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Breast Augmentation

Many women wish to increase the size and/or fullness of their breasts to make them more proportional to the rest of their body. Women of all ages come to our office desiring to enlarge their breasts for a number of reasons. Generally, women that have a genetic predisposition toward small breasts tell us that they desire to better fill out their clothes or bathing suits. Women that have lost breast volume after weight loss or breastfeeding typically tell us that they want to regain their breast fullness and/or cleavage. In all these cases, breast augmentation is usually the optimal way to increase your breast size, which can improve the way you look and feel about yourself.

To learn more about breast augmentation, please read through the detailed information provided below. If any questions come to mind, or if you are interested in scheduling a consultation with board-certified plastic surgeon Daniel C. Mills, MD, FACS, please contact Aesthetic Plastic Surgical Institute online or by telephone today.

What Is Breast Augmentation?

Breast augmentation, also commonly referred to as breast enlargement, is a surgical procedure that utilizes the placement of breast implants to add volume to the breasts. The addition of saline or silicone breast implants can increase the size of the breasts as well as improve shape and symmetry, giving them a more balanced appearance and enhancing the body’s overall proportions. Breast augmentation is customized for the individual patient’s needs. The type and size of the implants, as well as the technique utilized and the particulars of implant placement, will be discussed during the consultation process. Once you and Dr. Mills choose the best options for your goals, he will create a personalized treatment plan.

What Can Breast Augmentation Do for Me?

From enhancing one’s overall figure to correcting breast-related aesthetic concerns, there are several reasons women consider breast augmentation. Depending on an individual’s specific needs and goals, Dr. Mills can customize the breast augmentation procedure to help:

  • Increase the size and fullness of the breasts
  • Restore lost volume caused by weight loss, pregnancy, and/or breastfeeding
  • Improve the shape and symmetry of the breasts
  • Achieve a more youthful breast appearance
  • Make the breasts more proportionate to one’s body frame
  • Correct certain congenital defects
  • Rebuild the breast mound as part of a breast reconstruction

In addition to these physical enhancements, breast augmentation can also have a positive psychological impact on patients. Following treatment, many women tend to experience a boost in confidence that carries over into both their personal and social lives.

Am I a Good Candidate for Breast Augmentation?

Good candidates for breast augmentation generally include individuals who relate to one or a combination of the following:

  • Desire a larger bust
  • Have concerns about breast shape
  • Have noticeable breast asymmetries
  • Have lost breast volume as a result of pregnancy/breastfeeding, weight loss, or other factors
  • Want to improve overall body proportions
  • Wish to improve the fit of certain tops, bathing suits, and other articles of clothing

In addition, patients must have a firm grasp on what can realistically be achieved with breast augmentation to be considered a good candidate, and they must be in good health with no unmanaged medical issues that may inhibit proper healing. All of these elements can be thoroughly discussed during a consultation with Dr. Mills to determine proper candidacy.

What Breast Implant Options Are Available?

One of the biggest decisions that influences the outcome of breast augmentation is the type of implants selected. At Aesthetic Plastic Surgical Institute, Dr. Mills offers traditional saline and silicone implants, as well as cohesive gel “gummy bear” implants, manufactured by both Sientra® and Natrelle®. At the time of the consultation, Dr. Mills will explain the advantages and disadvantages of every implant available, helping you choose the most appropriate type, shape, and size for your specific needs and goals.

For more information about implants, please visit Dr. Mills’ page dedicated to breast implants.

Transaxillary Breast Augmentation

There are many surgical approaches for breast augmentation, which include inconspicuous incisions in the armpit, underneath the breast (just above the crease), around the areola or in the belly button. Dr. Mills can perform all these approaches, but prefers the transaxillary approach. Referred to as a TransAxillary SubPectoral Augmentation (TASPA), this technique involves making a small incision in the armpit to place a breast implant beneath the chest wall muscle. Dr. Mills feels that a TASPA generally yields the most natural-looking result with minimal scarring.

Dr. Mills is internationally renowned for the TransAxillary SubPectoral Augmentation technique and has given lectures around the world on the subject. He is extensively experienced with TASPA, having performed it for more than 30 years and utilizing the approach for thousands and thousands of patients. This approach not only allows for exceptionally natural-looking results, but also addresses a concern that many women share when considering breast augmentation: the noticeability of residual scarring. Since the incisions are made in the armpit, TASPA typically results in scars that are quite inconspicuous. By using this advanced incision technique, it essentially looks as though breast surgery was not performed.

What Can I Expect During the Breast Augmentation Consultation?

