Breast Surgery

If you are in good health, have reasonable goals for size increase, and you haven’t had radiation treatment of your chest for cancer, then you are likely a good candidate for this procedure. Your understanding of the limitations of breast enlargement is important and Dr. Rad will review these on an individual basis. Body proportions change with age, pregnancy and weight fluctuations. No matter how fit and healthy you are, your breast and body shape may not be exactly how you’d like. Breast implants offer immediate improvement and, while a strong self-confidence comes from within, improved body proportions can help your self-image. Particularly in Washington DC, women choose breast augmentation for many different reasons: some women wish a better fit and feel in clothes or to have more options in their fashion choices.

Others who have had one or more pregnancies have found that their breasts have lost fullness once breast feeding has ended. Or, patients may genetically have small breasts relative to their height, or hereditary asymmetry of breast size, shape and nipple position, or tuberous (constricted) breasts. Other patients leading a healthy lifestyle may find their breasts to be out of proportion with their otherwise fit and toned bodies. Patients with breast cancer who’ve had reconstructive surgery on one side may need an augmentation on the other side for symmetry. Finally, many women may want to feel more desirable to their partners.

The common thread running through each woman’s decision is the desire to improve their breast and body proportions, not to look obviously “done,” and to improve self-confidence. While not a replacement for healthy relationships or self-esteem, breast augmentation offers significant improvements that can lead to major improvements in how you feel about your body, and Dr. Rad carefully considers your unique goals in order to determine the appropriate options to meet them. While each patient’s reasons to have a breast enlargement procedure are varied and deeply personal, they are all valid. And when one feels self-confident in his or her personal appearance at any age, inevitably it has a positive effect on all aspects of life.

Breast implant sizes range from 100 cc to 800 cc. A 100 cc implant is a small A cup, and an increase of 1 cup size corresponds to approximately 140 cc increase in implant volume. The most commonly selected implant for augmentation is 400 cc which will increase breast cup size by 2-3 cups, depending on your starting bra cup size. In your consultation with Dr. Rad you will have the opportunity to use breast implant “sizers” which simulate an augmentation so that you can see your breast shape and size before making your decision.

This decision depends on your anatomy, goals and cost. Women with A or B cup sized breasts benefit from silicone for a more natural feel and softness. Women when C or larger breast size can choose either saline or silicone because their breast tissue gives a natural feel. Saline implants are much less expensive (~$400-$600 per pair) as compared with silicone (~$800-$1,200 per pair) implants. However, saline implants have a firm and relatively unnatural feel (called “palpability”) to the touch. Patients who have C cup breasts or larger may have saline implants without the downside of palpability, whereas patients with A or B cup breasts should consider silicone implants due to the palpability problem. Furthermore, placement of implants below the muscle may offset the downside of saline because the added layer of tissue softens the feel. Saline implants have the advantage of very small and hidden incisions, sometimes in the armpit, but ultimately natural feel is most important and justifies a slightly longer incision. Dr. Rad will carefully weigh each of these factors with you to determine the optimal implant type.

Teardrop implants were developed for breast reconstruction surgery (for mastectomy) because they offer the most natural shape. However, for breast augmentation Dr. Rad rarely recommends teardrop implants for many reasons: (1) teardrop implants are much more expensive (twice the cost) than round implants, and (2) it is now scientific fact that even plastic surgeons can’t tell whether round implants or teardrop implants have been used when shown before/after photos. Furthermore, teardrop implants can potentially rotate which, although very rare, may require surgery to correct. Because beautiful results are achievable with round implants just as much as with teardrop, spending thousands of dollars more on teardrop implants is not justified. Therefore, unless there are compelling reasons to choose teardrop implants, and Dr. Rad will guide you, then his preferred implant is round.

Neither is superior and each has advantages and disadvantages. In general Dr. Rad’s decision is based on numerous factors, including your lifestyle (for example, if you’re a body builder or very physically active, then sub-muscular placement may not be right due to “animation deformity”), your pre-augmentation breast size (if you have A cup breasts and choose saline implants then sub-muscular may be preferable), desire for fullness in certain areas of your breasts (sub-muscular placement gives more upper breast fullness), your choice of silicone versus saline (for patients desiring the most natural feel, silicone implants are superior to saline), incision placement (the safest approach in the natural underfold), and cost (silicone implants cost twice as much as saline but the difference in feel and appearance may be worth it for patients with A or B cup breasts). Dr. Rad will carefully weigh each factor and guide you to the appropriate decision.