What is a Breast Implant Placement or Breast Augmentation?

Breast implant surgery involves the placement of a silicone or saline filled prosthesis  on the chest wall to improve the size and appearance of the breast.  This often benefits those with naturally small breasts and those who have lost breast volume after having children.

Why should I choose Dr. Graham to perform my breast augmentation?

Dr. Graham is a board certified plastic surgeon with experience in all aspects of breast surgery.  He utilizes a special breast implant evaluation system.  This proven system uses scientific evidence to tailor each implant to the patient’s own anatomy and tissue characteristics.

What does breast implant surgery involve?

Breast implant surgery involves multiple choices.  Most of these factors are dependent on individual anatomy and preferences. The three main factors to consider are size, implant type, and plane/incision choice.

Size - Breast augmentation is not a one size fits all scenario, nor is it a situation in which the implant your friend or colleague had would be right size for you. The first thing taken into consideration is your chest wall width. We cannot put an implant in that is more narrow or wide than your current breast width. This would result in deformity that would not only appear off, but could often be uncorrectable. Once the breast width is determined, we can then determine your desired breast size. It is important not to choose an implant that is too large as this can irreversibly damage your breast tissue over time and result in problems such as rippling, double bubble deformity, and bottoming out. Therefore, we are conservative with our approach. We determine the size together based on your individual anatomy, your desires, and how you look with an implant sizer.

Implant Type - Implant type is based on your age, anatomy, and surgeon and patient preference.  Firstly, silicone implants are only FDA approved for those over 22 years of age.  Therefore, those under the age of 22 are candidates for saline implants. This is the only time we recommend saline.  For everyone else we recommend silicone implants.  They look and feel more natural, have less chance of rippling, and have a lower rupture rate.  From this point, we have to decide whether to use textured or smooth and round or shaped (gummy bear).  There are specific indications for each which we can discuss during your consultation.

Plane/Incision Choice - Plane is whether the implant is placed above or below the muscle. Usually, we place implants below the muscle as they have a lower complication rate and there is less chance of seeing rippling in this plane.  However, above the muscle is preferred in select instances. Incision choice, in our practice, is either periareolar (around the nipple) or inframammary (at the breast fold underneath).  Both choices can be very aesthetic.  We prefer inframammary as you have more surgical control over placement of the implant, less future interference with breast feeding, and an overall lower complication rate.  However, this is a choice we make together so patient desire is the ultimate consideration.

What are the main risks of this surgery?

Please refer to the following form published by the American Society of Plastic Surgeons


Will I have to stay in the hospital after surgery?

No.  Breast Augmentation is an outpatient procedure. In fact, Dr. Graham advocates a rapid recovery protocol in which you are back to normal activities within 48 hours. In fact, you are encouraged to shower and be out to dinner the night of surgery. You can have surgery on Friday and be back to work on Monday (your choice, of course).

What is the typical postoperative course?

Day 1

  • Keep dressings clean and dry
  • You will not need to wear a bra
  • No heavy lifting or straining

Day 2-14

  • You may now shower.  Tape will be in place over your incision.  This tape remains in place until removed by Dr Graham
  • Please begin arm exercises to prevent stiffness
  • No heavy lifting or straining

Day 14 to 1 month

  • You may slowly resume normal activities
  • You may resume sexual activity at 2 weeks (being gentle near the breasts)
  • You may resume cardiovascular exercise at 4 weeks (stationary bike is OK at 2 weeks)

You may drive when you are off narcotics and feel confident to control the car.   Most patients are able to drive within 1-2 weeks.
Time off of Work? Restrictions?
This is dependant on the type of work you perform.  Many patients with office jobs only require a week or less.  However, patients who perform heavy labor may require 4-6 weeks to recover.  You will not be able to do any heavy lifting for at least 4 weeks.