Cleavage, symmetry, fullness, proportions. Femininity. These are the words that come to mind when we think about breast augmentation. Considered together, they speak to my main goal: to give you the best, most lasting results.
My number one goal for your breast augmentation is simply to be an expert surgeon: that’s why I consider myself one part artist and one part architect. Breast augmentation is actually a very precise surgery: there are ways to perform a breast augmentation so that your chances of revision become very, very low. While your implants may not last forever, the issue with today's modern implants is NOT that the breast implants themselves rupture or leak. The keys to great outcomes are:
Cleavage is everything with breast augmentation. I often hear about how nervous patients are about a wide gap between their breasts after implants.
While some cleavage is genetically determined, in most cases the cleavage can be closely spaced with very little gap between the breasts. The cautionary step to avoid is symmastia, or breasts that touch across the midline. Close but not too close is the goal.
The best way to get the right amount of cleavage is to mark the cleavage goal beforehand, and to dissect just that amount in surgery. It sounds simple to get the cleavage right after breast implants, but it requires a bit of obsession in surgery and in markings. Implants should STILL be placed under the muscle, but that muscle needs to be divided in the midline to just the right amount during breast augmentation to get the cleavage right.
Choosing the right breast implant requires an understanding of your existing breast size in addition to your goal cup size. I like to use the 200 rule to connect breast implant size to breast cup size.
The 200 Rule: 200cc equals one cup size
For example, if you are a small B cup looking to get to a small C cup, you should use a 200cc implant. If you are a small B cup looking for a full C cup you may need an implant closer to 300cc. This would give you a cup size "and a half" to get you to the full C cup look.
The Choice is Yours
The choice is yours, and really there’s only two things I need to know:
Breast implants come in different shapes. These are:
Each implant is increasingly round and increasingly narrow. It follows that each implant is increasingly “augmented” looking. So, the reason that an ultra high profile implant looks “augmented” is because it is very round and very narrow. A moderate plus profile implant, in comparison, is much softer and less projecting (less round) and has more volume in the sides of the breast, which contributes a little more to a side profile width (what some women refer to as “side-boob”).
There’s a lot of concern about going too big or too small. We have a double check. Two failsafes to make sure that you pick the perfect implant for you.
First, we use silicone gel sizers in a surgical bra for you to try on in the mirror. This will give you a rough range of what the sizes do to your body. This is a great time to look at your proportions in a full length mirror and see how each size increase appeals to you and fits your body.
Second is our ultra techy virtual reality scan. We scan your actual breasts, and perform a virtual surgery based on the size goals from the sizers you liked. Voila! A before and after in 3D! We introduced this technology to help you visualize your possible results and have greater confidence in your choice.
Options for a Natural Looking Breast Augmentation:
Options for a Fuller and Rounder, more "augmented" look:
For a natural looking breast augmentation, smooth, round, moderate plus profile breast implants are the best option.
There are two options for a natural looking breast augmentation.
It's worth noting here that the moderate plus implant is more likely to create a slightly wider breast shape. This wider implant and wider breast creates a more defined smooth outer breast curve from the side. I often recommend this implant when women tell me they’d like to see more “side boob”.
Textured implants will settle the least, and maintain a high and round position on the breast.
There are three options for a full, round, "augmented" look after breast implants:
There are many different versions of beautiful breasts. The real question? What’s YOUR version. Together, based on wish pics and a detailed discussion, we will make two key decisions: implant size and implant shape.
We can help you visualize your ideal breast goals with our in-office sizing & a virtual reality scan. Our goal is to earn your trust and confidence. Our mission is unique. Part of our mission includes making sure you are confident in yourself and your choice. We give you all the possible resources so you’ll know you’ve made the right choice: YOUR version of beautiful breasts.
Gummy bear breast implants are more firm than traditional silicone breast implants. The Allergan Inspira implants (my favorites) come in three different types of firmness: SRF (Responsive, the softest gel), SSF (Soft touch, ironically named because it is FIRMER than the SRF), and SCF (Cohesive, the most cohesive silicone and therefore the hardest and firmest to the touch).
Firm implants are usually used for revision breast surgery. In patients with thin skin and little breast tissue, and particularly those with saline implants, rippling can occur. Firm, Gummy Bear gel (Cohesive gel implants) are less likley to ripple. So gummy bear breast implants are a great option for revision breast surgery to get rid of rippling.
Blueprints are my mantra for breast augmentation.
Precise markings lead to precise surgery. The result: Symmetry. Balance. Contour. When the markings for breast augmentation are symmetrical, the breast augmentation comes out symmetrical. While this sounds very logical, it requires an expert technician! One who is ready to focus on every last detail. That's me. Breast augmentation requires a very meticulous and perfectionistic surgeon to get it right. Implants are easy to just put in, but hard to place precisely. I am obsessive with the details.
Hyper-meticulous suture work
It's a difficult truth that not all surgeons are equal in their technical skills, just as not all doctors are equal in their bedside manner. Some artists have unique skills for painting, some surgeons have unique gifts with their hands. I place every stitch by hand using absorbable sutures buried underneath the skin. This means no suture marks, and the thinnest scar possible. My favorite saying from an old surgeon, not long forgotten: “The eye of an eagle, the heart of a lion, and the hands of a lady.”
There's nothing easy about sharing your insecurities, even if it is with your doctor. I do everything I can to make this process as easy as possible for you. First, you will talk with my nurse and she will gather your medical history and speak with you about your goals. We are a paperless office and we like to keep things lean and save a tree! Next, you'll have the chance to read more about your procedure on our office iPad.Schedule a Consultation Today
I like to make sure that we address all of your concerns and goals, so I'll then come in the room and you can share any wish pics or goals for your breasts. I will definitely ask you:
Next, I will step out so you can change. My nurse and I will come back into the room to do a basic breast exam, take some measurements and look at your overall breast shape. I then will do a scan of your breasts with a virtual reality camera. Next is the in-office sizing, using silicone gel inserts ("cutlets") where you'll be able to look in the mirror and see what sizes work best for you. Based on that, I can perform "virtual surgery" and show you what the results could look like with the shape and style of implants that you like!
