Breast Augmentation

Before After

Q: What’s Breast Augmentation?

Breast augmentation is one of the most popular cosmetic procedures performed in the United States for the last several years. Breast Augmentation, also known as Augmentation Mammoplasty, is a surgical procedure designed to accentuate and enhance the size and shape of a woman`s breasts. Breast Augmentation is beneficial for those patients who have lost breast volume due to pregnancy, nursing or weight loss; or simply for patients with small breasts who would like to have a fuller profile. Breast Augmentation, when performed for an appropriate candidate with a right size and correctly positioned implant, provide a natural look and help women with self-esteem improvement. Breast Augmentation, by itself, will make the breasts larger, but it will not lift or change the position of the breasts. It usually suffices on its own, but sometimes mastopexy, otherwise known as breast lifting or repositioning, may be required in addition to implant placement for the best possible result. This procedure is custom tailored for each individual patient’s needs. Dr. Rayham will be happy to address your specific concerns and provide you with detailed information to help choose specific approach to your breast augmentation procedure.

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Q: Why Should I Consider Breast Augmentation?

  • To enhance the size and shape of your breasts and improve overall body proportions.
  • To increase breast volume after pregnancy, nursing or massive weight loss.
  • To improve breast symmetry for patients with unequal sized breasts due to congenital condition or prior surgical intervention.
  • To improve self-esteem.

Q: How is Breast Augmentation Performed?

Dr. Rayham performs Breast Augmentation procedures in the hospital or ambulatory surgery settings in Manhattan/NYC, Brooklyn or Staten Island, New York. It is usually an outpatient procedure that generally lasts from one to three hours with the patient under a general anesthesia and asleep. You will go home the day of the operation.

Q: What’s my Incision Placement?

There are four conventional ways for breast implant placement. Dr. Rayham in his practices in Manhattan/NYC, Brooklyn and Staten Island, New York, offers his patients all four approaches, including Standard Incision Breast Augmentation, Peri-Areolar Incision Breast Augmentation, TUBA (Trans Umbilical Breast Augmentation), and Trans-Axilary Breast Augmentation.

Standard Incision Breast Augmentation – This approach utilizes the natural crease under the breast to place a small incision through which the implant will be placed. The length of incision is about one to one and a half inches long for saline implants and about two inches long for silicone gel implants. This infra-mammary incision allows the most straight forward approach to the tissues under the breast for most accurate implant placement. The incision usually heals well and scar gradually fades away and becomes barely noticeable.

Peri-Areolar Incision Breast Augmentation – This approach uses the advantage of color interchange between the darker skin of nipple-areolar complex and lighter area of the surrounding skin. An incision is made at the junction between the two types of skin around part of the areola and nipple. The length of the incision is also about one to one and a half inches for saline and about two inches for silicone gel implants. As healing occurs the incision blends in and becomes barely noticeable.

TUBA (Trans Umbilical Breast Augmentation) – This approach is used to place an incision away from the breast and at the level of the belly button. The main advantage of this approach is absence of visible incisions on the breast. A small semicircular incision is usually created at the upper edge of the belly button and saline implants placed through this incision. This is a nice way to enhance the breasts with minimal evidence of surgery being ever done.

Trans-Axilary Breast Augmentation – This approach is also used to place an incision away from the breast. It utilizes skin fold in the armpit area to place your incision. The length of the incision is about one inch. Saline breast implants are placed through those incisions. The scar usually heals well with no immediately visible evidence of operation ever being done present in the breast area.

Dr. Rayham offers his patients all four approaches to breast augmentation and he will be happy to discuss with you the pros and cons of each approach for your particular procedure.

The decision of what approach will be utilized to perform your procedure and whether or not you are a good candidate for the operation of your choice will be dependent upon the complexity of the problem that needs to be addressed. Dr. Rayham will be happy to discuss with you all possible options, including implant size, texture, type, position and incision placement, and the best approach to reach your goals.

Q: Silicone-Gels or Saline (Salt-Water) Implants?

