Breast Augmentation

Masri Clinic – Michigan’s Home for World Class Breast Augmentation

We all deserve to love our own body. And for women, an important part of the body is the breasts. If you find yourself unhappy or unsatisfied with the size or shape of your breasts for whatever reason, you’re not alone. Breast augmentation is one of the most popular cosmetic procedures in the United States for the last several years.

Masri Clinic is Michigan’s home for world class breast augmentation procedures. With triple board-certified surgeon Dr. Haitham Masri and his elite patient-centric team and practices, we have served countless patients in Michigan, connecting them with their ideal breasts.

Understanding Breast Augmentation

What Is It?

Breast augmentation or breast implant surgery is one of the most popular cosmetic surgeries performed around the world. Simply put, the breast augmentation procedure is performed to enhance the size and shape of a woman’s breasts.

While the procedure is simple, straightforward, and relatively risk-free, there are various factors that a patient and their doctor must consider before going through with it, such as the type or material of their breast implants, the type of incision for the breast implant procedure, and the desired size and shape of the breasts.

In a breast augmentation procedure, an incision is made into or around the breast area. From there, the doctor positions the breast implants under or over the muscle of the breasts. After placement, the incisions are closed and the entire procedure is complete in just one to two hours.

Everything You Need to Know About Different Types of Breast Implants

Unlike most surgical procedures, breast implant surgery is highly customizable. Breast augmentation patients can choose their desired implant positioning, type of breast implant (material, shape, and texture), breast implant size, and more. It is important for a patient to have a firm understanding of the breast implant options available to them prior to undergoing the procedure.

Material

The type of material a breast augmentation patient chooses can help define the sturdiness of the breast implant as well as its “feel” and longevity. Breast implants consist of an outer core and an inner core (or a rubber shell and a filling). While all breast augmentation implants have a rubber shell made of silicone, there are three types of filling a patient can choose.

Saline Implants

Pros

  • Uniform firmness, feel, and shape
  • Inflatable, allowing for a smaller incision
  • Flexible and adjustable
  • More affordable cost
  • No MRI required during post-op exams

Cons

  • Can feel less natural than other materials
  • In rare cases, the implant can leak (however the substance is safe for the body)

Saline breast implants are known for their uniform firmness, feel, and shape throughout the whole implant. This is due to their inflatable nature: when inserted into the incision, saline implants are empty.

After they are properly positioned, the implants are filled with sterile saltwater, creating the breast augmentation effect. The purpose of using implants that are inflated inside of the breast is to minimize the size of the incision.

Aside from creating a uniform firmness, feel, and shape throughout the breasts, saline breast implants are chosen for their flexibility. Patients can adjust the volume of the saltwater in their implant without suffering a large incision (with saline implant, the incision site is generally near the areola).

While saline implants are known for feeling firmer than natural breasts, skilled cosmetic surgeons can create the natural feel with sub-muscular implant placement, preferably below or beneath the pectoral muscle. This also negates the general risk of the saline implant creating a rippling appearance on the skin.

When choosing between saline or silicone in terms of implants costs, saline implants are usually more affordable than silicone or gummy bear breast implants. Patients also will not require an MRI when undergoing postoperative examinations.

While there are cases of the saline implant leaking through minuscule holes and eventually collapsing, it is important to note that the salt water substance within the inflatable implant is safe for the body to absorb. In cases of collapse, patients do not have to worry about safety, but are required to have the implant surgically removed (and if desired, replaced).

Gummy Bear Implants

Pros

  • Thick silicone gel implant, meaning it is less prone to damage or rupture
  • Feels and looks natural
  • Textured implant surface to keep it in place

Cons

  • Required MRI surveillance
  • Longer incision

Also known as form stable breast implants, gummy bear implants are silicone implants with highly cohesive gel. This creates a firmer and sturdier surface, as the silicone gel implants are thicker than that of traditional silicone breast implants. This means that if the implant breaks or becomes ruptured, it will still retain its original shape and structure.