There are dozens and dozens of medical journals that discuss all of the ways to avoid complications after breast augmentation. All of the critical factors involve avoiding bacterial contamination of breast implants. Not only does this decrease infection, but bacteria on the surface of the breast implant can lead to chronic inflammation and capsular contracture. Here are the many steps that I take to maintain Truly Sterile Technique during breast augmentation.
Each of these technical steps has been shown to decrease capsular contracture after breast augmentation. That means the OPPOSITE is also true. If any of these steps are NOT done, your surgeon is doing you a disservice during your breast surgery. This is what I call "cutting corners to cut costs." If the surgery costs less elsewhere, they may not be doing everything they can in order to maximize your long term safety during breast augmentation. Please go back through this list. Is your doctor using a nipple approach? The nipple incision is not the safest option! Is your doctor placing your implants over the muscle? Bad idea if you want soft breasts long term! Be sure to also compare the consistency and quality of results performed by the actual surgeon.
Everyone has heard of "overs" and "unders," but I get a lot of questions about Dual Plane. I think of Dual Plane breast augmentation as the best of both worlds. Think of it this way: women don't come in asking for "pec" augmentation, so why is the implant placed under the pec? Ideally, the implant should be placed under the breast to augment the breast. There are two problems with this. The first is that implants placed over the muscle can look too round and obvious for some patients' goals. The second problem is that implants placed over the muscle have a higher risk of hardness (capsular contracture).
The solution is the best of both worlds: a dual plane breast augmentation. In this approach, the muscle is released slightly to allow it to "window shade" upwards. This puts the implant under the muscle in the upper part of the breast, providing fullness of the “upper pole” and coverage from too much roundness. This coverage creates a smooth transition of the breast (instead of a stuck on look that you sometimes can see in fitness model competitions) AND it also protects the implants against capsular contracture. The lower pole of the breast has direct contact with the implant, creating a nice full round shape below. This allows the breast to be augmented where it should be: at the level of the breast and not the pec! If you think about it, the breast is ever so slightly lower than the pec muscle. Voila. Dual Plane Breast Augmentation explained.
It is natural to be anxious the day of surgery. I remind my patients that worrying is my job. It's my responsibility to worry about the results of your breast augmentation. I worry about everything going perfectly because I care. I will stress about the markings, the symmetrical result, the sterility, the incisions, the scars, the anesthetic.
It's my job to make this right for you. Your job is to pick a surgeon who will do those things. If you’re reading this far, your on the right track.
Since we have our own surgical facility, you will have the comfort of a super private and confidential experience. There is no "check in" process with new staff at a new facility. You'll come to the same office as your consult and we’ll bring you to the preop room for Netflix, an IV and a gown. Not quite “Netflix & chill” but close. The urine pregnancy test is next. Your spouse, girlfriend, mom, or family member can stay with you in the room for as long as you want (or don't want!)
I will come in smiling and ready with my sharpies and ruler to make all the required marks. I will answer any questions, and go over the game plan for your size and profile, along with any other details or questions you have. I'm never in a rush! Once your markings are ready, we will walk you back to the OR where you'll be gently sedated by my anesthesiologist. "Pick out a nice dream!" you might hear me say. Poof. You'll wake up in a jiffy. Even if you haven't had anesthesia before, we will make sure your breast augmentation is as safe as possible. That's really the true number one goal: safety. The surgery takes about 1.5 hours total from in the room to recovery, and your family can see you right afterwards.
I'm ready to work, and I'm more than willing to meet the demands of YOUR schedule. To learn more about our scheduling policies and procedures, click HERE.
The most common question I'm asked about scheduling is "how far are you booked out Dr. Oppenheimer?"
My staff knows my schedule even better than I do, but the short answer is “not long” from my point of view. I am inspired by helping women achieve their goals which is why I operate five days every week. I have full control over my schedule, because I am the only surgeon in my surgery center and I love what I do. Longer cases like mommy makeovers tend to book out further than shorter cases (breast augmentation / labiaplasty) which can more easily be added to the OR day. The slightly better question is: how long is it worth waiting for surgery with a doctor you trust to deliver the results you want?
The flash recovery breast augmentation sounds great, go out to dinner that night! While my patients have all of the elements of a flash recovery breast augmentation (bloodless surgery, gentleness to the rib cage, no bruising, nerve blocks, and rapid recovery anesthesia) please don't go out to dinner the night of your breast augmentation.
It's best for you to lay low and take it easy at home. While problems are rare after surgery, overdoing it can be one of the causes of bleeding or infection.
Time to the final result
It takes 3 months for your implants to settle to their final place after breast augmentation. Early on, your implants will sit high and the nipples will be pointing low. Sometimes--though very rare--one breast will settle quicker than the other, which can be related to your dominant hand. If the implants are sitting too high we may provide you a recovery band or bra bandeau, but this is also very uncommon. The "drop and fluff" takes about 3 months to finish, which is the settling and filling out of the implants in the breast.
One month to the gym, three months to the ring
We’ve treated professional athletes and professional moms. Either way, one month is ok for light cardio in the gym (public service announcement: intercourse is ok at 2 weeks as long as it is not the acrobatic kind, and the breasts are off limits for touching and kissing for 3 months). Six weeks to light weights. And 3 full months before resuming crossfit after your breast augmentation. Enter the ring at your own risk.