfigured by surgery to treat breast cancer
    – To improve breast appearance or create the appearance of a breast that is missing or disfigured due to trauma, heredity, or congenital abnormalities

  • Results of Breast Augmentation

    Breast Augmentation produces pleasing and satisfying results through enhancing the size and shape of breasts that women wish to have. It gives women a more flattering bust line, improving their appearance and boosting their self-confidence with regards to their figure.
    Those who would benefit the most in this procedure are the women having realistic expectations of improvement, not perfection, in the way they look.

  • Candidates for Breast Augmentation

    Every individual has her own notion on what is beautiful in a breast. Normal breast size, for some, might not be enough, and this procedure offers that change you might want. It is only your choice if you want to undergo this procedure, and the doctors will be happy to discuss the change in the size and shape of your breasts.

    Women who are good candidates for Breast Augmentation have at least one of following characteristics:

    – You think your breasts are too small or underdeveloped
    – The upper part of the breasts seems empty.
    – Your breasts do not have the same size or shape.
    – Your breasts do not have the same size or shape.
    – One or both breasts failed to develop normally or have an unnatural shape.
    – You previously had breast implants and are having problems with them.
    – Your breasts have lost volume due to pregnancy, weight loss or aging.
    – For breast reconstruction following mastectomy for breast cancer.

  • Your Consultation

    Before your breast surgery, RVB will carefully evaluate your general health status and any pre-existing health conditions that could compromise the outcome of surgery or bring risk to your health. A detailed measurements of the physical parameters of your breasts and the quality and quantity of your existing breast tissue to determine the proper choice of breast implant and technique.

    RVB may suggest a breast lift or Mastopexy in addition to Breast Augmentation in situations where there is excessive laxity or drooping of the breasts. If this is the case, Breast Augmentation alone would be insufficient to solve and correct this condition.

    A mammogram six months before surgery is required, and photos of your breasts will be taken before and after surgery.

  • The Breast Augmentation Procedure

    Breast Augmentation is done on an outpatient basis in an Ambulatory Surgery Center, and usually under general anesthesia.

    A number of options with regards to the location of the incision will be discussed to you, which would be dependent on the individual variables of your breast anatomy and the type and size of implant that will be used. Not all options are possible to every patient. The implant type, pocket placement and incision approach all have relative advantages and disadvantages.

    The following are the different type of incisions:

    – Infra-mammary Incision is made in the fold under the breast.
    – Peri-areolar Incision is made around the nipple.
    – Trans-axillary with endoscopic assist Incision is made under the arm.

    All incisions are kept short and unnoticeable. RVB will choose the surgical technique as well as the size and type of implant that will produce the result each individual desires.

    Implants can be inserted either under the breast tissue (sub-glandular) or partially under the pectoral muscle (sub-pectoral or sub-muscular). When implants are placed in a sub-muscular position (under the breast tissue and the pectoral muscle), there is less chance of capsular contracture, which is the shrinkage of the tissue capsule surrounding the implant that causes both implant and breast to feel unnaturally firm. Placing implants in a sub-glandular position (directly under the breast tissue) may be advisable in some cases, depending on the thickness and laxity of the breast tissue, and also the ability of the breast tissue to decently cover the implant. Once the desired pocket has been created, a temporary sizer implant is placed to determine the proper shape and size of the final implant. In this stage, RVB will evaluate your pre-operative photos and your desired results based on your previous discussions with the surgeon, as well as the photos you may have shown for comparison. The final implant is then chosen, inserted, and properly positioned within the pocket, and checked to insure that your breasts have the shape and size you expected before surgery. Although, take note that there can be no guarantee as to the final cup size of your breasts after the operation.

    Incisions are carefully closed with multiple layers of hidden sutures and surgical tape. However, in the case of revision surgery on the breast for encapsulation or other problems, drains are never placed. You will then be placed in a soft surgical bra with a supportive wrapping around the chest. You will wake up in the recovery room with minimal pain, or mild to moderate muscular soreness that is similar to a strenuous workout, after the implants have been placed partially behind the muscle.

    RVB will help you in deciding which incision, pocket placement, and type of implant you should have to get your desired results. They will utilize the most advanced techniques in order to minimize your risks, optimize your results, and return you to your normal, unrestricted activities as quickly and comfortably as possible.

  • Risk

    Capsular contracture is a process of gradual but aggressive shrinkage of this tissue capsule surrounding the implant. This causes the breast and implant to feel unnaturally firm and often times painful. Capsular contracture is usually progressive, worsening with time, over the course of several months to years. This situation may result in asymmetry of the breasts. The occurrence or severity of this condition varies with each individual. There is no reliable data as to how often it occurs. Asymmetry may also occur as a result of unexpected problems with early healing after implant placement.

    Patients are reminded that sensory changes may occur in the nipples or outer breasts. Also, patients with a very small volume of breast tissue or thin skin before surgery may notice visible wrinkling or rippling of the implants, especially saline, and more commonly when larger size implants are chosen. Another reminder is that there may be delayed wound healing for patients with diabetes, a history of radiation, autoimmune disease, or for smokers. Surgical scars may be unsightly. In order to avoid these problems, a thorough medical evaluation should be done before the surgery.

