Breast Augmentation

How Breast Augmentation Works: Implant Types, Techniques and More

Understanding implant types, surgical techniques, placement options and other aspects of your breast augmentation experience is essential for making informed decisions on your care with Dr. Terrasse.

Implant Types and Materials

The type of implant you choose can significantly influence your results, recovery and long-term satisfaction. Each implant type caters to specific needs. Dr. Terrasse offers several kinds of breast implants, including saline, silicone and cohesive gel implants.

Saline Implants (Allergen and MENTOR™)

FDA-approved saline implants are comprised of a silicone shell filled with sterile saltwater solution. The filling occurs during surgery, which allows Dr. Terrasse to make smaller incisions and adjust the fill volume precisely for optimal results. 

Cohesive Silicone Gel (Gummy Bear) Implants

Silicone implants are filled with a cohesive silicone gel that more closely mirrors the feel of natural breast tissue from Allergan, MENTOR™, and Motiva. These implants are known for holding their shape well over time. 

Even if the shell is damaged, these highly cohesive silicone implants maintain their shape with the help of form-stable gel. 

Implant Shapes and Profiles

Round Implants

Round implants provide fullness in both the upper and lower portions of the breast. They’re less likely to cause shape distortion when rotated and generally provide more upper pole fullness for enhanced cleavage.

Projection Profiles

Implants come in various projection levels, including low, moderate, moderate-plus and high profile. Dr. Terrasse selects the appropriate profile based on your chest width, existing breast tissue and desired outcome.

Motiva® Implants: Next-Generation Technology

Terrasse Aesthetic Surgery now offers Motiva implants, a major advancement in breast augmentation technology. Motiva implants offer several advantages over alternative implant types, including the following:

SmoothSilk® Surface Technology: This unique surface promotes better integration with your body’s tissues, resulting in softer breasts with significantly lower capsular contracture rates. 

ProgressiveGel PLUS®: This advanced gel formulation provides exceptional softness while maintaining structural integrity. The gel adapts to your body’s movements for a natural look and feel.

BluSeal® Visual Indicator: This cleverly engineered feature provides peace of mind by visually confirming the barrier layer’s integrity. 

Ergonomix® Design: These advanced implants dynamically adapt their shape as you move around, allowing for a teardrop shape when standing and a round shape when lying down. 

Surgical Techniques and Incision Options

Dr. Terrasse usually utilizes inframammary (crease beneath the breast) incision to place the implant. This approach offers excellent surgical access and typically heals with minimal visible scarring. 

Implant Placement

The subglandular placement method positions the implant behind the breast tissue and in front of the chest muscle, which cuts down recovery time but may not be suitable for patients with less natural breast tissue. 

With submuscular placement, the implant is placed partially behind the pectoralis major (“pec”) muscle. Finally, the dual plane technique combines these two placements, positioning the implant beneath the muscle in the upper portion and behind the breast tissue in the lower portion. 

Who Is a Good Candidate for Breast Augmentation?

Breast augmentation patients come from all backgrounds, differing in their motivations for pursuing treatment and in their physiques. 

Physical Considerations

The ideal breast augmentation candidate is in good overall health without any medical conditions that will significantly impair the healing process or the safety of the procedure itself. Being at your optimal weight prior to surgery and maintaining it after the fact is an excellent way to keep your results consistent. 

Dr. Terrasse will carefully review your medical history in an initial consultation to determine your eligibility for breast augmentation surgery. This includes assessing skin elasticity around the treatment area in order to determine whether the skin will adapt to added volume. 

Common Motivations for Breast Augmentation

Some women naturally develop smaller breasts, whether due to genetic factors, hormonal fluctuations or other influences. Pregnancy and breastfeeding can also cause significant, unwanted changes in breast tissue, as can significant weight loss. Natural aging processes and asymmetries also cause some women to seek out breast augmentation surgery.

Regardless of your motivation, Dr. Terrasse will create a treatment plan focused on improving harmony between your body’s natural features and proportions for natural-looking enhancement. 

Preparing for Your Breast Augmentation Surgery

Achieving and maintaining an optimal result is a team effort between you and Dr. Terrasse that extends well before and after the date of the procedure itself. Proper breast augmentation preparation is especially vital for a safe and successful outcome. 

Initial Evaluation

Dr. Terrasse conducts a comprehensive health assessment to identify any factors that could affect your surgery or recovery. This evaluation includes reviewing your medical history, current medications and any previous surgeries. You may need additional medical clearances depending on your age and health status.

Blood work and other diagnostic tests may be required to establish baseline health parameters. Women over 40 or those with family histories of breast cancer may need mammograms or breast MRI studies before surgery.

Medication and Supplement Management

Certain medications and supplements can increase bleeding risks or interfere with anesthesia. Dr. Terrasse will provide a detailed list of substances to avoid before surgery, typically including:

• Aspirin and anti-inflammatory medications
• Blood-thinning supplements like fish oil, vitamin E and ginkgo biloba
• Herbal supplements that may affect bleeding or blood pressure
• Some antidepressants and other prescription medications

You’ll receive specific timelines for discontinuing these substances, usually ranging from one to two weeks before surgery. In the days immediately before your surgery, you’ll be briefed on fasting requirements, arrival time, recommendations for post-op transportation and care, and more.

Lifestyle Modifications

Smoking cessation is crucial when preparing for breast augmentation surgery, as nicotine severely impairs wound healing and increases complication risks. You must stop smoking at least six weeks before surgery and continue abstaining throughout your recovery period.

