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Breast Augmentation

For a woman, one of the most gratifying cosmetic procedures for improving body confidence and feeling more attractive is breast augmentation. At my practice in Santa Monica, this is a favorite procedure, both for my Los Angeles County patients and for me. I love helping women achieve the breast size, shape, and symmetry they have always wanted.

Over the years I have performed thousands of breast surgeries, and I constantly push myself to continue improving my technique and results. I have devoted much of my time to advanced research in breast surgery and have many publications on this topic. As a result of my experience, I am frequently asked to teach instructional courses and to speak about aesthetic breast surgery techniques at many of our national plastic surgery meetings.

Whether you're ready to schedule your breast augmentation or you're just curious, I am happy to answer all of your questions. Request a consultation or call my office at (310) 576-3635 to schedule your appointment.

Breast Augmentation Patient Photos

Before
After

Breast Augmentation Case 347

This woman, age 24, came to my practice to enhance the size of her breasts and balance her figure. I performed breast augmentation using incisions in each breast fold (inframammary) and placed Sientra "gummy bear" anatomical silicone implants under her chest muscles. Many wome...

Before
After

Breast Augmentation Case 183

This 23-year-old woman came to my practice because she felt that her breasts were too small for her body. She was interested in breast enhancement, but wanted to maintain a natural appearance.I performed breast augmentation during which I placed silicone implants under the chest muscles usin...

Before
After

Breast Augmentation Case 166

This 31-year-old woman wanted to improve her breast shape and increase their size. Her complaints included asymmetry in size, "pointy" shape, and size that was disproportionate to her body. I determined the patient had a mild form of tuberous breasts, so I recom...

Before
After

Breast Augmentation Case 129

This patient met with me for a consultation because she had always felt that her breasts were too small. She wanted fuller breasts, but as an athletic woman she wanted to make sure that her breast size didn't affect her physical activities. I performed breast augmentation using...

Before
After

Breast Augmentation Case 117

This young woman, age 19, wanted to have fuller breasts that looked very natural. I recommended breast augmentation using silicone breast implants placed beneath the chest muscle. In addition to increasing this patient's breast volume with smooth, round, moderate-plus profile, cohes...

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A Personalized Breast Augmentation

Breast augmentation is about more than simply choosing the size of your breast implants. At my Santa Monica practice, I see women of different ages, body types, and lifestyles, each with different goals for their results. Some patients have relatively easy anatomy to enhance, while others can be very challenging due to preoperative asymmetry, drooping, or prior surgery. Each breast augmentation surgery is as unique as the woman undergoing it, and I make a point of really getting to know my patients and understanding what will make them happy. I take into consideration multiple physical factors, including height, weight, the width of the chest, the curvature of the ribcage, the elasticity of the skin, and how much existing breast tissue a woman has. You can learn more about my perspective on breast enhancement procedures by visiting this page.

I find that the emotional factors are just as important as the physical factors when it comes to breast augmentation, and by that I mean what a woman hopes to achieve from her breast augmentation. Some women want a more modest size increase just to fill out bras and fit better in clothing. Others want to have a more dramatic change, either to balance proportions or to achieve the look that they feel is most attractive. My job as a board-certified plastic surgeon is to help each woman achieve an appearance as close to her ideal as possible by using my extensive experience, knowledge, and skills.

What's the Difference Between Saline & Silicone Breast Implants?

Your Breast Augmentation Decisions

You have several decisions to make, all of which play a big part in the outcome of your breast augmentation. I help all of my patients with each of these decisions so that together we can achieve the most attractive, satisfying results.

Implant Placement

You can choose to have your implants placed over or partially under the pectoralis major (chest) muscle. I almost always place implants partially under the muscle (dual plane submuscular placement), even though this is a more technically challenging technique. I believe the advantages are worth it:

  • With more soft tissue over the implant, there is less of a visible edge to the implant, and less chance of visible wrinkling or rippling.
  • Because the muscle drapes over the top part of the implant, it creates a more naturally sloped and beautiful appearance.
  • Studies, including one I recently published regarding Sientra's textured implants, show there is a reduced risk of capsular contracture (hardening of scar tissue) with implants placed under the muscle, possibly because the muscle naturally massages the implant.
  • Mammograms tend to be clearer with this placement, as it pushes the breast tissue forward.

Incision Location

The incisions most commonly used for breast augmentation are the periareolar (made along the border of the darker circle of skin around the nipple), the inframammary (breast fold), the transaxillary (armpit), and transumbilical (through the bellybutton) incision. I generally do not use either the transaxillary or the bellybutton incisions because they don't allow direct access and visibility to the breast pocket. I believe that the meticulous and precise creation of the breast pocket is key to a great breast augmentation result. Also, if a woman needs another breast procedure, such as a breast revision or breast lift at some point in the future, there will be less additional scarring as these scars can be reused for access and skin tightening.

I sometimes use the periareolar incision, which runs along the lower or upper border of the areola. This leaves a very fine scar that is often difficult to see, and is hidden in a bra or bathing suit. I frequently use an inframammary incision as this provides excellent access to the breast pocket while avoiding dissection through breast tissue. The pros and cons of different incision locations is a discussion I have with each patient, and we generally decide together which option is best.

