Aesthetica Cosmetic Surgery and Laser Center
Loudoun – Fairfax – Northern Virginia
Cosmetic Breast Surgery
As many women age, they may lose fullness in their breasts while others may begin to notice excess breast skin. Some women will have both problems that lead to sagging, deflated breasts. If you would like to increase breast volume while also eliminating loose skin, plastic surgeon Dr. Phillip Chang can perform a breast augmentation surgery plus a breast lift (mastopexy). This procedure at Aesthetica Cosmetic Surgery & Laser Center in Leesburg, VA begins by removing loose skin from the breasts and then placing silicone or saline implants to get to your goal size. Breast surgery with a lift and augmentation addresses multiple concerns, such as size, position, and shape to create younger, perkier-looking breasts. Make an appointment for a consultation with Dr. Chang to go over your unique needs and wants, so he can help you decide if a breast surgery with an augmentation and a lift best fits your goals.
There are several reasons why you may be looking into breast surgery combining a lift with augmentation. It’s an ideal choice if you want to significantly rejuvenate your breasts while improving the firmness of your breast skin. You may have developed breast ptosis (sagging) caused by natural aging, pregnancy, or significant weight loss, therefore you would like to enhance the volume of your breasts — this can all be achieved with an augmentation and lift. Dr. Chang will be able to determine if a lift alone will get your desired outcome, or if both a lift and implants are better to attain your goals.
You are a good candidate for a breast lift with augmentation if :
- Your breasts have begun to sag and your nipple position is low AND you need more size or cleavage than a breast lift alone can provide
- You lost fullness or cleavage with age or after babies
- You are interested in increasing your breast size
- You want to be able to fit clothes that require at least a little fullness
- You feel that large and more uplifted breasts will allow you to feel more feminine
A good candidate for a breast augmentation who is healthy and who has realistic expectations
Breast augmentation is one of the most popular procedures performed by Dr. Chang. The main aim of a breast augmentation surgery is to make the breasts larger and firmer.
Breast augmentation can be performed using saline filled breast implants, silicone filled breast implants, or adding your own fat to fill the volume of your breasts. Each technique has its own nuances but all are performed under general anesthetic in a surgical setting.
Breast implant augmentation is a 1 to 1.5 hour procedure that is performed at the surgery center under general anesthesia or IV sedation. Long acting pain anesthetic is injected directed into the chest muscle to provide pain relief for at least the few hours after your surgery.
Dr. Chang uses the Keller funnel technique for silicone implants which allows for the smallest of scars, decreased rates of infection, and injury to the breast implant. The incision will be around 3cm in size. For all breast augmentation surgeries, Dr.Chang will use the dual plane technique which creates a pocket for the implant under the chest muscle.
Once the implants are in and positioned correctly, the incisions are closed using absorbable sutures.
All patients will need someone to collect them and take them home post surgery.
Saline Implants: Saline implants start empty and are filled after placement of the implant. For this reason (unlike silicone implants), very small 1.5 cm incisions can be used for implant placement. You have a choice of having your incision under the breast crease (inframammary crease) or under your areola (peri-areola incision). Once the incision is made, a pocket is created “under” the chest muscle. This placement provides better camouflage of the implant, allows better visualization for mammograms, and reduces the risk of a complication called capsular contracture.
The implant is then filled with saline. The patient will be evaluated in the sitting position where final adjustments are made for position and shape of the implant.
Silicone implants: come pre-filled with cohesive silicone gel (gummy bears). Because they are pre-filled, the larger the implant choice, the larger the required incision. In order to minimize the incision as much as possible, we will use a device called a Keller Funnel. With this device and technique, your incision will only be slightly larger than if you had requested a saline implant. An inframammary incision is generally used in order to hide the incision. Once the incision is made, a pocket is created “under” the chest muscle. This placement provides better camouflage of the implant, allows better visualization for mammograms, and reduces the risk of a complication called capsular contracture.
The patient will then be evaluated in the sitting position where final adjustments are made for position and shape of the implant.
This involves using the patients own fat which is taken by liposuction from another area of the body and then injected into the breasts. The fat is processed before being injected. This is best for patients who are looking for a small increase in breast size.
Women desire breast augmentation procedures for many reasons:
- the desire to feel more feminine
- wanting to have larger breasts
- wanting to have more volume in their breasts
A good candidate is someone who is:
- have fully developed breasts
- is over the age of 18
- is unhappy with the shape or size of their breasts
- women who have lost volume due to pregnancy and breastfeeding
- has a healthy attitude to the results of breast augmentation
It is important that patients make their own decisions regarding breast augmentation surgery and are not having it to please others.
The choice of breast implants size is obviously very subjective and very personal. What looks good to you to might not look good to someone else. What looks big to you might not look big to someone else.
There are many studies that have shown that the average woman finds a C cup breast to be the most attractive. That does not mean, however, that it should be your personal goal. Many factors obviously need to be considered:
- How conservative are you as a person?
- What kind of job do you have?
- Do you exercise a lot?
- What is your height?
- What is the width of your breasts?
