Video: All You Need to Know About Breast Augmentation Surgery

Watch this educational video to learn more about breast augmentation, including the best candidates for breast augmentation, choosing the right implant option, or determining whether you need a breast lift or augmentation. Featuring board certified plastic surgeons, Dr. Michael Roark, Dr. Lori H. Saltz, Dr. John Smoot, and Dr. Johan Brahme.


About Breast Augmentation in San Diego

Dr. Roark: Breast augmentation continues to be a very popular procedure in plastic surgery. What we’re doing is we’re enhancing the size and shape of a woman’s breast by introducing an implant on top of the chest wall under the breast.

The biggest revolution that’s going on in breast augmentation these days is that the implant companies have given us more choices for implants. They have really come to understand that one 300cc implant that’s round in every woman’s chest isn’t the right thing necessarily to do. There’s a lot of anatomical variation. There’s a lot of differences in a woman, whether she’s had a child or hasn’t had a child, how long she breastfed, how stretchy her breasts may be, and then anatomical variations. So the newer implants have different shapes. They have different gel/fill ratios such that we can then really find many more choices, so that we can fine tune the profile, the width of the breast implant, to the profile and width of the patient’s breast. So I find that that makes it exciting now.

And it’s not very hard to do the breast augmentation procedure, but there’s so much thinking and customization that has to occur in order to get the right implant, the right size, for the right patient’s anatomy, and I find that’s the challenge today with breast augmentation. So there’s an awful lot of practitioners that are in other specialties that do these operations, but I think all those powerful things that we learn in training in plastic surgery makes us able to perhaps make better choices to help our patients get the result that they want.

Dr. Saltz: The important thing to distinguish breast augmentations from breast lifts. Breast augmentations do not lift the breasts. They only fill out your tissues. If you need your breasts lifted, if your nipples are low or they’re pointing down, or your breast volume is below your folds, just putting in bigger implants and filling up the tissues is not going to lift the breasts. You’re just going to have larger saggy breasts. So if you need your breasts lifted, then you need to have lifts, which we call mastopexies. If you also want them larger, then you need lifts and implants. They can be done together. They can be done one or the other, or they can be done one and then maybe later the other.

Some people say, “I want my breasts lifted.” It does make the breasts look a little bit smaller because you’re consolidating all of the tissues, taking away some of the skin, and where it was a spread out breast, it’s now a tighter consolidated breast. It does make it look smaller. And so they’ll come back and say, “Well, now they look too small, and so I want implants.” That doesn’t happen very often, but it does happen. It can be done separately. Or somebody has augmentations and, after having children, their breasts have sagged and their implants have not. They want their breasts lifted back on to the implants, but the two procedures are separate.

Dr. Brahme: Probably the most common, actually the second most common cosmetic surgery procedure in the United States is breast augmentation. I believe it’s over a million done per year. Advances in breast augmentation is the fact that now we have much wider range of implant choices. We have implants that are shaped, that look like a breast. We have implants that are smooth, we have implants that are textured. We have implants that have different shapes, different projections, and so on and so forth.

So we have the ability to match breasts that look a little bit different, and everybody’s a little bit different from side to side, and most women are a little bit embarrassed about that. Some women don’t even know that they’re different from side to side until we start doing some measuring, but most women who are different know it. I try to put them at ease, and tell them what one of our nurses told me. She said, “They’re sisters. They’re not twins.” But with different types of implants, we can make them look more symmetrical.

And most people just want to look proportional. They want to fill out a bra. They want to fill out a bathing suit. The myth that everybody wants to have huge breasts, it’s not really true. Sure, there are people who come in who want very large breasts, and we can accommodate that. But most people come in and they just want to be proportional. They want their breasts to match the rest of their body, and that’s what we try to do. And in the consultation, what we do is that we have patients try on different types of implants so that they can give them a dry run and say, “Well, I like this,” or “Maybe a little bit larger,” and that way they can see the possibility of what they would look like afterwards.

Dr. Smoot: We have a unique system. We have two things that we do. First of all, I do measurements of the patient. The width, how much sag, how much the distance are between the folds, such that I can determine what I think will fit best. Once I do that, we then have them try on sizers in a bra and a shirt. They look at themselves and they go, “Yeah. I love it,” or, “No. That’s not big enough,” or, “Whoa. That’s way too big.”

Once I know what they want, I can say, “Yes, that is a reasonable good choice for you,” or, “No. You’re going way overboard. This isn’t going to look natural. You’re going to look very fake.” Then they can make a choice if that’s what they want or not. We also like to take a photo of the patient, such that we can actually take their actual breasts and, through the magic of computer technology, make them augmented to what they think they would look like. It’s not exact, but it gives them a good idea of what they would look like with the implants in.

Dr. Saltz: When it comes to breast implants, you have a number of options now that can be combined in a number of different ways. The first is whether you have a saline-filled implant or silicone-filled implant. A number of years ago, there was only the option of having saline-filled implants. They have been on the market for about the same length of time as silicone implants, but there was a period of time when silicone was taken off the market. Now both are back on the market, so women have the choice of either one.

And there’s goods, there’s pluses and minuses with both of them, but in my opinion, there’s more minuses with the saline implant than there are with the silicone implant. In both implants, you have a choice of whether you’d want a smooth surface or a textured surface, and there’s pluses and minuses for both of them. And it depends on the patient and what kind of breasts they have, how much laxity they have, what kind of activity they might be engaged in, and these are things you have to take into consideration.

There’s also now what we call different profiles, which is sometimes confusing to patients. Profiles refer to the width of the base, or the diameter versus the height, and there’s usually low, moderate, and high. Now some companies have moderate high and you can get combinations. High does not refer to higher up this way. It refers to high this way. And so we have breast implants that have narrower bases and higher or more projection, and we have ones that are wider and flatter. And it depends on the shape of the patient’s breasts, or chest and breast, in the look they want which one they might choose. Most of those are all round.

Then we have shaped implants. They are contoured so they’re shaped more like a breast, and those come in not only in different profiles but different bases. And the bases could be wider than they are tall, or taller than they are wide, or have a round base. And in addition to the base, they can be low, moderate, or high profile. So you can see that you can come up with so many. I can’t remember how many different combinations you can put together for your options in what you’re going to get.

Dr. Smoot: The recovery is pretty straightforward. After the surgery, which takes about an hour or an hour and a half to do, we then have them go home. They come back to our office the next day, which we check on them. We do check on the night of the surgery to make sure they’re fine. If everything looks good that first day, I’ll see them back in a week, and then we give them some instructions and make sure everything is healing properly. Then in about six weeks, and then about six months.

But it takes a good two weeks before I let them do whatever they want. After two weeks, they can do whatever they feel comfortable doing. They’re going to hurt anything. But it may be four to six weeks before they’re doing all the activities they were doing before. But generally speaking, it’s that first week or two that we really want things to be in a situation where they’re not doing too much, because what we don’t want them to do is to get active and cause some bleeding, and then we have to go back.