Breast enlargement surgery is one of the most popular cosmetic surgery procedures for women now. Size does matter for many women disappointed and unhappy with the size or shape of their breasts; they feel "out of proportion", "embarrassed" and "unfeminine". They want a bust that looks full, firm, balanced - and beautiful.

Over the past 30 years, thousands of women, who previously felt that their breasts were simply too small or had lost volume after childbirth or weight loss, have come to us for breast implants. As the market leader in this area, we offer a range of breast implants. The surgeon will talk through with you the most suitable type for you, depending on your particular body and the results you want.

You can expect the team of highly qualified and specialist cosmetic surgeons and our nurses to use only the latest techniques and implant technology to create the fullness of natural breasts - so that you can revel in the confidence of a professional and beautiful result. A breast uplift is also very often combined with a breast enlargement to give you not only the fullness, but also the lift that you're after.

what this breast enlargement procedure involves.

We aim to give you a completely natural looking bust that complements your figure. There is a range of breast implant sizes available, and the surgeon will discuss options with you during your consultation. We will recommend, and help you decide on, the right size for you after taking into account not only the look you want to achieve, but also your anatomy. So you can look forward to wearing clothes to show off your shapely figure rather than hide it.

Breast augmentation is a form of cosmetic surgery performed by our plastic surgeons for women who wish to increase the size of their breasts. In many cases the woman wishing to undergo a breast augmentation procedure feels her current breast size is too small or disproportionate to her particular body size. Breast augmentation is considered an aesthetic surgical procedure that most often occurs with women who have not been satisfied with her final breast development size reached after puberty, and in some cases women's breasts have developed unevenly and she would like to achieve proper symmetry. Women who have lost a significant amount of weight or have had pregnancies may find their breast size has shrunken and they wish to restore their breast size through breast augmentation.
Now breast augmentation is one of the most popular plastic surgery procedures in the world. In spite of their overwhelming popularity (here comes the bad news), breast implants have limitations. Breast augmentation surgery will not improve nipple asymmetry, move your breasts closer together, lift droopy breasts, or remove stretch marks. If you have droopy breasts, you may need a breast lift (mastopexy). Also, breast implants are not free of problems. In order to determine whether breast augmentation surgery is for you, you must weigh the risks and the benefits. The following pages will explain all of the options, Tips for Getting the Best Results from your Breast Augmentation ,Complications of Breast Augmentation and recovery of the surgery.
After you have had a chance to learn about the options in breast augmentation (below) and , be sure to visit to help you minimize your risks, expedite your recovery, and get the best possible results.

Before you sign up for breast augmentation surgery, you and your plastic surgeon should have a long discussion about these important issues:

1. Position (under or over the muscle)              
By implant position, plastic surgeons are referring to whether the breast implant should be placed above or below the pectoralis muscle. Advantages for placing the breast implant above the muscle include less discomfort post-operatively, less swelling, and less chance that the breast will appear to move when you are exercising your upper body. This last issue has been one of great concern for many women, especially those who have full workout regimes. Simply put, if your breast implants are under the muscle, then when you flex your pectoralis muscles (as you often do during workouts), your breasts may appear to move. Sometimes (though not commonly) the breast motion will appear quite distorted. Now, to bring things into perspective, you should realize that many women who work out (and even some professional female athletes) have implants under the muscle and are very happy with their appearance. In other words, if you work out a lot, do not automatically believe that your breast implants need to go over the muscle. Advantages for placing the implants under the muscle include less interference with mammography and less rippling in the upper half of the breast. Generally, thin and small-breasted women should favor implant placement under the muscle. The advantages of less interference with mammography, less rippling of the upper half of the breast, and more cushion between the implant and the skin outweigh the drawbacks, many of which are temporary. Athletic women should consider placement of the implant above the muscle (as long as they have adequate breast tissue and body fat) to avoid breast distortion when the pectoral muscles are flexed. Thin, small-breasted, athletic women must weigh the options. In general, they are probably better off with implants under the muscle. A more significant cosmetic problem for these women is rippling, which is less likely to occur in the upper half of the breast if the implants are placed under the muscle. Of course, this is your call. Be sure to discuss it carefully with your plastic surgeon. An alternative for these women is to have silicone breast implants.

