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Breast Augmentation

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Overview of Breast Augmentation Surgery in Washington

A breast augmentation, or breast implant surgery, is a popular surgical procedure whereby silicone gel or saline implants are placed beneath breast tissue to enhance breast size and improve shape. Whether your breasts have deflated post-pregnancy, or genetically your breast and body proportions have not had the balance you desire, Dr. Rad’s Washington DC breast augmentation patients seek the most natural proportions rather than a an overly augmented “done” look. Dr. Rad performs breast augmentation for patients who travel to Washington from the northeast corridor, from northern Virginia, Maryland, New York City and nationally.

With breast augmentation surgery, there are several options available which enables Dr. Rad to tailor the results to match the goals and preferences of the patient.

Am I a Good Candidate for Breast Augmentation Surgery?

If you are in good health, have reasonable goals for size increase, and you’ve not had radiation treatment of your chest for cancer, then you are likely a good candidate procedure. Your understanding of the limitations of breast augmentation 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 augmentation 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.

How Does Dr. Rad Approach Breast Augmentation Surgery?

There are two ways to perform breast augmentation: (1) with implants, either saline or silicone, and (2) with your own fat. There are advantages and disadvantages to each. Breast augmentation with implants offer a virtually unlimited increase in size and shape (within reason, of course). Some patients wish to avoid implantation of the most popular of options, silicone (although silicone implants are FDA approved and highly cohesive “gummy bear” gel does not leak).

An Breast augmentation with one’s own fat involves liposuction of areas where fat is not desired, and then careful injection of purified fat into the breasts; this offers the most natural approach, but the limitations are several: the maximum size increase is usually less than 1 cup (on average), the volume of fat transfer depends on whether one’s breasts are mostly fat (in which case more fat volume can be transferred) versus “fibroglandular” breasts (breasts which have more breast gland tissue into which fat transfer is more limited).

For women seeking the most natural augmentation and with small volume incase, fat transfer is a good option; for larger volume increases, particularly for patients who have small fibroglandular breasts, implants are the optimal option. If fat transfer is selected, Dr. Rad uses suction-assisted liposuction (SAL) or power-assisted liposuction (PAL) which prevents damage to delicate fat cells. Avoid Vaser-assisted or laser-assisted liposuction which destroys fat cells prior to liposuction.

Learn The Nuance Of The Washington Breast Augmentation


Breast Augmentation

Dr. Rad’s approach is unique for each patient, and it combines sophisticated, state-of-the-art techniques to achieve natural and long lasting results.

WHAT RESULTS CAN I EXPECT?

Your vision for your results will emerge through detailed consultation with Dr. Rad, meticulous examination of your anatomy, and careful pre-surgical planning. While Dr. Rad’s surgical approach is unique for each patient, the goal of naturalness remains constant.

Actual Washington Breast Augmentation Patient of Dr. Rad’s
See More Top Breast Augmentation Results

Sherber+Rad cannot guarantee specific results.
Individual results may vary.

Q+A

HOW DO I CHOOSE IMPLANT SIZE FOR BREAST AUGMENTATION?

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.

WHICH IS BETTER FOR BREAST AUGMENTATION: SILICONE OR SALINE?

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.

WHICH BREAST IMPLANT IS BETTER: ROUND OR TEARDROP?

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.

WHICH APPROACH IS BETTER: ABOVE MUSCLE OR BELOW MUSCLE?

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.

WHAT CAN I EXPECT DURING MY CONSULTATION WITH DR. RAD?

You will have Dr. Rad’s unhurried attention. Dr. Rad does not advise a “cookie cutter” approach, nor is his practice an “assembly line,” as is common in other practices that perform as many surgeries as possible. Dr. Rad endeavors to understand your preferences, goals and natural anatomy. Dr. Rad will guide your decision so that you have the highest likelihood of a successful result that meets most, if not all, of your goals. Dr. Rad performs a careful history and physical exam wherein he carefully examines your breasts for abnormalities such as lumps or masses. Dr. Rad measures your breast width, height, projection and other lengths (such as sternal notch to nipple, nipple to inframammary fold, and inter-nipple distance). Dr. Rad will then synethesize all this information in order to guide vis-à-vis: incision placement, breast shape and symmetry, cup size, appearance of scars and scar therapy, implat type, size and location (above or below muscle), the length of surgery, expectations for recovery and physical restrictions after surgery. You’ll also have the opportunity to try on “implant sizers” which are silicone mimics or augmentation, and which will give you a sense of your breast size after augmentation. Dr. Rad will answer all of your questions and he will also review the safety aspects of surgery. Dr. Rad thoroughly reviews expectations before and after surgery, and he takes time and gives unhurried attention to your questions.

