Breast Augmentation Implant & Procedure Types

Implant types

Because there several choices to be made about the style of your implant, it is important to discuss your options with your surgeon.


Two implant surface types are available to augmentation patients, smooth and textured. Textured implants have small bumps on their surface. These implants were developed in hopes of reducing the risk of contracture, a complication some women develop after augmentation. You can read more about contracture and other complications in our FAQs. Smooth implants have a smooth rather than bumpy surface. Many surgeons prefer smooth implants for their softer, more natural feel.


Women have the choice of implants filled with cohesive silicone gel or with saline (salt water solution). Both types of fill have been used since the earliest days of breast implantation. Unlike the older pre 1990 silicone implants with a more liquid fill, modern implants are filled with silicone that has a “gummy bear” consistency. While there is no evidence that exposure to silicone can cause any disease in human beings, some women prefer to have their implants filled with saline. In the unlikely event of a rupture in the outer shell of the implant, saline, a completely bio absorbable salt water solution would be simply absorbed into the body and the implant would deflate. Silicone is not bio degradable and therefore a woman would not likely notice any change in implant volume if there was loss of integrity in the shell of a silicone filled implant. Because of this, the FDA recommends a periodic MRI to confirm integrity of silicone filled implants. Most surgeons and patients agree that saline filled implants do not have the natural feel of silicone filled implants


There are two shape options for implants, tear drop or round. Generally, round implants conform best to the natural shape of the breast and offer women favorable results. Tear drop, or contoured, implants may be a fit for women who have had parts of the breast removed during a previous surgery, such as mastectomy reconstruction. Round implants may be either smooth or textured while shaped implants are always textured.


Implants can be placed either behind the breast tissue, subglandular, or behind the pectoralis chest muscles submuscular. About 75 percent of augmentation is done in the submuscular plane. Studies show that a submuscular placement may reduce the chance for scar tissue contracture and allows for easier mammography following surgery. Submuscular placement typically offers better results for thin women or women hoping to drastically enlarge their breasts. Subglandular placement may offer women with sag in their breasts better results.

Procedure types

Inframammary fold or Sub-pectoral

This procedure involves an incision in the fold underneath the breast and tends to allow the surgeon more direct control of implant positioning. About 70 to 80 percent of breast augmentations are performed using an inframammary fold procedure. The incision placement allows for minimal effects on the milk-producing areas of the breast. The same incision may also be used if complications arise or additional surgeries are needed. Inframammary fold augmentation works well for older patients or mothers, since age and pregnancy allows for a natural amount of sag in the breast. This natural sag allows for the surgical incision to be well hidden for most women. Young women, thin women, or women who have not had children yet and have no crease under their breasts may have a more visible scar with this procedure.


During this procedure, an incision is made in the armpit, or axilla, and is used to insert an implant either above or below the muscle. Some surgeons will use an endoscope, which is a small, fiber-optic camera, to help them complete the surgery. About 10 percent of breast augmentations are done using a trans-axillary procedure. The advantage of trans-axillary augmentation is that there is no scar on the breast itself. A potential disadvantage of this approach is that getting symmetrical implant positioned is somewhat more difficult, and correction of post-operative problems will likely require additional incisions on the breast. Also, there is potential for thickened scars that are visible with sleeveless clothing, bathing suits or while arms are raised.


In this procedure, an incision is made around the nipple-areolar complex and the scar tends to blend into the edge of the areola. Since the incision is very near milk-producing parts of the breast, women who receive peri-aeriolar augmentation may have more problems with breast feeding and nipple sensation following surgery. This is the preferred incision for women with very small breasts who do not have any fold under their breasts.

Trans Umbilical Breast Augmentation (TUBA)

This newer approach to augmentation uses an incision through the belly button. An endoscope, or small fiber-optic camera, is tunneled through the incision to a pocket under the breast. The implant is then inserted through this tunnel and inflated with saline. TUBA is only available for subglandular saline implants. Implants placed using TUBA have a slightly increased chance of damage. During placement, surgeons may possibly tunnel under one of the muscles. If there are any complications or additional surgeries needed, you may need an additional incision made closer to the breast. Lastly, manufacturers often do not honor an implant warranty if it is placed using TUBA. Because of these potential problems, our surgeons do not recommend the TUBA approach.

Contact for more information or to schedule a consultation with a Board Certified Plastic Surgeon 734-998-6022

Breast Surgery: Options

Breast surgery options

Breast surgery typically can be divided into three general categories: augmentation, reduction and reconstruction.

Breast augmentation

Breast augmentation is performed to enhance the appearance, size and contour of a woman’s breasts. Women consider breast augmentation — or augmentation mammoplasty — for different reasons. Some women feel their breasts are too small in relation to their body contour. Some women desire augmentation after size loss associated with pregnancy and lactation. Others desire to correct an asymmetry in breast size.

Breast augmentation is performed with implants that can be placed over or under the pectoralis chest muscle. The incision can be placed in the axilla (armpit), areola or lower breast. Breast augmentation can be assisted with endoscopes. When implants are placed beneath the pectoralis chest muscle, there is less interference with screening mammography. Women should be aware, however, that breast implants may interfere with the detection of cancer and that breast compression during mammography may cause implant rupture.

A breast implant is a silicone shell filled with either saline (a salt water solution) or silicone gel. A woman determines her desired size by fitting trial implants. Currently, saline filled implants are used on an unrestricted basis. Silicone gel filled implants are available only to women participating in approved studies.

Breast augmentation is a relatively straightforward procedure. As with any surgery, some uncertainty and risk are associated with breast augmentation surgery. Know your concerns and expectations. Review the benefits, risks and alternatives. Seek consultation with a board certified plastic surgeon.

Breast reduction

Large, heavy, pendulous breasts can be uncomfortable. The excess weight can cause neck pain, back pain, skin irritation, bra strap indentations, numbness or weakness. Breast reduction is known as reduction mammoplasty. The procedure involves removal of excess skin, fat and glandular tissue.

With this type of surgery, scarring can be extensive. Normal breast sensation, nipple-areola sensation and milk production are usually preserved. Possible side effects include pain and lumpiness from scar tissue and the inability to breastfeed. The reduction procedure reduces breast appearance, volume and contour, while preserving breast sensation and function. After breast reduction, women report tremendous improvement in their symptoms.

Breast reconstruction

Breast reconstruction seeks to recreate a breast with the desired appearance, contour and volume. The nipple-areola component also is recreated. Normal breast sensation and the ability to breastfeed are lost when the sensory nerves or milk glands and ducts have been removed or significantly injured.

The appearance, contour and volume of the breast can be recreated with implants or with a woman’s own tissue. If an implant is used, the implant is sized to match the opposite breast. A breast also can be recreated using a woman’s own tissue. At times, a segment of the lower abdominal wall can be used. Other tissue options for autologous (using your own tissue) reconstruction include the back muscle and skin or a segment of a buttock.

Breast lifts

In some women, the skin is not strong or resilient enough to support the weight of the breast, causing the breasts to sag. With this condition, called ptosis, there is too much skin compared to breast tissue. To give the breast a lift, or what is known as mastopexy, the excess skin must be removed.

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5 Weird New Breast Augmentation Procedures

Breast Implants? So 1990’s. These days silicone isn’t the only substance being used to boost our busts. From stem cells to Botox, doctors are developing new augmentation methods that are breaking barriers in the plastic surgery world.

Here are five weird new boob jobs worth knowing about.

Fat Transfer Breast Augmentations Using Stem Cells

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Actress and breast cancer survivor Suzanne Somers recently made headlines when she opted to have her breast reconstruction done using this fairly new method. After undergoing a lumpectomy and reportedly waking up with ‘half her breast gone,’ Somers had her breast restored to its original size using fat and stem cells harvested from her abdomen.

While noting that this method has only been around for about two years and isn’t yet widely used among plastic and reconstructive surgeons, Dr. Shahram Salemy, MD, FACS, and Medical Expert, says with advances being made, “we’re now seeing outstanding, lasting results from this approach.” The doctor first performs liposuction to remove some fat from areas like the hips or the abdomen, filters and concentrates it, and then injects it into the breasts.

“This is a good option for women who are not interested in having implants, have some excess fat in other areas of their body, and want a fuller look to their breasts,” Dr. Salemy says. It can also be used to correct size discrepancies between the two breasts.

Weight-Loss Assisted Breast Reconstruction

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The Cleveland Clinic is performing a relatively new breast procedure that’s been a breakthrough for obese women who are breast cancer survivors.