Gummy bear implants might be the most durable implants on the market, as they can withstand applied pressure without their shape becoming damaged or altered. While the choices of placement site and incision site are roughly the same as other silicone implants, gummy bear implants require a longer incision to accommodate for its thicker filling.

Finally, gummy bear implants are teardrop-shaped implants (as opposed to round implants). This creates an appearance of a breast with a natural bottom half droop, with less upper breast fullness. While there is a risk of the implant rotating slightly – causing a disfigured appearance – gummy bear implants are textured, giving your soft tissue the ability to grow around the implant, thus keeping it in place.

Shape

There are two kinds of shapes that a patient can choose for their breast implants: round breast implants and teardrop-shaped breast implants. As the names suggest, round breast implants have a consistently round and firm appearance throughout the implant, while the teardrop shape breast implants are shaped like tears. Each shape has their own advantages, and the type a patient chooses is determined by their breast implant goals.

Round Breast Implants

Pros

  • More affordable
  • No rotation problems
  • Fewer complications

Cons

  • May look less natural for women with less body fat

Round breast implants are the most common shape for breast implants, as they provide a fuller look, with more volume, thickness, and cleavage. There are four kinds of round breast implants, ranging from high to low projection; the best kind of round breast implant for you will depend on your goals and expectations.

Round breast implants are ideal for women who want to counter sagging breasts, lifting the breasts and creating an all-around full appearance. This shape also costs less than teardrop breast implants, partly due to the textured nature of teardrop implants (as opposed to the smooth texture of round breast implants.

Teardrop-Shaped Breast Implants

Pros

  • Looks better for thinner women with less breast volume
  • More natural teardrop look
  • Textured to keep it in place

Cons

  • There is a slight/rare risk of rotation

Teardrop breast implants create a less full but more natural look, as the implants are created with a bottom-heavy appearance, similar to a teardrop. While patients will not experience fullness in their upper breast, they will feel significant fullness in the lower half of their breasts.

Women who are more concerned about retaining the natural-appearance of their breasts often choose the teardrop-shaped breast implant. While there is a slight risk of teardrop-shaped implants rotating within the breasts – thus creating a disfigured appearance – this complication is extremely rare, and most patients will never experience it.

Texture

Smooth Breast Implants

As implied, smooth breast implants are made with a smooth outer shell. This creates a softer surface, producing a more natural appearance and feeling to the breasts. While not always the case, smooth breast implants have been occasionally found to have longer lifespans than textured breast implants.

With smooth breast implants, there is a slight risk of the implant shifting out of place, causing a visible rippling on the skin over it. A major factor in whether or not a patient experiences skin rippling is their natural existing breast tissue – the higher a woman’s breast tissue level, the lower risk of skin rippling.

Textured Breast Implants

Unlike smooth breast implants, textured breast implants have a grained silicone shell, producing a textured surface. A textured surface allows the implant to remain in place, sticking to the tissue in the breasts; this is why all teardrop-shaped breast implants have textured surfaces. Patients who get textured breast implants have less to worry about with positioning and adjustment issues. Textured implants also have a firmer and tighter feel and appearance.

While women with textured breast implants do not necessarily have to worry about rippling, they do have to think about the possibility of the implants developing wrinkles over time.

It is important to note that textured implants have been under fire from various regulators over the last few years, due to their connection with a rare cancer known as breast implant associated anaplastic large cell lymphoma, or BIA ALCL. While not actually a type of breast cancer or associated with breast cancer, BIA ALCL is an immune system cancer. The risk is extremely rare, with a recent FDA estimate finding it at 1 in 3817.

Breast Implant Sizes and Profiles

When considering a breast augmentation, perhaps the most important factor a woman must consider is their desired breast size goal. However, determining your ideal breast size goal isn’t as simple as giving your doctor your preferred bra size.

Rather, there are two different measurements that have to be considered and chosen: breast implant size and breast implant profile.