During your consultation and other pre-operative visits, you will select your implant size and type. This process can include use of the state-of-the-art VECTRA® 3-D imaging technology, which offers patients the opportunity to see what the potential breast augmentation outcomes may look like. The images can be modified to present a range of possible results based on different sizes and other factors.

Of course, size and dimensions both play a part, so the most important measurement is the current width of the breast. Ultimately, you want to avoid breast enlargement results that widen the breast halfway around the back, or an outcome that makes the breast look like a “can.” With this in mind, the width of the implant is as critically important as the size—it’s not just volume, but dimensions as well. Dr. Mills will review all of your implant options and provide you with pictures and suggestions, but ultimately you will choose which style, size, and dimension best fits your needs. To aid you in the decision, you will be given the time and opportunity to try on different ‘breast sizers,’ which will give you a better idea of how your new shape will fill out your clothing and bathing suits. (We recommend that you bring different types of shirts to your initial consultation to try on with the breast sizers and see your “enhanced” look.) It can also be helpful for you to bring in pictures of breasts that demonstrate what your expectations are for the outcome of the surgery. Dr. Mills can review these with you and let you know if this would be a realistic result for you.

Breast implants will not last forever and will likely need to be replaced with a subsequent surgery. Dr. Mills has always told his patients that the implants would last about 10 years, but with the new “gummy bear” implants, we’re hoping that they will last a bit longer. Breast implant manufacturers generally place a 10-year warranty on the implants. The FDA approved silicone implants for breast augmentation surgery in November 2006, following years of controlled clinical studies called the Adjunct Studies. All women age 22 years and older have the choice of using saline-filled implants or silicone gel-filled implants. Saline implants are made of a silicone shell and filled with sterile saltwater. Silicone gel-filled implants are made of a silicone shell and filled with a cohesive silicone gel. Silicone is a naturally occurring element found in sand, quartz and rock. Silicone can be manufactured in a variety of ways, including oils, gels, and solids. Silicone products have been shown to be bio-compatible, reliable, flexible, and easy to sterilize, making them an ideal choice for implantable and non-implantable medical devices. You can also talk with Dr. Mills about the latest in implant research and development, including the form-stable cohesive gel implant (“gummy bear” and fifth-generation gel). If you have any implant-related questions or concerns, Dr. Mills would be happy to discuss these and provide you with information on the latest research.

Once you have chosen your implant size and type and schedule surgery, you will meet with our pre-operative patient coordinator. She will review all of your pre-operative instructions with you and make sure that you complete all the necessary laboratory tests and health screenings, based on your personal medical history and surgical plan. If you are a smoker, you will be advised to quit smoking at least two weeks prior to surgery and not to resume for at least two weeks after surgery. Additionally, there are certain medications, herbs and potions that she will ask you to cease taking from two weeks prior to surgery to two weeks after your surgery. This appointment will also be a time for you to ask any final questions, so that you are physically and mentally ready for surgery and have an optimal recovery period.

What Is the Breast Augmentation Procedure Like?

On your surgery day, you should allow approximately 4 hours for pre-operative surgical admission, surgical time and post-surgical recovery. Our surgical team, including Dr. Mills, a nurse anesthetist or anesthesiologist, a registered nurse and surgical technician will be with you throughout your surgery and recovery. We ask that you have a responsible adult accompany you to and from the surgery center. This individual should be accessible by phone while you are in surgery and should be at our facility when you are ready to be discharged. After your surgery, you should have someone with you for the first 24 hours.

What Should I Know About Breast Augmentation Recovery?

Recovery time will vary from patient to patient, but the majority of women should expect to take approximately one week off of office-based work to rest during the initial stages of recovery. Although office jobs can usually be resumed at this time, Dr. Mills advises that any work or activities that involve heavy lifting or strenuous labor be avoided for at least two more weeks to provide ample time for healing.

You will have an office visit the day following your surgery, as well as several post-operative visits within the first week. These appointments are extremely important and we encourage you to come to our office regularly for the first week or so, for additional help with your post-operative regime. Your post-operative regime includes displacement exercises to keep the breast pocket open, which should result in softer and more natural-looking breasts. Dr. Mills and his medical staff will assist you in the displacement exercises during these initial post-operative visits.

At first, these exercises may be a little difficult, but we will take as much time as you need to feel comfortable with the exercises. It is often helpful to have a friend or spouse assist with the exercises, so we encourage you to bring them to your follow-up visits. Dr. Mills strongly feels that these exercises are critical to yielding the best result, while minimizing potential complications.