“In the past, obese patients who underwent a mastectomy were not candidates for breast reconstruction, in part because of the risks associated with operating on a patient with a high BMI, but also because implants are not made to properly fit the body of an obese woman,” says Abby Linville, Communications Associate for the Cleveland Clinic. “So, the doctors started a program that helped the women lose weight, get down to a healthy BMI, and then, using the excess tissue from the abdomen, they recreate a new, natural-looking breast,” Linville says.

It’s a medical trifecta-a woman overcomes breast cancer, loses weight, and emerges with a new, healthier-looking body, including a reconstructed breast and tummy tuck, all in one.

The Pastry Bag Boob Job

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You wouldn’t try to push a water balloon through a buttonhole, right? Common sense says no-the balloon would burst and create a mess! Plastic surgeons are faced with a similar task each time they insert a silicone breast implant into a small incision site.

When South Carolina-based plastic surgeon Dr. Kevin Keller, M.D. was introduced to silicone gel implants in 2006 (they had been off the market under FDA investigation for 14 years), he instantly felt there had to be a better way to insert large, pre-filled implants rather than trying to push them through small incisions using just a finger, which was standard procedure.

Dr. Keller turned to the kitchen-literally-and found the perfect inspiration: the funnel-shaped pastry bag. In 2009 the KELLER FUNNEL was introduced to U.S. plastic surgeons and today nearly 20 percent of all silicone gel breast implant procedures are conducted using the specially coated nylon tool.

Botox-Assisted Breast Augmentation

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Botox in our boobs? Sounds strange, right? When you hear about how New York City-based plastic surgeon Dr. Matthew R. Schulman is using it, it makes sense! Dr. Schulman has introduced a new method of breast augmentation using the injectable form of Botulinum Toxin.

According to Dr. Schulman, Botox-Assisted Breast Augmentation has two major advantages: less post-operative pain and a faster final cosmetic result. The procedure is done as a standard breast augmentation where the implant is placed under the muscle. After the muscle has been elevated, Botox is then injected into the muscle before the implant is placed. This partially paralyzes the chest muscle, resulting in less muscle spasms that naturally occur during the healing process, and dramatically reduces patient discomfort. Also, Dr. Schulman adds that with regular breast augmentation, it takes about three to four months for the implants to “drop” into the desired position. By paralyzing the muscle with Botox-Assisted Breast Augmentation, implants can settle into position in about three to four weeks.

Injectable Fillers to Plump the Bust

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You’ve probably heard of injectable fillers like Restylane being used to plump up your lips or cheeks to give your face a more youthful look. And now an injectable filler that’s similar to Restylane called Macrolane is being used throughout Europe and Mexico to boost breasts and butts too!

Macrolane is designed specifically for body shaping, and the company that makes it says results can last up to 12 months with a single treatment. In 2009 several media outlets reported that actress Jennifer Aniston used the substance to add fullness to her breasts, but it’s important to note that it’s not yet available for this type of use in the U.S. If deemed safe here in the U.S. for injecting into larger areas, Macrolane can give women a non-surgical alternative to boosting their bustlines.

  • By Jené Luciani

Breast enlargement (implants)

Always book an appointment to meet the surgeon before the procedure.

You may want to ask your surgeon:

  • about their qualifications and experience
  • how many breast enlargement operations they’ve performed
  • how many operations they’ve performed where there have been complications
  • about the type and manufacturer of the implant they use and why
  • about the surgical technique used and the placement of the implants
  • what sort of follow-up you should expect if things go wrong
  • what their patient satisfaction rates are

Read more about choosing who will do your cosmetic procedure.

Choosing your implants

There are 2 types of implants, made of silicone or saline.

Silicone implants are the most common type used in the UK. They’re less likely to wrinkle and feel more natural. However, they can spread into your breast and cause lumps.

Saline implants are more likely to fold, rupture or go down over time. If they do go down or rupture, the saline will safely be absorbed into your body.

You should discuss the pros and cons of each type of breast implant with your surgeon, along with the size and shape of your implants and where they’ll be placed (behind the breast or behind the breast muscle).

How long breast implants last

Breast implants do not last a lifetime. It’s likely they’ll need to be replaced at some point.

Some women may need further surgery after about 10 years, either because of problems with the implants or because their breasts have changed around the implants.

3. Your body type will help decide what kind of incision your doctors use.

If you have very small areola, that might make areola incision more difficult, says Dr. Doft. Scarring is also something to consider talking to your doctor about. Dr. Norman Rowe, MD, says that for some women who want to go topless, they’d prefer to use the areola incision method, while others want to use the underarm incision so they can wear tank tops freely.

4. Looking into your doctor’s social media presence can be very telling.

Nowadays, it’s not uncommon for patients to find doctors via social media like Instagram and Snapchat. These platforms, when used appropriately, can be a good indicator of the kind of doctor you’re getting, says Dr. Rahban. You can get a sense of the doctor’s personality and the kinds of surgeries they do, but “that being said,” he adds, “when a doctor utilizes it as an entertainer or for shock factor, it tells a lot about professionalism.”

5. It’s probably best to err on the side of more conservative when it comes to sizing.

Dr. Rahban estimates that 30 percent of the errors made in breast augmentation come down to incorrect size selection. “The most important thing with breast augmentation is to make sure that the implant you select is conservative and not too large for the size of your anatomy.” It’s a red flag if your doctor doesn’t seem concerned with advising you about the maximum size you can reach before developing medical complications.

6. Certain types of breast implants are associated with a kind of cancer called ALCL (anaplastic large cell lymphoma).

“At this point, they are unsure as to what causes it but believe it is somehow related to the texturing of the implant surface,” explains Dr. Rahban. It also seems that removing the implant along with any scar tissue can be curative. So far, statistics are rare, with 626 cases and 17 deaths reported worldwide. If you’ve gotten implants in the past, don’t freak out yet. “It is something to be aware of. While I don’t think it’s super alarming, it’s good to know what is on the horizon,” says Dr. Rahban.

7. You have a choice of different kinds of implant materials.

There’s saline, silicone, “gummy bear” (aka cohesive gel), and autologous fat, explains Dr. Rowe. For the latter, you’ll need around two to three pounds of fat to inject into the chest, and patients often need touch-ups to achieve symmetry. With saline, the implant ripples more, and some patients think that it feels heavier. If a saline implant ruptures, it’s absorbed into your body safely; however, the difference is very noticeable, so you’d likely want to see a doctor ASAP anyway, explains Dr. Doft. Silicone tends to feel more natural, hold its shape, and ripple less. Dr. Doft says the majority of her patients choose silicone.

8. Your first breast surgery probably won’t be your last.

Twenty-five percent of women will need another surgery after 10 years because implants don’t last forever. The implant could begin to leak over time or a “scar shell” could develop around it, warping the shape and causing a need for new implants. Weight loss, pregnancy, and change in preference are other factors that could lead the patient to having another surgery after a few years.

9. It will cost you around $3,719.

This average total, according to the 2016 statistics from the American Society of Plastic Surgeons, is based on the surgeon’s fee only and does not include the cost of anesthesia, facilities, and materials (stitches, bandages, drapes, etc.). The price will also depend on doctor, patient, and region. The cost of reduction, though, varies greatly patient to patient. A reduction procedure could take three to four times longer than an augmentation, and the cost would reflect that.

10. Generally, patients will only have to take five to seven days off work for a breast augmentation and about the same for a reduction.

You won’t be feeling 100 percent after that week, but you’ll be in good-enough shape to head back to the office if your job doesn’t require manual labor. However, if the implant is placed behind the muscle instead of on top (many women choose to do this for a more realistic look and less chance of a scar shell forming around the implant), recovery will be a little harder and you might be sore longer.

11. Breasts with implants feel different to the touch than real breasts.

Adam R. Kolker, MD, explains: Although silicone breasts feel similar to real breasts, they are still man-made and don’t feel like natural breast tissue. You’ll be more likely to notice there’s an implant in a woman who began with little breast tissue than a woman who had more breast tissue to begin with. Smaller implants and those that are placed below the muscle are harder to detect.

12. You can try on different boob sizes before deciding on one.

Using “sizers,” a bead-filled neoprene sack, you can stuff your bra to give you an idea of the size you might like.

Jovana Rikalo | Stocksy

13. You can’t go from small to huge all at once.

If you’re starting with a small A cup, don’t expect to go up to a DD cup in one procedure. It’s important to set realistic goals. Your body and skin need time to adjust to drastic changes, so a surgeon will likely suggest going up only a couple cup sizes at first, then increasing the implant size over the course of a few years.

