Metropolitan Plastic Surgery

Breast Augmentation

Breast Implants Virginia

When a woman has small, underdeveloped breasts or when she has lost the natural fullness of her breast after pregnancy, she may seek breast augmentation surgery. Typically, this operation not only enhances the entire aesthetic proportion of her body, but also improves her self-esteem and psychological well being.

Breast enlargement with implants is usually performed with the patient under general anesthesia. The incision can be placed in several areas, including the mammary fold (under the breast), the periareolar (around the dark skin surrounding the nipple), or the armpit area. A pocket is developed for the breast implant under the breast tissue or the muscles of the chest wall. Occasionally, it may be necessary to perform a breast lift at the same time as a breast augmentation. The final outcome of surgery may be greatly enhanced by this procedure, which places the nipple in a more appropriate position or eliminates excess skin.

The breast implants available today for augmentation are saline filled implants or silicone gel filled implants. In the United States, silicone implants were not available for cosmetic breast surgery for many years. The reason for this was the controversy surrounding the safety of silicone for use in elective surgery. To date, there is no scientific data that implicates silicone as being a dangerous substance. Silicone implants are now available to women who wish to have these implants placed for breast augmentation. However, you have to meet certain criteria for using these implants.  Alternatively, saline implants can be used as before for augmentation. These implants contain nothing but salt water and cannot harm you in any way. Ask your Virginia plastic surgeon, Dr. Marefat, to explain the health risks related to each of these implants and to tell you which implant he would recommend.

Once the breast implant surgery is performed, you will wear a form-fitting surgical bra for several days. Minimal swelling and discoloration may occur after surgery but disappear after a few days. You can expect to fully recover from surgery within a week and to return to strenuous exercises in a few weeks. Various degrees of breast firmness may develop after surgery. Speak with Dr. Marefat to find out how you can minimize this possibility.

What is Breast Augmentation (Breast Implant Surgery)?

Breast augmentation is a procedure for enlarging the breasts. The usual indication for this procedure is a woman who has small and underdeveloped breasts or a patient who has lost the natural firmness of her breast after pregnancy and breast-feeding.  

What alternatives are there for Breast Augmentation (Breast Implant Surgery)?

Unfortunately, to this date, there is no good alternative to breast augmentation without the use of breast implants. Autologous tissues (your own body’s fat and skin) used for breast augmentation will leave an unsightly scar and, therefore, these tissues are not used for augmenting the breast.

What does Breast Augmentation (Breast Implant Surgery) accomplish?

The purpose of the breast implant operation is to enhance the aesthetic appearance of the chest and to improve the proportions of the chest as compared to the rest of the body.  Often, this also improves the patient's self esteem and psychological well being.

What happens during the first consultation for Breast Implant Surgery?

In the first consultation, you will get a chance to discuss your concerns with our patient care coordinators and Dr. Marefat. We will tell you what you need to know about your procedure and will help you determine what is best for you.  You will receive information booklets and pricing on the procedures.

How is Breast Augmentation (Breast Implant Surgery) done?

The operation is usually done with the patient under general anesthesia.  This method of anesthesia is in the best interests of the patient, in terms of the comfort and ease with which the procedure is performed. There are three commonly used incisions in breast implant surgery, including the incision in the mammary fold, the periareolar skin, and the axillary area. The method that Dr. Marefat recommends is the inframammary fold incision. The breast implants can be placed either under the muscle or the breast tissue. Dr. Marefat prefers placing the breast implants under the muscle because he believes that it not only provides a greater amount of camouflage for the breast implants, but it also reduces the risk of capsular contracture (hardening of the breast). Occasionally, a breast lift is performed at the same time as the breast augmentation in breasts that require repositioning of the nipple areola complex.

What can I expect after Breast Augmentation (Breast Implant Surgery)?

You should expect a moderate degree of swelling and discoloration for 1 to 2 weeks after surgery. The expected postoperative recovery would be approximately 1 week, during which time you should limit your activities and rest as much as possible. The first 2 or 3 days are likely to be the most uncomfortable for you, with a moderate degree of pain, which is easily relieved with oral pain medications. After 3 to 4 days, you should be able to attend to minor activities around the house and go on short walks. By the 5th or 6th day, you should be able to return to work. The majority of patients return to work within a week. Although some patients feel good enough to exercise in the 2nd week, most do not resume their normal exercise routine until the 3rd or 4th week.  Undoubtedly, with the placement of the breast implants, there will be some changes in your lifestyle.  These would include the protection of the breast implants from injuries during strenuous activities and the protection of the breast from injuries sustained during mammography.

What size implants should I choose for my Breast Augmentation?

