Improves the size and appearance of the breasts by implanting saline or silicone implants if applicable (the use of gel-filled implants may be government regulated) either under or over the chest muscle, thus producing a cosmetic enhancement.
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This procedure takes approximately two hours.
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A general anesthesia is administrated and the patient is completely asleep, or an intravenous sedation is used, combined with local anesthesia.
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Either - depending on the patient's doctor's decisions.
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Mild, temporary discomfort, mild to moderate swelling, a change in nipple sensation (either more or less), and temporary bruising. Breasts may be sensitive to stimulation for a few weeks.
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The implants may need to be removed and/or replaced to treat problems including: deflation, implant rupture, the formation of scar tissue around the implant (capsular contracture), which may cause the breast to feel tight or hard, bleeding and/or infection. Other risks are an increase or decrease in sensitivity of the nipples or breast skin, which occasionally may be permanent.
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The patient can return to work within a few days. She should avoid any physical contact with breasts (excluding her bra) for approximately three to four weeks. Scars should fade and flatten anywhere from three months to two years after surgery, depending upon how an individual heals.
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The outcome varies from patient-to-patient. However the overall effect is enhancement of breast size for improved appearance.
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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. Here is an explanation of the advantages and disadvantages of both options. The advantages of placing the breast implant above the muscle includes less discomfort post-operatively, less swelling, and less chance that the breast will appear to move when you are exercising your upper body. Movement during exercise has been a great concern for many women. 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 during flexing. 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. One drawback is that rippling can be a significant cosmetic problem that can occur when the implant is placed over the muscle. The advantages for placing the implants under the muscle include less interference with a mammography and less rippling in the upper half of the breast. Also, there is more cushion between the implant and skin. In general, thin and small-breasted women are probably better off with implants under the muscle. Placement of the implants under the muscle has few drawbacks, many of which are temporary. The discomfort after surgery can be heightened along with more swelling. You may also find that your breast appears to move when you are exercising your upper body. Thin, small-breasted, athletic women must weigh the options. You need to 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. Even though working out can cause distortion of the breast, this is not too much of a problem unless you work out in the nude. So, do not automatically believe that your breast implants need to go over the muscle if you have a workout regime. An alternative for these athletic women is to have silicone breast implants. Of course, the placement of your implants is your call. Be sure to discuss it carefully with your plastic surgeon.

2. Breast Implant Surface (Textured or Smooth)

By implant surface, plastic surgeons are referring to whether the implant is smooth or textured. Once the implants are in place under your breasts, it is impossible to tell whether you have smooth or textured implants. A smooth implant is just that - as smooth as the surface of a balloon. Textured implants are rough, somewhat like sandpaper. 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. Also, textured implants are more likely to cause rippling, which can be a big problem for thin and small-breasted women. For these reasons, most plastic surgeons favor smooth implants for breast enlargement.

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. Furthermore, they find that teardrop implants may rotate, giving an unnatural appearance, and they impose restrictions in that they must be textured. Because plastic surgeons tend to recommend the techniques that work best in their hands, you should heed the advice of your plastic surgeon in this matter.

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. 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. Although the range, 300 - 450cc is probably the most common, the 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 and you must feel comfortable with your size.

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 implants 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 the breast implants were designed in anticipation of that. 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 the 17th of November 2006, the FDA approved silicone gel breast implants for use in primary breast augmentation for any woman over the age of 22. 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 they might have a higher rate of capsular contracture, the incision is usually longer, and the cost is higher than saline breast implants.

IMPORTANT: Surgical Escapes surgeons only use Silicone Gel Implants

7. Fill (This pertains only to Saline Implants, as Silicone Implants are pre - filled by the manufacturers)

Saline implants come in increments of about one ounce, which is 30 cc. Mcghan implants are made in 30cc increments (180cc, 210cc, 240cc, 270cc, 300cc, etc.). Mentor Implants are made in increments of 25cc (200cc, 225cc, 250cc, 275cc, etc.). Each saline implant can be and should be overfilled by an additional 25-30 cc. This is because the implants were meant to be overfilled, and the implant manufacturers not only stand by their products when they are overfilled, but they encourage surgeons to overfill them. Here's why: overfilling reduces deflation, rippling, and sloshing. Under filling has no advantages and significant disadvantages (rippling, sloshing, and deflation). So, after you select your desired final volume, your surgeon should select an implant that is one size smaller, and then overfill it to your desired volume.

8. Site of Incision

The options for site of incision are under your breast, around your nipple, in your armpit, or through your belly button. 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. Finally, the incision can be made through the belly button. This is called TUBA, or Trans-Umbilical Breast Augmentation. The advantage is that the incision is hidden inside the belly button. The disadvantages are that the implant must be placed in the sub glandular plane (over the muscle), the surgeon may not be able to correct certain breast asymmetries, the deflation rate may be higher, and revision surgery through the original scar is not possible, so an additional scar would be necessary (around the nipple or under the breast). For all of these reasons, few surgeons perform this incision when placing breast implants.

General advice for those considering Breast Augmentation

Ask us to help you minimize your risks, expedite your recovery, and get the best possible results from breast enlargement surgery. Do not believe websites which state that you will need to have your implants replaced every 10 years. You will only need to have them replaced if you are having a problem. Whereas you might have a problem and need to have them replaced, you might not. The rule here is - if it's not broken, don't fix it!

Lifelong follow - up is important.
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