14. Breast augmentations and reductions could possibly affect your ability to breastfeed in the future.

Women who have implants oftentimes choose not to breastfeed, so the data sets on these women are unclear. However, if you have an areola incision, there’s a small risk you could damage minor ducts and disconnect the areola complex with the main portion of the gland, hindering your ability to breastfeed. Women who have underarm incisions or incisions in the crease of the breast should not have a problem.

15. You might lose feeling in your nipples after a breast augmentation or reduction.

Loss of sensation in the nipples can occur whenever there is surgery to the breasts. This depends on a number of factors, including breast shape and surgery type. Even if you lose sensation in your nipples, they will still respond to cold and stimulation (aka they will still be able to get hard even if you can’t feel it).

16. You’re not a great candidate for a breast augmentation if you have a very strong family history of breast cancer, are obese, or smoke.

All these factors increase risks and complications during and after surgery. If you have any significant medical issues, you need to be evaluated and cleared before surgery.

17. Not all “plastic surgeons” are board-certified and trustworthy.

Thoroughly research surgeons who meet certain criteria before settling on one. First, make sure the surgeon is certified from the American Board of Plastic Surgery. Be wary of other “boards” that are not legitimate. Your doctor should also be a member of the American Society of Plastic Surgeons and American Society for Aesthetic Plastic Surgery, both of which have a very high standard of criteria and maintenance. Then make sure that the surgeon has experience in the type of surgery you’re wanting. Ask to see a body of their work and before-and-after photos. Speak to other patients. Schedule a consultation and get a feel for the surgeon’s approach.

18. You can get an areola reduction.

This is also called a mastopexy. Oftentimes women who get a reduction will also have an areola reduction so the areola is proportional to the new size of the breast. The area around the nipple is very forgiving with scarring.

19. You can’t walk in to a consultation and say you want X implant type through X incision location.

You and your surgeon will decide together which incision choice is best for you: underarm incision, incision in the crease of the breast (inframammary fold), or through removal of the areola. Your doctor will take into consideration your beginning breast size and shape, breast tissue, and a number of other factors before recommending which options are best for you and your body.

20. Any breast surgery can have a small effect on breast cancer screening in the future.

Breast health is important. Before the surgery, have a proper breast exam with your gynecologist. If you’re of age, get a mammogram. Most mammographers don’t have an issue if the implant is placed behind the muscle, but it is important to discuss with your surgeon.

21. Exercise, especially cardio that involves bouncing, is restricted after surgery.

Although you can start doing light cardio again after a week, most women will need to limit their exercise for up to 12 weeks.

Nemanja Glumac | Stocksy

22. Implants are more comfortable if the procedure is done postpartum rather than before the patient has kids.

But any implant placed under the muscle will increase the discomfort levels.

23. Augmented breasts will affect your posture just like the weight of natural breasts would.

The weight difference between equal volumes of saline, silicone, and breast tissue is slim to none, so a natural C cup and an augmented C cup are very similar in weight, says Dr. Kolker. If you choose an implant size proportional to your frame, you will see little effect on your posture. However, if you choose large implants, you will feel the effects.

24. Your boobs do not need to be a minimum size for a reduction.

This is all based on personal preference. Think of boob size in terms of a scale from small to large. Based on breast size before the procedure and desired breast size afterward, there are a number of incision options for a reduction for a huge range of results. You can even choose to get a reduction and an implant to replace some of the volume you’ve lost over time.

25. It is possible that your boobs can grow back after a reduction.

However, Dr. Kolker explains that if the procedure is done after pregnancy and your weight stays consistent, your breast size is unlikely to change.

26. Ask yourself the following questions and be comfortable with your answers before going through with the surgery:

  • How much does my current situation bother me?
  • Why do I want this procedure?
  • How excited am I to go through with this?
  • Can I handle the time off from work and exercise?
  • How much am I willing to expose myself to certain risks?

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Brooke Shunatona Brooke Shunatona is a contributing writer for Carina Hsieh Sex & Relationships Editor Carina Hsieh lives in NYC with her French Bulldog Bao Bao — follow her on Instagram and Twitter • Candace Bushnell once called her the Samantha Jones of Tinder • She enjoys hanging out in the candle aisle of TJ Maxx and getting lost in Amazon spirals.


Boob job costs & pricing

Breast augmentation is a surgical procedure which involves altering the size, shape, or position of the breasts. Thousands of women opt for breast surgery each year, making it one of the most popular forms of cosmetic surgery in the UK. Breast enlargement, breast reduction, and breast uplift are common procedures within breast surgery, and are all lovingly referred to as `boob jobs`.

How much does breast surgery cost in the UK?

Boob job prices in the UK start from £3,645 and increase to over £5,000, with the average cost sitting at £4,300¹. The price depends on a number of factors including the size and type of implants you want, the surgeon you use and the surgical provider you go for. It’s important to bear all of these factors in mind when planning your boob job, without being tempted to make a quick decision based on price alone. At Transform, our prices start from £4,995*

What does the price typically include?

This all depends on which surgical provider you choose, and it’s always worth asking the question of “Are there any additional fees?” Some providers offer a free, no obligation consultation so you can visit a few and weigh up your options. Typically, the price of breast surgery includes:

· Surgeon’s fees

· Anaesthesia

· Implants

· Overnight stay in a hospital

· Meals after surgery

· Pain relief and other associated medication

· Inclusive aftercare, with the offer of an extended warranty

Transform’s extended aftercare

We know that good, well-rounded aftercare is as important as the surgery itself. That’s why we strive to give our patients the very best, and we listen to your feedback when you tell us what you want. All of our patients are covered by our comprehensive 3-year aftercare programme, which you can choose to extend to 10 years. To learn more about what’s included, .

What payment options are available?

With flexible payment plans available, it’s now easier to get the boobs you’ve always dreamed of. Most surgical providers offer a low APR repayment plan with the option to pay for your boob job over several months to a year. At Transform, we offer 0% APR for the first 12 months, so you’ll pay zero interest if you spread the cost of your treatment over one year.

Here’s an example:

· If the cost of the procedure were £4,995

· You could pay a deposit of £500

· The amount of credit would be £4,495

· You would then pay 12 monthly instalments of £374.60

· The rate of interest is 0% per annum fixed, representative 0% APR

There are other payment options available, such as setting up a cosmetic surgery loan or opening up a piggy bank to save for your boob job as and when you want. It’s always best to discuss finance options with providers early on, that way you’ll know which plan is best for you and whether the provider you like offers it.

Finance Options

What our customers say

Danielle Grieve, who had breast enlargement surgery with Transform, said: “I decided to go for the teardrop implant, which cost me £5,300. You are already insured for 3 years but have the chance to pay an extra £200 to get them covered for 7 years on top of that, which to me is a great deal and would be silly not to get it. The cost of my operation was £5,500 altogether”

Our surgeons conduct thousands of boob jobs every year, so we understand that everyone has different needs when it comes to paying for surgery. Let’s get the boring bits out of the way so we can focus on helping you to be the best you. To book a consultation with us, .

Book a Consultation

¹Clinic Compare 2017

*Prices may vary, correct as of May 2019

Simon Ourian isn’t just a Beverly Hills dermatologist; he’s a Beverly Hills dermatologist with a huge Instagram following, which he uses to showcase his latest cosmetic innovations. A few weeks ago he introduced his nearly half a million followers to “nonsurgical nose jobs,” and more recently, he revealed what he calls the “nonsurgical breast augmentation.” In the post, Ourian details how he transplants fat from a patient’s own body to plump up her breasts (no implants necessary). Sound too good to be true? It probably is. This procedure is nothing new—and it’s not as easy as Ourian would have you believe.

Ourian explained to me that he uses the same “micro-droplet technique” on breasts as he does on his nonsurgical nose jobs, strategically injecting fat into different areas of the breasts. “This is an option for women who are looking for a relatively small increase, like going from a B cup to a C cup or a small D cup,” says Ourian. “It’s like a dermal filler for your breasts, but since the woman needs to have an area that can donate the fat, she needs to be at least ten pounds overweight for the procedure.” The procedure lasts about two hours, requires a local anesthesia, and costs between $6,900 and $8,900, says Ourian. He claims it lasts five to ten years.

The first problem? The procedure may have unexpected—and unpleasant—consequences. According to Bonnie Baldwin, a plastic surgeon in Houston, there’s a chance that the fat injected into your breasts may result in false positives during breast-cancer screenings. “If you inject the fat inappropriately, either by using too much pressure or putting in too big of a globule, it can result in large lumps in the breast, which can be mistaken for breast cancer on mammograms or during a physical exam,” she says. (Thankfully, once you biopsy the tissue, it will show up as benign.)

