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sundress ladyA good fit

Answers to common questions about breast augmentation

by Dr. Glenn M. Davis


Breast augmentation, or enhancement of breast size using implants, is one of the most commonly performed procedures in plastic surgery. According to the American Society for Aesthetic Plastic Surgery (ASAPS), almost 312,000 breast augmentation procedures were performed in the U.S. in 2009. This number reflects the increasing desire of women for larger, fuller breasts, but it also speaks to the safety of the procedure and the high satisfaction rate following surgery.


Breast augmentation is performed for women when breast size is inadequate due to underdevelopment, or when breast size has decreased following weight loss or pregnancy-related changes.


Before deciding on breast augmentation, it’s important to talk with your surgeon about your goals. There are several factors to consider, including the type of implant, incision, placement and size.


Below are answers to the most frequently asked questions on the topic.


Q: What’s the difference between saline and silicone implants?


A: There are differences between saline and gel, but one is not better than the other. Breasts should look natural with either implant, so the question becomes which implant is better for you. The major difference is the detection of a leak in the implant. With a saline implant, it’s obvious when a leak has occurred because the breast’s volume deflates over several days as the body absorbs the saline solution. A gel implant, on the other hand, is not absorbed by the body, and there is no change to the look and feel of a breast if there’s a leak. Gel implants are considered cohesive-gel or gummy-bear implants. There is no known disease caused by silicone gel in the body.


Q: How long does breast enhancement surgery typically take?


A: On average, it takes about an hour from the beginning to the end of surgery.


Q: How long is the recovery period?


A: There will be some discomfort for three to five days, but you should be able to resume normal activities as soon as you feel comfortable. Most patients take a week off from work, although it’s not uncommon for someone to have surgery on a Thursday and be back at work the following Monday.


Q: Where and how large will the incision be?


A: The most common incisions are at the fold beneath the breast, on the lower curve of the nipple or areola, and at the top of the armpit. There are positives and negatives to each, and there is no difference in healing, cost, recovery, or complications. The length of the incision will depend upon whether saline (one inch) or gel (two inches) is used.


Q: Can I breastfeed after breast augmentation?


A: If you have breastfed successfully in the past, then you should be able to breastfeed afterward. There is no mechanical reason to prevent breastfeeding with any of the techniques or incisions offered.


Q: How do I know if I need a lift or implants?


A: A breast lift is a surgical procedure designed to raise and reshape a sagging breast, determined by the skin. If a larger volume or cup size is desired, then an implant will augment existing breast tissue and fat. An implant will not change shape, and a lift will not change size. Sometimes a lift and implants are performed at the same time to increase both firmness and size.


Q: What type of anesthesia is used?


A: Most women have general anesthesia during this type of procedure.


Q: How can I determine what size I would like to be?


A: There is no reliable measurement of breast size. It’s important not to focus on bra sizes because they vary by manufacturer. The cup size of a 36C is quite different from the cup size of a 34C, although they are both “C” cups. One woman might find a 34B comfortable, while another woman with the same breast size might prefer a 34C or 36B. It does not matter what size bra you wear, but it does matter what you want to look like. While some surgeons find it helpful to have patients try implant sizes in a bra, others find it best to have patients show them a photograph of what they’d like to look like. The photograph then is used as a guide during surgery. Remember that this is the artistic part of the process.


Q: What is capsular contracture?


A: When any foreign object is implanted into the body, the body’s natural defense is to create scar tissue around it. In a small number of women, the scar tissue shrinks or contracts over time, and the breast can appear unnaturally higher and tighter. This condition is repaired by removing excess scar tissue. 


Dr. Glenn M. Davis is board certified by the American Board of Plastic Surgery and has more than 20 years of experience in the field. To learn more about the above-mentioned procedures, call (919) 785-1220 or visit