Q&A Topics: What to Think About with Breast Augmentation

with Dr. Christopher Saunders, MD

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Q: What results can you expect with breast augmentation?A: Results depend on what your breasts look like before surgery. Breast enlargement frequently gives women more attractive, fuller, bigger, and prettier breasts. The ideal goal is to maximize available “soft tissue coverage”—the skin, breast tissue, and the muscle that covers the breast implant. This coverage will determine what you will look like after the breast operation. Expect your breasts to become bigger versions of their preoperative selves. Your anatomy, implant size, and implant type (silicone or saline) help determine your look after surgery. Most women with normal breasts who choose natural sizes (B cup to D cup) will look natural and realistic after surgery.

Q: How safe is breast augmentation?A: Cosmetic breast augmentation is one of the most commonly performed cosmetic surgery procedures done each year, per the American Society of Plastic Surgery. The operation has a very high success rate, and it is considered extremely safe. It’s always done on an outpatient basis with a reasonably quick recovery.

Q: What happens to the breast muscle?A: The chest of a woman has a large, flat fan-shaped muscle, called the pectoralis major muscle, which sits beneath the breast. Breast implants are placed either beneath the pectoralis muscle or on top of it. Placing it beneath the muscle is called sub-muscular placement. Placing the breast implant on top of the muscle is called sub-glandular. Most medical studies show superior results with placing the breast implants beneath the muscle. I try to get the breast implants behind all the muscle possible, which leads to the softest breast, most natural result, and lowest complications.

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Q: What Is “settling” and how can it be managed?A: The muscle provides soft-tissue coverage, but the space behind it is very tight at first, and it takes time for this space to stretch out. It is similar to the slow changes that happen to the abdominal muscles with pregnancy. However, most people can look good in just a couple of weeks! During this process, the breasts will gradually change and soften. The breasts tend to slowly look more natural. It takes time, so be patient! Sometimes the breasts even look bigger as the muscle relaxes and the implants “come out.”

Q: Should you opt for saline or silicone?A: There are two main breast implants: saline and silicone. I do not “push” one breast implant over another. I believe it is a choice. Saline breast implants are filled with saline. The implant shell can be thought of as a plastic bag that holds the saline—a saltwater-filled “balloon” that is very natural in shape and feel. Silicone breast implants are filled with silicone gel. Silicone is a “gelatin”—also commonly referred to as “cohesive,” “gummy-bear,” or “gel” implants. As the principle investigator of a silicone research study at Christiana Care Hospital System, I can assure you that silicone implants are extremely safe; they have been studied for over 50 years and on millions of women.
Dr. Christopher Saunders is an expert in the field of cosmetic surgery. He is Board certified by the American Board of Plastic Surgery and practices cosmetic surgery exclusively.

Christopher Saunders, MD
Board-Certified Plastic Surgeon
Lombardy Center
 · 410 Foulk Road · Suite 201 · Wilmington, DE 19803 · (302) 652-3331
Brandywine Cosmetic Surgery · 1224 Baltimore Pike · Suite 100 · Chadds Ford, PA 19317 · (610) 459-1559
Medical Arts Pavilion 1 · Suite 137 · Newark, DE 19713 · (302) 652-3331

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