Plastic surgeons also question how much of the fat will survive, even when injected correctly. “We don’t know how much fat is going to stay in place in the breast,” says David Hidalgo, a plastic surgeon and clinical professor of surgery at Weill-Cornell Medical College in New York City, who has extensive experience with breast implants. “We know that it’s ranged quite widely. Some physicians think that only 25 percent of it survives, while some think that 75 percent survives, so it’s not a very predictable procedure.” (Hidalgo admits that the procedure may be an appealing option for patients who are wary of implants. “When a patient gets implants, those implants will eventually wear out and need to be replaced,” he says. “So you do this fat-transfer procedure once, it’s your own tissue, and you don’t have to change implants.”)

Finally, others worry that Ourian is downplaying the seriousness of the procedure. ” basically doing liposuction in the office, and then turning around and injecting it into the breast. Even if you’re not asleep, and even if you’re not in a hospital operating room, to me, that’s still a surgical procedure,” says Baldwin.

Even Ourian admits the procedure isn’t ideal for all patients. “In cases of a breast lift, where a person may have sagging breasts that causes the areola and nipples to be very low, this procedure cannot serve as an alternative,” he says.

When looking into the possibility of getting a breast augmentation, you may be worried about the complications and extra recovery time that comes along with a surgical procedure. However, did you know that you can get non-surgical breast enhancement? There are many reasons why a non-surgical breast augmentation might be the best option for you. Read on and find out!

The Process

When considering this procedure, it’s important to know how it’s done. This new wave of cosmetic treatment uses an injectable filler to enlarge and reshape breasts. The most popular filler used in this procedure commonly comes from fat removed from one part of your body through liposuction. The fat is then combined with stem cells gathered from your blood and then injected into your breasts. The stem cells help the fat assimilate to the new area in your body. With this procedure, there is no anesthesia, scalpels or recovery time. And the results tend to last for about five years.

No Extra Recovery Time or Unnecessary Complications

As with any surgery, there are operative risks for traditional breast augmentations to take into consideration, like a higher risk of infection or a reaction to anesthesia. Since you will not need to be under anesthesia for a non-surgical breast enhancement, the complications associated with full on surgery are non-existent, and there is no recovery time.

Low Chance of Rejection

The first step in this procedure to produce a filler made up of your own fat cells and stem cells. Then the concoction is injected into your breasts to reshape and enlarge them. There is little chance that your body will reject it because the filler is made up of your own fat and stem cells.

More Natural Looking Results

With traditional breast augmentation, the results can look obvious. Some women report that they look too round, too firm and generally unnatural. If you are looking for a more natural shape and feel, then this procedure might be right for you. As mentioned previously, the filler is made up of fat and stem cells, which is very similar to the tissue that already makes up your breast. So when the doctor adds this filler, the shape and feel is more natural.

Fillers are Natural

In traditional forms of a breast augmentation, a doctor will either use a saline or silicone implant. The saline implant is made up of a silicone shell filled with sterile salt water (saline). The silicone implant is a silicone shell filled with plastic gel (silicone). Both of these types of implants are obviously not naturally found in your body.
The fillers in a non-surgical breast enhancement are completely natural since they are made up of your fat and stem cells. Some women like that aspect of this procedure.

Two for One

Because the doctor uses liposuction to remove fat from a part of the body and then injects it into your breast, you get two procedures for one. So if you have extra fat on your stomach, thighs, arms, etc., then just tell your doctor to remove the fat from that area.

Are you the Right Candidate?

If you are looking for the following benefits, then a non-surgical breast enhancement might be right for you:
• No recovery time
• No risks that are associated with full on surgery
• More natural looking results
• Looking for a small lift (a traditional breast augmentation will give you more dramatic results)
• Low chance your body will reject the filler
• No silicon or saline will be permanently placed in your body

Epione is located in the heart of Beverly Hills, CA and is a state of the art, comprehensive laser and aesthetic surgery center. The team at Epione works together to restore or create your desired appearance, and our staff is dedicated to providing patients with the highest level of care and attention. We use the latest in technology for hair, skin and body contouring, strive to occupy a special and unique place in the hearts and minds of our patients.

America worships big breasts. A glance at TV, websites, magazine racks, and neighborhood billboards reveals boobs, boobs, and more boobs. Everywhere, we see cleavage spilling out of bras, swimsuits, and low-cut, strategically arranged garments. If media is not to be trusted then take a gander at the latest cosmetic surgery statistics. In 2014 alone, nearly 300,000 women (including teens) went under the knife to enlarge their breasts with implants.

Beyond the media or surgical stats, a woman simply needs to recall her own middle school years to understand the true power of breasts. As a member of the common herd, we all learned which traits (in both boys and girls) were in high demand, and big breasts inevitably made that list. It didn’t matter that only the mean girls and boys made any actual comments, there was attention paid, smiles exchanged, and giggles spreading, even among the “nice kids.” How everyday, then, for a woman who is not well-endowed (and also does not live under a rock) to feel second-rate despite the many well-meaning family and friends who say “it doesn’t matter,” “you’re still attractive,” or even, this most unlikely stretching of the truth, “you’re lucky.”

“I think they are full of sh–,” wrote filmmaker Nora Ephron of such supportive comrades in her essay, “A Few Words About Breasts.” She said, “I cannot shake it, cannot shake my feelings of inadequacy.”

While the insecurities of one successful writer does not make an argument, the number of products and procedures marketed to exploit such feelings suggests Ephron is far from alone. There’s a great deal of money to be made by promising women bigger boobs; apparently, cosmetic surgery is just the tip of the iceberg. With plenty already written about that particular product, Medical Daily will instead review, in a general way, the nonsurgical breast products available today. Conveniently, the bulk of them fall into three basic categories.

Nutritional and Other Natural Products

An estimated 50,000 nutritional supplements are currently available, according to The Natural Products Association (NPA), and more than a few of these are marketed as breast enlarging products.

“Anyone can sell a supplement, it’s very easy to do,” Dr. Tod Cooperman, president of ConsumerLab, which identifies quality health and nutritional products through independent testing, told Medical Daily. While the Food and Drug Administration is responsible for taking action against any adulterated or misbranded supplement after it reaches market, it does not approve each individual supplement. Essentially, then, a product is good to go as long as it contains only dietary ingredients (defined by the FDA) and its label lists all ingredients correctly.

Typically, breast enhancing products contain a variety of herbs, which fall into four general categories, described by ConsumerLab as:

  • phytoestrogens, including soy, red clover, flaxseed, fennel, hops, and other herbs;
  • traditional aphrodisiacs such as damiana and oat straw;
  • generic ‘women’s herbs’ including motherwort, blessed thistle, black cohosh, and chasteberry;
  • and miscellaneous herbs, such as palmetto and wild Mexican yam.

According to Cooperman, there’s, at best, only tangential science supporting most of the above supplements. All told, phytoestrogens present the most convincing case. These natural plant products mimic the effects of estrogen, a hormone known to increase breast size. While that sounds like a winner, by taking a supplement with phytoestrogens, women may be blocking their natural estrogen, which is more powerful. There’s the very real possibility, Cooperman explained, that these supplements might suppress growth, instead of encourage it, in pre-menopausal women.

Evidence from the scientific literature support his position. One recent study cited by the Mayo Clinic showed no evidence that phytoestrogen increased breast tissue density or growth. Meanwhile in another study of herbal compounds, Dr. A. Fugh-Berman of George Washington University neatly concluded, “The use of bust-enhancing products should be discouraged because of lack of evidence for efficacy and long-term safety concerns.”

The products not only fail to work, but Canadian researchers who conducted an investigation of 44 herbal products produced by 12 different companies found that more than half contained unlisted ingredients. A serious label-reading woman, then, might kick off an allergy by taking these products. Worse still, some supplements could trigger a serious drug interaction, warns the Mayo Clinic, especially in women taking blood-thinning medications such as warfarin.

What about all the natural creams and lotions and gels — do those work? According to The Natural Center for Health Research, these products similarly do not fulfill their claims, ointments intended to be massaged into the breast are simply another scam for reaping profits. Quoting the FDA, the Center noted: “For decades, millions of dollars have been spent on devices, creams, and lotions advertised as breast developers, all wasted.”

Suction Cups and Other Devices

Among breast enlarging devices, Brava Breast Enhancement and Shaping System (more commonly referred to as the ‘Brava Bra’) is possibly the best known. As described on the company’s website, “The BRAVA Starter System consists of two semi-rigid domes, with specially engineered silicone gel rims, and a sophisticated minicomputer, called a SmartBox, that creates and regulates the tension within the domes. A sports bra is also included, to hold the domes and the SmartBox in place.”