At your first post-operative visit, Dr. Mills will remove your surgical bra and wrap before assisting you with your exercises. Dr. Mills will determine what post-operative garment you should wear at this time. After this initial visit, you will be able to shower. You will usually have two sets of sutures, which will be removed at post-operative days 7 and 14, respectively. You will be advised not to use deodorant for the first 2 weeks, but can use a non-scented liquid deodorant after that time, treating the suture line with care. In the first couple of weeks, Dr. Mills will continue to monitor your progress and advise you in your post-operative regime and instructions. It is exceptionally important that you come to all recommended post-operative visits in order to minimize post-operative risks and complications and to help you achieve optimal results.

Within a short time following surgery, you will be able to resume your normal routine and enjoy your new shape. If you want to show off your new shape by summertime, we recommend that you schedule your surgery in the spring (or before). Springtime is the busiest time of the year in our office for that very reason.

What Are Some of the Risks and Complications That Have Been Associated with Breast Augmentation?

The most common complication associated with breast augmentation is capsular contracture. This condition, which involves a tightening of the scar tissue around the implant, may result in varying degrees of breast firmness, pain, and a change in breast appearance. While the national average for capsular contracture is 10%, in his 20-year paper, which showed the complications in a peer-reviewed article for the Aesthetic Surgery Journal, Dr. Mills had only a 2% rate of capsular contracture. Other risks include implant rupture (50% after 10 years) or leakage, changes in nipple or breast sensation (both temporary and permanent), and adverse reactions to anesthesia. In addition, a rare complication involving a type of cancer called Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) has been described, but only with textured breast implants, and Dr. Mills has not used a textured implant in the last five years. There is also a disease process known as breast implant illness (BII) that Dr. Mills can talk with you about during the consultation.

Will My Breast Augmentation Scars Be Noticeable?

With Dr. Mills’ use of the TASPA breast augmentation technique, residual scarring from the procedure is concealed under the armpit. Since there are no incisions created directly on the breasts, there will be no scars in these areas whatsoever. Other breast augmentation techniques, such as those that utilize incisions under the breast or around the areolas, will result in some level of scarring in the breast areas; however, even with these techniques, Dr. Mills is extremely careful with the creation and closing of incisions and works diligently to ensure that the noticeability of scars is kept to a minimum. He will also provide instructions on ways you can help the scars heal as well as possible during recovery. With the proper care, the appearance of scars should fade to some degree over time.

What Does Breast Augmentation Cost?

The cost of breast augmentation will depend on several factors, including the skill and experience of the plastic surgeon, the type of implants selected, and the surgical technique used to place the implants. At Aesthetic Plastic Surgical Institute, average fees for breast augmentation surgery range from $7,000-$8,500 (as of March, 2021). Because breast augmentation surgery is customized for each patient, the price will not be the same for each individual. Dr. Mills offers plastic surgery financing options that can fit virtually any budget. A member of our staff will be happy to discuss breast augmentation surgery with you and schedule a personalized consultation with Dr. Mills.

Will I Be Able to Breastfeed After Breast Augmentation?

If you are able to breastfeed prior to breast augmentation, you should still be able to do so after treatment when implants are placed safely and correctly by a board-certified plastic surgeon. The misconception that implants interfere with one’s ability to breastfeed stems from the fact that not every woman is capable of producing a sufficient amount of breastmilk for nursing in the first place. If a patient has not attempted to breastfeed before undergoing augmentation, she may wrongly attribute her inability to nurse to the presence of implants. With this in mind, it is important to note that when an incision is made through the breast ducts, such as a nipple/areolar incision, this may interrupt more ducts than if contact was never made with these ducts. This is one of the reasons why Dr. Mills does not generally use that surgical approach. For more on this topic, please see Dr. Mills’ blog post regarding breastfeeding and implants.

Will I Also Need a Breast Lift with My Augmentation?

A breast lift—or mastopexy—may be necessary if there is a moderate to significant amount of breast drooping present. While implants alone can provide a minor lift, they are mainly providing fullness to the superior pole; they will not be able to significantly elevate the position of breasts on the chest wall. The only way to do this is by removing excess skin and raising/reshaping breast tissue during a mastopexy—if breast tissue is out of place, it will only be like a weight on a slinky, pulling the breast tissue down. A combined breast lift and breast augmentation surgery can often safely be performed in a single procedure. Frequently, placing an implant corrects the loss of fullness on top—but if the nipple is pointing down, an incision must be made to move the nipple up. Starting in April of 2016, Dr. Mills began using GALAFlex®, which is a surgical, suture-type mesh that will eventually dissolve, and can be used as a demi-cup to add structure to the breast and address lost tissue, as evidenced by the signs of drooping.

