Breast augmentation is a confidence-boosting procedure that enhances your breast size and shape. Dr. Darren M. Smith is a highly skilled, board-certified plastic surgeon that specializes in this procedure. He has advanced fellowship training in aesthetic breast surgery, ensuring natural-looking results.
With cutting-edge techniques and diverse implant options, breast augmentation offers enhanced, proportionate contours. Whether you are aiming to go from a an A cup to a slightly larger B cup, or looking for a full C cup or beyond, Dr. Darren M. Smith will guide you towards achieving your aesthetic goals.
What is Breast Augmentation?
Breast augmentation, also known as augmentation mammoplasty, aims to increase breast size through the use of implants or fat grafting. Implants are carefully placed beneath breast tissue or chest muscles. Fat can be grafted into the soft tissue of the breast. The goal is to provide a natural-looking enhancement that suits your body type and desired proportions.
Reasons for considering augmentation include desiring fuller breasts, seeking balance after pregnancy or weight changes, correcting asymmetry, boosting self-confidence, or other personal goals.
Breast Augmentation Procedures
Several techniques can help achieve natural-looking augmentation results.
1. Augmentation with breast implants
Augmentation using breast implants remains the most common approach. Implants are carefully placed during surgery either behind breast tissue in a subglandular position or deep under the chest (pectoralis) muscles in a submuscular position.
Types of Breast Implants
There are two principal types of implant materials to consider – saline and silicone gel. The major manufacturers for these implants on the US market are Allergan, Sientra, and Mentor. Differences between manufacturers tend not to be clinically significant. There are differences in warranty programs. The decision between breast implant manufacturers generally comes down to the best size and shape, the different companies do offer slightly different options in this regard.
- Saline breast implants consist of silicone shells filled with sterile salt water after placement. These implants are approved for ages 18 and older. Some patients prefer these implants because if they rupture, the saline leaks out immediately and is absorbed by the body. However, these implants do not look or feel as natural as silicone implants.
- Silicone breast implants contain a silicone filling similar in consistency to a gummy bear. These are approved for ages 22 and above. These implants look and feel more natural than saline implants. If a rupture occurs, it may not be immediately obvious as the silicone in modern implants tends to stay in place..
Another less common kind of implant is the “structured saline implant”. These are manufactured by Ideal, and are sometimes referred to as “Ideal Implants”. These implants have an inner structure that reduces the motion of their saline contents. This is designed to make them look and feel more natural. Dr. Smith believes silicone is a better option from this perspective.
Other important implant characteristics of breast implants include:
- Firmness: Some implants are softer and some are more firm. Firmer implants tend to hold their shape, enhancing upper pole volume (the shape does not sag with gravity).
The most firm implants are often called “form-stable breast implants” because they hold their shape, or form. These implants are also sometimes called “gummy bear implants” as their gel inside feels similar to the popular candy of the same name. These implants maintain their shape even if the shell breaks due to their thicker gel consistency.
- Shape: Implants can be either round or “anatomic” (also called “tear-drop” or “shaped”). Round breast implants are circular and provide even volume distribution to the upper and lower pole.
Therefore, it doesn’t matter if they rotate in the pocket. Shaped breast implants have the profile of a tear-drop. They are also called “anatomic” because they match the shape of a breast when viewed from the side. They offer less upper pole volume and more lower pole volume. If these implants rotate it can give the breast an unnatural shape.
- Shell Type: Smooth breast implants have shells without any bumps or irregularities. Textured implants are covered with a rough surface. Textured implants were designed to stick to surrounding tissue like velcro, helping them hold their position.
This is especially important for shaped implants, as rotation can cause visible problems with breast shape. A textured implant is also designed to have a lower risk of capsular contracture. Textured breast implant shells have been associated with a very rare form of cancer (anaplastic large cell lymphoma, or ALCL) and are therefore seldom used in the United States. Since anatomic implants are usually textured to prevent rotation, anatomic implants are also rarely used in the United States.
Dr. Darren M. Smith can discuss the particular pros and cons of each implant material, structure, shape, and texture based on your individual goals, anatomy, and lifestyle factors. Choosing the best implant is critical to achieving natural-looking, long-lasting results.
2. Fat transfer breast augmentation
Fat transfer breast augmentation, also called “autologous fat grafting” is a natural approach to breast augmentation.
This technique involves using liposuction to carefully collect your own fat cells and then introducing them into the breasts. This option favors those seeking a smaller size increase with the preservation of their natural shape and feel. We cover fat transfer breast augmentation here
3. Composite Breast Augmentation
This is a powerful technique that combines implant-based breast augmentation with fat grafting. In composite breast augmentation, a breast implant is used to achieve the majority of volume enhancement.
