Breast Augmentation

The breast augmentation procedure can help women who wish to have fuller, larger, or more proportional breasts. Plastic surgeon 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 plastic surgery 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 plastic surgery 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 augmentation may improve 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 surgery 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 for your breast surgery treatment plan.

Implant Types

Saline Implants

Breast augmentation can be performed with saline or silicone implants during plastic surgery. Saline breast 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 breast implants generally have a higher risk of capsular contracture. Plastic surgeons will help you assess which implant type is right for you.

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 breast 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 gel 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 silicone gel 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 plastic surgery 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 the lower 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.

Incision Options

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 Incision

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 Incision

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.


Kind words from our patients

Professionalism at it's best. From the staff to Dr. Difrancesco, service is impeccable. All things that matter as it pertains to customer service will impress anyone who walks through that door. Dr. D is very knowledgeable of every service offered and leaves no question unanswered. She has a very pleasant bedside manner which is much needed in her field and the procedure results live up to EVERY expectation. I've had minimally invasive procedures on both my face, thighs, and legs and I am thoroughly pleased. She's 6 star in my books.

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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. Plastic surgeon Dr. DiFrancesco will work with you during your breast augmentation consultation to determine which breast implant surgery will fit your chest best to achieve your goals during your plastic surgery. 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.


Get your ideal look with the help of a double board certified plastic surgeon with experience in achieving excellent breast surgery results. To get started, contact our Atlanta office by calling or filling out our online form. Dr. DiFrancesco can begin planning your customized breast augmentation surgery, implant exchange or breast revision during a private plastic surgery consultation.

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

Breast Augmentation Frequently Asked Questions

Are breast implants under warranty?

Yes. Some manufactures do offer a warranty. For the latest information on breast implant warranties in Atlanta please call our office.

Can breast implants cause pain years later?

If you are experiencing pain years after your breast implant procedure it could be from implant rupture or scar tissue forming around the implant. You should follow up with a plastic surgeon for evaluation as soon as possible

Can breast implants last 30 years?

Yes, fat transfer to the breasts is becoming more common. Small volumes of fat may be transferring to the breast to increase the breast one cup size, correct small asymmetry or add more cleavage medially.

Can you breast feed after breast augmentation

Breast augmentation will not stop your ability to breastfeed.

Do breast implants cause autoimmune disease?

There has not been a study to show a connection with autoimmune disease and breast implants

Do breasts sag after breast augmentation?

Breast augmentation will give your breasts a small lift.

Do you have to replace breast implants every 10 years?

Breast implants typically last approximately 20 years. The earlier generation implants lasted 10 years on average.

Does getting breast implants make you gain weight?

You should not see a significant change in your scale after breast implants.

Does insurance cover breast implants?

Insurance will cover breast implants when they are used for breast reconstruction after cancer

How do you know if you have capsular contracture?

Capsular contracture is when normal scar tissue around your implant becomes firm and hard, changing the shape of your breast implant.

Is there an alternative to breast implants?

Yes. Fat transfer to the breasts is becoming a more popular procedure. Fat transfer can increase your cup by 1-2 sizes or help correct breast symmetry

What are gummy bear implant?

Gummy bear implants describe breast implants which have a more cohesive gel. If the implant were to rupture or break the silicone gel would act like a gummy bear.

What are Natrelle breast implants?

Natrelle implants are breast implants manufactured by Allergan.

What is the difference between a breast augmentation and breast implants?

Breast Augmentation is a surgical procedure to enhance your breast size. Breast implants are devices used to increase your breast size

Is breast enlargement possible without surgery?

I am not aware of anyway to enlarge your breasts without breast implants or fat transfer.

What is the average cost of a breast augmentation?

Breast Augmentation averages between $4,000 to $6,000

What makes the new teardrop-shaped breast implants different from the standard, round implants?

Shaped implants gradually slope from the upper pole (the highest part of the breast) to the lower pole (lower breast). This slight teardrop shape creates a youthful and very natural look.

Are these shaped implants FDA approved?

Yes. In fact, these silicone shaped implants have been in surgical use for about a decade in the US and were FDA approved this year.

Is the breast augmentation procedure different with these new implants?

No, it is an outpatient procedure with recovery like breast augmentation surgery with standard round implants. Most patients are fully recovered in four to six weeks.

In addition to the more natural look, are there any other advantages to the new, shaped breast implants?

Yes. They have lower complication rates for rupture and capsular contracture when compared to smooth round silicone implants used in breast augmentation.