Say what? In layman’s terms, the Brava system is a suction cup device worn like a bra. This “brassiere-like system” as it is described in one study, “applies a 20-mmHg vacuum distraction force to each breast for 10 to 12 hours/day over a 10-week period.” Basically, the suction cups exert a continuous pressure, causing the breast tissue to gradually, slowly expand over time.

BRAVA Breast Enhancement and Shaping System Courtesy of Brava LLC

While this may sound reasonable, only limited scientific support exists for the Brava system. The results from one 2007 study involving 50 women indicated 30 women found satisfaction with their results. “Long-term breast enlargement without surgery is possible with an external tissue expander,” noted the authors. (This study is quoted frequently on the Brava website.) Another study of 17 women found “daily use of an appropriately designed external expansion system” to be “effective and well-tolerated.” However, one of the authors of this study, Dr. R. K. Khouri, is the inventor of Brava system, according to the Miami Breast Center.

BRAVA Breast Enhancement and Shaping System. Courtesy of Brava, LLC

On, a website devoted to raising and answering health and beauty questions, the reports from impartial doctors are more skeptical. Some claim the results are negligible, while others say any results will be temporary, gradually lessening over time. Another online forum,, voices the opinions of “real” women who give the product mixed reviews. One positive response is glowing, while another woman claimed the growth she achieved disappeared over time.

That said, unlike supplements, there are no real health risks with the Brava Bra (when used properly), other than, possibly chafing skin (where the dome meets your skin) and sleepless nights. If you’ve got money to burn, lots of time, and more than your fair share of patience, this might be worth a no-expectations-try.

Fat Grafting

Finally, we arrive at fat grafting, also known as autologous fat transfer, a procedure where fat tissue is removed by liposuction and then processed and injected back into the breast area. Since removing unwanted fat from one part of your body and inserting it directly into your boobs is basically a dream come true for many women, fat grafting has been widely adopted in both plastic and reconstructive surgery.

“Fat is an appealing filler material for it is biocompatible, is abundantly available, can be easily harvested and processed, and can be injected in controlled amounts,” wrote the authors of a Loma Linda University Medical Center study published earlier this year. More importantly for consumers, unlike surgical implants, fat feels soft and natural to the touch.

Despite such obvious benefits, though, challenges and concerns exist. One issue is that fat grafting often takes up to four hours, while the recovery period may take two weeks or more. Then there’s safety.

“It can be tempting to think about fat grafting as a ‘safer’ procedure, since it doesn’t involve major surgery,” BreastCancerOrg states on its website; however, some doctors have theorized the procedure could raise the risk of breast cancer. That said, the organization notes that no large clinical studies have been conducted, with the current research tracking fewer than 100 women for less than four years.

While the long-term safety profile is not yet known, the aesthetic result also remains difficult to predict.

“Obtaining predictable, reliable, and consistent outcomes remains a significant challenge,” wrote the Loma Linda researchers, who added that as much as 40 to 60 percent of the volume of fat injected could be lost due to necrosis (tissue death) or resorption by the body. Interestingly, some doctors combine a Brava-like suction method with fat grafting, claiming it gives optimal results. In one study of 12 women, the authors found that pre-expansion of the breast tissue allowed for greater grafting volume with “reproducible, long-lasting results” in less than two hours.

In the end, there are three general options available to a woman seeking non-surgical breast enlargement. All cost a pretty penny, some pose health risks, and not one method can be whole-heartedly recommended by the scientific community. Still feeling inadequate and wanting to change? Do the research and proceed with caution.

Breast Implants & Augmentation in New York City & Westchester County

Greenwald Plastic Surgery

  • An experienced plastic surgeon who has performed thousands of breast surgeries and is known for achieving natural results
  • Served as a clinical investigator for cohesive silicone gel implants
  • Thousands of before and after photos for your review
  • Frequently sought after expert for revision breast surgery
  • Named a TOP DOCTOR in New York every year since 2012
  • Operates in a state-of-the-art surgical center that prides itself on patient safety

Offices located in Manhattan, Harrison, & Carmel, NY

  • Why Choose Dr. Greenwald?
  • Overview of Breast Augmentation
  • Who Is a Suitable Candidate?
  • Saline vs. Silicone Breast Implants
  • “Gummy Bear” Breast Implants
  • Breast Implants Placement Options
  • Incision Approaches
  • How to Choose Breast Implants
  • Recovering From Breast Augmentation Surgery
  • What Does It Cost?
  • How Long Do Breast Implants Last?
  • Does It Matter Where And By Whom I Have My Surgery Performed?
  • When Do I Know If My Breasts Have Stopped Growing?
  • What Expectations Should I Have If I Decide To Have Breast Augmentation Surgery?
  • What If My Breasts Are Two Different Sizes Or Shapes?
  • What Can I Do To Prepare For My Consultation With Dr. Greenwald?
  • What Will My Recovery After Breast Augmentation Be Like?

Why Choose Dr. Greenwald?

Dr. Greenwald’s Awards and Memberships

Joshua A. Greenwald, MD, FACS, is a board-certified New York plastic surgeon. Breast augmentation surgery is not a simple procedure, and your result depends on the experience and skill of your surgeon. Each patient is different and requires a unique procedure to achieve optimal results. Dr. Greenwald has significant experience in breast implant surgery, and performs hundreds of primary and revision breast augmentations yearly. He offers a choice of breast implant types, incisions and placement options. Most patients have minimal or no pain, minimal or no bruising, and a prompt return to normal activities. There are no drains and, typically, no sutures to remove.

Dr. Greenwald is proud to have been selected to the Mentor® LEAD Program Advisory Board in 2012 and 2013. Mentor Corporation is one of the leading manufacturers of breast implants in the United States, and each year Mentor invites a select group of plastic surgeons to discuss new products, programs and innovations in breast augmentation surgery. Dr. Greenwald is now using Allergan breast implants as he feels Allergan currently has the most comprehensive line of breast implants available. Dr. Greenwald has been selected as a Top Doc by Westchester Magazine and a Top Doctor by Castle & Connolly every year since 2012.

Dr. Greenwald performs his surgeries at the state-of-the-art Surgical Specialty Center of Westchester. He helped design this facility from the ground up. The facility meets and often exceeds hospital safety standards. Anesthesia is provided by board-certified anesthesiologists, and all of the nursing staff has significant experience caring for plastic surgery patients.

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Overview of Breast Augmentation

At the New York practice of Joshua A. Greenwald, MD, FACS, many women request augmentation mammoplasty, or breast augmentation surgery, with saline or silicone breast implants to enhance their breast profile. Dr. Greenwald performs breast augmentation surgery for patients who would like to:

  • Increase their breast cup size
  • Improve the appearance of sagging breasts that look flattened or deflated (often due to major weight loss or pregnancy/breastfeeding).
  • Improve undesirable shape or contour of their breasts
  • Improve breast asymmetry

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Who Is a Suitable Candidate?

Only a board-certified plastic surgeon such as Dr. Greenwald is qualified to determine if someone is an appropriate candidate for breast augmentation. Nevertheless, in general, suitable breast augmentation candidates include those who:

  • Desire larger or fuller breasts
  • Desire a greater degree of cleavage or of outward projection from the chest wall
  • Desire breasts that appear higher up on the chest wall
  • On the whole, have a positive self-image, but are frustrated with certain aspects of their breasts
  • Are in good physical and mental health overall
  • Have sensible expectations for the outcome of breast augmentation surgery, and are seeking aesthetic improvement — not necessarily perfection
  • Are pursuing breast augmentation of their own volition
  • Are not breastfeeding (Women who are currently nursing should wait 12 weeks after they have stopped breastfeeding to undergo breast surgery, so their true breast size can be established.)

Video: What to Expect from Breast Augmentation with Dr. Greenwald

Hear about the breast augmentation experience at Dr. Greenwald’s practice from one of his many satisfied NYC breast augmentation patients.

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Saline vs. Silicone Breast Implants

Dr. Greenwald offers his breast enhancement patients saline and silicone breast implants.

Saline breast implants have a silicone outer shell but are filled with saline solution, or sterile saltwater.

The main benefits of saline implants are that:

  • Dr. Greenwald can use smaller incisions with saline implants (than he would with silicone implants) because they are filled after they are inserted into the implant pocket.
  • The body can safely absorb the saline filling material in case the implant ruptures.

The principal drawbacks of saline implants are that:

  • They do not resemble the look and feel of natural breast tissue as closely as silicone implants do.
  • They are more prone to folding or wrinkling in the implant pocket.
  • They may be visible under the surface of the skin, especially in women with thin skin or little body fat.