Dr. Mills typically performs breast augmentation and breast lift surgery in two separate stages, though it is possible to combine these treatments in certain instances. The most appropriate surgical plan for your needs can be determined at the time of the consultation.

How to Choose a Breast Augmentation Surgeon

The first important step in breast augmentation surgery is choosing an experienced, qualified surgeon with whom you feel comfortable and confident. Here are a few tips that can help you know what to look for as you search for the best breast augmentation surgeon for your needs:

Take a Good Look at the Surgeon’s Credentials and Background

Research the prospective surgeon’s experience and credentials. Check to see if they are certified by the American Board of Plastic Surgery; find out how many years they have been in practice; and try to get an idea as to how many breast surgeries they have performed or how long they have been offering the procedure. Also, look at the surgeon’s memberships and professional affiliations, the awards and honors they have received, and see if their overall philosophy of care aligns with your expectations. Dr. Mills is not only certified by the American Board of Plastic Surgery, he also once served as the president of the American Society for Aesthetic Plastic Surgery (ASAPS).

It is also important to recognize that someone who calls themselves a “cosmetic surgeon” may not have officially completed a plastic surgery residency. This makes it especially critical to scrutinize the doctor’s credentials to determine whether they are a board-certified plastic surgeon.

Read Patient Reviews and View Before-and-After Photos

Many practices have patient testimonials and reviews of the plastic surgeon available directly on the website, and there are often reviews published through third-party sites, as well. By reading about other patients’ experiences with a specific practice, you can typically gain a clearer picture of the kind of care you may receive. By the same token, plastic surgery before-and-after photos featuring the surgeon’s previous patients can also give you an idea of the results that can be achieved. If there is not a breast augmentation photo gallery available on the website, you can feel free to ask the practice to see before-and-after photos when you visit the office. Also, look carefully at the surgeon’s before-and-after photos to make sure that standardized photography has been used, without excessive changes in lighting and angles.

Meet with the Plastic Surgeon and Evaluate Your Rapport

Once you have narrowed down your selection of prospective plastic surgeons, you can meet with them in a one-on-one consultation before making your final decision. During the consultation, you should feel that the surgeon is being honest, attentive, and thorough. The surgeon should answer all of your questions and go over the procedure in detail, illuminating all risks and benefits, and giving you a clear idea of the treatment and recovery process. Remember, this is a collaboration between you and the surgeon. You should feel both comfortable in the surgeon’s care and confident in their ability to help you achieve your goals both safely and effectively.

Additional Frequently Asked Questions About Breast Augmentation

Are breast implants safe?

Breast implants are subject to rigorous testing for safety by the U.S. Food and Drug Administration. In fact, breast implants are the most studied devices in the history of the FDA. Although silicone implants were pulled from the market in 1992, they were re-introduced in 2006 and have been utilized ever since. Although every surgical procedure carries risks, safety is Dr. Mills’ number one priority, and he takes maximum precautions to minimize the potential for complications. Dr. Mills will be happy to address any concerns you may have about breast implant safety at any time.

Can breast implants affect mammograms?

The presence of breast implants may affect mammograms. For this reason, we advise patients who have any type of breast implants to inform their radiologist. At the time of a mammogram, the radiology technician can adjust their screening methods for women with implants to help gather more accurate and conclusive results. Radiologists may also request other diagnostic studies, such as an ultrasound or MRI, if they deem it necessary to get a more comprehensive evaluation of the breasts.

What do breast implants feel like?

One of the many benefits of the advanced types of breast implants offered by Dr. Mills is their ability to both look and feel as natural as possible. Both saline and silicone implants can produce this effect; however, other components of the breast augmentation—such as implant size, the location of the implants, and the amount of fat currently in the breasts—will also play a role in the implants’ ability to create results that feel similar to natural breast tissue. Dr. Mills will make recommendations largely based on these factors so that the optimal results can be achieved.

How much do breast implants weigh?

Regardless of how large a breast implant may be, it is actually quite light in weight. The outer shell of both saline and silicone implants is composed of a silicone material, and the shell weighs the least. The substance inside the silicone shell typically only adds about a pound (454 grams is one pound) or two to the total weight of the breast implant, and it’s often even less than a pound. With this in mind, patients should not be very concerned about any potential weight gain due to the breast implants because they will likely not produce a significant difference.

How painful is breast augmentation?