WHAT CAN I EXPECT FOR RECOVERY AFTER BREAST AUGMENTATION SURGERY?

Breast augmentation recovery lasts 1-3 days for above-muscle implant placement and increases to 5-7 days with below-muscle implant placement. Most women can return to work after a long weekend. High-performance athletes may require up to 3 weeks to return to unrestricted athletic activity. Breast augmentation surgery is not extremely painful and discomfort is well tolerated. Much of the discomfort is a function of how active you are, and shortly after surgery you should not engage in physically strenuous activity such as unnecessary heavy lifting. You may conduct your normal “activities of daily living” such as eating, showering and sleeping, and walking is encouraged. Your length of time off work depends on your level of activity. If you have a physically demanding job, such as in mail or UPS package delivery, then you’ll need several weeks off (if you’re able to return to “light duty” where you can avoid heavy lifting then returning to work sooner is possible), whereas if you work at a desk then returning to work after a long weekend may be possible. You should refrain from driving if you’re taking strong pain medicine which usually lasts only a few days. Dr. Rad will guide your physical limitations in advance of, and following, surgery. Dr. Rad checks in with you both the night before and the night of surgery to ensure you’re comfortable leading to, and following, surgery. At your first follow up Dr. Rad will examine you and review detailed instructions for optimal scar healing, implant/brast massage and physical restrictions. Generally, your limitations are a function of your level of physical activity before surgery and Dr. Rad will guide you. Strenuous exercise can begin approximately 2-3 weeks after surgery but should begin with activities outside the chest area. Therefore, pushups or bench press, chest fly activity is discouraged, as is jumping or running, for approximately 4-6 weeks. However, you may work your core, arms and legs in the early phase and then ease into chest activities and, at the 8 week mark, unrestricted exercise. If you have specific concerns Dr. Rad will be happy to consider your unique exercise regimen.

HOW WILL MY SCARS LOOK AFTER BREAST AUGMENTATION?

Scars after breast augmentation are very small and Dr. Rad ensures they are well hidden either in the natural breast underfold (most common), the areola or armpit (rare). Surgical scars should be well moisturized at all times and protected from sunlight (i.e. ultraviolet rays). Dr. Rad recommends alternating Aquaphor ointment in the evening with Biocorneum at night. For enhanced results, application of vetted topicals such as La Mer The Concentrate and laser scar therapy performed by world renowned physician, Dr. Sherber, can make scars fade and soften rapidly. With diligent scar therapy Dr. Rad’s Washington DC patients enjoy results with minimal visible scarring.

HOW LONG WILL MY RESULTS LAST?

Implants do not need to be replaced routinely and they are designed to last many years, if not decades. After many years (sometimes 10 – 15 years) saline implants may rupture, which is not dangerous to you, and the rapid absorption of saline causes your breast to deflate. This requires replacement of the implant. However, silicone implants employing “gummibear” cohesive silicone gel technology (i.e. implants manufactured in the US by Mentor, Allergan and Sientra) will not to leak. Generally, if you are pleased with your breast implants and have no concerning symptoms then you do not need routine surgery to modify them and you may enjoy your results for decades.

WILL I NEED A BREAST LIFT AND A BREAST AUGMENTATION TOGETHER?

This depends on how low your nipple position is. If your nipples fall below the level of your “inframammary fold” (IMF, the natural under-fold of your breast) then Dr. Rad may recommend a breast lift or “mastopexy.” This procedure involves a lollipop shaped scar around your areola and down the center of your lower breast. However, this decision also depends on how large your implants will be. Larger implants may eliminate the need for a lift, or at least reduce the length of the scars. Dr. Rad always endeavors to minimize visible scarring and he will guide you as to the optimal approach to achieve your goals.

IS BREAST AUGMENTATION SAFE?

Breast augmentation surgery is very safe. During your pre-surgical consultation, Dr. Rad will assess your individual risks to determine the optimal path for you. By following Dr. Rad’s specific instructions your safety and optimal results will be ensured. While risks are associated with every surgery, keep in mind that the risks associated with breast augmentation are not life threatening. In fact you have a much higher chance of injury driving a car every day as compared with the risk of undergoing surgery by a Board certified plastic surgeon in a hospital-based surgical facility. However, we don’t think of risk before getting behind the wheel. Similarly, through careful planning and preparation Dr. Rad will guide you through your surgery safely and effectively.