Currently both, Silicone Gel filled and Saline (Salt-Water), implants are being offered in the United States for cosmetic breast augmentation purposes. The new generation silicone implants, unlike older types, have “gummy bear” consistency, minimizing potential for leakage even if they are cut open. The choice of the implant will be determined by you and Dr. Rayham during your consultation at our offices in Manhattan/NYC, Brooklyn or Staten Island, New York. Both, silicone gel filled and saline implants, can be placed over and under the muscle. Usually only saline implants can be placed utilizing TUBA ( Trans Umbilical Breast Augmentation) or Trans-Axilary Breast Augmentation techniques. Both silicone gel and saline implants can be placed through the infra-mammary or peri-areolar incisions utilizing Standard Incision Breast Augmentation or Peri-Areolar Incision Breast Augmentation techniques. Although not an absolute rule, patients with silicone gel implants report more natural feel to their breasts than patients with saline implants. The difference is especially noticeable in patients who have very little of own breast tissue. Dr. Rayham will be happy to address all of your questions regarding the differences between the two types of implants and how it should reflect your body and breast shape specifically.

Q: Under the Muscle or Over the Muscle?

The choice of the implant placement level, under the muscle (sub-muscular) or over the muscle (sub-glandular), is dependent in large on your breast anatomy, amount of breast native tissue, presence of so called tubular breast deformity, type and texture of the implants, and the approach used for your breast augmentation. Specifically, women with a limited amount of native breast parenchyma should have their implants placed under the muscle to prevent them from being noticeable and palpable. Patients who receive smooth textured implants should have them placed under the muscle to minimize chances of capsular contraction (hardening of the breast.) Women heavily involved in sports and professional body builders should avoid having their implants placed under the muscle, as this will make the implants visible during muscle contraction. There are additional factors affecting the choice of the level of implant pocket placement, and Dr. Rayham will be happy to discuss them with you during your visit with him.

Q: Textured or Smooth Implants?

The choice of textured or smooth implants , as it was noted in the prior section, is mainly dependent on the choice of the pocket for implant placement. Specifically, smooth implants should not be placed over the muscle, in the sub-glandular position, to minimize the chances of capsular contracture. Textured implants can be placed in either position.

Q: Are Breast Implants Safe?

In 2006, after extensive study of thousands of patients, FDA has approved the use of silicone-filled gel implants for cosmetic purposes. Silicone-filled gel implants have been used for years for breast reconstruction patients without any evidence of side effects. The saline-filled implants have also been on the market for many years without any signs of harm to the patients. The American Society of Plastic Surgeons (ASPS) offers a website with additional information about safety of both saline and silicone breast implants. We encourage you to visit or the FDA s website and further evaluate objective and science-based information and the guidelines set by the FDA for women who consider breast augmentation procedure. You can also call FDA directly (800) 532-4440 and they will mail you the booklet with pertinent information on breast implant safety.

Q: What Should I Anticipate After the Procedure?

Your procedure will usually last for about an hour, and sometimes up to three hours. Upon completion of your operation bandages or a bra will be placed to support your breasts, stabilize the implants in a desired position and minimize the movement of the breasts and resultant discomfort. You may experience some pain associated with the surgery which is usually controlled well with pain medications. Upon discharge you will have prescriptions for pain medication that you will take as needed, and antibiotics to decrease chances of infection. You should avoid wearing a bra with an underwire for about six weeks, or until the healing has occurred, to prevent undue pressure onto the incisions or healing tissues. There are usually no sutures that need to be removed. Dr. Rayham encourages his patients to refrain from smoking for several weeks before and after the surgery. While complications are rare, Dr. Rayham will discuss the risks of your procedure with you prior to proceeding with surgery. If is important to be well-informed ahead of time. You can minimize potential problems by carefully following the directions given to you after surgery.

If you live in New York or nearby, you can go home the day of your breast augmentation procedure. Our out of town patients normally stay overnight in one of our recommended hotels and can be driven home or fly home the next day following their postoperative check-up with Dr. Rayham.

Q: Am I a Candidate for Breast Augmentation?

You may be a candidate for breast augmentation if you have any of the above concerns and if you are in overall good health to undergo an operation. Click here if you’d like to email Dr. Rayham with a question or a concern.

We also encourage you to call us toll free 1 866 435 5357 (1 866 435 5357) , or 1 877 Dr.Rayham (1 877 377 2492) to speak with Dr. Rayham or RR Plastix New York Plastic Surgery Center experienced office staff.

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