Discomfort during the recovery process after breast augmentation can often be well-managed with medication and rest. Most patients will experience discomfort at its most prominent degree within the first three days. As the incisions heal, post-operative pain should fade. Following the recovery instructions provided by Dr. Mills can help ensure that pain does not last long after surgery and that discomfort is controlled during the healing process. 75% of Dr. Mills’ patients are only taking Tylenol® after the first day following surgery.

How can I reduce swelling after breast augmentation?

It is normal to experience swelling, numbness, and bruising for a few weeks following breast augmentation surgery. These symptoms should fade as your breasts continue to heal. In the meantime, medication can help relieve any discomfort or pain you may experience after the procedure. Dr. Mills might advise you to wear a surgical bra to facilitate the healing process of your breasts. If he does provide or recommend a bra, it can help protect your incisions, keep your sutures in place, and control swelling. Placing ice packs wrapped in a thin cloth over your breasts can often help minimize swelling, as well. Patients should closely follow the post-operative care instructions given by Dr. Mills to help ensure that the recovery process is as smooth as possible.

How should I sleep after breast augmentation?

Sleeping habits may need some modifications for a temporary period after breast augmentation surgery. During the healing process, it’s typically best to avoid any direct pressure on the breasts; therefore, it is generally recommended that patients sleep on their backs for several weeks. Dr. Mills may also suggest that some additional pillows be utilized in order to keep the upper body propped up while sleeping. These adjustments won’t need to be permanent—they are precautionary measures to be taken throughout recovery to ensure the breasts heal as effectively as possible following surgery.

What type of bra should I wear after breast augmentation?

The type of bra recommended after breast augmentation surgery will depend on each individual patient. In certain cases, Dr. Mills will provide patients with a support bra that will need to be worn for a specified period following surgery. For other individuals, it may be best to avoid wearing any kind of bra for several weeks. If the use of a bra is approved by Dr. Mills, it’s generally advised that it be of the kind that does not have an underwire. Our plastic surgeon will make a personalized recommendation that takes each patient’s unique needs into account.

How long do breast implants last?

The longevity of breast implants varies from patient to patient, but they typically last about ten years. Breast implants are not guaranteed to last forever and some women may need their implants removed or replaced at some point in their lives. With that in mind, patients who underwent breast augmentation should have routine breast exams and be watchful for any changes in the appearance or feel of the breast implants over time. Regular self-exams, routine mammograms, digital ultrasounds, and MRIs can help identify problems with the implants and distinguish if they need to be exchanged or removed.

How do I know if I have an implant rupture?

It is understandable for patients to be concerned about their implants developing a hole or a tear. Detecting an implant rupture will be different between saline and silicone breast implants. For patients with saline implants, a rupture or leak will likely be noticeable. They may see an obvious change in the shape and/or positioning of their breasts. In contrast, a rupture or leak will likely be less distinguishable for patients with silicone implants, as the breast appearance may remain stable. Routine breast exams are highly recommended as they can help identify ruptures or leakage. If necessary, a radiologist may also use an MRI or ultrasound to achieve a more accurate evaluation. Our practice offers complimentary breast implant ultrasound imaging for patients who had their implants placed by Dr. Mills. Our effective method of using high-definition ultrasound technology shows a clear view of the implant and allows Dr. Mills to distinguish ruptures or leaks. This can be a great alternative for our patients who do not have a primary care physician or lack insurance benefits that can cover the cost of advanced imaging tests.

What if I change my mind about breast implants later in life?

Breast augmentation is considered to have a high satisfaction rate, but there are some women who decide that they want their breast implants exchanged or removed due to medical or personal reasons. Dr. Mills offers a breast revision surgery called breast implant exchange for patients who want to switch the type of implant they have (e.g., silicone to saline implants) or change the size of their implant to meet their new cosmetic goals. If you would like to remove both implants without exchanging them, a breast implant removal surgery may be recommended for you. Dr. Mills encourages all breast augmentation patients to schedule a consultation with him if they have any concerns about their current implants or would like to explore breast revision surgery options.

Schedule Your Consultation

Dr. Daniel C. Mills has literally performed thousands of these procedures and is internationally acclaimed and known for breast augmentation, especially for his use of the Transaxillary Breast Augmentation approach. In fact, this operation is one of Dr. Mills’ favorite procedures to perform. We look forward to meeting you in consultation to develop a surgical plan that best suits your needs. Please contact Aesthetic Plastic Surgical Institute to schedule your one-one-one consultation. When you speak with our patient coordinator, she can direct you to view the Breast Augmentation Video Consultation online. Dr. Mills wants this to be a great experience for you and his staff will do everything we can to serve you.