Alcohol consumption should be minimized in the weeks leading up to surgery, as it can interfere with medications and affect healing processes.

Pre-Surgical Planning

Dr. Terrasse uses advanced imaging technology, including the Vectra 3D system, to help you visualize potential results with different implant options. This technology allows you to see simulated outcomes before making final decisions about implant size, shape and placement.

You’ll have multiple opportunities to try on sizing implants and discuss any concerns or questions with Dr. Terrasse and his team. This collaborative approach helps achieve results that align with your expectations.

Setting Up Your Recovery Space 

It may seem like a minor consideration before surgery, but creating a comfortable recovery environment at home will play a major role in your comfort and healing. Make sure your recovery area has comfortable seating with optimal back support, entertainment options and everything you need (food and water, medication, etc.) close by. 

What to Expect During Your Breast Augmentation Procedure

Dr. Terrasse performs breast augmentation as an outpatient procedure in fully accredited surgical facilities, prioritizing your safety and comfort throughout the process.

Anesthesia and Safety Monitoring

First, a board-certified anesthesiologist will administer general anesthesia. Throughout the procedure, your vital signs will be monitored with advanced equipment. Dr. Terrasse works exclusively with experienced anesthesia teams who specialize in plastic surgery. 

Procedure Steps 

While the approach can vary slightly depending on several circumstances, breast augmentation surgery typically follows these steps:

Patient Positioning: You will be positioned to allow optimal access to the treatment area while maintaining proper body alignment. Padding can be used to protect pressure points during the procedure. 

Incision: Dr. Terrasse will create the previously determined incision with extreme precision to minimize visible scarring while allowing sufficient access.

Surgical Techniques: Dr. Terrasse will create the pocket meant to house the implant, insert and position the implant, and perform any adjustments as necessary to achieve optimal symmetry and projection. 

Closure and Dressing: Incisions are closed, and specialized dressings are applied as you are prepared for recovery.

Immediately After Surgery

Following the procedure, you will be transferred to a recovery room, where staff will monitor you as the effects of the anesthesia wear off. Grogginess and some discomfort during this time are normal. 

Once a responsible adult has driven you home, your main focuses should be rest and pain management. Take prescription medication as directed by Dr. Terrasse to manage discomfort. You may experience tightness across the chest, which will resolve over time.

Week One 

Throughout the first week of your recovery, you will be advised to avoid strenuous activities (even lifting items as light as a couple of pounds) and rest as much as possible. Make sure to wear any garments provided to you to support proper healing. 

Discomfort usually peaks within the first half of the first week, steadily improving from there. You may be able to transition to over-the-counter pain medication around the end of the first week. Swelling and bruising are to be expected during this time, and can be alleviated with cold compresses. 

You will likely follow up with Dr. Terrasse within the first week or soon afterwards. Though you may be encouraged to take short walks and engage in other lighter activities, make sure not to lift objects beyond the approved weight or raise your arms over your head.

Weeks Two Through Four

During this phase, you should notice significant improvements in discomfort, swelling, and your ability to perform everyday activities.

If your job does not involve manual labor, you may be able to return to work during the second or third week (though lifting restrictions will still typically apply). Light walking may be encouraged, but it’s important not to engage in more explosive exercises requiring the body to bounce in any way. Upper body exercises will remain mostly or fully restricted during this time.

You may be cleared to drive during this time, provided you are not taking narcotic pain medications. Continue sleeping on your back to avoid putting pressure on the incisions, which are still healing. Dr. Terrasse is happy to answer any other questions you have about sleep positioning or activity restrictions during this recovery phase.

One to Three Months

Swelling will subside enough by this phase to reveal the most dramatic changes. The incision lines will fade and soften significantly. Your implants will settle into their final position, taking on a more natural and proportional appearance.

Barring any complications, you will likely be cleared to resume your full exercise routine by the end of these three months. 

Potential Risks and Complications

While breast augmentation is a safe procedure, it is not without potential risks. Knowing what to look for while navigating the recovery process (and afterwards) will help you determine when or if you need to call Dr. Terrasse. 

Capsular Contracture: This occurs when scar tissue forms around the implant and contracts, potentially causing firmness or shape distortion. Modern implant surfaces and surgical techniques have significantly reduced this risk.

Implant Rupture: Though rare, implants can develop tears or ruptures over time. Saline implant ruptures are immediately apparent as the breast size decreases, while silicone ruptures may be silent and require imaging to detect.

Infection: Surgical site infections are uncommon but require prompt treatment. Signs include increasing pain, redness, warmth and fever.

Changes in Nipple Sensation: Temporary changes in nipple or breast sensation are common and usually resolve within several months. Permanent changes are rare but possible.

Asymmetry: Minor asymmetry is normal and often improves as swelling subsides. Significant asymmetry may require revision surgery.

Dr. Terrasse discusses all potential risks during your consultation and provides detailed instructions for recognizing and managing any complications should they occur.

What Results Can I Expect?

Final results are typically visible between three and six months after surgery, though you will likely notice progressive improvements before that point. 

Immediately after surgery, your breasts will appear larger, but swelling and implant positioning may make them appear higher and firmer than your final results. This initial appearance is temporary and improves significantly as healing progresses.

Once final results have taken hold, your breasts should be symmetrically sized and positioned. You may notice an improved clothing fit, greater proportional balance between your upper and lower body, and more natural-looking contours. Your anatomy, the implant (size, shape, projection, etc.), the technique used and your aftercare practices can all influence final results.