    Breast implants do not affect fertility, pregnancy, or a woman’s future ability to nurse, there are no evidences found to prove otherwise. It is a fact that not all women may be able to breastfeed even without the implants. If the peri-areolar (nipple) incision is used for the procedure, there may be a greater risk of scarring within the breast or alteration in the ability to breastfeed as compared to the axillary (under-arm) or infra-mammary (breast fold) incisions, but there is no evidence gathered for it to be scientifically proven.

    Breast Augmentation may not be a one-time surgery. It is very likely that additional surgeries and doctor visits will be necessary over the course of your lifetime to maintain the appearance of your breasts after the procedure. This might be because of problems related to the implants themselves, like deflation, capsular contracture, rupture, etc., or because of aging changes, like pregnancies, weight gain, loss of breast tissue, etc., that affect the appearance of the breasts over time.

  • Recovery

    After the procedure, patients are placed in a soft surgical bra with a supportive wrapping around the chest. Do make sure someone is able to assist and drive you home and be available to care for you continuously for the first 24 hours. Since no drains are required except in the case of re-operative breast implant surgery, our patients are allowed to shower the day after surgery. Some pain or discomfort might be experienced the first day or two which is easily controlled with analgesic medications. But there should be minimal bruising. Also, tightness in the breast area is normal as your body adjusts to the implants. There is somewhat more discomfort and spasm when the implants are placed below the pectoral muscle. If this occurs, RVB may prescribe a muscle relaxing medication to control the spasms.

    Patients would be able to return to normal daily activities like washing the hair and driving, about 2 to 4 days after the surgery. In the first 2 weeks after the procedure, a bra should be worn at all times, except when showering. Moderate exercises like walking are allowed after the first week. Patients should avoid heavy lifting, tub bathing and Jacuzzi, or swimming for the next 2 to 3 weeks. While vigorous exercises like jogging and aerobics should be resumed in 3 to 4 weeks time. You may return to work in a day or two, but do avoid any strenuous activities for a couple of weeks after surgery.

    Your breasts may be appear somewhat swollen after surgery, but within a few weeks, the actual shape and size of your breasts will be apparent so you can begin to wear bras and clothes that you prefer. RVB suggests for you to get breast examinations at no cost from our office every 6 to 12 months. Continue breast self-examinations monthly, and have mammograms as recommended by your gynecologist or personal physician, which is generally yearly after age 40. We do request that you forward copies of all your mammography results to our office.


  • How much increase in cup size can I expect?
    - The size of your breasts after Breast Augmentation will depend on the implant used and the ability of your breast tissues and chest wall muscles to expand with the implant. In general, women with relatively large breasts can go larger than women who have very little breast tissue to begin with, also petite women cannot go as large as women with a larger physique. There is no guarantee as to the final cup size.
  • Are silicone breast implants dangerous?
    - To date, silicone breast implants are safe devices that do not pose any greater risk of causing disease than saline implants. If there is evidence showing that silicone breast implants could lead to systemic disease, BHMG would never use them. As for now, we would not hesitate to recommend silicone breast implants to a patient if the circumstances dictate that this would be the best choice of implant.
  • Do I need to massage my breasts and for how long?
    - Smooth implants, whether saline or silicone, above or below the muscle, must be massaged immediately after surgery to maintain the softness of the breasts. Maintaining a large space around these implants prevents or delays the encapsulation process. Textured implants do not require massage. We will give you detailed instructions if massage is required after the surgery.
  • When can I bathe?
    - You may shower 24 hours after surgery. Do not immerse your breasts under water or take baths in the tub, pool or ocean 3 weeks after surgery.
  • When can I resume exercise?
    - You may do walking and treadmill or riding a stationary recumbent bicycle within 2 days. No strenuous upper-body exercises for 2 to 3 weeks following surgery. Avoid any activity that may cause any discomfort.
  • When can I wear my preferred bras or clothes?
    - The swelling will settle in 2 to 4 weeks. The breasts are not likely to change much in size at that time, but may continue to soften and improve in shape. You can now wear your bras and preferred clothes at this point. You should wear the post-surgical bra given by our office for the first 2 weeks at least.
  • How long will my implants last?
    - Most implants last for 10 to 15 years. Any type of breast implant is subject to wear and tear and deterioration due to aging over time. Like a heart valve or artificial joint replacement, they are not to be expected to last forever. The implants are covered by a manufacturer's warranty against manufacturing defects, and most companies provide financial assistance for re-operation, and implant replacement at no charge, in the event of implant failure. However, you may incur other financial costs which are not covered.
  • Will breast augmentation affect my ability to breast feed?
    - In some cases, yes. However, there are certain precautions we can take during a breast augmentation that may help minimize those risks.
  • - If you are interested in a breast augmentation, but are concerned about your ability to breastfeed in the future, make sure to let us know. We can help you better understand your options and the risks involved.
  • Will my implants interfere with mammography?
    - Breast implants can interfere with mammographies, although mammography technicians have developed techniques to minimize the interference, and the risks can be mitigated by choosing a submuscular implant placement.