2. Breast Implant surface (textured or smooth)                     
By implant surface, plastic surgeons are referring to whether the implant is smooth or textured. A smooth implant is just that - as smooth as the surface of a balloon. Textured implants are rough, somewhat like sandpaper. Once they are in placed under your breasts, it is impossible to tell whether you have smooth or textured implants. Textured implants were developed because plastic surgeons thought that they would be less likely to cause capsular contractures  Unfortunately, studies have not shown a consistent advantage of textured implants over smooth when it comes to capsular contractures.

3. Shape (round or anatomic (teardrop))                            
By this, plastic surgeons are referring to round or teardrop shape. Round implants are shaped like jelly donuts. Teardrop implants are shaped more like the breast. At first, you might be thinking that (of course) teardrop implants would be better. However, most plastic surgeons disagree: they think that teardrop implants tend to become round with the forces of healing and that the teardrop implants do not necessarily give a better result.

4. Volume                                     
This is the all-important size issue. Breast implants come in all sizes with the most common sizes ranging from 200-600 cc. This is equivalent to 7-20 ounces. Within that range, 300-450cc is probably the most common. By the way, a cc (cubic centimeter) is the same as a ml (milliliter) - just in case you have visited other sites which refer to volumes in mls. This decision is highly personal and highly individualized. The best way to determine your size is by placing breast implant sizers (your plastic surgeon will hopefully have them) in your bra and then put a sweater, blouse, or t-shirt on (or, perhaps try all of them, as you will appear different in each). Do not allow your surgeon to dictate your size. You must have input in this decision.

5. Breast Implant projection (standard vs. high profile)               
Breast implants are designed so that, as volume increases, so does diameter (the footprint of the implant) and projection (the amount it sticks out, away from your body). Standard implants are designed so that MOST women who choose a given volume will be able to accommodate the breast implant's diameter beneath her breasts. This is so because women with narrower breast diameters often have smaller bodies and tend to choose smaller breast implants; women with wider breast diameters often have larger body frames and tend to choose larger breast implants. In other words, women tend naturally to choose an implant volume that is in proportion with body size and breast diameter, and breast implants were designed in anticipation of that. BUT, what if a woman wants a breast implant that has a larger volume than would be considered proportionate (by breast implant manufacturer standards) for her breast diameter, chest wall size, and body frame? In that case, placing a standard implant would risk an unnatural result, because it would be too wide for her body frame and would likely also extend too high and too low on her chest wall. In these cases, a High Profile implant is recommended. With a high profile implant, the volume is the same, but the diameter (footprint) is narrower and the projection (the amount that it sticks out away from your body) is greater. Most women (over 95%) are best suited to standard implants. The way to tell if you should have standard implants or high-profile is as follows: First, your surgeon should measure your breast diameter. Next, you should choose the implant volume that you want. Finally, your surgeon should compare the diameter of the desired implant size (standard implant) to the measured diameter of your breast. If the diameter of the implant size you selected is about the same or smaller than your measured breast diameter, then a standard implant is appropriate. If the diameter of the desired breast implant is larger than you breast diameter, then you should consider high profile breast implants.

6. Saline Vs. Silicone Gel                                       
On 11/17/06, the FDA approved silicone gel breast implants for use in primary breast augmentation for woman. This approval is expected to result in a large number of women seeking silicone breast augmentation.
Silicone breast implants provide a more natural look and feel, which is particularly important to women who have a modest amount of breast tissue. Although all women want a natural look and feel, women with larger breasts can often achieve this with saline implants. Women with smaller breasts typically cannot. The main disadvantage of silicone gel breast implants is that the incision is usually longer and the cost is higher than saline breast implants.

7. Site of Incision (This Pertains only to Saline Implants)         
The options for site of incision are under your breast, around your nipple,or in your armpit. An incision under the breast is placed within or near the natural crease beneath your breast. This incision has the advantage of having the scar hidden in the shadow of the crease under the breast. It also heals well. It also is the incision you would likely get anyway if you require revision surgery later in life. Most plastic surgeons use this incision. Around the nipple can give a good result in some women, but is riskier because it is at the focal point of the breast, so any irregularities in the scar will make it far more obvious. It also imposes a higher risk of nipple numbness and inability to breastfeed. Under the arm is an option and has the advantage of being hidden in the armpit. Although many of these scars heal favorably, some armpit (axillary) incisions can be unsightly. Also, revision surgery, if needed, might not be possible through the existing armpit scar, so an additional scar would be necessary.