There are limitations to how large you should go from a safety standpoint. As a general rule, an attractive implant should not be wider than the width of your breast. Otherwise, the implant becomes more visible and appears more round. Note, however, that some women don’t mind that appearance.
We have the Vectra 3D breast augmentation imaging system in the office to assist you with your decision.
After surgery you should rest at home and let yourself heal. Dr. Chang will send you home with a detailed recovery plan. There are a number of different ways to help aid recovery:
- All patients will wear a surgical bra for about 4 weeks.
- Final results should not be expected for at least 6 months to a year. Over that time, the swelling, particularly located in the upper breast will decrease, the implant will drop into its pocket, and the shape of the breast will become more teardrop in shape.
- You will be instructed to massage the implant 2-3 times a day to manipulate the breast down into its pocket as well as to keep your breast soft and mobile.
- Most patients are presentable without drawing attention in 1 to 2 weeks.
- Sutures if any are removed in 10 to 14 days.
- Strenuous exercise should also be avoided for 2 to 4 weeks to help in the recovery process.
- Lower body exercise is alright after 4 weeks but avoid jogging and running for another 2 weeks. Bouncing breasts need to avoided to help with healing.
- Apply aquaphor ointment to exposed sutures and incisions should be applied twice a day until the sutures are removed.
- Most patients will take 3 to 7 days off work.
- Pain can initially be moderate to severe – there will be pain medication injected into the breast during surgery to help with pain management the first few days.
At first, the implants feel like they are too high. Interestingly, most women actually like this phase as they have more exaggerated cleavage at this time. Over the next few months, the swelling at the top of the breast begins to diminish while the bottom of the breast begins to round out.
As with any surgery, there are associated risks. Only you can decide whether the procedure can achieve your goals and if the recovery and risks are acceptable to you. Complications are rare but can include:
- Local bleeding or bruising
- Implant displacement, asymmetry, or malposition
- Infection particularly from the absorbable sutures
- Loss of sensation although rare
- Widened or thickened scar
- Asymmetry (unevenness between two sides)
- Delayed wound healing with skin or tissue necrosis
- Extra skin at the ends of the incisions
- Capsular contracture
Unsatisfactory results may require additional procedures. Patients will generally be responsible for any associated facility fees.
Your cost for breast augmentation will depend on the type of technique (implants vs fat transfer) and the type of implant chosen. Note that silicone implants filled with new-age silicone gel will cost more than saline implants filled with salt water. See the pricing card below.
Breast augmentation is commonly performed with other procedures such as:
- Mommy makeover
- Breast lift
- Tummy tuck
We will help you with this decision at your consultation.
The proof is in the proverbial pudding. Look at our before and after gallery and tell us if any of Dr. Chang’s patients look fake.The key to not looking fake includes:
- Getting an “appropriate” size- the larger you go, the more unnatural you will appear. We use the 3D Vectra imaging system to help choose a size.
- Placement of the breast implant below the chest muscle. The chest muscle will soften the appearance and camouflage the implant to some extent.
- Silicone implants have less of a chance of “rippling” which is a tell-tale sign of breast augmentation.
- Surgical skill – again, refer to Dr. Chang’s before and after images. You will see!
Dr. Chang requires you to be at least 18 years of age for a breast augmentation. Patients need to have completed their breast development before a breast augmentation can be accurately performed.
The FDA recommends that patients be 22 years of age before placement of a silicone filled breast implant.
The answer is a definite NO.
The risk of breast cancer does not change if you have an implant. There have been two large studies about the risk of breast implants and breast cancer. Both showed that there was no difference and one even showed a VERY slight decrease in the risk of breast cancer. They hypothesized that the reason might be that the body’s immune system is at a higher level surveillance.
If you are planning to breastfeed after surgery, talk it over with Dr. Chang during the free consultation. It can be possible to breastfeed with the right technique and placement of the breast implant. As pregnancy and breastfeeding will affect the results, we recommend you wait until your family is complete before undergoing breast augmentation.
How is a breast augmentation with a lift performed?
Breast augmentation with the addition of a lift is a procedure that is performed at the ambulatory surgery center under general anesthesia or IV sedation anesthesia and takes about 2-3 hours.
- Step 1: The breast is injected with long acting pain medicine
- Step 2: The breast is injected with medication which decreases bruising
- Step 3: Breast lift incisions are made ( see below )
- Step 4: A pocket is created under the chest muscle for the implant
- Step 5: The breast implant is placed in the pocket
- Step 6: The breast lift is completed and the skin tailored as needed
- Step 6: Precise placement of the implant and breast shape is checked with the patient in the sitting position
- Step 7: The incisions are closed in multiple layers which is then protected with a surgical tape
The goals of breast lift surgery are to lift the breast, reduce stretched out breast skin, elevate the nipple to the level of the under-breast crease, and to add volume to the breast if needed using implants or fat transfer. If you need a lift in addition to a breast implant, the procedures can be done at the same time or done at separate times. It is important for you to know that revision breast surgery may be required in up to 20% of patients if the procedures are performed at the same time. To put this in perspective, if a plastic surgeon suggests performing the procedure in 2 stages ( the first stage places the implant followed by a lift procedure after a few months ), this strategy obligates you 100% of the time to 2 surgeries.