Breast Implant Sizes

Let’s begin with breast implant sizes and finding a patient’s ideal size. Breast implant sizes can range from around 80CC to about 800CC. A higher volume also means a wider base, ranging from 7.4 centimeters to 17.2 centimeters

Potential patients interested in figuring out their possible preferred implant sizes have three tests available to them: two DIY home tests and one that can be done in a doctor’s office.

  • The Rice Test: The preferred method of DIY breast implant size testing, the rice test, involves using rice with pantyhose to create an ersatz breast implant. Simply fill a pair of pantyhose with uncooked rice, however much you think you would need for a breast augmentation. Tie the pantyhose so the rice is safe and secure within, and place the bundle of rice in your bra cup; repeat for the other bra cup. Adjust accordingly, and measure the amount of rice needed for your preferred size (each ml of rice is equal to 1CC of breast implant size).
  • The Water Test: Using the same technique as the rice test, but instead with water and plastic bags (or water balloons if available). To truly get the best idea of how your “breast implants” look, try on various clothing in the mirror.
  • In-Clinic Sizers: Any trusted cosmetic surgery clinic should be equipped with implant sizers, or actual breast implants that potential patients can slide into their bra. This provides patients with the clearest idea of their appearance with various sizes (in some clinics, 3D imaging can also be used).

Questions to Ask Yourself When Choosing a Size

  • How much do I exercise or play sports? Larger breast implants can make certain exercises and sports much more difficult.
  • Is my personality compatible with my preferred breast sizes? Some patients may be surprised at the increased level of attention a new set of overly large breasts can bring them. You might want to consider a more balanced yet still fuller look over much larger breasts.
  • Will these implants look good on me personally? You should make sure your decision is based on you and your body, not on your friends or models around you.

Breast Implant Profiles

While the size of your breast implant is a significant factor in your breast implant results, your chosen breast implant profile is just as important. So what’s the difference between breast implant size and breast implant profile?

The breast implant size is a measure of cubic centimeters, which is why breast implant sizes are noted in CCs. Your chosen breast implant size is the raw volume of gel or saline filling that your breast implant will have; the higher the volume, the bigger the size.

However, not all anatomies are the same. The natural anatomy of the patient must be considered when choosing the perfect volume for breast implant size. While a breast implant can enlarge the size of the breasts, it can’t change a patient’s anatomical shape, such as their breast position, chest width, and the space between the bottom of the neck and the top of the breasts.

These anatomical factors are critical to consider, as they can drastically affect the appearance of the same breast implant size from one patient to another. What may look pleasing on one patient can look alien on another. To account for this, doctors consider more than just the breast implant size – they must also figure out a patient’s range of suitable breast implant profiles.

The breast implant profile is the second measurement to account for the patient’s natural anatomy. Simply put, the breast implant profile is the measurement of the breast implant’s outward projection in relation to its base width. The greater the projection, the narrower the base. Low profile implants have the widest bases and the shortest projections; high profile implants have the narrowest bases and the greatest projections.

A patient’s chosen breast implant profile determines the way their breast implant will be shaped. Each type of profile creates its own appearance, thus certain body types are more compatible with certain profile types. For example:

  • Low Profile (Highest Width, Flattest Depth): Commonly used for women with broader chests, as the greater width matches with the wide chest, creating a realistic and natural cleavage. Breasts will have a wide, full look – not too round and not too pointed. The implant is least noticeable while still producing visible results.
  • Moderate Profile (Medium Width, Medium Depth): A safe choice for patients who just want an average breast implant procedure, with no overly dramatic augmentation of any characteristic. If you are uncertain of your breast implant goal, this might be the ideal choice.
  • High Profile (Narrowest Width, Greatest Depth): The perfect choice for the busty, thick look. Women with narrow chest frames but still want large, projecting breasts often choose high profile breast implants, however too-large implants with narrow bases can increase the risk of breast rippling and wrinkling.

Implant Placement

After choosing the type of breast implant for a patient, doctors must consider the placement of the implant. There are a number of factors that can influence implant placement, but generally doctors can choose from three places to insert the implant. An implant can be inserted as a subglandular placement, subpectoral placement, or submuscular placement.

