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Breast Augmentation

Breast Augmentation – Richmond, VA

Breast augmentation is one of the most popular cosmetic procedures performed today. Countless women have undergone this procedure for a variety of reasons: to enhance their current shape, address volume loss after having children or weight loss, or to correct asymmetries in their natural breast volumes. Regardless of the motives, patients are overwhelmingly pleased with their results and enthusiastically recommend the procedure to their friends.

Why Choose Dr. Montante for your Breast Augmentation Procedure?

The key to a successful breast augmentation is understanding the desired outcome of the patient, evaluating the patient’s natural breast shape, and then tailoring an operation to meet those criteria. After over a decade in practice, Richmond Plastic surgeon, Dr. Montante, has extensive experience in the whole spectrum of breast surgery both cosmetic and reconstructive. He has performed countless breast implant procedures with fantastic results and many happy patients.

What factors should I consider for my Breast Augmentation?

Some key factors to consider when planning a breast augmentation are:

  • Implant selection
  • Implant position
  • Planned incisions.

All of these factors will be reviewed with you, during your consultation with Dr. Montante.

Silicone or Saline?

Breast implants are made of an outer silicone shell and are filled with either saline (or salt water) or silicone gel. Each implant type has its own advantages and disadvantages. Silicone gel implants tend to have a more natural feel and closely mimic natural breast tissue. They also tend to have less noticeable rippling under the skin, especially in thinner women. Recently, a more cohesive silicone gel has been incorporated into implants with the added benefit of retaining more implant shape. In certain patients, these so-called “gummy bear” implants may be a great choice to achieve the desired outcome. Because gel implants are filled to a fixed volume, they typically require a slightly larger incision for insertion to avoid injury to the implant shell.

Saline implants are typically less expensive than silicone implants. Because they are filled at the time of surgery, insertion requires a smaller incision, and the volumes can be adjusted more readily. However, saline implants may feel firmer and “less natural” than silicone implants. Also, rippling in the implant may be more noticeable under the skin, especially in thinner patients.

What different implant shapes are there?

Implants come in either round or teardrop (or anatomic) shapes. For most cosmetic procedures, the round implants are commonly used, while the anatomic shaped implants are more frequently used in breast reconstructions. Round implants typically have a smooth shell and can provide more dramatic enhancement of projection and cleavage. Anatomic or teardrop implants typically have a rough texture that keeps them from rotating. Both of these implant types can be used to achieve beautiful results.

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Before & After

View a selection of Before & After photos of procedures performed by Dr. Montante and the skilled team at Montante Plastic Surgery & Aesthetics. These photos provide actual results achieved to get a better sense of the possible outcomes following your procedure. 

If you have any questions about any of our treatments, please give us a call or contact us today!

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Implants come in a variety of volumes (usually expressed in cc’s) and shapes. Implant selection starts with understanding the desired goals of an individual patient in a thorough consultation with Dr. Montante. During the consultation, your natural breast anatomy will be measured and evaluated. Based on in-office sizing, an implant will be suggested to achieve your desired result. For a natural look, an implant should fit within the width of your natural breast. Larger implants may give a more “augmented” look and may require additional revision surgery, over time.

Choosing an Implant Size

What is involved in the Breast Augmentation procedure?

Breast augmentation is typically performed in the operating room under general anesthesia. Dr. Montante performs breast augmentation in a fully accredited operating room with Board Certified Anesthesiologists and Nurse Anesthetists. The procedure typically takes approximately 60 minutes.

What types of incisions are used in Breast Augmentation?

Incision placement is an important factor in planning a successful breast augmentation. The most common incision locations are along the inframammary fold, along the areola, and through the armpit. Dr. Montante prefers the inframammary or periareolar approach for most patients. These incisions provide the best access to precisely develop the implant pocket, are associated with few complications, and they are largely imperceptible. They also can accommodate either saline or silicone implants. Although the armpit incisions avoid incisions on the breast, they do not accommodate silicone implants as readily as the other incisions, and they may be associated with higher rates of revision surgery. Dr. Montante does not advocate use of the umbilical incision.

Where are implants placed in the breast?​

Implant position is another key factor in a successful breast augmentation. Implants can be placed in either the “submuscular” or “subglandular” positions. In the submuscular position, the implant is placed entirely under the pectoral (chest) muscle. The submuscular position is useful for the patient with little breast tissue, and it is typically associated with a lower incidence of scarring around the implant (capsular contracture). It provides a more natural result, especially in thin patients. Because placement requires elevation of the chest muscle, it may be associated with more pain and a slightly longer recovery. Implants placed directly under the breast tissue are considered subglandular. The subglandular position may be useful in patients with adequate breast tissue that are seeking more fullness. Athletic patients may prefer a subglandular position to avoid implant “animation” that may occur with implant placement under a highly developed or active pectoral muscle. Subglandular implants are associated with higher degree of capsular contracture, and they may pose more difficulty in visualizing breast tissue during mammography.

For the majority of patient’s, Dr. Montante uses a “dual plane” technique that combines the advantages of both submuscular and subglandular techniques to provide natural results. In this technique, the upper portion of the implant is in the subpectoral postion while the lower portion of the implant is covered by varying amounts of breast gland and skin. This approach provides natural results, while minimizing the risk of capsular contracture without potential interference with mammography.

What can I expect after my breast augmentation?

Breast augmentation is an outpatient procedure with minimal risk to most healthy patients. Although rare, some possible complications include: bleeding and/or hematoma formation, infection, capsular contracture, temporary (or, rarely, permanent) changes in nipple sensation, and asymmetry. While every effort is taken to make breasts as symmetric as possible, it is important to remember that asymmetry between breasts that exist preoperatively may exist following breast augmentation. Rarely, patients may require additional procedures to address persistent asymmetry or for implant replacement. Recovery following breast augmentation varies between patients, depending on the type of procedure performed. In general, patients usually require some extra help for the first 3-5 days following surgery. Patients with more sedentary jobs can usually return to work within a week of surgery. Patients with more active or strenuous jobs may require additional recovery time. Most patients can start light aerobic exercise after about 3 weeks and can return to regular exercise as tolerated by 4 weeks.

If you are interested in breast augmentation, please call (804) 325-4795 to schedule a consultation with Dr. Montante today!

Dr. Steven J. Montante

Dr. Steven J. Montante has many years of experience in the field and is board certified by the American Board of Plastic Surgery. He received his medical degree at the University of Pittsburgh School of Medicine and completed his plastic surgery residency at Medical College of Virginia at Virginia Commonwealth University.

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