In contrast, silicone breast implants have both a silicone outer shell and a silicone-gel filling.The greatest advantage of silicone implants is that they more closely look and feel like natural breasts than their saline counterparts. MemoryGel® breast implants are composed of an outer silicone shell and filled with a cohesive gel formulation that acts as a solid rather than a liquid, and holds together uniformly. Numerous studies have demonstrated the safety of silicone implants.

The principal disadvantages of silicone implants are that:

  • They arrive from the manufacturer pre-filled, so the Manhattan breast augmentation surgeon must use slightly larger incisions through which to insert them.
  • Patients with silicone implants are at risk of “silent rupture,” a condition in which the breast implant has ruptured, but the patient is not aware of it because the body cannot absorb silicone, causing the filling material to remain intact inside the implant pocket.

Because of the risk of silent rupture, the FDA recommends that women with silicone breast implants undergo a breast imaging exam such as an MRI or mammogram every three years, starting the third year after the initial breast enhancement procedure.

Silicone Implants

Allergan manufactures three main types of silicone gel implants: Natrelle Inspira Repsonsive, Natrelle Inspira Soft Touch and Natrelle Inspira Cohesive. All of these implants are made of cohesive silicone gel (not liquid silicone!). The Natrelle implants are smooth round implants that are available in various sizes and projections. Dr. Greenwald prefers cohesive silicone gel implants in cosmetic breast surgery for their more natural feel. All of Natrelle implants are “gummy bear implants”.

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Summary of differences between saline and silicone

Saline Silicone
Incision length Approximately 2.5 cm Approximately 3.5 to 4 cm
Outer shell Silicone Silicone
Implant Fill Saline Silicone
Implant Surface Smooth and textured surfaces available. Dr. Greenwald places all implants in a submuscular pocket and uses primarily smooth implants. Smooth and textured surfaces available. Dr. Greenwald places all implants in a submuscular pocket and uses primarily smooth implants.
Risk of “rippling” Rippling more common than with silicone implants especially in very thin patients Less rippling than with saline implants
Feel Soft particularly in patients that are not very thin. In thin patients, may feel firmer and ripple more than silicone implants. Soft and more natural feeling than with saline implants. Consistency more like breast tissue.
Average implant lifespan Implants are made to last a lifetime and are warrantied by the implant company for life. Patients are told there is .5% chance per year of having an implant-related issue. Implants are made to last a lifetime and are warrantied by the implant company for life. Patients are told there is .5% chance per year of having an implant-related issue.
Rupture Easy to detect Harder to detect
Harder to detect Cost less than silicone Costs slightly more than saline implants

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Breast Implants Placement Options

Dr. Greenwald offers two breast implant placement options: subglandular and submuscular.

With submuscular placement, Dr. Greenwald positions breast implants under the pectoral, or chest, muscle. Dr. Greenwald places more than 95 percent of his implants in the submuscular position. A lower incidence of capsular contracture, the ability to obtain high-quality mammograms and a more natural look are some of the reasons he prefers the submuscular position over the subglandular position.

With subglandular placement, Dr. Greenwald positions the breast implants under the glandular, or breast, tissue. However, subglandular placement may not be a suitable option for women with thin skin or little body fat because, in this case, the implant might be visible under the skin.

Incision Approaches

Dr. Greenwald offers three incision approaches: inframammary (crease incision), periareolar and transaxillary.

The inframammary approach – Dr. Greenwald makes the inframammary incision in or near the breast’s natural crease. This incision is easily concealed by the overlying breast and is rarely visible during normal activities. The inframammary approach allows for the precise creation of the implant pocket and the cleanest entry for the implant. It is associated with the lowest incidence of capsular contracture and the lowest incidence of sensory changes of the nipple-areola complex.

The periareolar approach – With this incision option, the breast plastic surgeon creates an incision around the outer perimeter of the areola (the darkly pigmented skin encircling the nipple). The periareolar incision is perhaps the least visible in properly selected patients because it is concealed by the darker skin of the areola. The incision can be reused if the patient requires revision surgery for bleeding or capsular contracture. It is the preferred approach if a mastopexy (breast lift) is needed. It has similar rates of capsular contracture to other incisions and a comparable rate of decreased nipple sensation.

The transaxillary approach – With this approach, Dr. Greenwald positions the incision required for breast augmentation in the armpit area. He utilizes an endoscope, or lighted camera, to help tunnel through the fat that is found under the skin (i.e., subcutaneous fat), creating an implant pocket behind the breast tissue. He typically uses this incision approach to insert unfilled saline implants. One of the drawbacks of this is incision is the increased incidence of implant malposition (i.e., lateral displacement of the implant pocket). If breast lift is also required, it cannot be done through an axillary approach.

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How to Choose Breast Implants

Aside from choosing the size and type of breast implants, the implant placement method and the incision approach, breast augmentation patients must also choose the shape and texture of breast implants. Dr. Greenwald prefers smooth round implants. The different profiles (i.e., moderate, moderate plus and high profile) available will be discussed during your consultation.

During your consultation, Dr. Greenwald will review the patient’s unique anatomy and aesthetic desires, and will help her decide on a suitable surgical treatment protocol that will best meet all her needs. This includes making decisions about the size, shape and texture of breast implants as well as the incision approach and placement method.

Dr. Greenwald will review before-and-after photos of breast augmentation surgery patients with you during your consultation to help educate you on sizing and expectations. He also utilizes the Mentor® Volume Sizing System to help you determine what size implants will work best for you. This will help you get an excellent idea of what your new breasts will look like.

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Recovering from Surgery

Video: Breast Augmentation Recovery

Learn more about the expected breast augmentation recovery time after breast implants surgery in New York City with Dr. Greenwald.

Before breast augmentation surgery, patients receive comprehensive pre- and post-surgical care instructions. Following breast augmentation surgery with Dr. Greenwald:

  • Most patients are able to resume normal activities within days of their surgery.
  • Many patients require a small amount of or no pain medication.
  • Most patients have little or no bruising.
  • Some patients experience temporary or possibly permanent changes in breast and nipple sensation; this may include pain, tenderness, a tingling sensation or numbness in the treated area. Nipple sensation returns to normal in the majority of cases.
  • Patients are permitted to go the gym at three weeks.
  • Patients are encouraged to sleep in a sports bra for three months.
  • It is also important to keep in mind that some patients look great immediately following their surgery while other patients’ implants take time (up to eight weeks) to settle into a more natural position.

Recovery Chart

Preoperative Patient’s preoperative testing and mammogram (if needed) is reviewed. Patient will have filled prescriptions for pain medications, antibiotics and muscle relaxants. Meet with Dr. Greenwald, our anesthesiologist and nurses.
Day of
A primary augmentation takes between 45 and 60 minutes. Patient receives an intravenous antibiotic prior to beginning procedure.
Approximately 1 hour – you must be sent home with a responsible adult who should plan on spending the night with you.
After Surgery Patients are sent home in a surgical bra with incisions covered with steristrips and gauze. No heavy lifting or exercising. ABLE TO SHOWER 36 hours after surgery after removing the gauze but leaving the steristrips in place (usually the night after)
Visit #1
Typically 5-7 days after surgery. Any sutures requiring removal are removed. Steristrips are replaced on the incisions as needed. Continue to wear a soft bra or underwire bra depending on implant position. Begin medial massage of implants.
Visit #2
Typically 18-21 days after surgery. Incisions are checked. Silicone scar therapy is begun. Able to return to gym. Typically underwire bra during day and soft supportive bra at night. Begin medial and superior-inferior massage of implants.
Visit #3
Patient’s are typically seen 3-4 months after surgery and then yearly.

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How Much Does Breast Augmentation Cost?

The overall cost of breast augmentation surgery in New York City includes the plastic surgeon’s fee, the anesthesiologist’s fee, the operating room fee, the cost of breast implants and the miscellaneous costs associated with breast augmentation surgery (e.g., the cost of: any needed lab testing, the surgical bra, pain medication, etc.). The final cost of breast augmentation may vary, depending on the patient’s unique anatomical needs and aesthetic desires for surgery, the complexity of the surgical procedure, if an adjunct procedure is being performed at the same time (e.g., breast lift surgery) and the type of breast implants chosen.

That said, Dr. Greenwald is temporarily offering special prices on breast augmentation surgery. For a limited time, primary breast augmentation surgery with silicone breast implants costs $6,495.00; primary breast augmentation surgery with saline breast implants costs $5,495.00. (These prices include the plastic surgeon’s fee, the anesthesiologist’s fee, the operating room fee and the cost of the breast implants.)