Subglandular Placement – The least complicated breast implant placement, subglandular placement places the breast implant right in front of the muscle, or in the back of the mammary gland. This is generally the preferred placement for women who regularly exercise, as it avoids possible interference with the pectoral muscles.

However, subglandular placement implants have a greater chance of developing capsular contracture, and are more vulnerable to rippling and being visible. This is due to the close proximity the implant has to the outer layer of the skin, with only the mammary gland and the skin in front of it.

Subpectoral Placement – Subpectoral placement places the implant another layer deeper, right underneath the muscle known as the pectoralis major. What’s interesting about this placement is that the pectoralis major has a certain structure that means only part of the implant is covered by it; the upper part being covered by the pectoralis major muscle, and the bottom half hanging underneath.

As this placement is deeper than a subglandular placement, there is increased inflammation, longer recovery time, greater pain (due to the required adjustment of the muscle during the procedure), but also less risk of visible rippling and capsular contracture.

Subpectoral placement is a great choice for most women, however patients with sagging breasts might want to steer clear. This is because the unsupported bottom half of the implant might increase the sag, and even possibly create a second separate bulge in the breast.

Submuscular Placement – The deepest placement type, the submuscular placement of the breast implant places it behind wall of the chest muscle (including the pectoralis major and non-pectoral muscles). With a longer recovery time and a more difficult procedure for the patient, the benefit of the submuscular placement is that they placed optimally for future mammograms.

Breast Implant Incision Types

Another important decision that the patient and their doctor must make together is the type of incision to be used for the breast augmentation procedure. While the chosen incision type is significantly influenced by the type of breast implant, understanding the various incision types can help a patient better decide their preferred breast implant.

Peri-areolar Incision

The peri-areolar incision is the incision made around the areola, or just along the lower edge of the areola pigment. This incision is strategically placed on the edge of the areola to help hide or camouflage the incision scar.

As this is the smallest incision possible for breast implants, the peri-areolar incision is generally reserved for inflatable saline breast implants, which demand the least space. For any other kind of breast implant, the peri-areolar incision is most probably not a possible option.

Inframammary Incision

The inframammary incision is done right underneath the breast, the area typically covered by the underwire of a bra (where the breast and the ribcage tend to meet). This incision can be long enough for most types of breast implants, and is best for women who have enough breast tissue for the breast to hang over the scar and hide it. This incision is not recommended for women with smaller breasts.

Trans-axillary Incision

Sometimes referred to as the scarless breast augmentation, the trans-axillary incision doesn’t leave a scar on the breasts or any visible part of the torso. This is because the incision is performed in the armpit, leaving behind a tiny scar that is typically hidden by the arm. The trans-axillary incision is notably more difficult than the inframammary and peri-areolar incisions, due to the distance from the incision to the breast.

After creating an incision in the fold of the armpit, the surgeon must then cut a channel to the breast. The implant is placed through this channel and pushed into proper placement in the breast. Should any complications arise during the procedure, the surgeon will be required to create a crease or nipple incision to remove or revise the implant.

Trans-umbilical Incision

Also known as the bellybutton incision or the TUBA incision, the trans-umbilical incision is the least commonly performed incision, with few surgeons who offer it due to its high risk of complication.

This incision begins at the upper edge of the bellybutton. With an endoscope, the surgeon cuts through the fat from the bellybutton to just below each breast. From here, a pocket is cut leading into the breast, and the implant is rolled and slid into place through the tunnel and the pocket.

When performed successfully, the trans-umbilical incision leaves the patient with less recovery time and scarring than other breast implant incisions. However, as the implants have to be slid through a tunnel from the bellybutton to the breasts, they have to be inflatable (thus saline).

Breast Implants and You: Is Breast Augmentation Right for You?

