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Understanding Breast Augmentation, Implants, and Enhancements

Breast augmentation surgery is often the procedure of choice for women who desire larger and often more symmetric breasts. The operation and recovery allow for the return to most work in 4 days and is generally way easier than most realize.

There are many reasons women seek breast enhancement. The challenge with bras to fit comfortably, the gap that occurs at the top of the bra, visible in clothing, difficult to fill in bathing suits, the issues with dressing off the rack, and just being comfortable without clothing.

Our clients include young professional women, moms, and athletes, with the most common concern that they want to look good, natural, and not obvious or overdone. It’s not just surgical technique, but artistic ability and experience that make the difference in patient outcomes.

No breast augmentation surgery is magic, but careful consideration before surgery will lead to the best reliable outcomes.

Genetics and Lifestyle

Nearly everyone has some breast asymmetry. Genetics and just simply how you developed can result in differences between breasts that complicate even simple clothing options. Implants don’t have to be extreme to really be effective. And changes in breast size and shape almost always follow pregnancy and weight changes. Simply aging changes breast contour even when weight remains stable based on hormonal changes.

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Before and After Photos

A gallery of real patient before and after images to assist in finding the sample results you might be looking for in surgical, injectables, and med spa.

How to Make the Decision

“Where do I start, which implant do I need, what incision, what pocket position (above or below the muscle), could fat be used instead, where should my surgery happen, and who will do the entire operation” all need to be answered.

And of course, the web is filled with advice in determining which type of implant, which shape, and which size implant is right for you? There are so many to choose from today and it can get quite confusing.

When you get the right education about implants, the correct procedure for your needs, and the understanding of how this procedure could impact your life, the decision making will certainly be easier!

Implants are all made of a silicone shell filled with saline (saltwater), silicone gel, or a variant of silicone gel called cohesive gel. The shape is either round with different profiles (projection) ranging from low (flatter implant) to high profile (very prominent height), and teardrop-shaped.

Teardrop-shaped implants are all textured because the texture helps the implant adhere to your tissue keeping the implant properly positioned to look good. A complication associated with these implants is that those that become separated from the tissue can rotate causing asymmetry and discomfort. These textured implants have been associated with a very rare type of lymphoma called BIA-ALCL,(breast implant-associated anaplastic larger cell lymphoma). We currently do not use textured surface implants in our practice due primarily to the availability of current technology for smooth surface implants to accomplish the needs of our clients.

Your body type (anatomy), genetics (how you will age), your current and projected lifestyle (our lives and ideas change) are all carefully examined and factored into choosing the correct type, size, and shape implant. An implant you hold in your hand does not mimic the shape and contour after implant surgery. And our bodies change and many other factors impact your body shape after surgery.

The correct implant education clears away any misconceptions and empowers women to make great choices that result in beautiful, natural-looking outcomes. Dr. Rudderman has helped guide many hundreds of women through this process and is proud to offer his patients only the safest, most reliable implants available today.

Real Patient Story

D’lynne, a 45-year-old woman, shares her life-changing experience with breast augmentation surgery, Dr. Rudderman and his team.

Breast Implant Safety

Are breast implants safe? Can you trust that your decision to use this device makes sense for you? What do we know?

Today there are approximately 30 million women globally that have breast implants. Implants are used for simple augmentations to breast reconstruction. There are currently no reported cases of breast implant-associated with breast cancer. There is an extremely rare association of textured surface implants associated with a type of lymphoma that has a very high cure rate (to date no data confirms only smooth surface implants associated with BIA-ALCL).

And many patients have had implants for decades without changes in breast, breast discomfort, or any symptoms of concern, using technology that would seem quite old compared to today’s implants.

Changing Existing Implants

No implant lasts forever. Implants are not considered lifetime devices and at some point will need to be replaced. Some women over time decide to have implants removed, even decades later because their bodies and breast have changed, or their lifestyle and clothing needs have changed. Many of these women enjoyed their breast after implants for years and desire a change. And some keep implants for life.

The most common reasons for the desire to revise a breast augmentation include the hardening of a breast – called capsular contracture, the desire to reposition the breast that has gradually relaxed laterally or down, and sometimes the incidental finding on a mammogram that is suggestive of implant rupture. There are some women who feel that implants of any type don’t agree with their bodies and their health and decide to have implants removed. All of these issues should be considered BEFORE surgery and discussed.

There are other issues that may arise over time after implants have been placed that would have you consider implant exchange, revision, or removal. All breast tissue will change with aging, pregnancy, weight change, and your lifestyle, and personal “style” may change so that your comfort with your appearance if the future may have you consider additional modifications to match your personality and comfort.

Dr. Rudderman is one of Atlanta’s surgeons of choice. He is specialized in many complicated problems of the breast & he employs delicate, advanced techniques to achieve the most natural-looking and safe results possible.

Dr. Rudderman is one of Atlanta’s surgeons of choice. He is specialized in many complicated problems of the breast & he employs delicate, advanced techniques to achieve the most natural-looking and safe results possible.