Fat is then grafted to further smooth the contour of the chest, especially at the upper pole of the breast to ensure a very natural appearance. Composite breast augmentation can also be used in those with less breast tissue of their own to ensure a smooth transition to the chest wall at the edges of the implant.
4. Combined Breast Augmentation (with Implants or Fat) and Breast Lift
Combining implant- or fat-based augmentation with a breast lift (also called a “mastopexy”) can further enhance shape and symmetry in individuals who have sagging, or “ptosis,” in addition to volume loss.
Factors like pregnancy or weight fluctuation over time may affect breasts in this manner. A combined breast augmentation and lift can simultaneously increase breast size and lift tissue, restoring shape, fullness, and proportion.
5. Breast Augmentation B to D Cup
Increasing 1-2 bra cup sizes is a frequently requested goal. B to D cup augmentations seem to be especially popular. These procedures tend to use implants in the 250cc to 350cc volume range.
An implant profile (degree of projection from the chest wall) and base width (diameter) is chosen to best match the patient’s unique size and shape. Infra-mammary, periareolar, or transaxillary incisions are made to access the subglandular or submuscular pockets.
Factors like existing tissue volume, skin elasticity, anatomy, and desired projection influence implant selection. Larger implant sizes are more likely to cause breast ptosis (or sagging) over time. Using an inframammary approach and submuscular implant placement is most likely to ensure the preservation of breastfeeding ability.
Initial Consultation
This important meeting allows time for a thorough discussion. Dr. Smith will carefully review your full surgical and medical history with you. A thorough physical exam assesses existing breast size, skin elasticity, and any concerns.
It’s also an opportunity for you to openly share your aesthetic goals and expectations with him. Implant options, potential risks and benefits, recovery timeline, and post-op care will be explained in detail.
Having realistic perspectives on what surgery can and cannot achieve is key. We will also use our advanced 3D imaging technology to let you see the result of different breast implant sizes on your own body to help you pick the perfect size.
The Surgical Procedure
Breast augmentation surgery follows several meticulous steps. These include:
1. Anesthesia
Dr. Smith uses general anesthesia for these procedures. You will be asleep, comfortable and safe. You’ll wake up approximately one hour after the procedure begins.
2. Incision Site Selection
Factors like your anatomy, skin quality, and aesthetic goals are considered to determine the optimal incision placement. All of these are approximately the same length (about 3-4 cm). The options are:
| Inframammary incision | In the crease under the breast. This position is the most frequently used. It is very well hidden and has the lowest risk of infection and capsular contracture.It allows direct control during pocket creation and implant positioning. |
| Periareolar incision | Along the bottom of the areola, the darker skin surrounding the nipple structure. When this incision heals perfectly, these scars can be nearly invisible. If, however, there is any problem with healing these scars be very easy to see. These incisions are also more prone to infection and scarring, as it is impossible to completely sterilize the milk ducts and some are cut with this approach. For the same reason, this approach is more likely to interfere with breastfeeding. |
| Axillary incision | Also called the “transaxillary approach.” Within the armpit, with no visible scars on the breast. This approach leaves no scar near the breast itself. It also has a higher rate of infection and capsular contracture, as the sweat glands in the armpit are cut, and these, like milk ducts, cannot be completely sterilized. |
3. Implant Pocket Location
Using one of the access incisions listed above, tissues are carefully manipulated to create pockets for your implants that will yield a rounded, natural, symmetrical shape customized for your anatomy.
Proper pocket dimensions are critical for a natural appearance and implant stability long-term.
Implant pockets can be formed in one of several anatomical planes:
| Subglandular placement | The implant is placed under the gland of the breast, but over the muscle. This approach may be chosen in some scenarios where the patient has very well developed pectoralis muscles. These results may not look as natural as there is less tissue (no muscle) covering the implant. |
| Submuscular placement | The implant is placed under the pectoralis major muscle. This is the most common approach and offers the most natural look and feel, as the breast gland and muscle are over the implant hiding it from the outside world. This approach also reduces the risk of capsular contracture. |
| Dual plane placement | This position involved placing the upper portion of the implant under the muscle and the lower portion under the breast tissue. This allows for a great deal of flexibility in shaping the breast. |
| Subfascial | The implant is placed under the pectoralis major muscle. This is the most common approach and offers the most natural look and feel, as the breast gland and muscle are over the implant hiding it from the outside world. This approach also reduces the risk of capsular contracture. |
4. Implant Insertion
Once pockets are formed, sterile implants are gently placed through the incision into the newly-fashioned pockets using a no-touch technique and a Keller funnel.
This is a carefully controlled process that avoids shifting or wrinkling the surrounding tissues. The Keller funnel allows us to place the implant into the pocket without actually touching it at all (the “no touch technique”).
