In 2020, there were approximately 250,000 breast augmentations performed by plastic surgeons. The continued popularity of breast augmentation is a testament to the high levels of patient satisfaction achieved with the operation. Breast augmentation is a safe procedure with several studies showing a very high satisfaction rate (95% at 6 years post-op). Even though patients who undergo breast enlargement come from a variety of backgrounds, most describe feelings of improved self-image, increased self-esteem, and better interpersonal skills after surgery.

Breast Procedures at SVIA

Breast Augmentation Patient Testimonial

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. Others may want to improve how they look in clothing or a swimsuit. Breast implants can dramatically change a woman’s appearance and self-esteem by enlarging breast volume to provide a fuller or more youthful appearance. In many cases, patients may be self-conscious about 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.

Additionally, breast augmentation can help reconstruct the breasts after cancer removal surgery to help reclaim a patient’s self-image. While not all cancer patients feel a desire to rebuild the breast(s) following a mastectomy, a combination of implant placement and other breast reconstruction techniques can help restore the appearance of one or both breasts as naturally as possible. Everyone has their own personal reasons for considering breast augmentation, and our board-certified plastic surgeons are here to discuss how to make your goals a reality.

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).

Before & After

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Implant Types

Here at Silicon Valley Institute for Aesthetics (SVIA), 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.

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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.

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.

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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.

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Pre-Operative

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.

Recovery

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.

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Cost of Breast Augmentation

At Silicon Valley Institute for Aesthetics, breast augmentation typically costs between $8,500 and $10,500. This price range includes the costs generally associated with cosmetic surgery, including the surgeon, anesthesia, and facility (operating room) fees. Breast augmentation is a highly customized procedure, therefore the price of each breast enhancement will be similarly tailored to each patient’s needs and preferences. Details unique to your treatment plan will influence your personalized quote, including:

  • The type of implants chosen
  • The breast augmentation technique utilized
  • The complexity of your procedure

Once Dr. Jerome Liu or Dr. Tom Liu evaluates your concerns in a consultation, our patient care coordinator will be able to provide you with an accurate cost estimate. We accept financing plans from an array of plastic surgery lending companies, including CareCredit®, ALPHAEON™ Credit, and Prosper® Healthcare Lending.

These financial institutions can make breast augmentation costs more manageable by allowing qualified patients to pay for their procedure in affordable, low- to no-interest installments. If you have any questions, please don’t hesitate to call our office and a member of our team would be happy to assist you.

How Long Do Breast Implants Last?

Breast implants can last for many years, even decades for a large portion of breast augmentation patients. In general, they do not need to be replaced unless you experience a complication or you simply want to exchange them for a different size or type of implant. Options include replacing saline implants with a silicone fill-material (or vice versa), exchanging them for a larger/smaller size, or removing your breast implants altogether.

For most patients, the results of breast augmentation are very enduring and last 15 to 20 years or longer. Certain factors can reduce the longevity of your breast enhancement, including pregnancy after the procedure or weight gain. It’s generally best to maintain a stable weight after surgery to avoid altering your new breast contours. Similarly, pregnancy and breastfeeding with implants may reduce the elasticity of the skin and change the outcome of your procedure. Dr. Jerome Liu and Dr. Tom Liu recommend living an active lifestyle and undergoing surgery only after your family is complete to best maximize the results of your breast augmentation.

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What are the Most Common Breast Implant Complications?

The risk of serious health outcomes after breast augmentation is extremely low, but there are certain complications that can occur after years of implant use. All of these conditions can be addressed during a breast revision procedure if necessary. In general, breast implants can come with a risk of:

Capsular contracture

Refers to the formation of scar tissue around an implant. While some scar tissue is expected after surgery, further treatment usually isn’t necessary unless the appearance of the breasts changes, or the scar tissue begins to feel tight, hard, or painful.

Implant rippling

Occurs when a patient can see or feel the edges of an implant. This may occur in cases where a patient doesn’t have enough breast tissue to adequately cover the implant. Rippling can often easily be addressed during breast revision with fat transfer techniques.

Implant rupture

Happens when there is a tear, break, or leak in an implant. Although a ruptured implant is very rare, we encourage patients to remain vigilant to changes in the look or feel of their breasts in case a “silent” rupture occurs.

Dr. Jerome Liu and Dr. Tom Liu will help ensure you know the risks and limitations of breast augmentation so you have a well-informed understanding of the procedure. Like all cosmetic surgeries, the risk of complications is significantly lower when you’re under the care of a board-certified plastic surgeon.

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Transgender Breast Augmentation

If you’re a transgender or gender non-binary patient who is seeking breast augmentation to achieve a more feminine chest, our plastic surgeons also utilize breast implants during MTF (male-to-female) top surgery. While the techniques used during breast augmentation and top surgery can differ, those who plan to undergo MTF top surgery similarly select the best incision location, implant placement, and size and type of implant.