Breast Implants Benefits

  • Breast Implants enhance the breast size
  • Breast Implants today both look & feel natural
  • Breast Implants carefully chosen can last for years
  • Breast Implants enhance the overall width, shape & projection of the breast and may create cleavage and improve symmetry
  • Breast Implants can be replaced or removed as the body ages & changes

Post-Surgery Expectation

  • You will wake up with a small dressing over the treated area and a surgical bra –
  • Mild swelling, & some discomfort is normal & to be expected – this resolves on its own and often requires some pain medication for 24 hours then only acetaminophen
  • You will be seen in the office 24 hours post-surgery and given a more comfortable bra
  • Swelling generally is mild and resolves in 2-3 weeks
  • Sutures are absorbable and do not need to be removed
  • You will have a type of brown paper tape on the incisions to protect the area and help with minimal scar formation
  • Most patients who have surgery on Thursday can return to desk work Monday
  • Avoid strenuous activity for 3 weeks, Dr. Rudderman will tell you when you can start to exercise again

Measurable results are typically visible immediately, but be patient. Healing and stabilizing takes time. It can take months for the “new you” to be clearly seen. The results of this procedure are long-lasting. The breast can and will naturally age over time but it is not common to need additional surgery for many years. Breast like all areas of the body is subject to change over time due to skin changes and the effects of gravity and aging. All breast augmentations and surgeries need good long term follow-up for evaluation of breast disease by your practitioner of choice.

The Breast Implant Consultation

Dr. Rudderman believes the consultation is critical for you and him. The Breast Augmentation consultation includes the following:

  • Thorough education and review of your breast augmentation options.
  • A complete overview of today’s breast implants and safety considerations.
  • A discussion on incisions, placement, your desires regarding breast volume, desired appearance and body balance, careful, comprehensive examination to evaluate breast volume tissue, skin characteristics, and position.
  • Other factors and discussion points will include the contour of your chest wall and chest wall muscles including the pectoral muscle, the contour, and position of your ribs and breast bone.

These treatments are not an emergency, and plenty of time will be allowed to have a full conversation to consider options. Additional visits can be provided until you feel confident that you are making the best decision for yourself in health, safety, and outcome.

Dr. Rudderman has done hundreds of breast surgeries and can project your likely outcomes. From the consultation evolves…trust, respect, mutual understanding, and a personalized treatment plan.

After your first consultation with Dr. Rudderman, you will realize that there truly is a difference in how surgeons approach their profession. For Dr. Rudderman that difference means understanding your goals and providing a level of service that places safety and comfort alongside predictable and pleasing outcomes.

Contact us at 678.566.7200 to meet with Dr. Rudderman in our Alpharetta office or Midtown Atlanta office.

Written and reviewed by:

This article was written by Dr. Randy Rudderman, who is board certified by the American Board of Plastic and Reconstructive Surgery (1994). He practices medicine at his offices in Alpharetta and Atlanta. Learn more about Dr. Rudderman, his medical training, and credentials.

Additional Information

We want to provide you with details regarding breast implants.

Now that women can choose from saline & silicone breast implants, the biggest question is: “Which one is right for me?”

Breast implants are medical devices made of biocompatible material. An implant is a sac (implant shell), which is surgically implanted into your breast for enlargement and to enhance the overall width, projection and shape. Implants have either a smooth or textured silicone shell that may be round or contoured to more closely mimic the shape and slope of a natural breast. The implant is placed either under your breast tissue or under your chest muscle.

Dr. Rudderman uses medical grade, biocompatible, silicone shell implants…either saline or silicone gel by Mentor and Allergan.

Saline Implants are silicone elastic shells filled with saline solution similar to your body fluid. Saline implants are inserted into a special pocket in your breast during surgery and are then filled with the saline solution.

Silicone Gel Implants are silicone elastics shells filled with cohesive silicone gel and mimics human body fat. Fat is a large component of female breast tissue. Silicone has become the implant of choice because it creates a natural looking breast contour. RESEARCH HAS SHOWN: there is no known link between breast cancer and use of silicone gel implants.

Implants Smooth or Textured

Implants can be smooth or textured to prevent shifting within the breast pocket pocket. With Saline implants – the smooth surface seems to reduce rippling that could occur.

The following chart further explains:
Fill type: a safe cohesive silicone gel that has been studied in over 10 million women worldwide.
Feel: Cohesive gel that is soft to the touch. Feels more like natural breast tissue.
Size: Profiles include: Moderate, Midrange, High,
Incision: Usually requires a 4-5 cm incision
Age: 22 years or older (exceptions may include reconstruction)
Safety: FDA approved 2006
Price: A premium option at a higher price

There are multiple incisions used for placement of breast implants including:

  • Inframammary crease, (the fold under your breast),
  • Areolar (around the dark area that surrounds your nipple),
  • Axillary (incision in the arm pit region) and umbilical (through an incision made near the navel

Dr. Rudderman most commonly uses the inframammary crease incision for implant placement for these reasons:

  • It heals the best of any of these incisions
  • It is well hidden in a crease that disguises visibility
  • It allows for a direct approach to develop the “pocket” that accurately matches the size, shape and contour of your selected implant
  • It protects the breast tissue from unnecessary scarring.

