Dr. Steven Fagien & Dr. Elbert Vaca

Breast Augmentation

Breast Procedures

Breast augmentation, or augmentation mammaplasty, is a surgical procedure that involves placing either a silicone or saline filled implant to enhance the shape and size of the breasts. Breast augmentation is the most popular aesthetic surgical procedure performed in the United States. Breast augmentation can be used to treat several concerns including:

  • Small breast size
  • Asymmetry between your breasts
  • Loss of volume in the upper portion of your breasts
  • Sagging of the breasts
Where is the breast implant placed?

The breast implant can be placed either directly beneath the breast tissue or beneath the chest muscle. The main factor determining where to place the implant is the quality and thickness of your skin and breast tissue. If you have thinner skin and breast tissue, the breast implant is typically placed beneath the chest muscle to better conceal the breast implant.

What incisions are involved?

There are 4 possible incisions that can be used for breast augmentation including: 1) beneath the breast, 2) around the areola, 3) in the armpit, 4) around the navel. The most commonly used incisions are beneath the breast or around the areola because these offer the best control to properly place the breast implant. These scars are typically easy to conceal.

How do I decide on the size of my breast implants?

This is a decision made by both you and your surgeon. The width of your breast and chest is the main factor that determines the implant size that will best fit your body. The implant size can be somewhat adjusted to fit your goals. It is important to know that the larger the breast implant, the heavier and often wider the breast implant becomes. Over time, an overly large breast implant tends to stretch and thin the tissues of your breast. These are all important factors to consider and will be discussed in detail during your consultation with Dr. Vaca.

What is the difference between silicone and saline breast implants?

It is important to know that all breast implants use an outer silicone shell, which can then be filled with either silicone or saline. There are advantages and disadvantages to choosing between a silicone and saline filled breast implant.

Silicone filled breast implants have a softer and more natural feel than saline implants. However, silicone implants are more expensive, require a slightly longer incision, and rupture of the implant shell can be more difficult to detect.

Saline implants can be placed using a smaller incision and rupture of the implant can be easily detected. However, saline implants feel firmer and less like natural breast tissue. The potential disadvantages of saline filled breast implants become more apparent with larger sized breast implants.

Can I increase the size of my breasts without using a breast implant?

In some patients who have good skin tone without drooping of the breasts, breast fat grafting (i.e. transferring your own fat from another area of your body to your breasts) may be an alternative way to increase the size of your breasts. There are several limitations to breast fat grafting including that only a mild to moderate increase in breast size can be achieved. The main advantage is avoiding the use of a breast implant.

Am I a good candidate for breast augmentation surgery?

During your consultation, Dr. Vaca will help determine if you are a good candidate for breast augmentation. The best candidates are healthy women with realistic expectations who desire improvement in the size of their breasts. There are many variables to consider including your breast and chest wall size and shape, the implant size and shape, use of silicone vs. saline filled implants, smooth vs. textured implants, and the type of incision. In addition, not all patients are best served by breast augmentation alone. If you have breasts with loose skin that lie low on your chest, a breast lift or augmentation – mastopexy may better address your concerns.

Can I breast feed if I have had a breast augmentation?

Yes! But it is important to know that many women without a breast augmentation are unable to successfully breast feed. However, several studies have demonstrated no difference in success with breast feeding between women who have and have not had a breast augmentation.

Can I have a mammogram after breast augmentation?

Yes! If you have had a breast augmentation, mammograms can still be performed using a different technique for breast cancer screening.

Does breast augmentation increase my risk of developing an autoimmune disease?

This question has been studied extensively over the past several decades. There is no conclusive evidence that breast augmentation increases a patient’s risk of developing autoimmune diseases.

What are the risks of breast augmentation?

All surgical procedures carry a degree of uncertainty and risk. Thankfully, the risk of a major complication is rare.

All surgical procedures involve incisions which result in scars. The majority of these incisions heal very well, but in some instances these scars may be more visible. Infection and bleeding can occur but are thankfully rare.

Scar can form around the breast implant leading to a change in the shape of the breasts over time, otherwise known as capsular contracture. Every woman naturally has some degree of asymmetry between both breasts – it is important to know that some degree of asymmetry will remain after surgery.

With textured breast implants (i.e. implants with a textured outer shell), there it the potential risk of developing a rare form of cancer. For this reason, Dr. Vaca generally avoids the use of textured breast implants. There is also the risk of needing further surgery after breast augmentation.

Before and After Photos

Breast Augmentation – Case 1

Breast Augmentation – Case 2

Meet Dr. Vaca

Dr. Vaca

Dr. Elbert E. Vaca is a Plastic & Reconstructive Surgeon who completed his medical training at The Johns Hopkins University School of Medicine and Northwestern Memorial Hospital.
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Meet Dr. Fagien

Dr. Fagien

Dr. Steven Fagien is one of the foremost oculoplastic surgeons in the United States and the world. He completed his medical training at the University of Florida and a fellowship in oculoplastic surgery at the University of Illinois Eye and Ear Infirmary.
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