Best Candidates for Breast Augmentation

The average age for women who undergo breast augmentation is 35, but adult women of all ages, from 18 to senior years, can successfully undergo a breast augmentation procedure. As breast augmentation is a cosmetic surgical procedure, anyone who is in good general health is a viable candidate for breast augmentation.

Patients who are experiencing the following breast issues may benefit from breast augmentation:

  • Asymmetrical breasts (in volume or shape)
  • General unhappiness with breast size or breast appearance
  • Sagging breasts
  • Breast appearance changes due to weight loss
  • Breast volume loss due to breastfeeding
  • Required breast revision from previous breast surgery procedure

Choosing to undergo a breast procedure is a decision that should not be taken lightly. Only patients who have thoroughly considered and understood the following should move forward with the procedure:

  • You understand your goals, reasons, and expectations for breast augmentation
  • You have reviewed the results of previous patients of breast augmentation and understand what the procedure can achieve
  • You understand the potential risks of breast augmentation
  • You are mentally and emotionally stable and secure
  • You understand the importance of post-operative maintenance and follow-up appointments, as well as the future need to replace your implants

What are the Costs?

According to the American Society of Plastic Surgeons, the average breast augmentation cost is $3824. Breast implant costs are determined by the location of the procedure, the type of breast augmentation to be performed, and the experience and expertise of the surgeon involved.

What’s the Recovery Time?

The recovery time after a breast augmentation procedure varies depending on the type of breast implant and the type of incision performed in the procedure.

On average, patients can expect a recovery time of a few weeks, with about 1-2 weeks of downtime from work and regular exercise. Patients should avoid driving for at least a week, and it is recommended to wear a sports bra constantly for three months after the procedure.

Relationship to Tummy Tuck Surgery

Many patients who consider the breast augmentation procedure are also interested in the tummy tuck surgery, and vice versa. A common question we get at Masri Clinic is whether the tummy tuck surgery and the breast augmentation procedure can be performed at the same time.

If a patient is in reasonably good health, there should be no problem performing the tummy tuck and breast augmentation together. These two procedures are commonly combined at many clinics; in many cases, it is encouraged to combine these two procedures, as it means a patient will only have to go through recovery once.

Breast Augmentation Experience

Before – Consultation and Preparation

Consultation for a breast augmentation will consist of a discussion between a patient and their chosen surgeon, in which they will discuss the patient’s breast augmentation goals and expectations, the types of breast implants available to them, the surgeon’s recommendations for the breast implant type and procedure.

A patient is recommended to ask any questions about breast augmentation procedure that they wish to understand. Remember: it is natural to be anxious or nervous about the procedure, and the surgeon and their team are there to assist a patient every step of the way.

Little preparation is required from the patient, although it is possible for the surgeon to ask them for the following:

  • Have a blood test performed
  • Avoid smoking, aspiring, and certain other pain medications for up to a week prior to the procedure
  • Avoid any other recreational drugs

It is advisable for the patient to bring a friend or family member who will help them and drive them home after the procedure. For the patient’s comfort, they should not be alone the first night after the procedure.

During – The Procedure

  1. Anesthesia – The procedure begins with general anesthesia or intravenous sedation for the patient’s comfort during the surgery.
  2. Incision – Depending on the type of breast implant, the surgeon will choose from a peri-areolar incision, inframammary incision, or trans-axillary incision (in rarer cases, a trans-umbilical incision).
  3. Implant Placement – After the incision, the breast implants are inserted through the incision and into the breast. This placement can be submuscular, submammary, or subglandular.
  4. Incision Closure – After the implants are inserted and properly placed in the breasts, sutures are used to close the incision.

After – Recovery

Breast augmentation is normally an outpatient procedure, so you should be able to go home within several hours. Immediately post-surgery there will be bruising and swelling, which will likely take 3-5 weeks to fade. The bandages and surgical dressings will be removed within a few days, but you will likely need to wear a surgical bra to support everything until it heals. Most women can return to work in just a few days.