Of course, in addition to these details, you'll also need to choose your implant. Learn more about the variety of breast implant options I offer.

Surgical Details

I perform breast augmentation using a board-certified M.D. anesthesiologist. I carefully make the incisions and use great precision when creating the pocket for the breast implant. I generally use implant sizers during surgery to be absolutely sure that I use the right size, shape, and style of implant to achieve the results we've discussed. I often use the Keller Funnel™ to insert the sizers and the final implants, as it can reduce the tissue trauma and implant handling during placement. I also always check patients in the upright position to ensure proper symmetry and implant placement.

Recovery & Results

Although modern surgical techniques offer women shorter and more comfortable recuperations than in the past, I still emphasize the importance of giving your body ample time to heal before returning to work and other everyday activities. It's crucial to listen to your body during this time and avoid straining yourself in order to achieve the attractive results you want.

I generally recommend that most breast augmentation patients take about a week off work, although you may need some additional time at home if your job is physically demanding.

Bra Use After Surgery

After surgery, you'll be fitted with a special surgical bra to support your breasts and reduce swelling during the healing process. After about 1 week, you can switch to a soft, underwire-free bra. If you wish, you may switch to a standard underwire bra between 4 and 6 months after surgery. This gives your incisions the opportunity to completely heal.

Throughout the first 24 hours following surgery, you'll need a trusted friend or family member to stay with you. I prescribe pain medication to help with any discomfort, but you'll likely find that you need it less and less with each passing day. I recommend taking several easy, short walks around the house following your surgery. Mobility is important to prevent blood clots and other complications, but you shouldn't strain yourself, either. In the days that follow, make it a goal to get up at least 5 times each day. Although each patient is different, you will likely be able to shower 48 hours after surgery.

Many patients have questions about physical activity after surgery. It's important to limit heavy lifting and exercise for several weeks. This gives the muscles of your upper body the opportunity to heal undisturbed and ensures an attractive, symmetrical result. About 6 weeks after surgery, you may carefully resume your normal exercises.

Keep in mind that each patient's experience is completely unique, and these recommendations are merely general guidelines. Your experience may vary, and I'll give you much more detailed recommendations based on your own procedure during your follow-up appointments.

Although you'll be able to appreciate your new, larger breasts immediately after surgery, it takes some time for your natural breast tissue to expand and your implants to soften and settle into their final positions. Most patients see more natural-looking results beginning to appear after just a couple of weeks.

Frequently Asked Questions

How do breast implants affect breastfeeding?

The likelihood of successful breastfeeding with implants is high when I use certain surgical techniques. I most commonly use the inframammary incision, which runs along the fold beneath the breast. Not only does this leave a discreet scar, but it also doesn't involve the structures of the nipple at all. This preserves the functionality of the breasts, making breastfeeding more possible than it would be with other incisions. If future pregnancy and breastfeeding are particular concerns of yours, we'll discuss your options at length during your consultation.

Can breast augmentation improve the look of sagging breasts?

Although minor sagging can be reduced with breast augmentation, the placement of breast implants alone will not correct moderate to severe sagginess. This is because the additional weight of the implant can further weigh down the breast, actually exacerbating sagginess. For patients who would like to improve both the size and position of their breasts, I recommend combining a breast augmentation with breast lift. This approach is quite common. During this procedure, I remove some excess skin and tighten the supportive structures of the breasts in addition to adding implants. This creates a larger yet lifted result that can be quite transformative.

Can I combine my breast augmentation with another procedure?

Yes. Many women choose to treat multiple areas of their body in a single surgery, a procedure often called a Mommy Makeover. During this surgery, I generally address both the breast and midsection to target some of the areas that are most commonly affected by pregnancy. Although most women opt for both a breast augmentation and tummy tuck surgery as part of their Mommy Makeovers, each patient can choose procedures that suit her precise needs. If you're interested in undergoing more than one procedure at a time, we'll discuss your options further during your in-person consultation.

How much does breast augmentation cost?

It's difficult to offer an accurate price range for plastic surgery via the Internet, especially for a highly personalized procedure such as breast augmentation. There are several factors to consider when pricing surgery, including the cost of the implant, the complexity of your procedure, operating room fees, and more. At the end of your consultation, we'll provide you with a written quote that reflects the total cost of your procedure. We do offer the option of emailing photos to my office. This gives me the ability to see approximately what surgery I would recommend, and enables my staff to provide you with a "ballpark" price estimate. I'm pleased to offer flexible financing options to help my patients achieve their aesthetic goals on terms that work for them.

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Dr. Robert Cohen

Certified by the American Board of Plastic Surgery

Dr. Cohen is a leader in the field of aesthetic plastic surgery whose expertise is highly regarded by both patients interested in improving their appearance, and plastic surgeons seeking to improve their techniques by attending his lectures. Dr. Cohen's goal is to understand your specific concerns, evaluate your anatomy in detail, and create a customized plan to help you achieve the best results possible based on the most modern techniques and materials available. Let him put his experience and aesthetic insight to work for you.

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