ARE IMPLANTS SAFE?

Silicone and saline implants are very safe and are FDA approved for safety. Silicone used today is “medical grade” and are “form stable,” meaning that the chance of leakage of silicone into tissues is extremely small. If a break or tear develops in the implant shell (a very unlikely event) then the internal silicone likely will stay where it is within the shell. If you have silicone gel-filled breast implants, the FDA still recommends MRI scans to screen for silent (i.e. no symptoms appear) rupture 3 years after receiving your implant and every 2 years after that. Based on current information, the FDA states that there is no association between silicone gel-filled breast implants and connective tissue disease, breast cancer, or reproductive problems. For more information read the FDA’s “5 things to know about breast implants.”

HOW DOES PRICING WORK?

Pricing has several components: (1) surgery fee (for Dr. Rad’s skill, care and expertise), (2) hospital anesthesia cost (for the board certified anesthesiologist to manage your comfort during surgery), (3) hospital facility cost (to “rent” the operating room and staff time), and (4) implant costs (for example, breast implants, chin or jaw implants, etc.). Dr. Rad performs surgery in a hospital operating room as this is the safest environment where board certified anesthesiologists are involved in your care. While more costly that in-office surgery rooms, this cost is justified to ensure your procedure is as safe as possible. Sometimes we offer concessions for multiple procedures.

HOW CAN I AFFORD SURGERY?

We consider bringing aesthetic surgery cost within financial reach to be a high priority and we have several mechanisms in place to make surgery affordable. (1) We participate with CareCredit, a medical financing company; the most popular plan is our *free* 6 month plan which is *free* since we cover associated financing fees (longer plans up to 60 months incur fees); (2) We offer concessions (discounts) on multiple procedures; and (3) hospital fees are lowered by efficient surgery: Dr. Rad works with a hand-selected team of professionals to lower OR time and associated hospital fees. We appreciate that cost is an important consideration in patients’ decisions to select their surgeons. While there is variability in cost between plastic surgeons, surgeons’ pricing can reflect the surgeon’s expertise, safety measures taken, the quality of your aesthetic results, and the caliber of your overall care.

Consultation with Dr. Rad

WHAT CAN I EXPECT FROM MY CONSULTATION WITH DR. RAD?

Our plastic surgery office in Washington DC is centered on your comfort and privacy. You’ll be received by our exquisitely attentive staff, and escorted to your own private cabana wherein you’ll feel relaxed and comfortable while consulting discreetly with Dr. Rad. First Dr. Rad will determine if you are a good candidate for surgery and during your consultation you should decide if Dr. Rad is the right surgeon for you. Credentials are crucial and, in addition to being Board certified in plastic surgery, Dr. Rad is Assistant Professor at Johns Hopkins, and he enjoys an impeccable reputation as a top flight aesthetic surgeon. His facial plastic surgery expertise is sought out as one of the best surgeons in Washington DC, northern Virginia and the US.

Your safety is Dr. Rad’s primary concern and he will review your medical history. You should inform Dr. Rad of any medical problems or medications that may affect your healing. If you are medically appropriate to undergo surgery then Dr. Rad’s focus will be to understand what specific aesthetic concerns you have. Washington patients expect natural results with minimal downtime. Dr. Rad will spend time carefully listening to your concerns, asking clarifying questions and then masterfully guiding you, step by step, to understand how your unique anatomy can be improved to convey a rested appearance. Dr. Rad’s goal is to determine the most comprehensive approach for long lasting, natural results while minimizing downtime. Dr. Rad first needs to understand your specific concerns and you should prepare your thoughts prior to your consultation. Think of words that convey how you feel about your appearance. For example, Washington DC patients often say they look fatigued, tired or lackluster because of undereye bags or dark undereye circles, or they look sad, upset or disinterested such as from heavy eyebrows, excess skin above the eyes or downturned corners of the mouth. Patients often relate concerns of looking older than how they feel and this can be caused by jowls, nasolabial folds, loose neck skin, lines and wrinkles. Try to put into words how your appearance bothers you, and the priority you give to each area. Dr. Rad will then present to you his expert opinion about which procedures would be best to restore your anatomy to create a rested and refreshed appearance. In addition to surgery oftentimes patients can benefit from other procedures such as brow lift, eyelid lift, facial fat transfer, or rhinoplasty. And since surgery is intricate Dr. Rad will guide you through a stepwise approach of aesthetic analysis and he’ll deliver his recommendations in a clear and honest manner. Dr. Rad will present all options available in modern day surgery, both non-surgical and surgical.