This technique is designed to reduce the rate of infection and capsular contracture.Anatomically guided adjustments are made until optimal projection and balanced, proportional contours are achieved to meet your personalized goals.
5. Incision Closure
The incision site, whether inframammary, periareolar, or axillary, is closed in layers using meticulous suturing to support the integrity of the new contour and promote healing with minimized scars.
6. Post-operative Care
Supportive dressings or bras, carefully designed movement programs, and follow-up care maximize results as your incision sites heal completely in the following weeks.
Post-Surgery Care and Recovery
It’s normal to experience some swelling, soreness, and minor discomfort for 1-2 weeks after surgery. Discomfort typically peaks within the first few days as the body heals.
Dr. Smith uses a rapid recovery breast augmentation technique that is optimized to get you back to your life as rapidly as possible. Most patients feel up to returning to a desk job in 48 hours.
We generally advise our patients that they can resume lower body workouts in 2 weeks and light upper body exercise at 4 weeks.
Strenuous exercise, aerobic activity, and heavy lifting should be avoided for 4-6 weeks after the procedure. We prefer that our patients sleep on their back for the first 1-2 weeks after the procedure .
Pain medications may cause constipation so stay hydrated with water and fiber-rich foods. Our rapid recovery breast augmentation technique is also designed to limit the amount of narcotic pain medication required.
Light activities like walking boost recovery when you feel ready. Gentle sexual activity may resume after about a week while limiting pressure on breasts for a full 6 weeks.
It is essential to follow our guidance on showering, wound care, and supportive bra wear to ensure a clean, safe healing environment.
Bathing may start after 48 hours but submerging your incisions in bathtubs, pools, or the ocean should be avoided for two weeks. We like our patients to wear a surgical bra for the first 2 weeks, a sports bra for the next 4 weeks, and then transition into any bra of their choice.
Patience, rest, and adhering to your post-op instructions will maximize results and prevent issues as your body adapts to its new contours. Don’t hesitate to contact Dr. Smith with any concerns.
The Breast Augmentation Experience
Potential Risks and Complications
While breast augmentation is generally a very safe procedure when performed by a board-certified plastic surgeon, all surgical procedures have some risks. Such risks include:
| Complication | Description |
| Implant malposition | The implant shifts from its intended position, impacting the appearance |
| Poor or visible scarring | May occur depending on one’s healing tendencies and incision site |
| Changes in nipple sensation | Like numbness or hypersensitivity |
| Post-operative infection | At incision points or around implants that may require treatment to avoid serious issues |
| Capsular contracture | Involves a hardening of scar tissue surrounding the implant, distorting its shape |
| Implant leakage or rupture | The shell of the implant is broken, compromising the device |
Dr. Smith will discuss minimizing these complications through careful technique selection, incision location tailored for your unique case, and advising on post-surgery guidelines.
Benefits of Breast Augmentation
Achieving Fuller Breasts
Augmentation is able to precisely increase breast size and provide an enhanced shape that creates a balanced and proportional appearance. Custom sizing allows one to achieve one’s personal aesthetic goals.
Correcting Breast Asymmetry
Using different implant sizes allows us to improve symmetry between breasts that differ in size, contour, or position.Correcting breast asymmetry not only addresses a cosmetic concern, but also can improve self-confidence.
Lifting Ptosis (Breast Sagging)
While breast augmentation cannot treat significant ptosis, very mild cases can be improved with implants. Breast augmentation can be combined with a lift (mastopexy) to increase breast size while effectively elevating and reshaping breasts affected by factors like aging, weight changes, or breastfeeding. These powerful combined procedures yield a more full, perkier profile.
Addressing Tuberous Breasts
This congenital condition involves breasts that have a very tight inframammary fold and a long, narrow shape. Breast implants can form a stable foundation for the reconstruction of breasts with this challenging anatomy. .
Achieving a Youthful Appearance
By restoring lost volume, augmenting the upper pole curve, and balancing proportions, one’s figure takes on a rejuvenated aesthetic. This can boost feelings of femininity and self-esteem.
Achieve Your Aesthetic Goals with the Expert
You’ve considered the potential benefits of breast augmentation and are ready to pursue a more youthful, balanced look. Now it’s important to choose a board-certified plastic surgeon who truly understands your goals and health concerns.
Dr. Darren M. Smith’s patients benefit from years of specialized training and thousands of safely performed procedures. Through a private consultation, Dr. Smith can expertly evaluate your case, discuss procedural and implant options tailored to your unique needs, and address any questions to help you make an informed decision.
Experience the confidence afforded by working with an expert. Contact our practice today to schedule your consultation and take the first step towards achieving your personal breast aesthetic goals.
Augmentation Services we offer