You should choose a size that is becoming to your body and you think is right for you. Many patients come to the doctor's office and say that they don’t want to be “too big.” However, you must know that the most common complaint of a patient after this operation is that she wishes she were a little bigger.  Therefore, we recommend that a patient choose a size that is a bit larger than what she thinks is ideal. During the operation, Dr. Marefat chooses  breast implants that are appropriate for the frame of the patient by placing a temporary sizer and looking at the breasts while she is in a sitting position. Based on this sizer, Dr. Marefat chooses the permanent breast implants for the patient. Dr. Marefat generally increases the size of her breast by one or two cup sizes.

What risks are involved with Breast Augmentation (Breast Implant Surgery)?

Virginia breast implants surgery is one of the safest operations we perform. However, like any surgery, there are risk factors associated with it. Dr. Marefat generally discusses the following complications with the patient in her second consultation prior to surgery. You should understand that all these complications are extremely rare and are not a deterrent to surgery for most people.

A complete list of possible side effects and complications will be provided to you when you schedule your surgery. You should talk to Dr. Marefat for more information on each of these possible risks.

  • Capsular contracture. With breast implant surgery, the most common complication is capsular contracture. This term refers to firmness of the breast caused by the shrinking of the scar tissue surrounding the breast implants. Unfortunately, there is no way to predict in whom this problem will occur.  It may occur in one breast but not the other. If this problem occurs, we may have to perform a corrective procedure. The treatment options for resolving this type of problem include nontreatment, if the condition is mild and acceptable to the patient, or surgical correction. Closed capsulectomy (release of the contracture by external pressure) is no longer done. Open capsulectomy would entail returning to the operating room for releasing the capsule, either by making incisions in the scar tissues or by removing the scar tissue completely. This allows the breast implant to sit comfortably in its pocket and stay soft. The risk of developing capsular contracture is approximately 10%, although higher numbers have been reported in some studies.
  • Implant Failure. The breast implants themselves have a failure rate. They may leak or rupture. The risk for future implant replacement is approximately 1% per year for each implant.
  • Calcifications. Sometimes with breast surgery there may be a small degree of trauma to the breast tissues or the fatty tissues in the area, and this may result in late calcifications. Occasionally, these calcifications may create some doubt as to the presence of breast cancer. If this occurs, it may be necessary to biopsy the area in order to rule out cancer.
  • Anesthesia risk. Anesthesia has its own risks and complications. With modern equipment and techniques the risks from surgical anesthesia are minimal.
  • Bleeding. Any surgery will have risks of bleeding or infection, but the likelihood of such problems is very small.
  • Scarring. Occasionally, there may be excessive or obvious scarring in the incision. This happens very rarely, and does improve with time. Sometimes we may need to revise the scar at a later date. We generally do this after 9 to 12 months from the time of the initial surgery. 
  • Sensory changes. There will be temporary breast and nipple sensory changes that usually resolve in 6-8 weeks. Very rarely, there may be permanent loss of nipple sensation. Unfortunately, there is no relationship between the type of incision used and the development of this problem.
  • Chronic pain. A few patients in the literature have been reported to have chronic pain as a result of breast augmentation.
  • Minor Asymmetries. Most women have minor asymmetries in their breasts, and this is completely natural.  If there is a major difference between the two sides of the breasts, this can be corrected to a certain extent. Major problems of asymmetry cannot be completely corrected and may persist after the operation. 
  • Implant movement and visibility. Certain position changes may cause indentations in the breast that reveal the presence of the implant. This has generally been a problem in women who are very muscular and whose muscle contractions can displace the implant in its pocket.
  • Disappointment with results. Some patients are disappointed with the results of their breast implants surgery. This is sometimes related to the fact that they had unrealistic expectations in terms of the outcome of the operation.

Am I at risk for breast cancer with Breast Augmentation?

There may be a slightly increased risk of compromised detection of early breast cancer by having breast implants. With improved, state of the art, radiological techniques for detection of breast cancer, this is unlikely. Furthermore, the saline breast implant is completely clear in the x-ray, making it easier for the radiologist to see all the breast tissue. Patients who have breast implants are more likely to examine themselves and to be examined by a health professional. For this reason, the likelihood of having an undiagnosed tumor is lower.

What about risk of connective tissue disease and arthritis with breast implants?

The rare and unsubstantiated risk of connective tissue disorders, such as arthritis, relates to silicone implants; you should not worry about this with saline breast implants.

Will breasts implants affect future pregnancies or breast-feeding?

You should not have any problems with nursing ; however, there have been a few cases in which the patient has not been able to nurse. Certainly, this is not a common complication of this operation.

When are the Breast Augmentation (Breast Implant Surgery) sutures removed?

