Breast Augmentation

The breast augmentation procedure can help women who wish to have fuller, larger, or more proportional breasts. Dr. DiFrancesco chooses from a variety of breast implant sizes, materials, and procedure techniques to customize the surgery based on the patients’ unique needs.

What is a Breast Augmentation?

Enhance your appearance and improve your self-confidence and body contour with a breast augmentation procedure! Breast augmentation involves using implants or fat to fulfill your desire for fuller, youthful breasts or to restore your breast volume lost after weight reduction or pregnancy. Breast augmentation, or “Boob job,” using breast implants both saline and silicone has been one of the most common plastic surgery procedures performed over the past 5 decades. Most recently, breast enhancement has been performed with fat grafting giving patients a more natural option to small volume augmentation, adding cleavage in the middle – so breasts are closer together, and to correct asymmetries between your breasts. Breast implants are the most studied device by the FDA, manufacturers have developed safe implants in many different shapes, styles, and sizes to fit your individual needs and fulfill your desires for breast augmentation. Dr. DiFrancesco has been an active consultant for the implant manufactures to help develop the best and safest implants for her patients. Call today for a consultation with your Atlanta plastic surgeon, Dr. DiFrancesco.

Candidates for Breast Augmentation

Breast augmentation is a long-term solution with a proven track record of satisfying results for women who wish to enhance their breast size, shape, and overall appearance. If you are in good medical health, a non- smoker,Breast augmentation is a long-term solution with a proven track record of satisfying results for women who wish to enhance their breast size, shape, and overall appearance. If you are in good medical health, a non- smoker, and have realistic expectations, then you are most likely a good candidate for breast augmentation. Breast implants maybe used for congenital breast deformities or deformities from illness or injury to improve breast appearance. If you feel your breasts are too small for your body or you are self-conscious wearing low tops, swimsuits, or form fitting clothes, breast implants can help. Patients who have lost that youthful breast shape with pregnancy/ breast feeding or weight loss commonly select implants to restore their breast volume. These patients may also need a breast lift with their breast implants to return their breasts to a pre-pregnancy look. During your consultation with Atlanta plastic surgeon Lisa DiFrancesco, MD, you will discuss which implant shape and size to choose, the incision placement and if you need additional procedures such as a breast lift.

Implant Types

Saline Implants

Breast augmentation can be performed with saline or silicone implants. Saline implants are filled with sterile saline and are often filled at the time of surgery to allow for minor adjustments in size to help correct for asymmetry. The disadvantage of saline implants is in the sub glandular position they are more visible with rippling. The saline implant will deflate, and the saline will be absorbed by your body when the implant ruptures. Saline implants generally have a higher risk of capsular contracture.

Structured Saline Implants–Ideal Implants

Breast augmentation with multichambered implants. Saline with a silicone structure core to allow the implants to hold their shaped better than traditional saline implants.

Silicone Implants

Breast Augmentation with silicone gel implants are pre-filled with a soft elastic gel which feels more like a natural breast. Silicone implants are less visible in the sub glandular position with less rippling. However, if the silicone implant ruptures, the implant and the gel will need to be removed.

Form Stable Cohesive Gel–Shaped Implants

Breast augmentation with these “gummy bear” silicone gel implants hold their shape much better because the gel is more cohesive made from more cross-linked silicone molecules. These implants are thicker and firmer feeling than traditional silicone implants. The implants may come in round or shaped/anatomic like a tear drop. The shaped implants give the breast a more natural ptotic appearance which less upper pole fullness than round implants.

Autologous Fat Transfer

During a fat transfer breast augmentation, or natural breast augmentation, liposuction is used to remove fat from an area of your body such as abdomen, thighs or hips. The fat is sterilely processed and prepared for injection into your breasts. Fat transfer is best for small volume augmentation, correcting asymmetry, or used in conjunction with implants to add more medial fullness.

Smooth vs. Textured Implants

Patients have the option of choosing smooth or textured implants for their procedure. Smooth implants have a smooth surface on the implant shell and are found on round implants. Textured implants have a rough surface to help prevent the implant from rotating in the pocket. Textured implants have a low capsular contracture rate when placed in the sub glandular pocket. Shaped implants are textured to help prevent the implant from rotating upside down.

implant position

Implants may be placed in front of the pectoralis muscle, commonly known as sub glandular, or sub muscular, behind the pectoralis muscle. A sub muscular implant only sits partially behind the muscle with as much as 50 % of the implant in thelower pole in the sub glandular position depending on individual anatomy. A breast augmentation performed by placing the implant in the sub glandular position will allow the implant to be more visible especially in small breasted women and has a higher risk of capsular contracture. Sub muscular implants may be associated with animation deformity in which the implant moves with contraction of the pectoralis muscle. The dual plane technique incorporates the advantages of both sub glandular breast augmentation and sub muscular breast augmentation by releasing the breast tissue from the pectoralis muscle avoiding animation deformity.

Location of the Incision

Breast augmentation through an inframammary incision is positioned underneath the breasts. It is the most common incision used in breast augmentation and the scar is well hidden under the breast. It allows your plastic surgeon to have the greatest visualization to perform a dual plane breast augmentation controlling the breast implant pocket during breast augmentation. This helps prevent long term complications such as breast implant malposition. The inframammary fold can be adjusted in cases of breast asymmetry and congenital breast disorders and reinforced to prevent the double bubble complication. The disadvantage of the inframammary incision occurs with inexperienced surgeons the scar may migrate onto the breast.

Periareolar Breast Augmentation

Periareolar breast augmentation uses an incision at the junction of the areola and the breast skin. This will allow the scar to blend into this natural area of demarcation. The surgeon will have good visualization of the breast pocket for sub muscular and sub glandular breast augmentation. The disadvantage is the breast implant is exposed to the normal bacteria found in breast tissue, increasing the risk of infection and capsular contracture. Another disadvantage to periareolar breast augmentation is the incision maybe too small for a pre-filled silicone implant.

Axillary Breast Augmentation

The axillary incision is not on the breast, but it may be noticeable when a patient raises their arm. Studies have demonstrated breast augmentation through an axillary incision has a higher rate of breast implant malposition.

The Breast Augmentation Procedure

A breast augmentation is performed under general anesthesia as outpatient surgery. Breast implants can be found in many different shapes and sizes. Dr. DiFrancesco will work with you during your breast augmentation consultation to determine which breast implant will fit your chest best to achieve your goals. The procedure will take approximately 1-2 hours and is commonly combined with other procedures such as a breast lift, fat grafting to the breast, or an abdominoplasty (Tummy Tuck) in a mommy makeover. Dr. DiFrancesco uses the long acting local anesthetic exparel to help minimize post procedure discomfort. Most patients will experience bruising and swelling after breast augmentation. Your final results will become visible over the next several months as your breast implants continue to settle.

Contact DiFrancesco Plastic Surgery to see which procedure is right for you!