Our plastic surgeons would be happy to speak with you about your goals and explain the process of MTF top surgery in a consultation. Whatever the reason, breast augmentation surgery can provide psychological, aesthetic, and personal benefits for the right candidate. To find out if breast augmentation is right for you, please contact our office to schedule an appointment with Dr. Jerome Liu or Dr. Tom Liu.

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Breast Augmentation FAQ

Am I a good candidate for breast augmentation?

How do I choose between high, medium, and low profile implants?

How can I achieve a natural aesthetic result?

How do I decide which incision is right for me?

How do I know if I need a breast lift or just an implant?

When is the implant supposed to be in the right position?

Am I a good candidate for breast augmentation?

Breast augmentation involves the placement of a saline or silicone filled implant behind the breast and muscle to increase the size of the breast. The only effect of the breast implant is to increase the volume of the breast. Therefore, good candidates for breast augmentation are patients who would like an increase in size without the need to raise the nipple or the breast from a position that is too low. The ultimate goal is to fill the breast to provide a more youthful appearance without damaging the skin and tissue.

How do I choose between high, medium, and low profile implants?

Breast implants come in all different sizes and shapes. Ultimately, during the consultation, we will find the implant(s) that fit your body the best. The profile of the implant indicates how projecting the implant is relative to the base width. In general, the moderate profile (generally known as a moderate plus) is the most versatile and widely used implant for primary augmentation. This implant strikes a good balance between offering projection and volume while maintaining a natural appearance. High and low profile implants are sometimes used depending on specific circumstances for a patient. Low profile implants are more likely to be used in someone who only wants a small augmentation and high profile implants tend to be used more commonly in revision or secondary surgery.

How can I achieve a natural aesthetic result?

No two breasts are the same. Therefore, there is not one implant that is perfect for everyone. We now have many shapes and sizes of implants available today that patients can achieve a natural shape and feel with implants. These include newer 5th generation silicone round implants, anatomic-shaped “gummy bear” implants and the new, structured IDEAL saline implant. The board-certified plastic surgeons at Liu Plastic Surgery aim to achieve the patient’s goals while maintaining a natural look. At a consultation appointment, you will have a customized evaluation, bio-dimension analysis, and measurement to determine which implant is right for you to create a natural aesthetic result and feel.

How do I decide which incision is right for me?

There are several incision locations available for breast augmentation surgery. The location is dependent on a patient’s anatomy and the type of implant. The most common and most advantageous incision is the inframammary fold (breast crease). Most importantly, the breast crease incision is associated with the lowest rates of capsular contracture. Furthermore, this incision is hidden in the fold with minimal visible scarring. The cease incision also gives direct access for implant placement and gives the surgeon the most control in the operation to achieve the best results. The breast tissue is not disrupted because the implant does not need to go through the breast to get behind the breast and muscle. Other incision sites include periareolar (nipple) and transaxillary (armpit). The periareolar incision is associated with higher rates of capsular contracture and patients can experience loss of nipple sensation. Per manufacturer guidelines, the transaxillary incision is limited to saline implants only. Both of these latter incisions (periareolar and transaxillary) decrease the surgeon’s ability to be precise with the operation.

How do I know if I need a breast lift or just an implant?

Breast augmentation involves the placement of an implant to enlarge the breast. However, breast augmentation does not change the shape of the breast. If the breast shape has changed with gravity, time, or pregnancy, a breast lift (mastopexy) may be needed to restore the shape of the breast. This would involve additional incisions to raise the position of the nipple and remove some of the extra skin on the breast. A simple way to determine whether a breast lift would be needed is to examine the position of the nipple relative to the breast crease (where the breast meets the chest wall – where the underwire would sit). If the nipple is below this line, then a breast lift (mastopexy) might be needed. If the nipple sits above this line, then it is likely only an implant would be needed.A breast lift with an implant, also known as an augmentation-mastopexy, can be performed at the same time in good candidates. This would involve one trip to the operating room where both an implant is placed under the muscle and the breast shape is adjusted by lifting the nipple and removing any excess and damaged skin. Only a consultation with a board certified plastic surgeon could tell you if this would be the best option for you.

When is the implant supposed to be in the right position?

The implant pocket and the implant should be in the correct position immediately after surgery. Even though the implant is correctly placed, sometimes they appear high because the lower pole of the breast has not had time to stretch out and there is post-surgical swelling in the upper part of the breast. Post-operatively, the pocket can stretch a little bit until the breast capsule matures. Most surgeons believe that the breast capsule stabilizes between 3-6 months. After 6 months, the capsule is likely mature. Although there is long term remodeling, if the implant is not in the ideal position, a revision surgery to remove or manipulate the capsule is likely needed after the 6 month mark. Every patient is unique so there can be patient-to-patient variation. There are also differences in the amount of expected maturation between silicone versus saline, textured versus smooth, and round versus shaped implants.

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