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Breast Augmentation

breast1-300x200Breast augmentation (enlargement) using breast implants is one of the most common plastic surgery operations performed in the United States and the number of women seeking breast enlargement continues to increase. In 2007, there were approximately 350,000 breast augmentations performed by plastic surgeons. The continued popularity of breast augmentation is a testament to the high patient satisfaction with the operation.

Breast augmentation is a safe procedure with several studies showing a very high satisfaction rate (95% at 6 years). Even though patients who undergo breast enlargement come from a variety of backgrounds, many describe feelings of improved self-image, increased self-esteem, and better interpersonal skills after surgery.

Why Women Choose Breast Augmentation

Women may elect to undergo breast augmentation for many reasons. Some women merely want to increase the size of their breasts. Breast implants can dramatically change a woman’s appearance and self esteem by enlarging the size of the breasts to give a fuller or more youthful appearance. Breast augmentation may improve how a woman looks in clothing or in a swimsuit. Other women may be self-conscious of their breast size or shape following pregnancy, breast feeding, or massive weight loss. In these situations, breast implants can help restore the natural volume and contour of the breast.

Patient Choices and Operative Techniques

Several choices confront the patient who is thinking about breast augmentation. Depending on who your surgeon is, Dr. Jerome Liu or Dr. Tom Liu will walk you through the decision making process and help you select an implant and operative procedure to help you achieve your goals. The pre-operative decisions can be divided into: implant type (silicone gel versus saline), implant size, pocket placement (above or below muscle), and incision (inframammary fold, peri-areolar, or axillary).

Implant Types

Here at Liu Plastic Surgery, we offer the latest silicone and saline implants in a variety of shapes and sizes. We aim to deliver results that exceed your expectations while maintaining a very natural look. Our plastic surgeon will discuss all of your options with you, and a large part of the initial consultation will be focused on describing the implants, answering your questions, and helping you determine which size and type of implant is the best option for your needs.

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Implant Size

Choosing an implant size is an important decision. Although there are many ways to estimate the effect of an implant, nothing is more important than having a detailed discussion with your surgeon, either Dr. Jerome Liu or Dr. Tom Liu. We also have a variety of sample implants in the office for you to feel and examine.

Our goal is to help you select an implant that will produce natural-appearing breasts without the stigma of being “overdone” or “over the top.” A properly selected implant can improve the fullness of the breasts and augment the cleavage without causing distortion. On the other hand, an implant that is too large will look unnatural and cause distortion of the breast. Furthermore, an over-sized implant may have long-term effects on the surrounding breast tissue, leading to thinning skin and tissue as well as increased stretch and sagging of the breast.

Incision Selection

There are several incisions that are commonly used for breast augmentation: inframammary fold (breast crease), peri-areolar (nipple), and axillary (armpit). Selecting an incision for the placement of a breast implant depends on several factors and not every patient is a candidate for each incision.

The most common incision used in the United States is the inframammary fold incision. This is often considered the best incision because it is associated with the lowest rates of capsular contracture. The breast crease incision also provides the best avenue to control implant placement, position, and symmetry.

Implant Placement – Above Versus Below the Muscle

Breast implants can be placed above or below the muscle. The location of the implant is often referred to as the “pocket dissection.” A subglandular implant is placed under the breast but above the muscle, whereas a submuscular implant is placed below the breast and below the muscle. There are advantages to each approach.

There are several advantages of a submuscular implant. First, there is a slightly lower risk of capsular scarring around the implant (hardening) that might occur with time. Second, there is less rippling or palpability of the implant because it is placed beneath the breast and the muscle. Finally, mammograms are easier to perform and are easier to read in patients who have submuscular implants (compared with subglandular implants). Subglandular implants may be ideal in some patients. In patients who are extremely athletic or are body builders, subglandular implants are less likely to distort or move during contraction of the muscle. Finally, a subglandular implant may be used to provide a “mini-lift” in women with sagging breasts, therefore avoiding a larger operation.

The Consult

Your initial consultation will take approximately 45 minutes to one hour. During this time, Dr. Liu will take a thorough medical history, help you with the decision making process, and answer all of your questions. You will also have an opportunity to see and feel sample silicone and saline implants. The goal of the consultation is for you to obtain all the information you need to make an informed decision regarding breast augmentation surgery.


Approximately 2 weeks prior to surgery, you will have a pre-operative appointment. At this time, you will sign the surgical consent, have photos taken, and receive an information packet. The pre-operative packet includes detailed instructions for before and after surgery. It is important to avoid aspirin, ibuprofen, and other blood thinning medications for at least two weeks before surgery. Also, do not eat or drink anything after midnight on the evening prior to surgery.

About the Operation

Breast augmentation surgery typically takes around 1 hour and is an outpatient procedure. The operation is performed under general anesthesia with an anesthesiologist present. Having an anesthesiologist present allows Dr. Liu to concentrate on attaining the best cosmetic result possible instead of dividing his attention between the operation and monitoring the vital signs of the patient. Dr. Liu always performs breast augmentation surgery using the latest surgical techniques to achieve a natural appearing result.


Patients go home on the same day as surgery but should have a responsible adult stay with them for 24 hours. The recovery period ranges from 3 days to 1 week with most patients feeling very well by 4-5 days. Strenuous activity should be avoided for 2 to 3 weeks. Dr. Liu will follow you closely during the recovery period and will let you know when you can resume full activities.


Whatever the reason, breast augmentation surgery can provide psychological, aesthetic, and personal benefits for the right candidate. To find out if breast augmentation (breast implants) is right for you, please make an appointment with Dr. Jerome Liu or Dr. Tom Liu.

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Out of Town Patients

Plane Icon More and more of our patients are finding us through referrals by friends and family members or through internet research. For our out-of-town patients, we provide free pre-consultations by phone so you can feel confident in your decision to meet with us at our office.