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Breast Augmentation

Breast Augmentation in 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.

Dr. Montante during a breast augmentation procedure

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.

Implants-min

Silicone or Saline Implants?

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.

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!

Additional Breast Augmentation FAQs:

All Breasts unwind after time because the weight elongates the skin, elasticity diminishes as we get older, and the amount of breast tissue growth lessens as we age. These three factors signify your breasts may sag whether there are implants present or not.  

The implants will add more weight to the chest area, which may improve your comfort level, with adjacent scar tissue and contour adjustments providing more than just aesthetic help. More often than not, your breasts will droop less, especially if you wear a properly fitting bra religiously after surgery.

Product lifespan has dramatically increased over the decades and should last a considerable amount of time. The most popular reasons for having revision surgery are because of lifestyle changes, or patients not satisfied with the size. The chances of damaging or deflating your implants in the first decade is low, about two percent, according to the Institute of Medication.

The rule of thought is that if they pose no problem either physically or aesthetically, leave them in for as long as possible. However, we are seeing a growing number of women downsizing by swapping their implants to smaller sizes or taking them out without replacement. These are women who seek a more active lifestyle, or older women who don’t see the need to carry implants around any longer.

This choice is the most critical decision you can make when considering breast augmentation. Although any surgeon, or licensed physician for that matter, can legally perform breast augmentation, it’s best to seek out the services of board-certified plastic and reconstructive surgeon who specializes in breast surgery. These health care professionals go through the most rigorous training in surgical procedures that reconstruct the anatomy and must requalify every ten years for certification. They also must adhere to the most strict ethical standards in medicine.

Breast surgery can give you some added cleavage, but it is not necessarily designed for this reason. Choosing the right implant size, submuscular or subglandular placement, and considering your anatomy will all determine whether the surgery will add to your cleavage. Dr. Montante will work with you to develop a specific plan that will enhance your cleavage as much as possible. You may also consider having a breast lift.

Because all patients will heal differently, there’s no exact timeline as to how long your recovery will take. On average, recovery takes between two and six weeks. After surgery, you’ll feel tired, sore, and will need someone to help drive you home. We will prescribe you pain medication for the first week, after which you will gradually improve over the next several weeks.

If you have a non-strenuous job, you’ll likely be able to return to work within a week. If you have a more active job, you may need to take additional time off to heal.

Patients should refrain from exercise for a minimum of 2-3 weeks after their breast augmentation surgery. When you do return to exercising, be sure to start slow and gradually build up to where you left off.

The no-touch technique is a revolutionary implant insertion method in which Dr. Montante will insert your implant using a specialized device called a Keller Funnel. This method allows Dr. Montante to easily insert the implant into your breast with much less risk of contamination, infection, tissue trauma, and capsular contracture. It also improves healing time and uses smaller incisions.

Silicone implants are widely considered to look and feel more natural than any other type. They are softer and are less prone to wrinkling than saline implants.

It’s highly typical to experience changes in nipple sensation after breast augmentation surgery. Some patients feel an increase in sensation, while others may lose it. Fortunately, this condition almost always resolves within a few months.

Most professionals agree that drains are not necessary after initial breast augmentation surgery. Dr. Montante’s surgical preparation and advanced techniques should prevent the need to use drains after your surgery.

Dr. Montante will use dissolvable sutures so that you will not have to have them removed after surgery. Dissolvable stitches are safe, proven, reliable, and sanitary.

Bleeding and hematoma formation, infection, capsular contracture, temporary (or, rarely, permanent) changes in nipple sensation, and asymmetry are the most common complications of the surgery. These complications are rare, and Dr. Montante will take all the necessary steps to decrease their risks.

Dr. Montante believes that understanding what the patient wants to gain from a breast augmentation procedure is absolutely crucial to have a successful surgery. He will listen to your needs and tailor his approach to your specific aesthetic goals.

In your consultation, we will listen to your desired aesthetic goals and work with you to come up with the best implant size for you. We will size you in-office and suggest an implant that aims to achieve your desired result. Dr. Montante is an expert and will work with you every step of the way.

Knowing your body is the key to choosing the right implant for you. Your body frame, shoulder width, hip width, weight, height, and breast volume will all be factored into what type of implant you choose. If you are not sure, Dr. Montante will explain this to you in your consultation.

As breast augmentation is an invasive surgery, there will be scars. That said, Dr. Montante is an expert who will place his incisions carefully so that they will not be visible. Depending on the technique that we’ll use for your surgery, incisions may be placed in your armpit,  under the breast fold, or in line with the curve or your areola. Scars after surgery will significantly fade over time.

Most women have no problem breastfeeding after their surgery. Since breast augmentation does not obstruct ducts or any areas involved in milk production, it should not be a problem.

It is possible for implants to break. Trauma, implant age, and other factors may cause the rupturing of saline or silicone implants. If you have a saline implant, the saline solution will be harmlessly absorbed by your body and flushed out by your body’s natural systems. Your breast will look and feel slightly deflated.

With silicone implants, the thick gel will seep out of the implant much slower. If your silicone implant leaks, you may see a change in size and shape and experience pain and swelling. If you think you may have ruptured an implant, don’t hesitate to call us immediately.

Sublandular (above the muscle) Breast implants may get in the way of your mammogram. You should speak with your radiologist beforehand to see if they can perform a mammogram if you have breast implants. Patients who choose subpectoral (under the muscle) implants are more likely to have a successful mammogram.

The FDA states that there is a very slight risk of developing a form of cancer, breast-implant associated anaplastic large cell lymphoma (BIA-ALCL). This cancer is highly rare (about 1 in 30,000), and implant manufacturers are doing their best to create implants that reduce the risk of (BIA-ALCL) even more. Regular check-ups and reporting any signs and symptoms will also considerably reduce the chances of this cancer affecting you long term.

Tightness after surgery is very common. Your body will gradually become accustomed to the increased volume after several weeks. You will not hurt anything if you move, although you should be careful for the first few weeks as your incisions heal and swelling and tenderness subside.

We recommend that you wear a medical compression bra, also known as a surgical bra, immediately after your operation. This type of bra will keep wound dressings in place, inhibit movement of the implant, help alleviate swelling, and help your body heal more quickly. After the first week or so, you may shift to a sports bra. Dr. Montante can recommend the option that will be right for your unique situation.

Breast augmentation requires general anesthesia. Dr. Montante performs breast augmentation in a fully accredited operating room with Board Certified Anesthesiologists and Nurse Anesthetists.

As breast augmentation is a major surgery, we advise that our patients have someone there to help them immediately after surgery. Many patients choose to have some extra help for the first 3-5 days after their procedure.

There is no exact time frame for when, or if, you need to have your implant replaced. Generally, you should consult with a professional every ten years or so to see what they recommend. Although implant designs are continually improving, they are not indestructible and should be monitored regularly.

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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