There are a number of things that can be done before, during, and after breast augmentation surgery to ensure the lowest complication rate, the speediest recovery, and the best results. Explained below are a number of the steps we take for a long time. Ask your doctor if he or she takes these extra steps. If the answer is no, ask why.


Evaluating your breasts carefully:  During your initial breast enhancement consultation, we will examine your breasts and make careful measurements which will guide our doctors in advising you about your breast augmentation options. We will make special note of nipple position, breast volume, breast width, distance between your breasts, breast shape and projection, and height of the fold beneath each breast. We will point out asymmetries (no two breasts are symmetric), and will explain which of your breast features we can improve and how. If your doctor does not evaluate your breasts carefully and make careful measurements before your breast augmentation surgery, you should question him or her.
Using sizers to get the results you want:  We recommends bringing two tight sports bras to your breast enhancement consultation session so that you can use implant sizers to determine the volume of breast implants that will give you your desired result. This is extremely useful in determining your final breast size and helps eliminate uncertainty and anxiety for you. We will offer guidance on implant size, but you will make the final decision.
Customizing Your Surgical Plan: Each woman differs in their physical features and goals. Therefore each woman deserves a surgical plan tailored to her needs. We will explain all the breast augmentation options and will design a plan that is best suited to your needs.

Reducing Infection: To reduce the risk of infection, we will give you two different antibiotics (Ciprofloxacin and Kefzol) at the time of breast augmentation surgery (most doctors prescribe only one antibiotic). Together, they cover virtually every possible bacteria. Additionally, they EACH provide combined coverage for the most common cause of infection, which is Staph. Next, we recommend that you have your breast enhancement operation in our state-of-the-art surgery suite (which is known for exceptional demand, comfort, and safety), where the risk of infection is substantially lower Next, our staff will sterilize the instruments doctor will use during your breast augmentation surgery upon your arrival, rather than days or weeks ahead of time. This ensures the highest degree of sterility, as the instruments will be brought directly from the autoclave onto the operating room table, as opposed to being stored between the time they are sterilized and used (which is done in other operating rooms). our nurses will then carefully perform the "prep," which is where the operating room nurse scrubs your skin prior to surgery with bacteria-killing solution. Finally, during your breast augmentation operation, doctor will be the only person who handles your implants, thereby reducing the possibility of contamination. All of these steps have enabled our docters to have a zero rate of infection (so far). Given that we performs hundreds of breast augmentations each year, this is a very impressive record.
Reducing Capsular Contracture: No one knows exactly why capsular contractures form around breast implants, but most plastic surgeons think that they are related to bacterial contamination that occurred at the time of surgery. Therefore, every step taken to reduce the risk of infection (see above) should translate into reduced risk of capsular contracture. We have found that, indeed, all of the efforts we have made to reduce infection have resulted in a reduced risk of capsular contractures. In fact, although the national risk for capsular contracture is 10-50% (depending on which study you read), we own rate of capsular contracture is less than 1%. We also thinks that breast implant displacement exercises are important for keeping your breasts soft and natural.
Reducing Nipple Numbness: Permanent nipple numbness occurs in 15% (national average) of all women who have breast augmentation, due to damage to the nerve which provides sensation to the nipple (the 4th intercostal nerve). As this nerve is small, it is often not visible during the operation, hence making damage more likely. To minimize the possibility of damage to the nerve, we avoids "cutting" or "cauterizing" anything in the area of the nerve, which is on the side of the breast nearest the armpit. Instead, we gently stretches tissues apart to make room for the implant. By stretching rather than cutting, we are more likely to stretch rather than cut the nerve. Because stretched nerves are unlikely to develop permanent numbness, whereas cut nerves are likely to develop permanent numbness, we have a less than 2% rate of permanent nipple numbness in our practice. Be certain to ask your doctor about this issue.
Reducing Asymmetry: Even though we look at breasts all day long, we have never seen a pair of symmetric breasts. Our doctors will point out to you where your asymmetries exist so that she or he can help you understand which asymmetries can fix and which ones cannot. Regardless of the degree of your asymmetries, we will strive to attain the best result for you and the highest degree of symmetry possible. Toward this end,we will actually sit you up during surgery to see how your breasts look while you are in an upright position (we all know that breasts appear quite different when one is lying down versus standing or sitting up). This enables us to make final adjustments to ensure the closest degree of symmetry possible and the best result for you.

