Augmentation

Cost

Insurance will sometimes cover this procedure. In cases where insurance does not, the prices are as follows:

$5900 saline implants

$6500-$7200 silicone implants

cohesive gel implants ("gummy bear" implants) are higher in price than regular gel implants

Who Is a Good Candidate?

While it is not a requirement to have undergone hormone therapy, it is recommended to try and maximize native breast growth with > 12 months of hormone therapy to obtain optimal surgical results. Patients who have plateaued in their breast development after a sufficient time on hormone therapy are very good candidates for this surgery, as often times hormones alone will not give a sufficiently sized breast. 

Additionally, consideration must be given to where the implants are placed - either above or below the pectoralis major muscle. For a more natural looking result, implants are often placed below the pectoralis major muscle, however consideration must be given to how thick or strong the pectoralis major muscle is as well as how wide the sternum is, as this limits how close together the implants can be placed. During the initial consultation, Dr. Kayan will review the pros and cons of implant placement in the subglandular or subpectoral positions as each patient may differ in what position gives the best result for that particular patient. 

The Procedure

Breast augmentation is done as an outpatient procedure in an ambulatory surgery center.  Surgery is done under general anesthesia and takes a less than 1 hour. An incision is made either under the breast (inframammary fold) or around the nipple (peri-areolar), and a saline or silicone implant is placed either above your muscle (subglandular) or below the pectoralis major muscle (subpectoral). The incisions are closed with dissolvable sutures and skin glue, and the patient is wrapped in a compressive ACE wrap. The length of the incisions depend on what type of implant is placed, as well as how large the implant is. Saline implants require smaller incisions (4 cm or less), and most silicone implants between 225-325 cc can be done through an incision around 4 cm. For silicone implants in the 325-450 cc range, the incision is between 4.5 - 5 cm, and larger implants above that will require incisions >5 cm. Very slightly larger incisions are needed for more cohesive gel implants because these implants are less deformable and do not fit through a smaller incision as easily as standard gel implants. 

Recovery 

All dressings may be removed and patients may shower after 48 hours. After showering, most people will either re-wrap in the ACE or put on a tight, front closure sports bra. These can be purchased online or at any sports apparel store. We advise patients not to do any overhead reaching for 1 week or lifting more than 5 lbs or high end exercise for 4-6 weeks after surgery, as this can disrupt healing and cause bleeding. Some type of chest compression will need to be worn 24/7 for the full 4-6 weeks, then patients may be fitted for an underwire bra 6 weeks after surgery or after the incisions are completely healed. The implants will appear to sit very high up on your chest at first, and will start to settle down into place starting around 1 month after surgery. It takes anywhere from 3-6 months or longer for the implants to settle into their final position. 

Long term maintenance of implants

If a saline implant ruptures, it is noticeable quite quickly as the breast will return very quickly, usually in less than a week, to its original size. If a silicone implant ruptures, it is not obvious. The FDA recommends that patients with silicone breast implants get an MRI 3 years after their initial surgery, and every 2 years thereafter to screen for implant rupture. The lifespan of a breast implant is 10-15 years. Other risks that are commonly mentioned are capsular contracture, which is a process by which the scar capsule around the implant thickens or hardens, and causes a sometimes noticeable asymmetry in the breasts. Capsular contracture will often require an operation to remove the implant and abnormal capsule around it.