A. Absolutely! Natural breast augmentation is what I specialize in. Most of my patients choose implants in the 200-350 cc range. Women now want a subtle enhancement with smaller implants to balance their toned abdomen and are coming in asking for discreet, unobtrusive, natural breasts. Some of my patients say to me, “I want to know I had implants, but I don’t want everyone else to know.” They want to look like they were born with them. Women emphasize filling out the top part of the breast (the “upper pole”), not necessarily increasing significantly in volume. Most of my patients only want to go up 1 or 2 cup sizes.

Your Consultation

After I determine your specific goals, then I will perform a breast exam, including measurements and photos. The photos are just of your torso, never have your face in them, and are for surgical planning. Individualizing the breast augmentation plan for each patient is paramount. I do this using our 3D imaging system, where you can virtually “try on” implants and see what the breast augmentation would look like on your body. We will also put silicone inserts in your bra to get a sense of the volume and shape of the implants.

We will go over the different types of implants available, and you can see and touch each one to determine the one that feels the most natural to you. We will choose your implant based on your preference and my recommendation on which implant is right for you.

We will also discuss which plane I recommend for your implant. The implant placement can be below the muscle (submuscular), below the strong covering of the muscle (subfascial), or above the muscle (sub-glandular). The plane we select for your implant depends on your anatomy and goals.

You may find that composite breast augmentation, a combination of implant and fat transfer to the breast, best meets your goals. A composite is often chosen by patients who want a softer, more natural feel of the upper part of their breast or desire a more narrow cleavage gap. I perform the fat transfer using fat collected and purified from liposuction of the abdomen, hips, or thighs. I then transfer the purified fat into the breast to enhance its shape and feel. A good analogy is like icing on the cake – the transferred fat is the icing, and the implant is the cake.

Your Surgery

I generally perform a breast augmentation with a 3-4 cm incision in the crease, which allows the most direct access to the breast, heals the best, and preserves sensation and lactational ability. Once I create the pocket, I place a sizer, a silicone shell that fits your breast width, and confirm what volume implant fits into your breast to ensure a hand-in-glove fit. Once I select the proper implant volume, we wash the breast with an antibiotic solution. The final implant is then placed into the pocket with a minimal touch technique, observing meticulous sterility. Your incision is then closed in several layers.

Your Recovery

After augmentation, I ask my patients not to lift anything heavier than 10 lbs for 4 weeks and avoid excessive reaching, pushing, or pulling. These restrictions ensure that the breast pocket heals well around the implant. Patients can drive in about 3 days after they are off pain medications and return to work after about 7 days.

Implants typically stay high for the first several weeks to months, gradually descending into the lower part of the breast to meet the incision. One side will always descend a little faster than the other. Don’t worry, this is normal! At 1 month, you can start to lift more; at 3 months, you are beach-ready. You can expect to see final results in around 9-12 months.

It is important to me to always provide a natural look for my patients. I am thrilled to see my patients’ new confidence once they see the results of this subtle yet impactful augmentation.

If you are considering a breast augmentation, please call our office or use the surgical consultation form on our website; I am happy to have a discreet consultation with you to discuss your options.