While desk jobs are fine, strenuous exercise and heavy lifting should be avoided for 4-6 weeks to avoid making the swelling worse and to minimize risks of tearing unhealed tissue. While the incision should be completely healed within about two weeks, you can expect the scar to take up to a year to fade to its final shade. Skincare products and other skin care solutions can help the scar lose visibility.

Risks – Possible Complications

Like all surgeries, breast enhancement runs a risk of infection and bleeding, which we minimize through good surgical practices. More specific risks include rippling, changes in nipple sensitivity, capsular contracture, and rupture.

Rippling means that the implant develops a ridge or wrinkled texture that is apparent either visually, to the touch, or both. If it occurs, you’ll need a revision surgery to correct it, but it can generally be corrected by sizing the implant correctly, filling it to the right level, and placing it under the muscle.

Changes in nipple sensitivity are quite common and can mean either numbness or hypersensitivity. In most cases, these changes are temporary and will go away in a few months as the nerves heal. While there are some medications that will help to restore sensitivity, this is something you should discuss with Dr. Masri at your consultation if you are concerned.

Capsular contracture is less common. It’s an immune reaction in which the scar tissue overreacts to the implant, leading to a hard, abnormally-shaped, or painful breast. It can be treated with a revision surgery.

Finally, rupture is always a possibility with implants surgery. It can be detected easily by feel with a saline implant but can require an MRI with a silicone one. Chances of a rupture are smaller with a properly-sized implant, but since implants do not always last forever, there is always a small risk. If this happens, it is necessary to remove and replace the ruptured implant.

FAQ – Frequently Asked Questions

What happens if I get pregnant after getting breast implants?

Pregnancy after an augmentation is perfectly safe. Your breasts will still grow and fill with milk during pregnancy, and most women are still able to breastfeed. The only real risk is that the implants will make your pregnancy-enlarged breasts even heavier, which can contribute to sagging, making another procedure likely.

Can implants correct my asymmetry?

Yes. There are several ways to correct asymmetrical breasts during an augmentation. In most cases, implants of differing sizes will be used to make up for the natural imbalance, but it is also possible to use an implant on one side and just perform a lift on the other, or in extreme cases, use an implant on one side and perform a reduction on the other.

Will implants correct my sagging, or do I need to have a lift?

An implant will have some lifting effect, but it depends on how heavy your natural breasts are. Larger breasts may require more of a lift than implants alone can provide. At your initial breast augmentation consultation, measurements will be taken to help you and the Masri Clinic team decide on the correct treatment for your concerns.

Will I be able to get exactly the results I want?

Everybody is shaped a bit differently, which means that identical implants placed in the exact same way will look quite different on different women. This can be disappointing if your ideal body is a type very different from your own natural shape. For those patients who have realistic expectations, though, results are typically very much in line with what is discussed at their consultations.

What other breast procedures does Masri Clinic offer?

As a leading center for breast augmentation in Michigan, Our team at Masri Clinic performs a range of breast augmentation surgeries. We also offer male breast reduction, breast reconstruction, breast reduction, and breast lifts on top of our breast enhancement or breast enlargement procedures.

Why Masri Clinic? Schedule Your Breast Augmentation Consultation at Masri Clinic Today

For nearly 30 years, Dr. Haitham Masri has helped patients with various cosmetic and plastic surgery procedures, both surgical and non-surgical. Dr. Masri and his team seek to understand every patient’s individual needs and concerns, to give each of them top-level service and commitment.
Contact plastic surgeon Dr. Masri today and learn how we at Masri Clinic can help you with your breast augmentation procedure.

Click Here Now to Request an Appointment

Other Procedures at Masri Clinic

At Masri Clinic, we perform breast augmentations and so much more. Masri Clinic offers a wide range of cosmetic and plastic surgery in Michigan, both surgical and non-surgical. These include:

Acne Scarring Removal | Hydrafacials | Chemical Peels | Microdermabrasion | Anti-Aging Facial Solutions | Neck Lift | Rhinoplasty | Laser Hair Removal | Laser Skin Solutions | Dermal Fillers

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