Reducing Pain: Breast implant placement under the muscle can be very painful with an unpleasant recovery period....OR it can be minimally painful with a much faster recovery. After you are asleep, we inject long-lasting numbing medicine (similar to Novocain, but much longer lasting) on all sides of each breast. This "blocks" the nerves from sending pain signals to your brain after surgery. Before doctor closes your skin, she or he puts a large dose of the same numbing medicine directly into the area where the implant is sitting. This essentially "marinates" the tissue surrounding the implant with numbing medicine. For a variety of reasons, the body is very slow in absorbing the numbing medicine around the implant, and it therefore can last for several days. Don't worry, though, because once it wears off, you do not suddenly feel pain. In fact, most do not even notice when it wears off. It has been shown in multiple medical studies that blocking the initial pain a patient feels after surgery markedly reduces their overall pain and speeds their recovery. Some plastic surgeons advocate placing a pump in the surgical site to infuse numbing medicine for a few days following surgery. Although this is effective in controlling pain, it is no more effective than placing a large single dose into the pocket at the time of surgery. Further, it introduces a much higher risk of infection, as the pump tubing communicates the outside world with your implants for as long as the pump is in place.
Reducing Nausea: One of the most common causes of nausea is pain. We have found that taking the above steps to reduce pain has markedly reduced the incidence of postoperative nausea and vomiting, even in those who are prone to it. Further, we advocates a number of simple medications which are very effective in reducing nausea. All of our patients receive decadron (a steroid which reduces nausea), Zofran (an anti-nausea medication that is so effective that it is routinely prescribed for cancer patients), Scopalamine (a medication which helps motion sickness), and Pepcid AC (this over-the-counter medication is a fabulous drug which further inhibits nausea in surgical patients). By taking all of these steps, we have effectively reduced the rate of nausea and vomiting in our surgery center. In fact, although the national average for postoperative nausea and vomiting is 33% and 22%, respectively, the incidence of nausea and vomiting at our cosmetic center is less than 7%.

Breast augmentation can give you fabulous results. However, it also poses some complications that can lead to unfavorable results. This page will explain the complications associated with breast augmentation surgery . After you have had a chance to learn about the complications on this page, be sure to visit the page “Tips for Getting the Best Results from your Breast Augmentation” to help you minimize your complications, expedite your recovery and get the best possible results.

Capsular contracture Capsular contracture is a scar that forms around the implant, causing it to feel firm, look unnatural, and potentially hurt. When you see pictures of a woman with obvious implants who looks like she has "coconut breasts", she more than likely has a severe capsular contracture.If you develop a mild capsular contracture, you may not be bothered by it and may not even notice you have one. If you develop one that is moderate or severe, you will probably require surgery to correct the problem. Surgery involves removing the scar and placing a new implant. With this, the capsular contracture normally will not return.
Placing the implant under the muscle has a lower risk of capsular contracture than placing the implant over the muscle. We will try our best to help minimize capsular contracture.
Interference with mammography
Breast implants do interfere with the ability of a mammogram to "see" all of your breast tissue. Placing the implant under the muscle allows for the least amount of interference.
With the breast implant under your muscle, mammograms can "see" about 90% of your breast tissue. With the breast implant over the muscle (AKA under the breast), mammograms can "see" 75% of your breast tissue.
Whether under of over the muscle, implants do not interfere with your ability to detect lumps in a self breast examination. Self exams are found to be the most successful way in discovering the majority of breast cancers. Implants also do not interfere with ultrasound or MRI scans, which are helpful in the evaluation of breast masses.
Implant displacement
Implants can move out of position at anytime after breast augmentation surgery. They can move upward, downward, left or right. If they move only a little, you may not even notice. If they move a lot, you may need further surgery to move them back into position. Fortunately, this problem is not common. The larger the implant, the greater the chance that it will displace downward. We will use a special breast bra to support and fix your new breasts.
Silicone Implant rupture
Seldom
Rippling
Rippling is much less common with silicone than saline.
Infection
Infection, if it occurs, usually does so within two months of surgery. Infection occurs in about 1% of all implant surgeries. If an infection occurs it often requires antibiotics and the removal of the involved implant. A new implant can be placed six months later, which means you would have to go for six months with very uneven breasts.
Nipple numbness
If the possibility of having numb nipples is unacceptable to you, you should not have breast augmentation because no surgeon can guarantee preservation of nipple sensation. The national risk of having permanently numb nipples is about 15%.
Breast feeding and pregnancy
Breast feeding ability is not altered by implants. Many women ask about the effect of future pregnancy on augmented breasts. In most cases, implants will not affect the fate of your postpartum breasts. Here is why: following pregnancy (and breast feeding), your breasts will shrink to their pre-pregnancy size (or there about). During this process of shrinking, your breast skin may either tighten or not tighten. If it tightens, you will most likely not have breast droop. If it does not tighten, then your breasts will unfortunately droop. Whether or not the skin tightens has little or nothing to do with the presence or absence of implants.