Dr. Rudderman uses an implant placement technique that is technically specific, respectful to the tissues & provides a precise implant pocket without trauma to those tissues. There is less swelling, less pain & little to no bruising…healing is faster.

Above or Below the Muscle

Breast implants can be positioned either under or above the pectoral muscle of the chest wall. In a sub pectoral (usually called sub muscular) breast augmentation , the breast implants are positioned under the muscle and are generally mostly covered by muscle and partially covered by breast tissue.

Sub glandular technique places the breast implant in a pocket deep to the breast tissue and above the pectoral muscle. The decision on breast implant positioning depends on the volume and consistency of breast tissue and skin, and desires for outcome. Potential for capsular contracture is usually greater when the implant is placed above the pectoral muscle. These issues will be discussed during your consultation. Dr. Rudderman uses the sub-pectoral approach most often for breast implant placement.

Patients with significant breast droop may require a breast lift options particularly when a sub pectoral implant position is selected.

Breast Implant Frequently Asked Questions

Search our list of FAQs for the answers you are looking for.

Breast Augmentation surgery involves placement of a breast implant to increase the volume and modify the contour of the breast. Breast Implants are most commonly placed below the pectoral chest muscle to achieve a natural aesthetic outcome and may be placed above the muscle in patients depending on their desires and clinical exam.

Yes, he performs all of his patient’s surgeries. Many surgeons use assistants to suture or perform part of the operations. Dr. Rudderman performs the entire operation on every patient. You should ask during any consultation to know who will be your operating surgeon.

Most patients will look close to normal right after surgery. Some patients may look nearly fully normal within a few days. When breast implants are placed, particularly under the pectoral chest muscle, the muscle will have some inflammation for several weeks and the upper margin of the breast may look full. This begins to resolve within the first several days, nor because of implants moving or “settling” but due to your tissue relaxing. Patients in 2-3 weeks can look normal in a bathing suit or workout clothes, and most patients feel that at around 3 months that they feel fully natural and are not daily aware that they have had surgery. If mild asymmetry is present before surgery in regards to nipple/areolar position or size, or breast volume and contour, often the noticeable asymmetry improves with implants alone. In cases where additional procedures are desired to achieve an outcome, this will be fully discussed as options during your consult.

All surgeries involve some discomfort. Dr. Rudderman is highly skilled and uses advanced techniques and refined instruments that minimize comfort during his surgical procedures. Many patients will take some pain medications for several days and often can take Tylenol for relief 1-2 days after surgery.

There are several reputable companies that provide the safest known products for use today. There are dozens of shape options available because every patient has unique characteristics that we consider to achieve your desired outcome as naturally as possible, including chest contour, breast volume, rib and chest wall shape, height, weight, bra diameter, history of pregnancies, and other factors. Dr. Rudderman will explain which implants are most likely appropriate for your specific needs, and review their characteristics, warranty information, and general risks of use.

No. The technique Dr. Rudderman uses with Implant placement is designed to specifically and gently position the implant in a carefully prepared implant pocket. The technique is performed to eliminate the need for massage, and massage specifically should NOT be performed because it can add to inflammation and implant malposition or displacement. You should as well not place ice or heat on your breast after surgery. After your operation, you will be in a soft surgical bra that is changes the following day in our office with a soft sports bra for you to wear as you heal.

You will need to avoid all rigorous, strenuous activities for a few weeks until healing is adequate and Dr. Rudderman tells you it’s ok. Aerobic exercise increases your heart rate and blood pressure and can cause the operated area to swell delaying your healing. We will see you frequently during your healing process to help you return to your normal activity as soon as possible. Exercise can be an important part or recovery, and we follow your recovery closely to help you reach your goals.

Yes. All cases are supervised a Board Certified medical doctor who has specialized in anesthesiology.

Yes. All of our surgeries are performed in a fully accredited surgery facility using state of the art technologies and a world-class staff with all the comfort and safety factors as a hospital surgery suite.

Dr. Rudderman’s patients most often return to desk jobs in about 4 days. He can give you a time frame specific to you during your consultation.

Breast Augmentation surgeries are considered to be cosmetic procedures. Cosmetic procedures are not covered by insurance.

Yes. Financing is available today for all the breast procedures Dr. Rudderman performs. Please check in our business office for information about it.

You will need someone to drive you to your surgery, stay there and then drive you home and stay with you overnight after you have had anesthesia. Dr. Rudderman will advise you based on what you have had done and especially if you have small children. Your follow-up visit will usually be within 24 hours, and you will generally need to have someone drive you to this appointment.