There are 3 possible incisions that can be used for breast augmentation including:

• beneath the breast (i.e., inframammary)
• around the areola (i.e., periareolar)
• in the armpit (i.e., transaxillary)

The most commonly used incisions are beneath the breast or around the areola because these offer the best control to properly place the breast implant in the majority of patients. These scars are typically easy to conceal.

This is a decision made by both you and your surgeon. The width of your breast and chest is the main factor that determines the implant size that will best fit your body. Based on the width of your breasts, the implant size can then be somewhat adjusted to fit your goals. It is important to know that the larger the breast implant, the heavier and often wider the breast implant becomes. Over time, an overly large breast implant tends to stretch and thin the tissues of your breast. These are all important factors to consider and will be discussed in detail during your consultation with Dr. Vaca.

It is important to know that all breast implants use an outer silicone shell, which can then be filled with either silicone or saline. There are advantages and disadvantages to choosing between a silicone and saline filled breast implant.

Silicone filled breast implants have a softer and more natural feel than saline implants. However, silicone implants are more expensive, require a slightly longer incision, and rupture of the implant shell can be more difficult to detect. After breast augmentation with a silicone implant, the FDA recommends a breast MRI or ultrasound 5 years after surgery, then every 2 – 3 years thereafter to evaluate the integrity of the implant.

Saline implants can be placed using a smaller incision and rupture of the implant can be easily detected. However, saline implants are more prone to visible rippling, feel firmer and less like natural breast tissue. The potential disadvantages of saline filled breast implants become more apparent with larger sized breast implants.

Thankfully no. Modern breast implants can remain intact significantly longer than 10 years – if there are no issues with your breasts implants, then no surgery is necessary.

Reasons to undergo further surgery after breast augmentation include breast changes with aging and pregnancy/breastfeeding – these patients may experience stretching of their skin, hormonal changes of their breast tissue, and drooping of the breasts which may benefit from changing the breast implants and/or a breast lift.

Other potential reasons to change breast implants include capsular contracture, implant rupture, the desire for a different implant size or type, visible implant rippling, the desire to remove the breast implants.

All surgical procedures carry a degree of uncertainty and risk. Thankfully, the risk of a major complication is rare.

Scar can form around the breast implant leading to a change in the shape of the breasts over time, otherwise known as “capsular contracture”.

Every woman naturally has some degree of asymmetry between both breasts – it is important to know that some degree of asymmetry will remain after surgery.

With textured breast implants (i.e., implants with a textured outer shell), there is the potential risk of developing a rare form of cancer called, “Breast Implant Associated Anaplastic Large Cell Lymphoma”. For this reason, Dr. Vaca exclusively uses smooth surfaced implants, with rare exceptions.

Breast implants are not lifelong devices and will likely require replacement during the patient’s lifetime.

During your consultation, Dr. Vaca will help determine if you are a good candidate for breast augmentation. The best candidates are healthy women with realistic expectations who desire enhancement in the size and shape of their breasts. There are many variables to consider including your breast and chest wall size and shape, the distance between your breasts, the location and size of your areolas, pre existing breast asymmetries, the implant size and shape, use of silicone vs. saline filled implants, smooth vs. textured implants, and the type of incision. In addition, not all patients are best served by breast augmentation alone. If you have breasts with loose skin that lie low on your chest, a breast lift or augmentation – mastopexy may better address your concerns.