Anesthesia:
Your breast augmentation procedure will most likely be performed under general anesthesia, but not always. Some plastic surgeons can capably perform breast augmentation under sedation anesthesia, but be sure to ask about your doctor's experience with this. It is important to ask what methods will be used to keep you comfortable during surgery.

Length of surgery:
The actual procedure takes 1-1 1/2 hours. However, the length of time you will be in the operating room will be longer.
Once you are transferred to the operating room, it takes awhile to get you ready for surgery. You will have monitors placed then sedated or put to sleep. You will then be "prepped" which means your skin will be carefully cleansed to rid it of normal skin bacteria. Drapes will be placed around your body and the surgical "field" will be set up. The breast augmentation surgery will then begin.
After your procedure is over, your skin will again be cleaned and a dressing will be applied. Once you've awakened and are stable, you will be transported to the recovery room. For these reasons, your procedure could be scheduled for anywhere from 1 1/2 to 3 hours.

Length of stay:
Some of the cases will stay in the hospital for one night and some will be allowed to go home the day of surgery.

Discomfort:
Discomfort will vary for each patient. On average discomfort is mild to moderate following implant placement over the muscle. Discomfort is moderate to severe following implant placement under the muscle.
There are a number of ways to reduce your discomfort and we could well control it.

Swelling:
Swelling is least if the implants are placed over the muscle and most if the implants are placed under the muscle. Regardless, it is usually at its peak 3-5 days after surgery and thereafter improves. If your implants are over the muscle, 75% of the swelling will be gone in 2 weeks and the rest will resolve over the next several weeks. If your implants are placed under the muscle, 75% of the swelling will be gone in 2-4 weeks, and the rest will resolve over a few months.

Bruising:
Most women do not bruise after breast augmentation. If you do, however, do not worry, because it is not unusual and does not affect your final result. If any exists, it improves within a week or so.

Shower:
Most plastic surgeons will let you remove your bandages and shower within a few days.

Stitches:
Most surgeons use stitches that absorb and do not require removal. If your surgeon uses stitches that require removal, do not be critical or suspicious, as this is not uncommon. If stitches are to be removed, they will be removed in 5-7 days.

Back to work:
You may return to work in 4-7 days if the implants were placed over your muscle, and 7-10 days if the implants were placed under your muscle. If your job requires lifting, you may return to work in the same time frame but will probably have lifting restrictions.

Resume exercise:
For implants placed over the muscle, most plastic surgeons will ask you to stop all exercising for 1-4 weeks after surgery. For implants placed under the muscle, 2-8 weeks is the normal wait time.
As a side note, we have found that women planning to have implant placement under the muscle have less pain and a speedier recovery if they can stop pectoral exercises 4 weeks before surgery.

Your new look

As excited as you will no doubt be with your new look, we strongly advise you not to purchase any new bras until at least a month or two after your surgery as it is very hard to predict which cup size you will end up requiring. Breasts with implants behave differently to natural breasts, and we do recommend a proper fitting with a professional bra fitter to get a bra that is both comfortable and flattering for your new size.

It may take you some time to get used to your new look, and you may initially be concerned that friends or colleagues may notice your change in size and comment on it. In the majority of our cases however women experience a noticeable upsurge in self-esteem after this procedure and enjoy the freedom and confidence that breast augmentation surgery brings.