Breast augmentation, customized to you.

Breast augmentation helps increase the size and shape of the breast. With the latest implant technology, the specific implant shape, firmness, and projection can be customized to your goals and desires — rather than fitting you to one standard look.

Dr. Chen will discuss the best and latest treatment available to address your goals. Unlike previous generations of breast implants, augmentation today should be customized to you. The consultation is a two-way street — a chance to discuss your body shape, preferences, and the specific areas of the breast to be addressed. Your input is well received and necessary for a successful outcome.

Your first question to consider is whether you prefer saline or silicone. The majority of implants placed in the United States are silicone, which generally have a softer, more natural feel. Both are encased in a silicone outer shell; saline implants require an additional step in which the saline is added after the implant is inserted into your body.

The major manufacturers of breast implants are:

• Allergan (Natrelle)
• Mentor
• Sientra
• Motiva

Dr. Chen will make the smallest incision possible — usually around 4–5 cm — that still allows safe placement of the implant. It's important to express your preferred selection during consultation. There are several incision options:

Inframammary — Made in the crease where the breast meets the chest. This is the best-healing incision of all the types and is considered the cleanest.

Periareolar — Made right under the nipple. This won't work if you have small nipples or need a larger incision for a larger or shaped silicone implant. Because small amounts of bacteria from the milk ducts can enter the tissue, it may increase the thickness of the capsule that forms around the implant, which can leave a feeling of firmness.

Transaxillary — Made in the armpit; the scar is visible when you lift your arms. Some implant manufacturers don't recommend this approach because of potential damage to the implants.

Scars generally fade gradually over six months to a year and return to the color of the surrounding skin.

There are two primary options for placement of the implant:

Submuscular (partially under the muscle — also called "Dual-Plane") — Ideal for those with a small amount of natural breast tissue, as the overlying muscle adds an extra layer over the implant. It's often used with saline implants, which are then less likely to be palpable. Placement under the muscle gives a more natural slope, makes the implant harder to feel, and makes any rippling less obvious.

Subglandular (over the muscle) — Good for those who want more apparent projection, since the muscle won't push the implant down, and well-suited to those with more natural breast tissue. It usually means a faster recovery with less discomfort — though the implant may be more visible and easier to feel.

One of the fun parts of your initial consultation is trying on implant sizers, which give you an idea of what you'll look like at each size. The office staff guides you through the sizing process — you aren't simply left alone in a room with a box of implants to try on.

Bringing a close friend makes a big difference: a lot of topics are covered on consultation day, and a second set of ears helps you weigh the decision and remember all the details.

The natural reaction is to answer in cup size, but cup sizes aren't standardized — a 36D from one company can vary considerably from a 36D at another. That's part of why each implant is measured in volume, in cubic centimeters such as 350cc or 450cc. During consultation, Dr. Chen takes your breast measurements to recommend a range of implant sizes that fit your frame.

Augmentation can also be customized to how wide or projected the implants are, which affects how much side breast or cleavage you develop. In general, the larger the implant, the wider it is. Some women have asymmetrical breasts that may call for a larger implant on one side to balance them.

You can choose either round or teardrop-shaped implants. Teardrop implants — also called contoured or anatomical — project farther at the bottom than the top, designed to follow the natural contours of breast tissue. Interestingly, most patients and doctors still opt for round implants.

The final shape depends on several factors. Your body type, the amount of pre-existing breast tissue, and the location of implant placement are much more indicative of how your breast will ultimately look than the implant's shape alone.

"Implant profile" describes how far out the new breast will project. You can choose a moderate, moderate-plus, or high profile — and your lifestyle plays into the choice.

Moderate — A rounded, natural look that projects the least. A good option if you have a broad chest.

Moderate plus — Also called normal, regular, or standard. More projection but less width than moderate; often suited to a narrower build.

High — Full size and the most projection, with a lot of fullness in the upper breast. Because it has the least width of the three, it won't push into the underarm area — making it a strong option for a very narrow build. If you're athletic, your profile should match your lifestyle without interfering with how you move.

The surface of an implant may be smooth or textured. Once an implant is placed, your body forms a "capsule" around it. Texturing was originally thought to lower the chance of capsular contracture (a hardened capsule), but that's likely more dependent on the technique of placement. In shaped implants, texturing is important to keep the implant from rotating in the chest.

Gummy bear cohesive gel implants are a specific type of silicone implant — the latest advancement on the traditional silicone implant. The silicone inside holds its structure more strongly and longer than older implants. Cut in half, the gel still holds its shape, and these implants are less likely to develop folds and ripples. Their shape directly dictates how the breast will look after surgery.

Gummy bear implants aren't for everyone. Because the gel is dense, some patients feel they are too firm or don't look as natural — which is exactly the kind of trade-off Dr. Chen will walk through with you.

Breast augmentation is performed as an outpatient surgery under general anesthesia. The surgery usually takes about one hour, and you go home the same day.

You'll be given a compression garment to wear after surgery to support the breasts in their new position and help reduce swelling. Many patients don't need strong pain medication after breast augmentation, though it can be prescribed as needed. Most patients are able to return to work after several days to a week.

Good candidates for breast augmentation typically:

• Desire fuller, perkier, and more youthful breasts
• Have a mild degree of breast sagging, which can be lifted with augmentation techniques
• Have some breast asymmetry, which can be corrected during surgery

All breast implants today are considered state-of-the-art and can last a lifetime. Dr. Chen will discuss the long-term picture with you so you know exactly what to expect.