To schedule a consultation, or to learn more about breast augmentation surgery, contact the practice of Dr. Greenwald by calling (914) 421-0113 or (212) 518-1642 today.

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How Long Do Breast Implants Last?

There is a common misconception among patients that breast implants need to be replaced every 10 years. The reality is that the rupture rate or implant failure rate at 10 years is approximately 10%. Most implant companies offer a lifetime replacement warranty. If the implants rupture, you receive a new implant from the company (not the physician’s office). Certainly, the breast implant companies are not in the business of losing money. They offer this warranty because implant rupture is a rare event. Most surgeons tell their patients that there is a .5-1 percent incidence of rupture per year. At 10 years, there is a 10 percent chance that you may experience an implant rupture and a 50% chance at 50 years!

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Does It Matter Where And By Whom I Have My Surgery Performed?

Be sure that your surgery is performed in an accredited surgery center. Be sure there is an anesthesiologist present for your case. Be sure your surgeon is certified by the American Board of Plastic Surgery and has significant experience in breast augmentation surgery (primary and secondary surgeries). Dr. Greenwald has significant experience with both primary and revision breast augmentation surgery.

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When Do I Know If My Breasts Have Stopped Growing?

Breast growth is usually complete 3–4 years after your first menstrual period. Continued fluctuations in breast size and shape is impacted by fluctuations in body weight, pregnancy and certain medications.

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What Expectations Should I Have If I Decide To Have Breast Augmentation Surgery?

Provided you are a good candidate for breast augmentation surgery, your new breasts will be a larger version of your old breasts. Breast implants alone can correct volume deficiencies but it is important to realize that an implant alone will not provide you with perfect symmetry, and will not change the shape of your breast. All patients have asymmetric breasts both before and after surgery. During your consultation, Dr. Greenwald will note your natural asymmetries and discuss a plan to address them. Often times, severe difference in the breasts are best addressed with a combination of breast procedures (i.e. a breast lift at the time of augmentation).

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What If My Breasts Are Two Different Sizes Or Shapes?

All women have some degree of breast asymmetry. While women are aware of severe differences they may have, it is important to realize that all patients do have subtle breast asymmetries. It is important to be made aware of these differences prior to your procedure so you understand how they will be addressed during your procedure.

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What Can I Do To Prepare For My Consultation With Dr. Greenwald?

Most patients who come to Dr. Greenwald are referred by a friend, family member or another physician. These people — particularly a prior patient — are an excellent resource for a new patient. They will be able to provide with a lot of information that will be reinforced during your consultation. It is always a great idea to look at pictures of breast augmentation and take a picture of the patients you like. It is also helpful if you come to your consultation wearing your favorite bra — this is often a really great way to show Dr. Greenwald the size and look you hope to achieve. During your consultation, all aspects of the procedure will be reviewed in detail and photos will be taken.

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What Will My Recovery After Breast Augmentation Be Like?

Recovery after breast augmentation is as variable as the patients we take care of. As far as timing, patients are permitted to shower the day after their procedure. Most patients should expect to experience tightness and swelling that usually subsides within a week. The implants will continue to soften for the first few months after your procedure. You will be given muscle relaxants and pain medications. Some patients never take a pain pill while others take them all! Some patients look great immediately after surgery while some take a few months to settle in. Do not worry if you do not look like you envisioned immediately after surgery. Bruising is variable from patient to patient as well and will resolve. Patients should plan to “take it easy” for a few days and return to work at 5–7 days after surgery and typically back to exercise at 3 weeks. Most patients will feel like going to the gym before this time but it is important not to! You will be seen by Dr. Greenwald 1 week and 3 weeks after your procedure. If you are concerned about something at any point, you will be seen!

Dr. Greenwald is pleased to offer his breast enhancement services to women throughout NYC, Westchester County and Fairfield County, including Greenwich and Stamford, CT. To discuss your breast augmentation goals, please schedule a consultation. Contact Dr. Greenwald’s practice by calling (914) 421-0113 or (212) 518-1642 today.

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If you are unhappy with the appearance of your breasts after breast surgery, or you are experiencing complications from a previous procedure, the talented plastic surgeons at the New York Group for Plastic Surgery can help.

Breast Enhancement 3D Simulations

Your breast enhancement procedure begins with a private consultation with your NYGPS surgeon. During this initial meeting, your surgeon will discuss all aspects of your upcoming surgery, listen to your goals for your results and evaluate whether it is the right procedure for your unique needs.

Your surgeon will also use the Vectra XT imaging system to capture ultra-high resolution 3D images and show you the projected results of your procedure. This state-of-the-art technology processes these images with your exact measurements, skin texture and volumetric analysis and allows you to “try on” different possible outcomes, ensuring that you develop a shared understanding of treatment objectives with your surgeon.

At your consultation, the surgeons at the New York Group for Plastic Surgery will listen to your goals and visualize your expectations, with their recommendations, to develop an individualized surgical plan.

What types of breast implants are available?

Saline breast implants are filled with sterile salt water. Should the implant shell leak, a saline implant will collapse and the saline will be absorbed and naturally expelled by the body.

Saline breast implants provide a uniform shape, firmness and feel, and are FDA-approved for augmentation in women age 18 or older.

Structured saline breast implants

Structured implants are filled with sterile salt water, and contain an inner structure which aims to make the implant feel more natural.

Silicone breast implants

Silicone breast implants are filled with silicone gel. The gel feels a bit more like natural breast tissue. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket. A leaking implant filled with silicone gel will not collapse.

If you choose silicone implants, you may need to visit your plastic surgeon regularly to make sure the implants are functioning properly. An ultrasound or MRI screening can assess the condition of breast implants.

Silicone breast implants are FDA-approved for augmentation in women age 22 or older.

Gummy bear breast implants

Form-stable implants are sometimes referred to as gummy bear breast implants because they maintain their shape even when the implant shell is broken.

The consistency of the silicone gel inside the implant is thicker than traditional silicone gel implants. These implants are also firmer than traditional implants.

Shaped gummy bear breast implants have more projection at the bottom and are tapered towards the top. If a shaped implant rotates, it may lead to an unusual appearance of the breast that requires a separate procedure to correct.

Placement of gummy bear implants requires a slightly longer incision in the skin.

Round breast implants

Round breast implants have a tendency to make breasts appear fuller than form-stable implants. Higher profile options can achieve even more projection.

Because round implants are the same shape all over, there is less concern about them rotating out of place.

Smooth breast implants

Smooth breast implants are the softest feeling. They can move with the breast implant pocket, which may give more natural movement.

Smooth implants may have some palpable or visible rippling under the skin.

Textured breast implants

Textured breast implants develop scar tissue to stick to the implant, making them less likely to move around inside of the breast and become repositioned.

Texturing offers some advantage in diminishing the risk of a tight scar capsule.

*It’s important to note that breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) occurs most frequently in patients who have breast implants with textured surfaces. For more information on BIA-ALCL, visit our BIA-ALCL Summary page. Discuss all benefits and risks related to your breast implant procedure with your board-certified plastic surgeon. Understanding all potential risk factors will help with better decision-making that is best for you and your health.

Allergan Biocell Device Withdrawal Information

Implant manufacturers occasionally introduce new styles and types of breast implants, so there may be additional options available.

Whether you choose saline or silicone implants, it is important for you to monitor your breast implants and follow-up with your plastic surgeon for appropriate checkups.

Next: Risks and Safety

What Is Breast Augmentation Surgery?

Breast augmentation is a cosmetic surgery procedure to increase breast size and enhance breast shape, typically through the placement of silicone or saline breast implants. From a cosmetic surgeon’s perspective, the ultimate goal of breast augmentation is to enhance a patient’s natural proportions and create a more symmetrical, aesthetically pleasing breast profile. The exact procedure is tailored to meet a woman’s individual needs.

There is no “typical” breast augmentation patient, and women choose to have the procedure for many different reasons—having larger breasts is just one of them. Breast augmentation is one of the most effective procedures to correct noticeable breast asymmetry, and breast implants can be used to help correct tuberous breast deformities. Other common goals of breast augmentation:

  • Restoring breast fullness lost after pregnancy & breastfeeding
  • Feeling more confident in a swimsuit
  • Adding balance to better complement curvy hips
  • Enhancing self-image

How To Choose A Qualified Cosmetic Surgeon

If you’re considering breast augmentation, the most important decision you’ll make is who will perform your procedure. When you visit a cosmetic surgeon, ask how many breast augmentations he or she has performed, and be sure to look at plenty of before and after photos during your consultation—this will help you get a feel for a cosmetic surgeon’s aesthetic style.