Dr. Rad and Board certified dermatologist Dr. Sherber often collaborate to optimize patients’ results and to minimize invasiveness. As such Dr. Rad’s modern approach to surgery harnesses the power of both dermatology and plastic surgery as both specialities address different aesthetic challenges. For example, plastic surgery is effective to lift, tighten and volumize loose, atrophied tissues, whereas dermatologic treatments such as laser, radiofrequency tightening and skincare are best to improve skin texture, pigmentation and tone. Dr. Rad can address any concerns regarding skin quality and how to obtain and maintain optimal results.

Dr. Rad will review with you photos of his patients’ results (many of which you’ll not find online due to privacy concerns) to highlight his aesthetic approaches and skill. He will take your photographs, which remain confidential, to assist with the planning of your surgery. For your safety Dr. Rad performs surgery in a hospital-based operating room, considered to be the safest environment, rather than in the office. Anesthesia is delivered by a board certified anesthesiologist (MD) and you’ll be under light anesthesia which is important for your safety and comfort.

You will receive a customized quote for the procedures in which you’re interested. Once approved we may then move forward with pre-operative preparations and you will meet with Dr. Rad again at your final in person consultation prior to surgery. Dr. Rad’s reputation as one of the most technically gifted surgeons attracts patients nationally and from around the world. We cater to patients from across the globe by arranging virtual consultations, luxury accommodations at The Jefferson hotel, Washington’s most luxurious 5 star boutique hotel, as well as private nursing care. Your privacy, comfort and safely achieving exceptional results are our top priorities.

What are Dr. Rad’s patients saying?

“Dr. Rad and his staff are beyond compare. After having one breast augmentation result in extremely painful capsular contracture, I was wary seeking out another surgeon to fix it. Dr. Rad was very careful in listening to my specific desires and concerns, and reflected that in his suggestions for how to proceed. He and his staff provide a warm and inviting atmosphere, and the results speak for themselves. I am so much more comfortable now! Pain free and even more beautiful results than before.”

Megan in Arlington, VA – Mar 31, 2018

About your Washington surgeon

Dr. Rad’s credentials, results and patient reviews speak for themselves. Princeton (magna cum laude) and Duke University educated, Dr. Rad is a Johns Hopkins trained board certified plastic surgeon and Assistant Professor of plastic surgery there. Dr. Rad has performed thousands of aesthetic facial surgeries and he specializes in minimally invasive, scarless approaches featuring minimal downtime. He is ranked in the top 3 plastic surgeons in DC, has the highest patient ratings across all doctor review websites and has been an invited expert in international conferences teaching his techniques to surgeons from around the world. Dr. Rad’s patients seek to look refreshed and rested with natural results, minimal scars and the least downtime. He has innovated scarless techniques due to his patients’ needs for discretion and hidden evidence of surgery. Dr. Rad has membership with the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, and he is certified by the American Board of Plastic Surgery. Through rigorous written and oral examinations, these national societies have vetted Dr. Rad’s education, training, professional qualifications, surgical competence, and ethical conduct as having met the highest standards in the world.

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What is the cost of Breast Augmentation surgery in DC?

Breast implant cost depends on choice of silicone gel or saline, round or teardrop, and the manufacturer (Mentor, Allergan, Sientra). Round saline implants are cheapest at $400-$600/pair, whereas round silicone gel implants are $800-$1,200/pair, and teardrop silicone implants are $ $2,000-$2,400/pair. In general, most patients choose round silicone for the most natural feel. Teardrop implants are rarely selected because of their high cost and the improvement in shape does not justify the extra spend. Therefore, because of variable implant cost, the total cost of breast augmentation in our Washington DC office is $6,500 to $8,000. The implant cost is passed directly to you (i.e. it is not marked up). Also, the total cost of surgery is determined by the implant type, as well as which hospital surgery center you elect to have your procedure (fees vary). Perhaps most importantly, you’re buying experience. Surgery should be performed by a skilled and qualified plastic surgeon who has done hundreds of breast augmentations, and corrective work ends up being more complicated and costly. The cost is one of several factors, and it is not the most important.

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Sherber+Rad1101 15th St. NW, Suite 100, Washington, D.C. 20005