Sutures are generally removed 2 weeks after breast implants surgery in Virginia.

How many visits do I have after Breast Augmentation (Breast Implant Surgery) in Virginia?

We like to see our patients frequently after surgery. You are seen by the doctor or nurse within 2-3 days of  breast implants surgery. Then the normal postoperative routine is 1 week, 1 month, 3 months, 6 months, and 12 months. Of course, if there is a need, you may be seen more often. After the first year, we encourage our patients to come in for routine follow-up visits every 3-5 years.

When can I cover my bruises with make-up?

You should be able to put make-up on the bruises after the first week. However, we do not recommend putting make-up on your incisions until they have completely healed. This may result in tattooing of the skin by the pigments of the make-up.

Will insurances cover costs for future problems with my Breast Implants?

Most insurance carriers may not cover you for problems related to breast implants since they were placed for aesthetic reasons. You should have no problems, however, in obtaining coverage for breast diseases unrelated to the implant surgery. The breast implants manufacturers give a lifetime warranty for their products. Some manufacturers will also cover for costs of surgery if the product was found to be defective. You should ask your Virginia plastic surgeon for details about coverage.

Should I get a baseline mammogram before Breast Augmentation?

It is a good idea to obtain a baseline mammogram prior to placement of the breast implants. Dr. Marefat recommends this in all patients over 35 years of age.

Am I a good candidate for Breast Augmentation (Breast Implant Surgery)?

The best candidate for breast implants is a woman who has small and underdeveloped breasts or who has lost the natural firmness of her breast after pregnancy and breast-feeding. Women who have very asymmetrical breasts are also good candidates. Generally, the younger you are, the better a candidate you are for cosmetic surgery. But the physiologic age of a person is more important than the chronological age. That is to say, you may be 60 years old, but your skin and general health could be better than that of most 50 year olds.

How do I pay for Breast Augmentation (Breast Implant Surgery)in Virginia?

You can pay for breast implant surgery by certified check, credit card, or cash. Payments for cosmetic surgery are expected prior to the procedure. If you are scheduling your surgery several weeks in advance, you can pay by personal check.

Are there Breast Augmentation (Breast Implant Surgery) scars?

Yes. But these scars usually heal very well and become almost imperceptible after several months. The benefit of having the scar in the fold of the breast is that even if it does not fade completely, it is still hidden in an area that is usually not seen.

Does Breast Augmentation (Breast Implant Surgery) hurt?

Yes. However, the pain involved in breast implants surgery is very tolerable. We have heard our Virginia patients describe it as “muscle aches and pains” or just “soreness.” The doctor likes to inject the area of surgery with a long-lasting anesthetic solution that significantly reduces the pain in the first few days after breast implants surgery. Many patients do not finish the pain medications prescribed to them for relief. Having said that, remember that pain is very subjective, and it is not easy to predict what degree of pain you will have.

Will I be awake during Breast Augmentation (Breast Implant Surgery)?

No. Dr. Marefat likes to do this procedure with the patient under general anesthesia. If there are risk factors related to your health for having general anesthesia, we can sometimes do this procedure under heavy sedation. If you are just having a small touch-up procedure, and this can be done in the office, then you will be awake. However, if you are having a large revisional procedure, or having multiple changes made to your breast, your surgery will most likely be done in an outpatient facility under general anesthesia.

Where will the Breast Augmentation (Breast Implant Surgery) be performed in Virginia?

Breast implant surgery is done in an ambulatory surgery center in Virginia. The doctor does not do this operation in the office. The surgery center provides a safe environment without the inconveniences of a busy hospital operating room.

Are medical photographs taken of the Breast Augmentation (Breast Implant Surgery)?

Yes. In all cosmetic and reconstructive cases medical photos are taken. Photographs are mandatory. This is the only way for us to compare your “before” to your results. Photographs in plastic surgery serve much the same role that x-rays serve for orthopedic surgery.

How do I get started with Breast Augmentation (Breast Implant Surgery) in Virginia?

Dr. Marefat and the staff at Metropolitan Plastic Surgery would be happy to help you set up a private consultation to discuss breast implant surgery in Virginia. Schedule an appointment online or call one of our locations, our Arlington, Virginia office at 703-516-7600 or our Woodbridge, Virginia office at 703-560-9583.

Are there financing options for Breast Augmentation (Breast Implant Surgery) in Virginia?

Dr. Marefat offers a number of financial assistance programs and payment programs to cover the cost of breast implant surgery in Virginia. Please visit the Patient Financing section of our website for more details or ask the staff at Metropolitan Plastic Surgery about these options so you can get started with breast implant surgery in Virginia today.