Make sure your cosmetic surgeon is board certified; this ensures that he or she is specifically trained and experienced in cosmetic surgery, including breast augmentation, and that your procedure will take place in an accredited facility, which is essential for your safety. Finally, don’t choose a breast augmentation surgeon based on price. You cannot put a price on your safety & results. Most cosmetic surgeons offer multiple financing options to help a patient fit breast augmentation into her budget.

Breast Implant Choices

There’s never been a better time to have breast augmentation, as today you have more choices than ever to help you customize your new look. Whether you’d like more dramatic curves or a modest boost in cleavage, there’s an option for you. Here are some choices you can expect to go over during your consultation process:

  • Filling type: Saline, Silicone Gel, or Highly Cohesive Silicone “Gummy Bear” Implants. Neither is “best,” but there are some differences in cost, feel, and incision requirements that you need to consider. Your cosmetic surgeon will help you find the right implant type for you.
  • Shape: Saline & Silicone Gel implants are typically round, while gummy bear implants come in shaped and round options. Round implants will typically achieve a fuller upper pole (the top portion of your breast), while shaped implants lend a gently sloping look to your breast profile. Both can look very natural with a skilled cosmetic surgeon’s help.
  • Profile: Your cosmetic surgeon will help you choose this based on your existing proportions and your goals. Generally, patients with a more petite frame will require a higher profile implant to achieve the desired size increase while ensuring the implants are not too wide at the base.
  • Size: Breast implants range in size from about 150cc to 800cc or larger. Many patients require a different sized breast implant for each breast; this helps to achieve the best possible symmetry. The size you choose depends on your existing breast size, your personal goals, and your cosmetic surgeon’s recommendations.

Of course, all of these options make it even more important to choose a cosmetic surgeon who is well-qualified and has experience using a variety of breast implants.

Incision Options for Breast Augmentation

One common question that patients have before breast augmentation is, “What will my scars look like?” You’ll be glad to learn that an experienced, qualified cosmetic surgeon will use a surgical technique that places breast augmentation incisions so the resulting scars are easily hidden and inconspicuous, even to the patient herself. Depending on your anatomy and your desired outcome, your cosmetic surgeon will use one of the following incision techniques to place your breast implants:

  • Inframammary. This involves a short incision made in the crease underneath the breast, called the inframammary fold. This leaves a thin, 1 to 2 inch scar that is easily concealed within the crease. Advantages of this incision type include a wider access point, allowing a cosmetic surgeon to place larger silicone implants or gummy bear implants with precision.
  • Peri-areolar. The incision is made around the outer edge of the areola, so the resulting scar is located within this natural transition in pigmentation. Cosmetic surgeons will often use this incision type if they are also performing a mild to moderate breast lift at the same time.
  • Trans-axillary. This involves a small incision made within the armpit, through which your cosmetic surgeon will place the breast implant using a specialized camera and instruments to ensure optimal placement. This leaves a small scar within the armpit but achieves a breast augmentation with no scar on the breast itself.
  • Transumbilical. This technique involves an incision just above the belly button. Each breast implant is inserted through this incision and then brought up to the breast. Advantages of the transumbilical technique include a single scar with no scarrring on the breast itself.

Life After Breast Augmentation

Breast augmentation is an outpatient procedure, typically performed using general anesthesia. You can expect to walk around on your own a few hours after surgery, and most patients feel up to leaving the house within the next day or two.

You may feel sore the first week or so, and you will need to limit strenuous exercise for about 2-4 weeks. Your cosmetic surgeon may also ask you to wear a supportive surgical bra or sports bra for a certain period of time after breast augmentation—it is crucial to follow your cosmetic surgeon’s instructions to ensure you heal optimally.

If your breast implants are placed partially beneath the pectoral muscle—the preferred method in most cases—your breasts may seem to sit high on the chest at first. This is normal, and your implants will settle into their optimal position over the next several weeks, with final results after a couple of months.

Once you have your breast implants, you’ll want to keep the following in mind:

  • It’s safe to have mammograms with breast implants, so be sure to maintain regular screening as prescribed by your doctor.
  • For silicone implants, it is recommended that patients undergo periodic monitoring (via mammogram, ultrasound or MRI) to screen for ruptures, which are rare.
  • Future pregnancies or weight fluctuations may affect your results, and a secondary surgery may be needed to correct any changes you are unhappy with over time.
  • Nothing can stop the normal aging process; over time, breast tissue will change. You can help prevent unnecessary sagging by wearing a bra with adequate support for your activity level.

When performed by a qualified cosmetic surgeon, breast augmentation is a safe surgery with long-lasting results, and the overwhelming number of patients are very glad they chose to have the procedure. The best way to decide whether or not breast augmentation is right for you is to meet with a board certified cosmetic surgeon for a consultation. You can find cosmetic surgeons in your area by using our ABCS Find-a-Surgeon tool.

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Breast Implants 101: What Are The Different Types Of Breast Implants

In today’s day and age, it’s fairly common and acceptable for men and women to alter their features with plastic surgery. A breast augmentation, for example, is one of the most commonly performed plastic surgery procedures. But, how much does the general public truly know about the different types of breast implants and breast augmentation? Usually, only that it involves silicone.

If you’re thinking about getting a breast augmentation, you’re going to want to know a lot more than that. To help you, we’ve gathered information about the different types of breast implants, along with some pros and cons for each different breast implant.

The Different Types Of Breast Implants

Silicone breast implants are filled with silicone gel and are FDA-approved for breast augmentation in women over the age of 22. They are the most common breast implant on the market and are probably what you think of when you talk about boob jobs.

Pros Of Silicone Breast Implants:

  • Silicone breast implants are the softest and most natural feeling option available.

  • Because they are completely round, it doesn’t matter if they move or rotate.

  • They are they less likely to “ripple” under the skin, making the implant noticeable.

  • If they do happen to leak, your breast will still hold its shape.

Cons Of Silicone Breast Implants:

  • Because the implant is pre-filled, there will need to be a bigger incision.

  • Regular silicone breast implants are only available in a round shape (some women may prefer the teardrop shape)

  • Implant ruptures are difficult to spot because the breast retains its shape. Because of this, it is necessary to have regular MRI tests to ensure that your implants are intact. The first typically occurs three years after surgery, then every two years after.

Highly Cohesive Silicone Gel Breast Implants

Highly cohesive silicone gel breast implants also referred to as “gummy bear” or form stable breast implants, are known for being thicker and firmer than breast implants with traditional silicone gel.

Pros Of Silicone Gel Breast Implants:

  • Because of their thicker consistency, these form stable breast implants have been shown to offer better long-term performance, with lower rates of rupture, rippling, capsular contraction, or malpositioning.

  • They are available in both round and teardrop shapes.

  • Choosing the teardrop option may provide more natural looking results since the top of the breast will not be rounded and the bottom side will be fuller and raised.

Cons Of Silicone Gel Breast Implants:

  • Stable form implants are firmer to the touch, so they may not feel as natural as regular silicone implants.

  • These implants will require a longer incision than regular silicone implants.

  • There is a small chance of rotation with the teardrop shape that requires a separate procedure to correct.

  • They are generally the most expensive type of implant.

Saline Breast Implants

Saline breast implants are filled with sterile salt water and are FDA-approved for women over the age of 18. Saline breast implants have lost some popularity due to the increase of silicone breast implants, but they remain an affordable option for patients looking to improve their breasts’ appearance without breaking the bank.

Pros Of Saline Breast Implants:

  • Saline solutions are very safe for the body. Should the implant leak or rupture, the saline will be safely absorbed by the body.

  • Ruptures are easy to detect.

  • These implants will offer the best upper pole fullness and projection.

  • Saline breast implants are filled at the time of the surgery. This allows for the volume to be adjustable, which is a good option for women who do not have equal breast sizes.

  • Only require a smaller incision since the implant is not pre-filled.

  • Generally the most affordable implant option.

Cons Of Saline Breast Implants:

  • May not feel as natural to the touch as silicone implants.

  • Implant ruptures are more likely to happen than with silicone implants, in which case the breast will lose its shape and deflate.

  • Rippling under the skin is more visible.

  • Saline breast implants are heavier and may cause the breast to become more bottom-heavy over time.

More Information

Although some plastic surgery offices may offer additional breast implant options, saline and silicone implants (both highly cohesive and regular) still remain the most trusted and high-quality breast implants available. Silicone breast implants are often offered in different styles and implant manufacturers introduce new styles all the time. To determine which of the several different types of breast implant is right for you, contact us to request a consultation.

Breast augmentation without implants

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