TYPES OF BREAST LIFT TECHNIQUES
Breast Lift with Donut Style Incisions –
Breast lifts using a donut-style incision are performed for only for patients who need a very small lift. If the areola size is too wide or the areola needs to be lifted more than about 2 cm, the donut incision will widen with time. This means that even though the length of the incision is shorter compared to the others, gravity will widen the incision and make it more visible.
Breast Lift with Lollipop Style Incisions –
Breast lifts using a lollipop incision are designed for middle sized lifts or for patients who need the nipple to be lifted by more than 2 cm. The donut incision around the areola is extended downward which takes the tension off the areola. In this way, the scar around the areola is less conspicuous even though the overall length of the scar is longer. This technique also provides for excellent cleavage.
Breast Lift with Anchor Style Incisions –
Breast lifts using anchor-style incisions are designed for larger lifts with a lot of skin to be removed. The donut incision around the areola is extended downward which takes the tension off the areola. An incision is then made along the infra-breast crease to remove extra skin and fat that tends to bunch up in this area.
What to Expect
Pain after a breast augmentation and lift
- Breast augmentation can be a relatively painful surgery.
- Patients who choose to add Exparel can expect to be pain free for up to 3 days
- Most patients are off of narcotics after 3-5 days
Return to work after a breast augmentation and lift
- Return to work in about 5-10 days ( but will still be sore )
- Return to light walking and 10 pound weights in 5 days
- Return to aerobic exercise and 20 pound weights in 21 days
- Drive in 7-10 days or have stopped narcotic medications for 48 hours
When will you see the final results of a breast augmentation and lift
- Most patients will have residual swelling for up to 3 months
- Some patients will have decreased or sometimes increased sensitivity in the nipples for 3-6 months
- Final shape is not apparent for 6 months to a year
Get A Lift and New Shape
Attain the curves you dream about by scheduling a surgical breast augmentation with a lift at Aesthetica Cosmetic Surgery & Laser Center. Dr. Chang will help you create a personalized procedure plan that meets your concerns and wants so you can see your ideal results. By addressing the position, size, shape, and skin of your breasts, your surgical augmentation and lift can lead to a younger appearance. Make a consultation with Dr. Chang at our Leesburg, VA office to find out more information about your options for breast surgery.
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Breast Augmentation with Short Scars for Silicone Implants
Women desire breast augmentation procedures for many reasons. Want to know how the procedure is performed? Wondering about the size of the scars? Watch here to see Dr. Chang performing a breast augmentation.
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Other Popular Procedures
Cosmetic breast surgery includes breast augmentation, breast lift, breast reduction and breast reconstruction. Other common procedures include nipple and areola reduction.
Body contouring procedures include abdominoplasty, lower body lift, circumferential body lift, as well as thigh and arm lifts. Some patients need it all especially after weight loss surgery.
Face surgery includes facial rejuvenation procedures such as face, neck, and forehead lifts or simple nonsurgical procedures such as botox, cosmetic facial fillers, or laser skin treatments. Other procedures include nose jobs or ear reshaping.
Skin and Anti-aging
Vaginal health includes treatments for vaginal dryness, laxity, and even urinary incontinence. Common procedures include labiaplasty surgery, as well as Diva Laser Tightening.
Northern Virginia - Loudoun - Leesburg - NOVA
Dr. Phillip Chang is a leading plastic surgeon in Loudoun County who specializes in surgical and nonsurgical cosmetic procedures for the breast, body, face, and skin. He is board certified in plastic surgery by the American Board of Plastic Surgery and is the founder of Aesthetica Cosmetic Surgery & Laser Center in Leesburg, VA. Dr. Chang is dedicated to providing high-quality service that concentrates on the unique needs and concerns of his patients. He believes combining attentive care and minimally invasive techniques is the best avenue for achieving beautiful, natural-looking results. Dr. Chang is thrilled to be serving the greater northwest area of Washington, D.C. with top cosmetic care that is dependable and trustworthy.
Interested in learning more about Dr. Chang? Click here.
We are based in Leesburg, VA. Located as part of the Lansdowne medical complex, you have access to our 24-7 state-of-the-art facility as well as access to Lansdowne hospital. We are based directly across the road from INOVA hospital. There is ample parking, elevators to bring you to our third floor offices, and welcoming staff to sign you in.
We are proud of our surgeries and cosmetic procedures and love that our patients are happy too. They like to shout it out on Google, Yell, Facebook, and right here on our website. Check out our reviews here.
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All potential patients receive either a phone, virtual, or in-consultation for free.
During the consultation we will discuss your treatment wishes and expectations. This is the time to ask us lots of questions to really understand what is involved, what the costs will be, and what is expected of you. This is also a great time to get to know Dr. Chang.
Aesthetica has received numerous awards from the Loudoun County Chamber of Commerce, New Beauty, Best of Loudoun, Posh 7 Top Picks, and Dr. Chang is internationally known for his lectures and advances in precise surgical technique as demonstrated through his unique mini-facelift procedure.
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